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

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

#121

Post by trhway »

est31 wrote: post #104
rkagerer wrote: post #72

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 maint…

you described precisely the reason why anyone wielding deciding power on the matter and acting rationally wouldn't allow the second doses be administered until [almost] everybody (in the country or on the whole planet) gets the first one. To prevent such a situation the subjects of that power have to stockpile.

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

#122

Post by TheDong »

exabrial wrote: post #118

As many have been saying, optimizing to minimize case count has been where the entire handling of the pandemic has gone wrong. Let's not repeat this mistake yet again. We need to optimize to minimize long term effects: death, disabilities, mental health, etc. These are things that actually matter.

What are you advocating for here?

It seems to me like case count and most long-term effects are linked. If we reduce case count sufficiently that we can stop quarantining, that improves mental health, and case count should be pretty strongly correlated with death and long-term effects.

In the case of rolling out vaccination, are you suggesting we do something differently? Is there any difference between optimizing for minimizing cases and minimizing those other things in a vaccine rollout? In my mind, to optimize for any of those things, you'd roll out vaccines asap.

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

#123

Post by hombre_fatal »

wbl wrote: post #81
breck wrote: post #79

Earlier quoted context omitted.

This comment was flagged so I vouched for it. You may disagree with it but it’s a reasonable position. Look at the official moderna data from the FDA. The placebo and vaccine groups of 15k have the exact same death rate. So according to the very dataset used to approve the vaccine, there is a strong case that COVID isn’t killing people, rather it’s their underlying conditions. And curing COVID will not save most of t…

Did you look at the death rate this year? We are on track for 10٪ excess deaths, most of those with at least a decade of life expectancy. The clinical trial for the vaccine was not going to see this with only a few hundred observed cases. That's only a handful of deaths.

> 10٪

FWIW, that "Arabic percent sign" is barely visible on my 13" laptop while ASCII's "%" is impossible to miss.

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

#124

Post by cygx »

helge9210 wrote: post #115
wbl wrote: post #81

Earlier quoted context omitted.

Did you look at the death rate this year? We are on track for 10٪ excess deaths, most of those with at least a decade of life expectancy. The clinical trial for the vaccine was not going to see this with only a few hundred observed cases. That's only a handful of deaths.

Do you account for people who died from psychological effects of lockdown and job loss, and from not requesting medical assistance for other conditions because of fear of covid-19?

Look at the time evolution of excess deaths in countries such as Belgium that were hit hard by the virus:

https://ourworldindata.org/grapher/excess-mortality-raw-deat...

There's a clear signal we can attribute to Covid infections, whereas any such second order effects are not readily apparent.

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

#125

Post by toast0 »

est31 wrote: post #104
rkagerer wrote: post #72

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 maint…

The last year has been supply chain disruption after supply chain disruption.

If the vial manufacturer has a covid outbreak at their facility and has to stop manufacturing for two weeks, your scheduled shipments aren't going to be on time.

As supply goes up, and we get past the priority recpients to the general public, it probably makes sense to reduce the stockpile requirement; some general public aren't going to come back for their second dose anyway, and more risk is appropriate for general public than high risk groups.

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

#126

Post by pstrateman »

UncleOxidant wrote: post #93
inglor_cz wrote: post #8

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.

Aren't we doing the same here in the US?

Mostly, each state decides what to do with vaccines though, so it's not as uniform.

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

#127

Post by wwweston »

mlyle wrote: post #113
tehjoker wrote: post #86

Earlier quoted context omitted.

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.

Wargame the scenarios. You wouldn't want to give one dose on purpose, but reserving a whole bunch of doses to prevent some people from getting only 1 in a worst case scenario is silly. That 20-70% efficacy number includes the entire period between dose 1 and 2. It looks way better 10 days after dose 1, btw-- MLE around 80%. e.g. single dose -- 50% efficacy (to be pessimistic); double dose -- 95% efficacy. 10M doses "…

This is a productive line of thinking.

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

#128

Post by bosswipe »

breck wrote: post #79
helge9210 wrote: post #53

Earlier quoted context omitted.

> This should drive down the death rate pretty fast. You can't drive the death rate that didn't rise in the first place. In Israel people are dying with COVID-19, not because of it. We are yet to see someone die from COVID-19 who is not terminally ill, fat and diabetic, immunosuppressed (after organ transplantation or cancer treatment) or very old.

This comment was flagged so I vouched for it. You may disagree with it but it’s a reasonable position. Look at the official moderna data from the FDA. The placebo and vaccine groups of 15k have the exact same death rate. So according to the very dataset used to approve the vaccine, there is a strong case that COVID isn’t killing people, rather it’s their underlying conditions. And curing COVID will not save most of t…

I hope a lot of people with your beliefs have the courage of their convictions and refuse to take the vaccine so that I can get the vaccine sooner.

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

#129

Post by rsynnott »

jpster wrote: post #120
rsynnott wrote: post #110

Earlier quoted context omitted.

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

I hope so. But, frankly, most national and local responses to this outbreak have been subpar. I do not take it for granted that we (the US) can pull off this major logistical challenge smoothly or on an aggressive timeline.

New vaccines will likely be approved over the next few weeks (particularly the Oxford one), greatly increasing supply, and the kinks around distribution and administration will be slowly worked out (the Oxford one will also reduce the logistical challenges there; no special transport or storage needed). I'd be very surprised if rates don't go up considerably within a month.

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

#130

Post by jcims »

Lewton wrote: post #44
jewayne wrote: post #29

Earlier quoted context omitted.

The US is DEFINITELY doing this. Each time a first dose goes out of the Pfizer warehouse in Michigan, the second dose for it is set aside. Not only that, but they literally set aside ANOTHER 500,000 doses "just in case". They seem to be prioritizing smoothness of rollout and equity across states over immunizing the maximum number of people possible.

Whelp, guess I'm wrong on this one. That is extremely disappointing

What happens when people start missing their second dose because of insufficient supplies?

- Endless stories of incompetence in the media

- Lack of clarity in need for second dose

- Infections in suboptimally vaccinated people draw question towards efficacy of vaccine.

These are all going to have deleterious effects on future messaging and policy decisions. There's no way to survive this situation with your reputation intact as there are loudmouths on both sides, at least try to salvage the process restore confidence in the underlying medical science.

I've been in a situation where medical policy directly contravenes with the health of a dearly loved individual. We lost that battle and the lives of myself and my children will be forever changed. However, I can rationally see the merit of this approach.

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