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

theglobeandmail.com

151–160 of 210 posts

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

#151
I know second hand that UCSD is giving all doses right now. Vials contain 20% more to account for spills, so they are using this extra to give extra vaccinations. The second dose for each patient will come from future vaccine shipments. Other providers in San Diego may be doing the same thing.

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

#154
post #134

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?

Sometimes taking chances is worth it. As far as I have heard, every single vaccine trial has concluded “yeah, our vaccine is effective.” So if people had been allowed to take experimental vaccines, the pandemic would have been a lot better. In this circumstance as well, taking a chance is worth it. Even if the virus mutates, changing the mRNA vaccines shouldn’t take more than a week.

"allowed"

Do you think there were a bunch of experimental vaccines just floating around on the . . . dark web? ... That's not how it works. The vaccine makers themselves have no interest in distributing unproven vaccines. I myself was highly confident (and posted such on HN) that we would have a successful coronavirus vaccine, based on the scientific information available early in the pandemic. But it wasn't a surety. You must have a randomized trial or you risk very very bad outcomes. Some experimental vaccines (e.g., dengue) actually make the viral infection worse. Some don't work at all (e.g., Sanofi's covid vaccine). Heck Sanofi's vaccine is likely the easiest to manufacture and distribute. If we followed your "plan", it would likely be that most got the ineffective Sanofi vaccine and we would be moving dead bodies around with bull dozers as "vaccinated" people failed to practice social distancing.

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

#155

Earlier quoted context omitted.

> So if people had been allowed to take experimental vaccines, the pandemic would have been a lot better. > In this circumstance as well, taking a chance is worth it. Nope nope nope nope. This is the literal example of survivor bias. You can't look at the results and use them to inform prior behaviour. The vaccine could have had catastrophic side effects.

I think it is clear the regulatory framework wasn't ideal. The last stage of the trial (which took three months) was not about if they were safe - but simply if they worked. Meaning, they were cleared to have minimal side effects, just unclear if it worked. If you had approved people to choose to take the vaccine in August we could have had 50M people with shots already. A lot of people have my skepticism that the ma…

50M doses isn't something that gets suddenly summoned. It's a big logistics problem. Your assumption is valid only if the pharmas have capacity to make a extremely big amount of vaccine doses. That costs money and (I guess) materials, and both of those things could go towards a vaccine that is proven to be effective.

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

#156

Earlier quoted context omitted.

I thought that the point of vaccinating essential workers first is that they are those that are more likely to spread the virus so by starting with them you stop the virus before it reaches the seniors. Depending on the factors (% of seniors vs. essential workers, availability of vaccine) I can see either approach being more effective.

Not aware of evidence that vaccination stops or reduces spread. Given that asymptomatic and presymptomatic people are the main spreaders, it's certainly not a given. Vaccinating front line health and care workers does make sense for two reasons 1) Far more likely to catch it 2) Far more problematic if they catch it and are off ill because of it Other front line workers like police probably less important -- less like…

There's a 3rd reason. Healthcare workers are frequently working directly with high risk people.

An asymptomatic infection of a healthcare worker could lead to a typhoid mary situation. Especially if they are in the right area of interaction (geriatric care, oncology).

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

#157

Earlier quoted context omitted.

> So if people had been allowed to take experimental vaccines, the pandemic would have been a lot better. > In this circumstance as well, taking a chance is worth it. Nope nope nope nope. This is the literal example of survivor bias. You can't look at the results and use them to inform prior behaviour. The vaccine could have had catastrophic side effects.

I think it is clear the regulatory framework wasn't ideal. The last stage of the trial (which took three months) was not about if they were safe - but simply if they worked. Meaning, they were cleared to have minimal side effects, just unclear if it worked. If you had approved people to choose to take the vaccine in August we could have had 50M people with shots already. A lot of people have my skepticism that the ma…

I think you misunderstand the clinical trial approval process. Yes, phase 2 is primarily about safety, but these are much smaller trials than phase 3, which in turn is much smaller than the post-marketing patient population (cohort). Safety issues routinely arise in phase 3, or even after, due to the much larger cohort sizes. Good phase 2 results are not proof of safety, rather an indication of safety. It is bordering on genocidal levels of reckless endangerment to release a vaccine for general use after Phase 2 in the hopes that it might be effective and is probably safe.

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

#158

Berlin today closed it's sole vaccination center. Allegedly because of a lack of interest by the target audience. So we now reserve all doses, not just the second one. Total organizational fubar.

People have been forced to endure lockdown and masks, but they have a choice about vaccines. We should just vaccinate the elderly and anyone else who wants it and get back to 100% normal life - ditch the mask rules and social distancing.

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

#159

Earlier quoted context omitted.

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.

I'd read medical studies and news articles over the summer that intubation was causing worse outcomes than things like proning in many cases, with dramatically improved survival rates in hospitals that avoided intubation. I'm wondering if advice on that has changed at this point. There was also an interesting piece on HN about jailbreaking CPAP machines to increase supply, although that might not be necessary now?

The standard of care has evolved based on the data. Unlike other respiratory infections, intubation often provides no benefits and some harm to those COVID patients who are not literally dying of asphyxiation (critically low O2 saturation). Basically intubation is now a last-ditch effort, that can and does save lives. But you'd better hope you don't need it because the likelihood of needing intubation AND surviving it are low.

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

#160

Earlier quoted context omitted.

Not aware of evidence that vaccination stops or reduces spread. Given that asymptomatic and presymptomatic people are the main spreaders, it's certainly not a given. Vaccinating front line health and care workers does make sense for two reasons 1) Far more likely to catch it 2) Far more problematic if they catch it and are off ill because of it Other front line workers like police probably less important -- less like…

There's a 3rd reason. Healthcare workers are frequently working directly with high risk people. An asymptomatic infection of a healthcare worker could lead to a typhoid mary situation. Especially if they are in the right area of interaction (geriatric care, oncology).

Firstly healthcare workers should be being tested on a very frequent basis to catch for asymptomatic cases (as well as tons of PPE), secondly there's no evidence the vaccine will stop that type of transmission.
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