Are vaccines the light at the end of the tunnel?

[Arizona Wildcat]

1 hour ago, 39august said:

Rick, I didn't see the CDC guidelines for vaccination priorities. Can you post those, please? 

First responders and those in care facilities first.  That is about 20 million in the US.  Those over 65 or with health issues such as diabetes etc.  Some 130 million in this group.  

The media is reporting that it will take until mid January to get the first group innoculated.  Actually not correct as they can all get their first dose likely in December.  28 days between doses.

Not the caveat - the states actually decide who is first and could legally do their own thing.  Arizona put in its vaccine request for December this week.

If set up like was done for measles some years ago it should go quickly.  Having nice weather and likely using large parking lots and other outdoor facilities makes it easier here.  With schools closed they likely will be used.

Edited December 2, 2020 by Arizona Wildcat

[excitedofharpenden]

6 hours ago, TeeRick said:

Go Pfizer!  Go UK!  They say 800,000 doses being delivered in the next few days to weeks.  And 40 million on order.  Excellent news for the UK.  I sure hope it succeeds!

This is from the quoted article.  "Elderly people in care homes and care home staff have been placed top of the priority list, followed by over-80s and health and care staff."

 

Similar to the US priorities announced by CDC yesterday.

 

As doses get delivered and priorities are set - it will be interesting to see how many can actually get vaccinated per day.  That will be a bottleneck.

Yes. It's great news. I think the issue with the Pfizer one is looking after it at low temperature. The Oxford/AstraZeneca vaccine is much easier. Anyway, it's a great start and what I'd been hoping for. Vaccinated against Covid-19 by Easter 2021?  I hope so 🤞

 

Phil 

[KnowTheScore]

12 hours ago, sandancer said:

We have a cruise in April and if it goes (?????) and we’ve been vaccinated I’ll be getting those cruise clothes out. 

 

Ah but will the clothes still fit after all this lockdown ??? 🙂

[cangelmd]

On 11/30/2020 at 2:40 PM, Ken the cruiser said:

My guess is for us in most parts of Alabama and other rural areas, we'll probably wind up getting the Moderna vaccine as theirs has a more obtainable cold storage requirement than the Pfizer vaccine.

 

Moderna said its vaccine is expected to be stable at standard refrigerator temperatures of 2 to 8 degrees Celsius (36 to 48°F) for 30 days, up from a previous projection of seven days. That contrasts with Pfizer Inc's vaccine candidate, which must be shipped and stored at ultra cold temperatures or on dry ice and can only last at standard refrigerator temperatures for up to five days.

 

But with a 94+% effectiveness rate, that sounds pretty good to me.

 

Moderna Vaccine Storage Requirements Enables Distribution in Rural America: U.S. Official | Top News | US News

 

On 11/30/2020 at 1:08 PM, TeeRick said:

Yes hopefully the CDC will be clear and decisive.  And then I hope that these recommendations are the high-level roadmap that the states all follow.   But why do I have a sinking feeling that it will be much more complicated and political and chaotic than that?  hmmmm....

https://www.cbsnews.com/news/coronavirus-vaccine-governors-determine-priority-health-secretary-alex-azar/

Having some state to state variability is not as bad as you might think - if everyone will wear masks, wash hands, limit contact with people and hold on.

I know Ken that Alabama ADPH has submitted a fairly detailed plan that makes sense for Alabama, but might be different than the plan for New York. When more than one vaccine is approved, the amount of vaccine received or requested by each state is going to vary depending on the distribution plan - but the general trajectory will be forward.

pits going to,be more chaotic than say the UK, but the US is a big place with many different circumstances.

From the ADPH briefings sent out to MDs, the plan is more detailed about getting vaccine to rural areas and NHs because of poverty, distance and the need. Taking care of healthcare workers, first responders and eventually getting it out to CVS is relatively easy.

[sandancer]

4 minutes ago, KnowTheScore said:

 

Ah but will the clothes still fit after all this lockdown ??? 🙂

Believe me if it means cruising I’ll just go out and buy more!

