COVID-19 vaccine discussion

6 minutes ago, Anastasis said:

Wut?  None of these technologies are tried and true.  They are all novel and the the adenovirus vector approach is fucking cool and creepy.

I was under the impression that the AstraZeneca vaccine was pretty old technology. You’ve proven me wrong.

https://www.google.com/amp/s/www.cbsnews.com/amp/news/mink-covid-denmark-cull-animals-rise-from-mass-grave-zombie-minks/
 

I think “Zombie Minks” gets me to a 2020 Bingo

I was curious about how big these vaccine shipments might be so I looked it up.  Pfizer's ultra-cold vaccine comes five doses to a vial, 175 vials to a tray, up to five trays per box.  So one box can hold up to 4,375 doses.  To get everyone vaccinated in Travis County in six months, we would need about three boxes per day of vaccine.  The Army logistics general suggested that cities might get weekly deliveries, so maybe we would get 20 boxes per week.

The vaccine is going to come with supply kits.  Each kit has materials for 100 injections.  No idea how big they are, but we will need about 130 kits a day in Travis County, or about 920 a week.  Of course, the kits need no refrigeration, just a closet somewhere.  The kit supply could run a bit ahead of the vaccine supply, so long as you had storage.

This stuff just isn't that big.

Assuming we can get those quantities of vaccine and kits, I think the biggest problem will be local distribution.  Who is allowed to get a dose, who needs a second dose, how to sort out all of the super cold vials to get to multiple distribution sites, making sure you have kits and vials at the same place.  To me, a big central vaccination site makes the most sense, maybe with some mobile trucks driving around to nursing homes and other less mobile populations.  The Erwin Center would be a great spot.

I'm guessing the convention center and palmer events center aren't getting a whole lot of use right now

If this is repeat info, please ignore. This is what I have heard through my job, so it might be more applicable to getting it to our nursing homes than the general public.

Pfizer has developed a special shipping container for distribution. There is dry ice inside that needs to be replenished every 5 (maybe 3) days.  Then when you are ready to give it is good for a few more days at more easily obtained temps.  A large portion of the distribution and administration is going to be through CVS and Walgreens.  I have been seeing lots of job listings for temporary immunization  pharmacists at both of those so this seems to be happening.  The nursing homes we serve are going to have to sign up with one of them to get their residents vaccinated since my company won’t be doing it.

Also, according to the regulations, the actual person who administers the vaccine has to fill out about 3 pages of documentation for each dose given.  This will limit the number of doses each person can administer.

As of right now, I hear I will probably be eligible to get it in phase 1.  I also saw they haven’t finalized exactly who will be eligible in each phase yet, so who knows. As a pharmacist, I am only considered a health care worker sometimes.

  I am sure the limited roll out is partly to get the logistics figured out before expanding it to the bulk of the population.   It will be a shit show at the beginning.  

34 minutes ago, blacklab said:

I'm guessing the convention center and palmer events center aren't getting a whole lot of use right now

Back to School Bash with Otis Day and the Knights not a thing right now?

They should be running a drive through vaccination program at every hospital, pharmacy and urgent care clinic in central Texas. 

Edited November 28, 2020 by Anastasis

Tracking for the second dose gonna be a mess. What if you get the Pfizer shot but when you need the booster only moderna is available? 

1 hour ago, Anastasis said:

Tracking for the second dose gonna be a mess. What if you get the Pfizer shot but when you need the booster only moderna is available? 

My guess is that you won’t get the first Pfizer shot unless they are extremely confident they will have the second Pfizer shot ready for you. Otherwise they’re wasting resources.

I guess you could get the moderna shot in your scenario but then you need to come back for a second moderna shot, or 3rd overall in your case.

Will need to label and hold back a secons dose for every first dose administered. Is there a timeframe in which the second needs to be administered in order to consider the vaccination successful?  Such that if the person doesn’t show up to get the booster in time, that dose goes back into rotation?

