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We should administer Covid-19 vaccines as fast as possible, not reserve doses

theglobeandmail.com

101–110 of 210 posts

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#101

Israelis give shots to medical workers and oldest citizens first. This should drive down the death rate pretty fast. If this approach works, Covid-related deaths in Israel should visibly drop by the end of January.

Sort of... there are still plenty of healthy people that only didn't die due to intubation.

I'm curious to see the numbers there as well. If we vaccinate the old, then resume life as normal, we're going to overwhelm intubation machines.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#102
This is an early stage situation. Once the supply pipeline starts running smoothly, having some number of doses in reserve will still be needed, but not as many.

Combat logistics for ammo has the same problem. The person in charge of vaccine distribution planning is an Army logistics general, who will see that.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#103

Earlier quoted context omitted.

All countries are doing these groups first, of course Israel is probably the country doing it the fastest so I agree, we should see the results faster. And I agree with the topic, better 2 people somewhat immune "now" than half with the full vaccine immunity.

The CDC tried to have non-medical essential workers ahead in line of seniors. The argument was that, although more people would die (including more African Americans), it would even out black vs white ppl deaths metric. [edit] source: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

Here's a more recent presentation from the ACIP working group: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

The order the working group currently proposes:

1a: health care personnel, long-term care facility residents

1b: frontline essential workers, persons aged 75 years and older

1c: persons aged 65-74 years, persons aged 16-64 years with high-risk conditions, essential workers not recommended in phase 1b

2: all people aged 16 years and older not in phase 1, who are recommended for vaccination

The parent comment is also mischaracterizing the reasons the presentation gives for putting essential workers at the same priority as persons aged 65-74. Here's what it says (page 33):

* Essential Workers are at high risk of exposure. Prevention of disease will reduce transmission

* Preserves services essential to the COVID-19 response and overall functioning of society. “Multiplier effect”

* Workers unable to work from home

* High level of interaction with public or others in the workplace

* May be unable to control social distancing

* Frequently interact with others in the workplace

* Racial and ethnic minority groups disproportionately represented in many essential industries

* ~1/4 of essential workers live in low-income families

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#104

So what happens if the second dose arrives very (eg. many months) late? Can you start again and give 3? And is there any chance all the partial immunities will catalyze resistant mutations?

> So what happens if the second dose arrives very (eg. many months) late? Can you start again and give 3?

Stockpiling of vaccines is a method to obtain certainty that you can vaccinate on schedule. There are better methods of ensuring certainty, e.g. by supporting manufacturers as well as possible to meet schedules, analyze weaknesses in supply chains, trying to counter them early, etc.

The issue is the cost of maintaining the stockpile:

> she and her colleagues projected that frontloading vaccine doses would avert between 34 and 42 per cent more symptomatic coronavirus infections, compared with a strategy of keeping half the shipments in reserve.

What's the cost of delaying the second shot for some groups? It's certainly non-zero, but 34 to 42 percent less symptomatic infections is a lot of prevented infections (and death).

The cost-benefit analysis gives a clear conclusion: don't stockpile.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#105

Somewhat off topic but in theory, would it be possible to have jab #1 be Moderna's and jab #2 be Pfizer? Would it be ethical to test this? Is there anything inherent in either's approach that would make this dangerous?

That's something that may well get trialled at some point. In the absence of a trial, it certainly wouldn't be ideal, though.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#106
post #68

Earlier quoted context omitted.

Page 31, table row "mitigate health inequities" says: An upside (green) of vaccinating essential workers (non-healthcare) first: "Racial and ethnic minority groups disproportionately represented in many essential industries. ~1/4 of essential workers live in low-income families." A downside (red) of vaccinating adults age >65 first: "Racial and ethnic minority groups under-represented among adults >65". The next page…

This is one of the better critiques I’ve found of the CDC’s very absurd position: https://www.persuasion.community/p/why-im-losing-trust-in-th... Literally their plan was to kill a greater number of people “because ethics”. It goes against well established pillars of ethical logic against “leveling” outcomes by intentionally making things worse for a group that is better off, and against the most fundamental tenant o…

Be warned Yascha has become (or always was, I'm not sure) a grifter hack. He jumped on the cancel culture grift now he's joining in with other armchair epidemiologists such as Matty Yglesias and Nate Silver in misreading slides and propagating a made up controversy about vaccine distribution. The ACIP meeting was recorded and open to journalists. They could go review it, but strangely they didn't. I don't see them reporting video from the meeting where they say anything of the sort your're suggesting.

EDIT: This whole thing is nothing but semi-sophisticated click bait and this is objectively untrue:

> "When the CDC is willing to kill thousands of people in the name of social justice, it's hard to know whom or what to trust.

> So I wrote about its shocking failure of judgment, and my crisis of faith in America’s institutions, for @JoinPersuasion." -- Yascha Mounk, Dec 23, 2020 [1]

Others here have already explained this and shown the priority list from CDC.

[1] https://twitter.com/yascha_mounk/status/1341866668528717824

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#107

This is an early stage situation. Once the supply pipeline starts running smoothly, having some number of doses in reserve will still be needed, but not as many. Combat logistics for ammo has the same problem. The person in charge of vaccine distribution planning is an Army logistics general, who will see that.

It's a different problem here-- making sure the second dose is available at all costs.

The problem here isn't a logistics problem, but a "which alternative is worse" problem.

It sure looks like 1 dose is still >50% effective after day 10. The data is sparse: you wouldn't want to give people a single dose on purpose. But holding back more than half the doses in case there's a low probability event of a complete supply disruption seems overcautious. Hold back 25%.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#108

Canada is the slowest among G7. vaccines administered per 100 people: • Canada at 0.14 • United States at 0.59 • United Kingdom at 1.18 • Bahrain at 3.23 • Israel at 4.37

Honestly no-one should be reading _too_ much into numbers, especially all-time numbers, just yet. The UK approved early, so it has a head start. Most EU countries only started in the last few days. The US and Canada are somewhere in between.

Daily numbers will start to become more useful in the next couple of weeks.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#109
post #50

I don't get why nobody seriously considers a one-dose regimen for the fastest possible vaccine rollout. All available data for both, Biontech/Pfizer and Moderna's vaccines suggests that one dose is enough for >90% efficacy which would be sufficient to reach herd immunity. There was a very good opinion article in the NY Times [1] about that, but not much more. The problem here is that a one-dose regimen was not studie…

That's not what the Pfizer paper showed. There was a confidence interval from between 20-70% iirc for the first shot. Maybe if we're lucky it's on the higher end, but I would stick to proven science if we're going to combat this thing effectively.

[deleted]

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#110
post #88

Earlier quoted context omitted.

Check this out: https://ourworldindata.org/covid-vaccinations The sources they use to compile the data are listed here: https://github.com/owid/covid-19-data/blob/master/public/dat...

Wish I could find estimates showing “At current / projected vaccination rates it will take X years to vaccinate 90% of the population”, per country. I heard on TWiV (This Week in Virology podcast) for the US it was ~6.6 years and I believe it was based on < 90% of pop.

_Current_ rates are likely not worth worrying about, not this early on. Rates should be expected to increase fairly dramatically in the next weeks.
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