COVID-19 vaccine discussion

I mean.....it seems like this is the only way to read it.
Rule 1: APH, and ONLY APH, will be getting all future doses of the vaccine in the area.  Private providers have been told to get fucked, they aren't getting anymore.
Rule 2: APH is only going to provide the vaccine to people who are a) over 65 and b) don't have health insurance.
So.....if you are either under 65, or you are any age and have health insurance, you can get fucked, forever and ever.
What.  A fucking.  Clusterfuck.

In the next few weeks, CVS in the 512 area will be getting an unknown quantity of doses.

It appears that they have almost finished their LTC vaccinations.

3 hours ago, Brisketexan said:

Exhibit 11 billion in "rules for me, and not for thee."

Also....if ONE FUCKING MOTHERFUCKER down there who spent the last year calling COVID a "hoax" gets the vaccine, they should be subject to public censure and ridicule by the Lege.

Yeah, pipe dream - we've already seen a crapload of politicians just like that getting the vaccine.  Sigh.  There's no fucking justice in this timeline.

none of them should be getting it if they are under 65.  I get health care workers and first responders but beyond that this should only be aged based and that's it.

crazy enough I think New Jersey was prioritizing smokers...the insanity is mindblowing

Edited January 19, 2021 by dcar00

10 minutes ago, Armybrat said:

I thought the poor were given free insurance under the ACA?

what kind of poor are you talking about?  the I make less than 50K poor or I make nothing and live on welfare poor.

APH has these health care orgs like communitycare, etc that service low income.  they are being prioritized.

the insurance thing is what Brad was mentioning.  people with good "private" insurance through work are at the back of the line if under 65 at this point because if they get it they have a better chance of survival.

Were you able to sign up?  my guess is they will continue to prioritize over 65 uninsured/underinsured v. insured but I haven't bothered to look at the portal. someone up thread said say you have no insurance. Could be an algorithm to put insured farther back but don't know.

Edited January 19, 2021 by dcar00

I thought the poor were given free insurance under the ACA?

Real talk, what?

Medicaid has existed since the 60’s, so the very bottom has been covered for a while. The closest thing to what you’re saying would be Medicaid expansion, but Texas has not done so, so that doesn’t apply here. Most people between the Medicaid threshold, which again in Texas is still at the base level and quite low (not that the expanded threshold is very high but that’s beside the point), and quite comfortable have not given shutting remotely close to free insurance.

17 minutes ago, Armybrat said:

I thought the poor were given free insurance under the ACA?

No you didn’t 

 

28 minutes ago, SubliminalHorn said:

No you didn’t 

Yes I did. One of my sons signed up for it several years ago, plus his two boys are on Medicaid.

Have signed up at two venues to get on the appointment waiting list. No replies yet.

5 hours ago, Skipper said:

Seriously.  WTF.  Insurance isn't even covering or involved with vaccination right?   Is this just Austin's/Casar's mechanism to try to prioritize the poor?  I mean if you are working class but responsible enough to have health insurance you are at the back of the line?  Unreal.

They're paying for the administration fee. Government is only paying for the vaccine and they won't cover patients with insurance. Only way I can collect the admin fee is to bill a patient with no active coverage.

1 hour ago, HRSchenker said:

Only way I can collect the admin fee is to bill a patient with no active coverage.

APH strategy making more sense all of the sudden. 

You know, I don't mind being in a line for the vaccine, or having others in front of me, or letting 65+ go first ... whatever the rules are.  But it is crazy that there are different rules and registration for each county.  It is crazy that one county gets to make rules for the region, because they effectively control all of the vaccine available.

The state is giving vax to the hubs with the promise that the hubs are going to distribute it according to state guidelines.  Austin tacks on more rules, gives it to legislators but denies it to people because they have health insurance unless you are willing to lie and say you don't.  San Antonio has a different system, Dallas a different system, UT gets vax but evidently can't give it to anyone outside of the system even though I think Dell Med is partially taxpayer funded.

It is crazy.  The state should have set up hubs with a single registration system and the same set of rules for everyone.  I don't mind being in line but it would be nice to know *where* I was in line and nice to have uniform rules set across the state.

3 minutes ago, Texas Jeff said:

You know, I don't mind being in a line for the vaccine, or having others in front of me, or letting 65+ go first ... whatever the rules are.  But it is crazy that there are different rules and registration for each county.  It is crazy that one county gets to make rules for the region, because they effectively control all of the vaccine available.