[phoenix_dream]

On 11/30/2020 at 1:08 PM, TeeRick said:

Yes hopefully the CDC will be clear and decisive.  And then I hope that these recommendations are the high-level roadmap that the states all follow.   But why do I have a sinking feeling that it will be much more complicated and political and chaotic than that?  hmmmm....

https://www.cbsnews.com/news/coronavirus-vaccine-governors-determine-priority-health-secretary-alex-azar/

I agree with you 100%.  I am very concerned about how the governor of our state will handle things.  Not commenting pro or con on how he has handled things so far- politics forbidden here and I will try to respect that.  But I just have a bad suspicion it will be more about trying to appear politically correct than about what truly makes sense and is fair to everyone.  In that vein I am concerned Chicago will get much more priority than the rest of the state, including the suburbs (and I am talking percentage-wise, obviously due to population their dose numbers will be higher).  I guess we will have to wait and see.  Fingers crossed.

[UnorigionalName]

2 hours ago, Arizona Wildcat said:

First responders and those in care facilities first.  That is about 20 million in the US.  Those over 65 or with health issues such as diabetes etc.  Some 130 million in this group.  

The media is reporting that it will take until mid January to get the first group innoculated.  Actually not correct as they can all get their first dose likely in December.  28 days between doses.

Not the caveat - the states actually decide who is first and could legally do their own thing.  Arizona put in its vaccine request for December this week.

If set up like was done for measles some years ago it should go quickly.  Having nice weather and likely using large parking lots and other outdoor facilities makes it easier here.  With schools closed they likely will be used.

 

where are congressmen, CEO's, sports players, and celebrities in the list?

[phoenix_dream]

1 hour ago, UnorigionalName said:

 

where are congressmen, CEO's, sports players, and celebrities in the list?

At the  top of course!!

[nocl]

4 hours ago, 39august said:

Rick, I didn't see the CDC guidelines for vaccination priorities. Can you post those, please? 

This link is to the presentations for the CDC Advisory Committee on Immunization Practices.  They detail the 1A participants and the reasoning behind it.

 

https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12.html

[Arizona Wildcat]

4 hours ago, UnorigionalName said:

 

where are congressmen, CEO's, sports players, and celebrities in the list?

I don't care.  Not enough of them to make a difference.  Between Pfizer, Moderna and AZ then USA has purchased 700 million doses delivery in 2021 or before.  More from J&J and others.  For the US there will be plenty of vaccine by Spring.

[D C]

On 9/25/2020 at 9:58 AM, mimbecky said:

 

My tennis partner was stuck in South Africa from March-July and this vaccine was being given there. She received it and said it was for the above reason but I don't know how SA would have known and acted on this information that far back.

I told my doctor that I had gotten a MMR booster and why.  She said "humm. good idea".  Of course if I had asked her recommendation in advance, she may have thought differently LOL.

I also saw this attachment on the news the other day.  I guess with this plan, it doesn't matter if you are a senior unless you are in a "dense settings" which I take to mean retirement facility etc.  Does that mean an older person who isn't working in these positions or isn't living in a facility would be in the very last phase? 😳

 

 

 

M

 

Those numbers seem preposterous (depending on what 'essential workers' means) 

 

Non-kids (not recommended for the vaccine from what I've seen), non-young-adults.... so the average 25-60 year old people not in a patient-care role comprise only 5% of the population?  Engineers, accountants, business people, marketing, advertising, and any other sort of role is part of the only 5% in phase 5?

 

Frankly, if we only give this to healthcare workers and those in extended care facilities, we'll prevent enough deaths such that covid won't even qualify as an epidemic any longer. 

 

 

[D C]

7 hours ago, excitedofharpenden said:

Yes. It's great news. I think the issue with the Pfizer one is looking after it at low temperature. The Oxford/AstraZeneca vaccine is much easier. Anyway, it's a great start and what I'd been hoping for. Vaccinated against Covid-19 by Easter 2021?  I hope so 🤞

 

Phil 

Delivering a product at dry-ice temperatures is hardly the highest hurdle in this race. 

 

The media seems to have latched onto this as some insurmountable challenge when any 3rd grader could come up with a practical solution. 

[LGW59]

1 hour ago, Arizona Wildcat said:

I don't care.  Not enough of them to make a difference.  Between Pfizer, Moderna and AZ then USA has purchased 700 million doses delivery in 2021 or before.  More from J&J and others.  For the US there will be plenty of vaccine by Spring.

but keep in mind, $$$$$ talks.

[nocl]

1 hour ago, D C said:

Delivering a product at dry-ice temperatures is hardly the highest hurdle in this race. 

 

The media seems to have latched onto this as some insurmountable challenge when any 3rd grader could come up with a practical solution. 