2 minutes ago, Pato del Muerto said:

Will need to label and hold back a secons dose for every first dose administered. Is there a timeframe in which the second needs to be administered in order to consider the vaccination successful?  Such that if the person doesn’t show up to get the booster in time, that dose goes back into rotation?

I got mine 3 weeks apart

Here is Texas' vax plan:

https://www.dshs.state.tx.us/news/updates/Texas-Vaccine-Plan-10-16-2020-DRAFT-CDC-Submission.pdf

 

Pfizer has developed a special shipping container for distribution. There is dry ice inside that needs to be replenished every 5 (maybe 3) days.  Then when you are ready to give it is good for a few more days at more easily obtained temps.  

1 hour ago, Anastasis said:

at every hospital, pharmacy and urgent care clinic in central Texas. 

Except we’re all kinda busy seeing the Covid patients and running tests. Seriously, we’re stretched really thin. 

32 minutes ago, Newdoc said:

Except we’re all kinda busy seeing the Covid patients and running tests. Seriously, we’re stretched really thin. 

That is probably the thinking behind using the big chain drug stores.  Also, they are whores for anything that will increase their volumes and are more than willing to abuse their staff to make it happen.  
My boss told us some absurd statistic like 95% of the public lives within 10 or 20 miles of a Walgreens or CVS (my numbers are surely off, but the number was eye raising) .

This is where it would be good to pull people out of retirement and use some of the military with some training to do these vaccine administrations.

11 minutes ago, Druggist said:

That is probably the thinking behind using the big chain drug stores.  Also, they are whores for anything that will increase their volumes and are more than willing to abuse their staff to make it happen.  
My boss told us some absurd statistic like 95% of the public lives within 10 or 20 miles of a Walgreens or CVS (my numbers are surely off, but the number was eye raising) .

 

Just now, Newdoc said:

This is where it would be good to pull people out of retirement and use some of the military with some training to do these vaccine administrations.

Just read that they are allowing pharmacy techs to administer the C19 shots.  For once, a drive though at a community pharmacy actually sounds like a good idea. 

That container misspelled “NOTYET”

No mispelling, "Yeti" is Latin for "Two Weeks"  

1 minute ago, Lobo said:

No mispelling, "Yeti" is Latin for "Two Weeks"  

 

No mispelling, "Yeti" is Latin for "Two Weeks"  

Moderna will apply today for FDA authorization.

https://www.cnn.com/2020/11/30/health/moderna-vaccine-fda-eua-application/index.html

18 minutes ago, Borachio said:

Moderna will apply today for FDA authorization.

https://www.cnn.com/2020/11/30/health/moderna-vaccine-fda-eua-application/index.html

Do hospitals have dates yet on when they will begin vaccinations?

54 minutes ago, Borachio said:

Moderna will apply today for FDA authorization.

https://www.cnn.com/2020/11/30/health/moderna-vaccine-fda-eua-application/index.html

Normally you have to pay the fda millions to process an application. I wonder if that was waived for covid related submissions. 

7 hours ago, Pato del Muerto said:

Normally you have to pay the fda millions to process an application. I wonder if that was waived for covid related submissions. 

I sure hope so.

So will we have a choice of which vaccine to get or will it just be based on what my local pharmacy gets in stock (assuming they only get a vaccine from one company and not all 3)?

10 minutes ago, Beantown Express 2.0 said:

So will we have a choice of which vaccine to get or will it just be based on what my local pharmacy gets in stock (assuming they only get a vaccine from one company and not all 3)?

You probably won’t get to choose.  But the first 2 that will be approved (Moderna and Pfizer) have little to any difference in terms of efficacy, type of vaccine (mRNA), or side effect profile

Who's the third besides Moderna and Pfizer and what's the difference in this third one?  Does it have Electrolytes?  That'd be so 2020. . 