The state is giving vax to the hubs with the promise that the hubs are going to distribute it according to state guidelines.  Austin tacks on more rules, gives it to legislators but denies it to people because they have health insurance unless you are willing to lie and say you don't.  San Antonio has a different system, Dallas a different system, UT gets vax but evidently can't give it to anyone outside of the system even though I think Dell Med is partially taxpayer funded.

It is crazy.  The state should have set up hubs with a single registration system and the same set of rules for everyone.  I don't mind being in line but it would be nice to know *where* I was in line and nice to have uniform rules set across the state.

It's going to create a ton of chaos when we get into more of the general public stages. People are going to be vaccine hunting all over the place. 

I generally believe in localized government but this is a case where there should be state, if not federal standards. Without any coherency on those levels, we've predictably found ourselves in a mess.

But yeah, what Austin is doing is pretty dumb. 

Edited January 19, 2021 by BradInATX

The state has never had any trouble sticking its nose in to what it thinks local governments should he doing

I have a feeling this will be the only week austin/Travis is prioritizing over 65/uninsured...that, or I’m liking my chances for a significant bump in vaccines coming my way next if I’m Wilco or Hays public health departments

 

The state has never had any trouble sticking its nose in to what it thinks local governments should he doing
I have a feeling this will be the only week austin/Travis is prioritizing over 65/uninsured...that, or I’m liking my chances for a significant bump in vaccines coming my way next if I’m Wilco or Hays public health departments
 

Cabela's bout to get 100k doses.

Cabela's bout to get 100k doses.

I’ll take that...I’m already on their system.

2 hours ago, Texas Jeff said:

You know, I don't mind being in a line for the vaccine, or having others in front of me, or letting 65+ go first ... whatever the rules are.  But it is crazy that there are different rules and registration for each county.  It is crazy that one county gets to make rules for the region, because they effectively control all of the vaccine available.

The state is giving vax to the hubs with the promise that the hubs are going to distribute it according to state guidelines.  Austin tacks on more rules, gives it to legislators but denies it to people because they have health insurance unless you are willing to lie and say you don't.  San Antonio has a different system, Dallas a different system, UT gets vax but evidently can't give it to anyone outside of the system even though I think Dell Med is partially taxpayer funded.

It is crazy.  The state should have set up hubs with a single registration system and the same set of rules for everyone.  I don't mind being in line but it would be nice to know *where* I was in line and nice to have uniform rules set across the state.

Preach on brother. On top of all of that why should an Austin City Councilman have any say on what is going on for the people that didn't elect him in the other parts of travis county. Shouldn't it be county health officials?

The state made a big mistake with the ridiculously large 1b definition of 65+ Or 16+ with at least medical condition. Then the state hands out a minuscule number of doses to cover that group.  Many hubs are still focusing on their category of 1b, subgroup A of 75+.

the state just confused everyone with their 1b category and wasted the time of many.

APH is going to lose interest in serving as the hub provider once they have vaccinated all the homeless and indigents. 

22 minutes ago, Anastasis said:

APH is going to lose interest in serving as the hub provider once they have vaccinated all the homeless and indigents. 

BLM = Bums Lives Matter (/cr)

Registration begin today in Minnesota for the next stage of vaccination. People O65, preK-12 teachers and district staff, child care workers. MDH is aiming to use the hub model, with 9 community vaccination sites to be opened statewide. Gov. Walz was also very clear that the effort is being constrained by limited vaccine supply.

The primary side effect of getting vaccinated seems to be bragging about getting the vaccination.

I'm in favor of a strategy that gets as many shots in arms as quickly as possible.   I would much rather live in a State that gets everyone that wants to be vaccinated vaccinated in 6 months vs. 12 months by ensuring it's done "in the correct order".   After medical personnel, it should have been opened to everyone 65+.  As soon as it looked like those spots started to fill up (i.e., if you aren't 65+ and on the ball, your loss), reduce to anyone 50+ then 35+ then everyone 16+.   Honestly, the sooner you start getting the under 65 (i.e., employment class) vaccinated the sooner you will see a reduction in the spread.  And I do think it's a good policy to let people sign up in any county they want.  If folks in rural counties "don't believe in vax" and aren't going to be on the ball about signing up, let people in the cities take their place.  The goal after every vaccine site should be they have zero doses left at the end of the week until next shipment arrives.

