Have any of the vaccines been tested on those actually dying of COVID-19? Would they be likely to have any effect on survival? Seems like those who are actively dying could potentially benefit the most from a vaccine rather than frontline medical workers and the elderly and should be given priority (if it helps). If a vaccine could prevent death then even with few doses available initially it seems possible that no more people would have to die at all (or many fewer).

Thinking about this perhaps those who have already experienced organ damage may not be helped much. But perhaps if everyone who was hospitalized was immediately vaccinated the death rate would drop drastically. My guess (and it's just a guess) is that the phase III trials did not try to answer this question directly, and in fact may have excluded anyone who already had a COVID-19 diagnosis (the drug companies want to show maximum effectiveness which would mean vaccinating before being exposed to the disease). That does not mean it would not help prevent deaths in hospitalized cases though. If none of the early doses are given to those hospitalized then it could be a long time before we know the answer to this question. Probably as the vaccines become more widely distributed someone will try it. But trying it early could potentially save the most lives (again, if it works).

However, maybe there are good reasons you don't vaccinate someone who already has a disease. Maybe it's a large burden on the body to ramp up the immune system in a different way when the body is already fighting off the infection? I don't know, but I'd like to see more public discussion of this. Here's one article I was able to find that suggests adverse reactions at least are unlikely (seems it's actually been tried a few times):

"COVID-19 patients, those with antibodies too may be vaccinated, says Health Ministry"

https://www.thehealthsite.com/news/covid-19-patients-those-w...

Another thing I don't see being discussed much is that while the phase III trials involved tens of thousands of people, only a few hundred people who received the placebo exhibited COVID-19 as far as we know. It would seem that means the vaccines have really only been tried against the disease itself just a few hundred times (and found not to work for about ten of those few hundred). Even if you assume that 10x more people caught COVID-19 but had no symptoms or mild symptoms, that still means very few actual challenges of the vaccine against the disease. It does show that the vaccines are fairly safe since there were few adverse events in the tens of thousands vaccinated, but it does not really seem to show that the vaccines are actually widely effective. The NY Times has a good article about this:

"2 Companies Say Their Vaccines Are 95% Effective. What Does That Mean?"

https://www.nytimes.com/2020/11/20/health/covid-vaccine-95-e...

So it seems possible the vaccines may be much less effective , we won't really know until many, many people are vaccinated. That's no reason not to get vaccinated since the safety seems good from the trials. But it could affect the future dramatically. I guess since we can't know until lots of people have been vaccinated, we just have to wait to find out, nothing more can be done. Presumably data will be being collected so someone (maybe not the public) will have an ongoing readout of effectiveness.