Sept. 28, 2020 — Solely 17% of medical doctors say they’ll get a COVID-19 vaccine whether it is licensed earlier than all clinical trials have been accomplished, based on outcomes of a Medscape ballot.
The ballot requested medical doctors and nurses how possible they had been to order or use therapies or vaccines if the FDA grants emergency use authorization earlier than part III trials are accomplished.
The ballot was first posted on Medscape.com on Sept. 2. Of these responding, 17% of medical doctors stated they’d order or use the vaccine; 63% stated no; and 20% stated they had been uncertain. Youthful medical doctors had been extra prone to say they’d not get a vaccine below such circumstances (68% of these youthful than 55 years stated no, vs. 61% of these ages 55 years and older.)
The Washington Put up reported final week that the FDA is anticipated to roll out a tricky new normal for emergency authorization of a COVID-19 vaccine.
Nurses had been much less possible than medical doctors to say sure (11%); 69% stated no; and 20% stated they had been uncertain. Solutions didn’t range 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 latest emergency use authorizations (EUAs) of interventions to deal with COVID-19 haven’t been primarily based 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 the usage of plasma collected from survivors of COVID-19 as a therapy for the illness.
The Nationwide Institutes of Well being’s COVID-19 Therapy Pointers committee stated 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’d or have ordered convalescent plasma for hospitalized COVID-19 sufferers.
9 p.c of medical doctors and a pair of% of nurses stated they’d ordered it; 28% of medical doctors and 40% of nurses stated they’d. However, 44% of medical doctors and 29% of nurses stated they’d not. The remaining 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 severely ailing 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 stated the most important drawback with the EUA for plasma was the “false claims about efficacy.”
“The info will not be convincing of its efficacy for COVID-19, and convalescent plasma had no vital impact in Ebola. The most effective state of affairs for utilizing plasma could be in a medical trial.”
Medical doctors and nurses had been additionally requested whether or not they would order, or have ordered, remdesivir, given the accessible medical trial proof that supported the EUA. Medical doctors had been extra prone 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%) stated no than stated sure, and 14% had been uncertain. Amongst nurses, 39% stated no and 24% had been uncertain.
Amongst medical doctors, solutions on remdesivir differed by work setting. Whereas 37% of hospital medical doctors stated they’d or had ordered remdesivir, 52% of those that had been office-based answered that manner.
General, most medical doctors and nurses (about 60%) reported they’d not handled sufferers hospitalized with COVID-19.
Commenters had completely 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, “Folks in vital management roles have to be held accountable for his or her actions. Should you serve in an workplace and are receiving insupportable political strain from superiors to take actions which can be inconsistent together with your coaching and private integrity, then you’ve however just a few choices.
“Persuade your superiors of their misguided directives or resign. Historical past isn’t going to be sort to those that have supported these unscientific and fully inappropriate positions.”
A registered nurse wrote that issuing the EUA can discourage finishing medical 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 best way of well-planned and designed analysis that may really decide its true usefulness,” she wrote.