12 hours ago, Anastasis said:

APH strategy making more sense all of the sudden. 

follow the money..

Please be clickbait

https://deadline.com/2021/01/another-new-covid-19-variant-in-l-a-vaccine-resistant-denmark-1234675834/

Another New Covid-19 Variant Discovered In L.A. Might Be Vaccine Resistant, Researcher Says; Strain First Identified In Denmark
Tom Tapp
January 18, 2021 2:49PM PST

Coronavirus
CDC
Two days after the Los Angeles Public Health Department announced that the much-talked-about UK variant of Covid-19, known as B.1.1.7, had been identified in the region, the California Department of Public Health revealed that another lesser-known strain had been circulating in the county as well.

Known as L452R, the newly announced arrival was first identified in Denmark in March. It showed up in California as early as May.

Dr. Charles Chiu, a virologist and professor of laboratory medicine at UCSF who, in concert with state authorities, has been genetically sequencing test samples to identify new variants said early indications are the L452R might be less susceptible to the currently approved vaccines, but more investigation is needed.

“This variant carries three mutations, including L452R, in the spike protein, which the virus uses to attach to and enter cells, and is the target of the two vaccines that are currently available in the United States,” said Dr. Chiu. A spike protein mutation could, then, interfere with the vaccine’s efficacy.

According to the California Department of Public Health, Santa Clara County has sequenced a large number of positive specimens collected from community testing sites and outbreaks in the county. The L452R was present in specimens from the community and from several large outbreaks, including outbreaks where very high numbers of people exposed contracted the virus.

“This variant was identified in several large outbreaks in our county,” said Santa Clara County Health Officer Dr. Sara Cody. She called that correlation “a red flag and must be investigated further.”

The new variant also has been detected in Los Angeles, Mono, Monterey, Orange, Riverside, San Francisco, San Bernardino, San Diego, San Luis Obispo, Humboldt and Lake counties. Because genomic sequencing is sparse, it is currently unknown how prevalent L452 is statewide, nationally or globally.

Dr. Chiu said L452R grew from about 3.8% of the samples he tested in late November 2020 through early December to more than 25.2% in late December through early January 2021...

 

 

 

Otherwise

Edited January 19, 2021 by B00M
Spoiler tags no worky?

So Danish Mink Zombies somehow brought the new strain to the city that was the first to vilify wearing minks?  

2 hours ago, Skipper said:

I'm in favor of a strategy that gets as many shots in arms as quickly as possible.   I would much rather live in a State that gets everyone that wants to be vaccinated vaccinated in 6 months vs. 12 months by ensuring it's done "in the correct order".   After medical personnel, it should have been opened to everyone 65+.  As soon as it looked like those spots started to fill up (i.e., if you aren't 65+ and on the ball, your loss), reduce to anyone 50+ then 35+ then everyone 16+.   Honestly, the sooner you start getting the under 65 (i.e., employment class) vaccinated the sooner you will see a reduction in the spread.  And I do think it's a good policy to let people sign up in any county they want.  If folks in rural counties "don't believe in vax" and aren't going to be on the ball about signing up, let people in the cities take their place.  The goal after every vaccine site should be they have zero doses left at the end of the week until next shipment arrives.

The top 5 states in % vaccines administered aren’t dominated by urbanized states.  It was a Houston hospital, not some rural folks, paying healthcare workers to incentivize getting the vaccine.  

 

North Dakota	68,675	52,955	77.1
West Virginia	205,475	153,692	74.8
New Mexico	204,750	137,531	67.2
Oregon	335,075	216,924	64.7
Kentucky	337,450	213,567

 

1 hour ago, B00M said:

Please be clickbait

https://deadline.com/2021/01/another-new-covid-19-variant-in-l-a-vaccine-resistant-denmark-1234675834/

Another New Covid-19 Variant Discovered In L.A. Might Be Vaccine Resistant, Researcher Says; Strain First Identified In Denmark
Tom Tapp
January 18, 2021 2:49PM PST

Coronavirus
CDC
Two days after the Los Angeles Public Health Department announced that the much-talked-about UK variant of Covid-19, known as B.1.1.7, had been identified in the region, the California Department of Public Health revealed that another lesser-known strain had been circulating in the county as well.

