Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

theglobeandmail.com

Post reply on HN
Print view View original

171–180 of 210 posts

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

#171

Post by rsynnott »

bb123 wrote: post #163
rsynnott wrote: post #129

Earlier quoted context omitted.

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.

Is that likely to get approved in the US? My understanding is that the trial was not good enough to pass the FDA bar.

Ah, looks like they may hold off til Feb. for US approval. (Results expected from another trial by then)

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

#172

Post by tehjoker »

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 "…

I wonder if hitting the delivery targets of 20M per month is going to be achieved. That's the first bottleneck before the vaccine supply.

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

#173

Post by bluGill »

vkou wrote: post #164
toast0 wrote: post #125

Earlier quoted context omitted.

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 co…

I would bloody well hope that people manufacturing COVID vaccines are the quintessential essential workers, who should be the first in line for getting COVID vaccines. On the other hand, given how poorly essential workers are actually treated by our society, I doubt that's how things actually work. (See - senior hospital administrators getting vaccines ahead of front-line medical staff...)

And their supply chain, but now we are at everybody anyway.

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

#174

Post by tehjoker »

tehjoker wrote: post #86
jpdus wrote: 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.

Note reviewing the paper: 95% CI 29.5% to 68.4%, mean vaccine efficacy prediction 52% for 1st shot.

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

#175

Post by tehjoker »

aquadrop wrote: post #170
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.

Did you see that graph with amount of cases in control/vaccine groups? Where around day 10 vaccine group graph shows massive drop. It looks pretty convincing. And by now they have much more data, especially with lots of cases nowadays. That simple move can save thousands of live and I think worth considering, instead of just ignoring everything.

I just reviewed it and somehow I missed that detail that the inflection point was way before the second vaccine on the first reading. Very interesting.

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

#176

Post by bluGill »

random5634 wrote: post #143
JoeAltmaier wrote: post #24

Earlier quoted context omitted.

Sure it is. Again, if there should be some issue with the supply chain, then the first dose could be 'wasted'. For hospital personnel etc that would be a bad scenario. We're not talking millions/billions of doses. We're talking about what are really very small numbers. It may be worth taking some very small hit in herd immunity, for an assured continuity of care.

Is there an actual serious claim that the first dose would be wasted? This claim is being made despite CLEAR CDC guidance on how to handle delayed vaccination doses? I'm serious - where is the citation for the claim you are making that the first dose is wasted if the second dose is not perfectly on schedule. The reason this claim is likely a lie is that millions / billions of vaccines are given out. Every school chil…

Provide citation yourself for this case. Nobody can, there is no data to cite. The only data that we have is that getting both doses on schedule works. Everything else is speculation.

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

#177

Post by cogman10 »

iso1210 wrote: post #160
cogman10 wrote: post #156

Earlier quoted context omitted.

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.

> Firstly healthcare workers should be being tested on a very frequent basis to catch for asymptomatic cases.

Agreed. It's a good idea even if they have been vaccinated until community spread is way down.

> secondly there's no evidence the vaccine will stop that type of transmission.

Why do you say that? The vaccine should trigger a strong immune response which should keep most people from getting infected. That's my assumption anyways.

Seems like the multi-prong approach here is the most helpful anyways. Vaccine + testing + masks to eliminate spread as much as possible in vulnerable communities.

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

#178

Post by jpster »

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.

Here’s why I worry: https://twitter.com/ashishkjha/status/1343768397084053505?s=...

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

#179

Post by jdkee »

selljamhere wrote: post #52
dvivsivd wrote: post #43

Earlier quoted context omitted.

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-...

I don’t see any arguments in those slides about trying to “even out black vs white ppl deaths metric.” Social inequality is one of several factors included in their ethical and logistical plan, but interpreting that as an implied black vs white issue seems like a very uncharitable view of the author’s intent.

"“Older populations are whiter, ” Harald Schmidt told the New York Times. “Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit.”

See https://www.nytimes.com/2020/12/05/health/covid-vaccine-firs...

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

#180

Post by sampo »

iso1210 wrote: post #147
mrighele wrote: post #65

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…

> Not aware of evidence that vaccination stops or reduces spread.

There isn't any evidence for the opposite, either. There is no evidence either way. You can't just choose between two unknown options based on which one you like, and then defend your position by saying that there is no evidence against it.

Post reply on HN