By Rabbi Yair Hoffman for 5tjt.com UPDATED 1:00 PM
The plan was to drive a relative to get the second vaccine, but due to the snow and ice, the relative didn’t want to go, and it was delayed for 2 and ½ weeks. A colleague at work stated (incorrectly, as it turns out) that the second dose will be ineffective by then. This background provided the impetus for the following opinion that our two dose policy during this temporary period of not enough vaccines – is sheer insanity.
GRAVE MISTAKE
In light of current stocks of the COVID vaccines, we should be changing our policy of holding over vaccines from double doses to fewer people to single doses to more people. The current policy in light of the just released data about how effective the first dose actually is – is insanity. Beyond insanity – it is murderous and unethical.
Right now, only some 60 percent of available vaccines have actually been used. The CDC’s data tracker compiles data from healthcare facilities and public health authorities. It updates daily to report the total number of COVID-19 vaccines that have been distributed to each state and the total number each state has administered.
As of 6 a.m. EST Feb. 3, a total of 55,943,800 vaccine doses have been distributed in the U.S., and 33,878,254 have been administered, or 60.56 percent. That means about 10.27 percent of the U.S. population has received a vaccine. Additionally, 27,154,956 people have received their first dose of the vaccine, and 6,436,931 have received the full two doses.
THE REASON
The reason is that we are holding back so that we can have enough of a supply for scheduled second doses. But the current data shows that when we delay the second dose, the first dose works even better. The first dose is 91% effective at 4 weeks after it is given, according to the Pfeizer study. Also see similar numbers in https://www.nejm.org/doi/10.1056/NEJMoa2034201
QUESTION
So now we have a question: Until the cavalry of huge amounts of vaccines arrive, should we be giving 100,000 people a 95% effective vaccine regimen or 200,000 people a 91% effective regimen?
Before we get to the halacha, let’s do the math.
Let’s assume that 1 out of 200 people who get COVID 19 will die from it. And let’s assume that over the next six months, 20% of the 200,000 will get COVID. So that means 40,000 people will get it.
Of those 40,000 people if no one was given the vaccine – 200 will die.
If 100,000 were given the two dose vaccine regimen, 100 people will die of the other 100,000 that were not given the vaccines. And of those that were given the two doses, 5 will die. Total deaths would be 105.
If 200,000 were given the one dose (and 40,000 would have gotten COVID and 1 in 200 would die) then we have only 18 deaths since it is 91 percent effective.
It is a no brainer. Do the math. Some have cited data from Israel that the numbers are not as effective after the first dose. Let’s not forget that we are talking a month after the first dose, and it could be that the strain in Israel is different than here.
WE MUST CHANGE THE POLICY IMMEDIATELY.
This is with the Pfizer vaccine. According to an article in the New England Journal of Medicine article by Sadoff, the J&J Vaccine data is even better. We must really move on this data. Of course, when feasible, people should get the second dose regardless – because it will bring up their chance of survival by no small amount.
FDA AND CDC ARE WRONG
The issue at stake here is not a medical one – it is a mathematical one and the experts that should be consulted here are the actuaries and mathematicians – not necessarily the doctors. The actual vaccine data has been suppressed until recently. We should be reaching out to our politicians, our governors, the CDC and the FDA to change the recommendations now.
If any reader doubts this – please consult with a mathematician or an actuary. Don’t take my word for it. Most doctors who are statistically trained will agree. This is also the view of
Dr. Makary, professor of health policy at the Johns Hopkins University School of Medicine.
From a halachic point of view, the situation is analogous to that discussed by Rav Yoseph Teumim in his Pri Magaddim 228:1 – that when there is a vaddai mesukan and a safek mesukan and there is not enough medinie for both – we administer it to the vaddai mesukan.
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13 Responses
There is no question Rabbi Hoffman is correct. I have been making this point for a week already
The author should have consulted a mathematician before publishing. The 1-2% mortality is generally among the elderly. The vaccine effectiveness studies are using healthy adults of all ages. The flu vaccine is less effective among the elderly than younger adults. We dont know the effectiveness of this vaccine among the elderly after one or two doses. Therefore the author’s argument is true for front-line workers; but not necessarily correct regarding the elderly, who should actually be the highest priority.
With all due respect for the author, it’s clear that the most effective venue for action here – from both halachic and pragmatic points of view – would be to bring this issue before Gedolei Haposkim and community leaders.
Halachically, Gedolei Haposkim have far more authority than any individual Rav to influence the entire community to accept a psak like this.
Pragmatically, they would have the clout to mobilize the tzibbur and askanim to lobby to change public policy. By contrast, neither the author (as an individual), nor the YWN readership, has the influence needed to bring about a change in a national or state policy. Hopefully, the author has brought this issue to their attention, or will do so ASAP.
Rabbi Hoffman – Please provide a link or citation to the source of your assertion that the first dose of the Pfizer vaccine is 91% effective at 4 weeks after it is given. The data that I have seen to date is vastly different.
This article is mathematically 0.
This article overlooks the reason for the second dose. Without the 2nd dose the first dose soon fades away and becomes useless. The 2nd dose is needed to lock in the vaccine and make it permanent.
Rabbi Hoffman is right about the CDC and our professional governing bodies not following the science. Remember, the same CDC or Fauci did not know to warn us that the disease is coming (because they didn’t know), the same CDC did not know the disease was here when it was here already ( as they didn’t know what it is) the same CDC did not know how to treat it when it was here already ( they still don’t) BUT the same CDC knows that the vaccine is effective and good for us and WE blindly need to believe him ? WHY? is his reputation in knowing, good? It is clear that the treatment that many Physicians treat early on works and as long as we have the treatment the disease is treatable. With the vaccine, it is yet to see! Hashem Yeracham! WE need to turn to Hashem!
I understand the point, however, it’s a bit much to use the term “murder”. Murder is an act, this is not the situation. And there is no certainty that any particular person will even become ill.
Recently RYH has become more and more audacious with his opinions about COVID issues. There are top experts in the field making these decisions, and laymen must express their opinions with caution and reservation.
The exact opposite is true. The less people that take the first dose, the less risk of them dying from ADE.
Rabbi Hoffman giving medical advice is like my physician poskening complex shilos.
Barbers and taxi drivers always share their personal opinions on world affairs. Can’t help wondering what gave them the gumption delusionally think they are qualified to dispute experts in the fields. Now a rabbi is doing the same. Maybe he should apply for a position with CDC.
The rabbi should stick to paskening within his area of expertise. His knowledge level about virology, epidemiology and public health policy is sorely lacking.
Barbers and taxi drivers always share their personal opinions on world affairs. Can’t help wondering what gave them the gumption to delusionally think they are qualified to dispute experts in the fields. Now a rabbi is doing the same. Maybe he should apply for a position with CDC – he obviously thinks he is qualified, at least in his mind.