I've tweeted about how vaccine pauses seemed a rly bad idea a fair bit, but the decisions made by some countries to do them while very rare events were investigated (& the arguments put forward that this would help boost faith in the vaccine) just have not held up

The data from Europe on the AZ vaccine is brutal. In countries where toll out was paused people net think the vaccine is actively unsafe! That is terrible failure of regulation.

And this isn't an anti-EU point. The EMA has generally been really good on this. It *never* recommend a pause, it always urged States to keep using AZ & it recently has tried pushing again to emphaise how benefits outweigh risks at *all* ages and *all* incidence levels

I also think its sensible the EMA is stopping reporting a running tally of clots. If you've done millions of doses & it remains rly rare you have the info needed for a warning & a running total on just one specific side effect probably just drives unhelpful focus & behaviour

In America the J&J pause seems even worse. The rates of a similar side effects are even rarer & the need for a flexible, single shot vaccine possibly even greater (to get out & meet vaccine hesitant ppl in their communities)

That will hopefully change as this all settles down & vaccine teams get to talk to ppl one on one. But that was all that was ever needed. You can just get hesitant ppl to talk to people they trust about the risk reward pay off. Pauses & bans make no sense

I never liked the argument, especially in the US, but also here of regulators saying ordinary people don't understand risk reward trade offs & so the regulator needed to make that decision for them by banning its use in certain age groups or stopping the roll out totally.

I disliked the stay in your lane response to criticism even more. For a start public attitudes are clearly not a lane medical regulators are experts in anyway. And secondly covid has surely shown the value of input from smart outsiders to decision making.

Finally & slighlty differently, in the UK the JCVI might still come out and recommend restricting AZ use in the under 40s next week. This wld probably lead to some of ppl saying "see, the UK has basically aligned with the EU states, not so world beating now eh?"

But this misses that the only reason the JCVI wld likely feel comfortable making that decision is that the UKs vaccine roll out has been so fast it has helped crater covid rates & deaths. A delay of a few weeks *now* is v different to a delay when cases are very high

I, personally, hope the JCVI don't change anything but I'd understand if they did. Rly fast vaccine roll outs are rly good & its been so annoying to see some in EU say things like "we will reach the same end point as the UK (all adults offered a vaccine by July) so its all fine"

Doing more early saves more lives, prevents more transmission & brings the epidemic to an end sooner. Those are all things you shld strive every sinew for! I'm delighted vaccine roll out is picking up but "Cruising across the finish line" just shows you weren't trying hard enough

Good thread on similar issues. US vaccine numbers falling. Hard to see the pause as much of a good idea & very possibly it was a really terrible one https://twitter.com/Paul__Bruno/status/1388504188888379393?s=19