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If we think broadly in terms of two groups, the relatively small high risk group and the much larger low risk group, I think a strategy that ought to be considered is giving two doses to the high risk group and one dose to the low risk group (assuming manufacturing capacity hasn't yet met demand by the time the low risk group is being vaccinated).

The vaccines seem to be pretty efficacious with a single dose. Likely in the range of 90% efficacy. Of course more data would be tremendously valuable here, but based on the data we do have and our knowledge of other vaccines this is a reasonable number.

Vaccinate frontline healthcare workers (however that may be defined, but ideally just those working with covid patients and those distributing vaccines) and those 65+ with two doses.

If we're still not able to manufacture enough vaccines to immunize the general public by the time those high-priority groups are done, switch to a single dose schedule.

Why divide it up like this?

The first group is relatively smaller (16% of the population) and makes up a large majority of hospitalizations (50%) and deaths (75%). The goal is maximum immunity to reduce those outcomes.

The second group is larger and significantly less likely to need treatment. The goal is to reduce spread. Vaccinating two people with 90% efficacy is much better for this goal than vaccinating one person with 95% efficacy.

I also believe that once the high risk group is vaccinated, which again only requires 15-20% of the population to get their vaccines, hospitals will no longer be under any risk of being overburdened and life should return to near normalcy. Continue to carry out single dose vaccinations for the rest of the population, ideally based on age brackets, but lift restrictions asap.


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