Edited November 30, 2020 by Lobo

10 minutes ago, Lobo said:

Who's the third besides Moderna and Pfizer and what's the difference in this third one?  Does it have Electrolytes?  That'd be so 2020. . 

No, I Don't Know's on third.  Who's on first.

Alls I know is the relief pitcher is Jose Placebo, and he's from the Dominican.  

7 minutes ago, Lobo said:

Alls I know is the relief pitcher is Jose Placebo, and he's from the Dominican.  

But he's only 11.  And looks like this:

27 minutes ago, Lobo said:

Who's the third besides Moderna and Pfizer and what's the difference in this third one?  Does it have Electrolytes?  That'd be so 2020. . 

AstraZeneca will be the third one, I believe. It uses an adenovirus (common cold virus) to carry the gene coding for the coronavirus spike protein into cells. Earlier in this thread, I posted a link to all the vaccines in development.

And it’s significantly less effective, but cheaper.

2 minutes ago, StruggleBus said:

And it’s significantly less effective, but cheaper.

In a fun little twist, the state of Wyoming will be footing the bill for its residents to be vaccinated. Reddest, most anti-socialist state. And I doubt there will be much clamor to make the people for it. 

2 minutes ago, Pato del Muerto said:

In a fun little twist, the state of Wyoming will be footing the bill for its residents to be vaccinated. Reddest, most anti-socialist state. And I doubt there will be much clamor to make the people for it. 

Unless there is something maybe unique about the logistics of the state that Wyoming is picking up, the tab is being picked up by the federal government. 

16 minutes ago, Anastasis said:

Unless there is something maybe unique about the logistics of the state that Wyoming is picking up, the tab is being picked up by the federal government. 

Maybe I need to go back and reread what they put out there. Could be they worded it as if it’s them for reasons, could be I misread or misinterpreted. 

50 minutes ago, Anastasis said:

Unless there is something maybe unique about the logistics of the state that Wyoming is picking up, the tab is being picked up by the federal government. 

The Medicaid/Medicare cost sharing models between states and the federal government, after 50+ years, is still understood by exactly one computer and 7 women.  

On 11/30/2020 at 9:11 AM, Bevo said:

Do hospitals have dates yet on when they will begin vaccinations?

FDA meeting December 10th to review Emergency Use Authorization request for both vaccines. General overseeing Warp Speed said delivery of vaccine will be anywhere from hours to within 24 hours to many locations after EUA granted. They can be begin administering when received.

Most healthy people under 65 won’t be getting a vaccine until April/May 

edited to add links

https://www.wsj.com/articles/u-s-plans-to-ship-first-covid-19-vaccine-24-hours-after-authorization-11600275910?mod=article_inline

https://www.wsj.com/articles/the-covid-19-vaccine-when-will-it-be-available-for-you-11606339361

 

 

Edited December 1, 2020 by Neonmoon

23 minutes ago, Neonmoon said:

FDA meeting December 10th to review Emergency Use Authorization request for both vaccines. General overseeing Warp Speed said delivery of vaccine will be anywhere from hours to within 24 hours to many locations after EUA granted. They can be begin administering when received. 

Most healthy people under 65 won’t be getting a vaccine until April/May 

 

Thanks. I wonder what the efficacy is like after one dose. My wife and I can get vaccinated sometime during the week of the 10th but that would push the booster into January. So during the whole month of December we would be on our first dose.

 

1 hour ago, Pato del Muerto said:

Maybe I need to go back and reread what they put out there. Could be they worded it as if it’s them for reasons, could be I misread or misinterpreted. 

 

24 minutes ago, Lobo said:

The Medicaid/Medicare cost sharing models between states and the federal government, after 50+ years, is still understood by exactly one computer and 7 women.  

Yeah, it may be some Medicaid semantics. As I understand, all vaccine supplies are being provided by the federal government; however administration is reimbursed by various other entities...

