Sept. 28, 2020 — Solely 17% of medical doctors say they may get a COVID-19 vaccine whether it is approved earlier than all clinical trials have been accomplished, in accordance with outcomes of a Medscape ballot.
The ballot requested medical doctors and nurses how seemingly they had been to order or use remedies or vaccines if the FDA grants emergency use authorization earlier than section III trials are accomplished.
The ballot was first posted on Medscape.com on Sept. 2. Of these responding, 17% of medical doctors mentioned they might order or use the vaccine; 63% mentioned no; and 20% mentioned they had been uncertain. Youthful medical doctors had been extra more likely to say they might not get a vaccine beneath such circumstances (68% of these youthful than 55 years mentioned no, vs. 61% of these ages 55 years and older.)
The Washington Submit reported final week that the FDA is anticipated to roll out a tricky new commonplace for emergency authorization of a COVID-19 vaccine.
Nurses had been much less seemingly than medical doctors to say sure (11%); 69% mentioned no; and 20% mentioned they had been uncertain. Solutions didn’t fluctuate considerably by age.
The ballot was taken after Medscape Editor-in-Chief Eric Topol, MD, wrote to FDA Commissioner Stephen Hahn on Aug. 31, detailing why he thinks current emergency use authorizations (EUAs) of interventions to deal with COVID-19 haven’t been based mostly on proof.
Topol cited three EUAs particularly: one for hydroxychloroquine on March 30 (revoked in June for lack of proof), one for convalescent plasma on Aug. 23, and an expanded EUA for remdesivir to deal with any affected person hospitalized for COVID-19, not simply these with extreme illness.
The letter, which was additionally posted on-line, drew greater than 500 feedback.
One other ballot query involved using plasma collected from survivors of COVID-19 as a remedy for the illness.
The Nationwide Institutes of Well being’s COVID-19 Remedy Tips committee mentioned this month that present information is inadequate to suggest utilizing convalescent plasma to deal with sufferers who’ve COVID-19.
The ballot requested medical doctors and nurses if they might or have ordered convalescent plasma for hospitalized COVID-19 sufferers.
9 p.c of medical doctors and a couple of% of nurses mentioned they’d ordered it; 28% of medical doctors and 40% of nurses mentioned they might. Alternatively, 44% of medical doctors and 29% of nurses mentioned they might not. The remainder had been uncertain.
One ear, nostril, and throat physician who responded to the ballot wrote, “As as to if or not I might take into account prescribing convalescent plasma for a significantly in poor health COVID affected person, sure I might. And if I ever discovered myself falling off a cliff, I might attempt to seize onto any twig projecting from the cliff.”
However the responder mentioned the largest downside with the EUA for plasma was the “false claims about efficacy.”
“The info aren’t convincing of its efficacy for COVID-19, and convalescent plasma had no important impact in Ebola. One of the best state of affairs for utilizing plasma could be in a scientific trial.”
Docs and nurses had been additionally requested whether or not they would order, or have ordered, remdesivir, given the out there scientific trial proof that supported the EUA. Docs had been extra more likely to say they’d or would order it (42%) than had been nurses, at 37%.
However in each teams, there was a lot uncertainty concerning the drug. Solely barely extra medical doctors (44%) mentioned no than mentioned sure, and 14% had been uncertain. Amongst nurses, 39% mentioned no and 24% had been uncertain.
Amongst medical doctors, solutions on remdesivir differed by work setting. Whereas 37% of hospital medical doctors mentioned they might or had ordered remdesivir, 52% of those that had been office-based answered that approach.
General, most medical doctors and nurses (about 60%) reported they’d not handled sufferers hospitalized with COVID-19.
Commenters had totally different views on the proof behind EUAs. Some stood by their help for hydroxychloroquine, despite the fact that the EUA for it was revoked on June 15.
A reader who agreed with Topol’s criticism of the EUAs wrote, “Individuals in important management roles should be held accountable for his or her actions. In the event you serve in an workplace and are receiving insupportable political strain from superiors to take actions which are inconsistent together with your coaching and private integrity, then you may have however just a few choices.
“Persuade your superiors of their misguided directives or resign. Historical past just isn’t going to be variety to those that have supported these unscientific and utterly inappropriate positions.”
A registered nurse wrote that issuing the EUA can discourage finishing scientific trials.
“The saddest factor is not a lot that EUAs are allowed in emergencies (if really believed potential profit outweighs potential danger), however when it’s allowed to get in the way in which of well-planned and designed analysis that may really decide its true usefulness,” she wrote.