The issue is not the ability to ship at dry ice temperatures.  A company I worked for was doing that in the Mid-90s.  The problem is the cost.  In the mid 90's it was costing us to about $45 to drop ship a package of 6 vials of our product (6 vials was one course of treatment for an infusion oncologic).  Did not impact us that much since a course of treatment was about $9000 so the $45 was not much.

 

With a vaccine that costs about $30 per vial or less the shipping costs would be a major percentage of product cost.

 

The other issue is the coordination at the receiving end.  The ability of many locations to hold the product is limited so the scheduling of patients must be tightly coordinate with receipt of product to make sure doses are not wasted.  When you are doing this for a few hundred shipments not much of an issue.  When you are doing this for hundreds of thousands doses it becomes a fairly difficult task that I suspect is beyond the skills of most third graders, even with very advanced computer scheduling system.

 

If they do drop shipping it would take up a considerable percentage of an already overloaded package delivery system in the US.  

 

I suspect that they will need to use a hub an spoke approach with storage centers in key locations, and use of couriers to take it from there to individual inoculation locations.  That would turn the scheduling requirement into a local issue that would be manageable.

 

1 is easy  1 million becomes a bit more difficult.

Edited December 3, 2020 by nocl

[emmas gran]

This is a link to article on BBC news giving the priority for vaccines

https://www.bbc.co.uk/news/health-55045639

 

There is also a new trial for visiting elderly in care homes--the visitor is tested and 20/30 minutes for result. They wear a mask, apron and gloves for the visit as no skin touching allowed but they can give the elderly relative the long awaited hug. Its heartwarming in this awful time

https://www.dailymail.co.uk/news/article-9012141/Heartwarming-pictures-capture-man-89-hugs-daughter-time-FEBRUARY.html

[anniegb]

17 hours ago, TeeRick said:

Go Pfizer!  Go UK!  They say 800,000 doses being delivered in the next few days to weeks.  And 40 million on order.  Excellent news for the UK.  I sure hope it succeeds!

This is from the quoted article.  "Elderly people in care homes and care home staff have been placed top of the priority list, followed by over-80s and health and care staff."

 

Similar to the US priorities announced by CDC yesterday.

 

As doses get delivered and priorities are set - it will be interesting to see how many can actually get vaccinated per day.  That will be a bottleneck.

Logistical challenges mean that care home residents are not top of the list.  Care home staff and NHS staff are.

 

Annie

[D C]

6 hours ago, nocl said:

The issue is not the ability to ship at dry ice temperatures.  A company I worked for was doing that in the Mid-90s.  The problem is the cost.  In the mid 90's it was costing us to about $45 to drop ship a package of 6 vials of our product (6 vials was one course of treatment for an infusion oncologic).  Did not impact us that much since a course of treatment was about $9000 so the $45 was not much.

 

With a vaccine that costs about $30 per vial or less the shipping costs would be a major percentage of product cost.

 

The other issue is the coordination at the receiving end.  The ability of many locations to hold the product is limited so the scheduling of patients must be tightly coordinate with receipt of product to make sure doses are not wasted.  When you are doing this for a few hundred shipments not much of an issue.  When you are doing this for hundreds of thousands doses it becomes a fairly difficult task that I suspect is beyond the skills of most third graders, even with very advanced computer scheduling system.

 

If they do drop shipping it would take up a considerable percentage of an already overloaded package delivery system in the US.  

 

I suspect that they will need to use a hub an spoke approach with storage centers in key locations, and use of couriers to take it from there to individual inoculation locations.  That would turn the scheduling requirement into a local issue that would be manageable.

 

1 is easy  1 million becomes a bit more difficult.

Shipping would not be in small lots except for the 'last mile'.  With usage imminent, temperature becomes less critical. We also have 4 major shipping firms in the U with no indication that they're overloaded (first I've ever read that) and vaccines are already being shipped for distribution.  

 

Again, not even close to the highest hurdle in the race. 

[TeeRick]

6 hours ago, anniegb said:

Logistical challenges mean that care home residents are not top of the list.  Care home staff and NHS staff are.

 

Annie

Annie can you clarify? Logistical challenges? Which ones?  In the US we use the terms "nursing homes" and "assisted care  facilities" .  Are they called "care homes" in the UK?  In the US early in the pandemic we had the majority of COVID related deaths in these facilities.  They will be in the very first wave vaccinated in the US plan, along with the workers in these facilities.  If they can be protected by early 2021 that would be a great start to saving lives.  