1. If you are in Medicare, CMS pays for it directly. 

2. If you are in Medicaid, CMS is paying for it indirectly.

3. If you are in commercial insurance, the insurer must pay for it with no cost-share to the individual.  They are required to pay either their in-network negotiated rates or something approximating the CMS rates (~$50 for the two shot series I think).

4. If you are uninsured, there is a vehicle for reimbursement to the provider directly from CMS.     

1 hour ago, Neonmoon said:

Most healthy people under 65 won’t be getting a vaccine until April/May 

For as quickly as this whole process has occurred, this part feels...underwhelming. 

6 minutes ago, Chet Steadman said:

For as quickly as this whole process has occurred, this part feels...underwhelming. 

I'd bet good money that, barring any unusual setbacks, it will be sooner than that. It'll be slow at first but they'll figure out ways to speed things up. Money to be made and whatnot. 

CDC ACIP will be having an emergency virtual meeting tomorrow to discuss and vote on vax prioritization plans...

Webcast

December 1, 2020 is an emergency virtual meeting. No registration is required.
Meeting time, 2:00-5:00pm EST (times subject to change).

Stream: https://www.ustream.tv/channel/VWBXKBR8af4

Agenda: https://www.cdc.gov/vaccines/acip/meetings/downloads/agenda-archive/agenda-2020-12-508.pdf 

 

Edited December 1, 2020 by Anastasis

I'd bet good money that, barring any unusual setbacks, it will be sooner than that. It'll be slow at first but they'll figure out ways to speed things up. Money to be made and whatnot. 

Pfizer and BioNTech said they expect to produce 50 million doses by the end of 2020 and 1.3 billion doses in 2021. If the 2021 production goal is distributed somewhat evenly throughout the year, that’s around 100 million doses per month. No idea how that would get distributed to various countries, obviously it won’t all be for the U.S.

I haven’t seen production goals for the Moderna or AstraZeneca vaccines.

Last I read, we need about 70% for herd immunity, either through vaccination or actual COVID infection. That’s 230 million people, but maybe 30 million have already had COVID, which I assume is a conservative estimate. So perhaps we need ~200 million people to get vaccinated, or 400 million doses.

I would be surprised if the U.S. isn’t quickly approaching that by next summer, which means a large percentage of people will be getting vaccinated in January-March timeframe.

1 hour ago, Chet Steadman said:

For as quickly as this whole process has occurred, this part feels...underwhelming. 

 

1 hour ago, NorthLoop said:

I'd bet good money that, barring any unusual setbacks, it will be sooner than that. It'll be slow at first but they'll figure out ways to speed things up. Money to be made and whatnot. 

I think it will be sooner because roughly 23% of Americans are anti-vaxxers. 
 

edit: I just realized the next three-four months will be a barrage of who did/who didn’t get the vaccine stories and how it was unfair. Brace yourselves. 

Edited December 1, 2020 by Neonmoon

23% were anti-vaxxers.  Half of them will change their tune.  Of that other half, we can expect a 2% mortality rate as everybody breathes on one another again.  

1 minute ago, Neonmoon said:

 

I think it will be sooner because roughly 23% of Americans are anti-vaxxers. 

That plus some will refuse a new vax just because it’s new. 
 

but also some will get vaxed that either knowingly or unknowingly had the virus so in some ways that’s a waste of material. 

15 minutes ago, Neonmoon said:

edit: I just realized the next three-four months will be a barrage of who did/who didn’t get the vaccine stories and how it was unfair. Brace yourselves. 

The prior ACIP recommendations put essential workers over both Age 65+ and high risk medically complex patients for prioritization based on considerations related to health inequalities and promotion of justice. Age 65+ scored better on the implementation dimension, but essential workers highest on the ethics dimension. High risk folks score same as essential workers on science and implementation, but were edged out by the ethics dimension. There is going to be some bitching and moaning for sure no matter how it shakes out. 

ETA: Here is the deck. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-11/COVID-04-Dooling.pdf

 

Edited December 1, 2020 by Anastasis