They held out for something else because the Russian vaccine had undergone no phase III trials yet. It had only undergone phase I and II trials, which just test whether it is safe to give to people, not whether it actually does anything helpful.
The vaccine underwent Phase I and II safety trials, and was thought to be safe. Russia than began directing the limited quantities being manufactured towards at-risk health care workers, while they ran efficacy trials.
There's nothing magical, or ordained by God that says we must run an efficacy trial with 30,000 individuals. By early January, Russia had only administered a couple hundred thousand doses.
In retrospect, it's highly likely this would have been the correct approach in all vaccines so far in use. In the middle of a pandemic, there's a very strong argument that should be vaccinating as quickly as possible after Phase II trials are complete, before waiting for a long-running efficacy trial. As you said, efficacy trials are not testing for safety. There's already a huge risk to individuals and to society from the virus itself.
If vaccines were widely deployed after phase II with no proof they actually work, there would have be some that did not work that got widely used. The people that got them would they have immunity, and slack off on distancing and masking.
Once you did have a vaccine that you knew worked, there would probably be problems convincing those who got an ineffective vaccine that they need to come in again.
FDA is not a universal regulator. Different countries can have different procedures.
phase 1 : 1-100 phase II 100-1000 phase III 1000-3000 https://d18x2uyjeekruj.cloudfront.net/wp-content/uploads/201...
Russia had been first to market in August, yet most of the richly developed countries held out for an American company to give them a vaccine.
Russia didn’t have enough resources to even distribute it to their own people back then.
What a waste for Russia, as usual, with both PR, mindset and completely botched worldwide sales campaign. And so many people could have been already helped around the world.
Meanwhile the Pfizer and Moderna vaccines have a huge fawning press telling people a ton of “maybes” and saying basically nothing concrete but urging everyone and their dog to get it, even if they have antibodies, cause you know, stuff and maybe and trust us this is better! Here is a typical example of the cringe:
https://www.forbes.com/sites/brucelee/2020/12/24/should-you-...
Your body normally doesn’t have anything like these little spikes. So the spike protein appearing inside your body can be like a Kanye West fan appearing at a Taylor Swift fan party. Or cottage cheese inside a hot dog. Your immune system then is supposed to say, “hey, this doesn’t belong here,” and generate a response to the spike protein.
By exposing your immune system to a very specific component of the virus, your immune system may be better able to focus specifically on this component, rather than fire off in random directions when it first encounters the virus in a natural infection. This could then potentially lead to a stronger and more persistent immune response than what may occur after a natural infection. Since the immune system is rather complex, more studies are needed to confirm this possibility.
“We have no clue so you gotta get this drug now!! $$$”