[zap99]

6 hours ago, anniegb said:

Logistical challenges mean that care home residents are not top of the list.  Care home staff and NHS staff are.

 

Annie

That is not what was said on the news conference this morning. Care home staff and residents first.

[zap99]

2 minutes ago, TeeRick said:

Annie can you clarify? Logistical challenges? Which ones?  In the US we use the terms "nursing homes" and "assisted care  facilities" .  Are they called "care homes" in the UK?  In the US early in the pandemic we had the majority of COVID related deaths in these facilities.  They will be in the very first wave vaccinated in the US plan, along with the workers in these facilities.  If they can be protected by early 2021 that would be a great start to saving lives.  

In the UK they are marketed as something else. Happy retirement villages, community of independent ,but old ravers, anything but old people's homes, but we all know what they are😁

[TeeRick]

15 hours ago, phoenix_dream said:

I agree with you 100%.  I am very concerned about how the governor of our state will handle things.  Not commenting pro or con on how he has handled things so far- politics forbidden here and I will try to respect that.  But I just have a bad suspicion it will be more about trying to appear politically correct than about what truly makes sense and is fair to everyone.  In that vein I am concerned Chicago will get much more priority than the rest of the state, including the suburbs (and I am talking percentage-wise, obviously due to population their dose numbers will be higher).  I guess we will have to wait and see.  Fingers crossed.

Some states like CA, WA, OR, NV and NY have governors that said they would set up their own "mini-FDA review" so not sure of the time line for them to review and approve a vaccine if the FDA approves the EUA.  Politics aside there is a surge and people are losing lives in these states too.  

https://www.usatoday.com/story/news/health/2020/10/29/states-medical-group-add-independent-covid-19-vaccine-review-boards/3755473001/

 

According to the news, thousands of doses have been flown to your home state to O'Hare already by United airlines to start vaccinations in Chicago asap.

[TeeRick]

On 11/29/2020 at 5:59 PM, phoenix_dream said:

Agree with you 100%.  Yes, when people get the vaccine they should be told ahead of time that there might be side effects and what they are.  But I am very concerned about all the sensationalist media coverage of this.  They will do anything for headlines.  Would anyone with intelligence be willing to potentially suffer some short lived but uncomfortable side effects for a day or two rather than catching a deadly disease?  The answer is a resounding yes.  But unfortunately intelligence seems to be in short supply these days, replaced by chaos and fear, largely (but admittedly not solely) driven by the media.  The media disgusts me on a daily basis and this is one of their most egregious campaigns.  

 

My hope is that when the vaccines are first available, some of the first recipients will be those in positions of important leadership and soon-to-be-leadership who can set a positive example for the public and try to ease some of the fears.  I don't care what anyone's political leanings are, but if the country and state leaders and elected leaders get the vaccines early on it will go a long way to move the population to do the same.  There are dozens of other reasons they should be in the first group, but IMHO this is a primary one.  Perhaps not those who have already had the virus, but definitely ones who have not.

Have you seen this?  Former presidents stepping up to the call.

https://www.usatoday.com/story/news/politics/2020/12/03/covid-vaccine-obama-bush-clinton-said-theyll-take-publicly/3806592001/

[TeeRick]

More on Sputnik V the Russian COVID vaccine.

 

https://apnews.com/article/europe-moscow-coronavirus-pandemic-vladimir-putin-europe-093e3ef365591e9eafde5874253b04cf

[nocl]

2 hours ago, D C said:

Shipping would not be in small lots except for the 'last mile'.  With usage imminent, temperature becomes less critical. We also have 4 major shipping firms in the U with no indication that they're overloaded (first I've ever read that) and vaccines are already being shipped for distribution.  

 

Again, not even close to the highest hurdle in the race. 

Shipping in large lots requires specialized equipment, not just dry ice mailers.  The large lots use mailers stacked inside freezers.

 

Again your last mile comment, requires a hub and spoke approach which will require setting up distribution centers with special equipment, not just dry ice shippers.

[emmas gran]

They are saying a batch is 975 vials of Pfizer, a slight programme when going to Care Homes in which the elderly reside. This may delay that stage until they “figure it out”

 

Apparently this vaccine will survive in a “cooler type box” for around 5/6 hours 

Edited December 3, 2020 by emmas gran
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