Dr Bonnie Henry

There’s a right way to do things… and a wrong way… and if you think I’m about to talk about the removal of Donald Trump from office… I might. But not today… there’s time for that later, and, as I’m writing this, the people capable of doing exactly that are thinking about the right way to do it. By the time I get around to writing about it, he might be gone. Wouldn’t that be cool. At least he’s been permanently removed from Twitter. Four years too late. But the same thing could be said about the entire presidency.

So, on a completely different topic, what’s the right way to build IKEA furniture? What’s the right way to land a plane? In many cases, you can just wing it, though it’s highly advisable to listen to the people who designed it, built it, and presented it to you with specific instructions. That’s probably the best outcome. The bookcase might be fine (nobody will notice you had to remove a panel and flip it around because you did it backwards the first time) and you might land the plane with too much fuel on a runway that’s too slippery… and not slide off the runway… but going against the design specs is never recommended. As the famous acronym RTFM says… Read… The… Manual…

I’ve been a big supporter of the vaccine and have cheered on Pfizer and Moderna and all the rest of them… and a big reason why is because I understand the process that went into their creation. I understand how it was done so quickly and where the bureaucratic corners were cut to save time and where the relevant science was kept pristine, specifically the clinical trials and testing and follow-up. Out of all of that detailed science came the very detailed instructions.

Nobody was too sure what these vaccines would look like when they finally emerged; the super-cold requirement of the Pfizer vaccine was unexpected. The fact you’d need two jabs instead of one… that was expected, but the timing between them wasn’t clear. Weeks? Months?

Pfizer came out with their vaccine… and, first thing, the temperature requirements. Here’s the number. Transport it at that temperature. Thaw it like this, mix it like that. Can we transport it a little warmer? No. Can we dilute it a bit differently? No. Can we thaw it for longer? No.

These “no” answers aren’t Pfizer trying to be difficult; it’s quite simply the range of what’s tested and what’s expected for the outcomes they’ve projected. Which is why there’s appropriately a lot of head-scratching and pushback on Dr. Bonnie Henry’s strategy of spacing out jabs, well-past the recommended time frame. Pfizer says space them three to four weeks apart. Moderna says four weeks. Dr. Henry wants to push it to 35 days. Why? Here’s her argument…

A first jab provides significant protection. Pfizer has said 52% after just one dose, though England’s own studies argue it’s 89%. Moderna is purported to be 80% after one dose. If the intention is to protect as many people as you can, then you try to get the vaccine into as many arms as possible… and you give everyone first doses and then wait around for the next shipment.

Apparently, the timing works out in such a way that if you stretch the time between shots a bit, more people can get that first one. Dr. Henry stated their plan was to use everything they got initially as first doses. That’s fine, if you can stick to the script. But… this on-the-fly modification, contrary to the specs from Pfizer?

I’ll be honest, if I signed up to get the vaccine with the understanding that I’d be getting the follow-up shot within the specified time period… and was later told, no… we’re going to do it a bit differently… I’d be upset. I might have chosen to wait a bit, until I can be guaranteed the right period of time is being adhered to. There is already enough vaccine anxiety out there; a lot of people are skeptical and worried and, while not being anti-vaxx, want to make sure things go well before they take it themselves. To introduce a variable into this equation that can, at best, maintain the status quo but, at worst, derail things… seems like a bad idea. If a bunch of once-vaccinated people become ill, now we have to figure out why and when and how – did the vaccine fail? Were they infected between jabs… or did they not develop the proper immunity, thanks to the spacing of doses? This would do nothing to instill confidence. On the contrary.

I didn’t sign up to be a test subject, to test the boundaries of efficacy. Around here, nobody did. That doesn’t mean this will cause problems… certainly, it might be ok. In fact, other jurisdictions, under the same plan of “get the first one into as many people as possible”, are stretching that time even further. In Denmark, up to six weeks. In the U.K., up to 12(!) weeks.

But let’s be clear, when you introduce a variable, this is no longer an execution of a plan. This is now an experiment, and the BCCDC may as well be tracking the results of playing with these time frames, as should the U.K. and Denmark; collect the data… because if there are issues down the road, it will be useful to know. It’d be also be useful to know that 35 days (or 42 or 84) works just as well as 28.

I’m guessing their thinking is that “pretty good” for a lot of people is better than “really good” for far fewer people… especially when “pretty good” might actually turn out to be “really good” as well.

Except… that’s not what a lot of people signed up for; if something is worth doing, it’s worth doing right. The argument that this is “right” or “right enough” doesn’t hold a lot of water when the designer/manufacturer itself doesn’t agree. I think for a lot of people, myself included… we’ve waited this long, and we can probably wait a little longer… there’s just too much at stake.

Who was the great mind that came up with this quote… Plato? Socrates? Nietzsche? Oh yeah, no… it was Eminem: “You only get one shot to take your shot so don’t blow it.” Or something like that. See what happens when you veer off-script? Sometimes it doesn’t work so well.

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