Known as L452R, the newly announced arrival was first identified in Denmark in March. It showed up in California as early as May.

Dr. Charles Chiu, a virologist and professor of laboratory medicine at UCSF who, in concert with state authorities, has been genetically sequencing test samples to identify new variants said early indications are the L452R might be less susceptible to the currently approved vaccines, but more investigation is needed.

“This variant carries three mutations, including L452R, in the spike protein, which the virus uses to attach to and enter cells, and is the target of the two vaccines that are currently available in the United States,” said Dr. Chiu. A spike protein mutation could, then, interfere with the vaccine’s efficacy.

According to the California Department of Public Health, Santa Clara County has sequenced a large number of positive specimens collected from community testing sites and outbreaks in the county. The L452R was present in specimens from the community and from several large outbreaks, including outbreaks where very high numbers of people exposed contracted the virus.

“This variant was identified in several large outbreaks in our county,” said Santa Clara County Health Officer Dr. Sara Cody. She called that correlation “a red flag and must be investigated further.”

The new variant also has been detected in Los Angeles, Mono, Monterey, Orange, Riverside, San Francisco, San Bernardino, San Diego, San Luis Obispo, Humboldt and Lake counties. Because genomic sequencing is sparse, it is currently unknown how prevalent L452 is statewide, nationally or globally.

Dr. Chiu said L452R grew from about 3.8% of the samples he tested in late November 2020 through early December to more than 25.2% in late December through early January 2021...

 

 

 

Otherwise

So this strain was identified 10 months ago and been around here since May?  I'm gonna go with shades of clickbait.  That said I think we should all fully expect that like the flu this virus will mutate and reduce vaccine "effectiveness". That said effectiveness I believe is measured in terms of yes/no does it stop you from getting it.  I think like people can still get certain strains of the flu after vaccination that often the vaccine does help mitigate the severity (for example my daughter was vaccinated for flu in 2019...got it TWICE in late 19 and early 20 and neither time was of much consequence) Not to mention I am sure like flu they will continue to reformulate the vaccine to the latest and greatest strains that pose the most risk

I'm gonna withhold running around naked and screaming we are all gonna die for now.  Who is with me?

Edited January 19, 2021 by Surly Bevo

I read an article written by a virologist at the beginning of the pandemic that said Covid shouldn't mutate as wildly as the flu because of differences in their makeup.

Edited January 19, 2021 by kevwun

6 minutes ago, Surly Bevo said:

So this strain was identified 10 months ago and been around here since May?  I'm gonna go with shades of clickbait.  That said I think we should all fully expect that like the flu this virus will mutate and reduce vaccine "effectiveness". That said effectiveness I believe is measured in terms of yes/no does it stop you from getting it.  I think like people can still get certain strains of the flu after vaccination that often the vaccine does help mitigate the severity (for example my daughter was vaccinated for flu in 2019...got it TWICE in late 19 and early 20 and neither time was of much consequence) Not to mention I am sure like flu they will continue to reformulate the vaccine to the latest and greatest strains that pose the most risk

I'm gonna withhold running around naked and screaming we are all gonna die for now.  Who is with me?

Ditto.  The C19 vaccine acts like the flu vaccine is supposed to.  It triggers an immune response to the virus so that if you were to get the virus, your body's reaction to it isn't so dire that you need to be hospitalized.

People think that they can go back to normal life when they finally get the vaccine.  Sorry but it doesn't work like that.  You can still get sick, you just won't get as sick.  You still need to mask up and socially distance yourself.  You just have some body armor.

26 minutes ago, kevwun said:

I read an article written by a virologist at the beginning of the pandemic that said Covid shouldn't mutate as wildly as the flu because of differences in their makeup.

Yeah well he/she/them were wrong.

Good luck. You will be wearing a helmet with face shield for the next 10 years.

34 minutes ago, Surly Bevo said:

So this strain was identified 10 months ago and been around here since May?  I'm gonna go with shades of clickbait...

I'm gonna withhold running around naked and screaming we are all gonna die for now.  Who is with me?

I donno man, the flagellants do make a convincing case

43 minutes ago, Surly Bevo said:

So this strain was identified 10 months ago and been around here since May?  I'm gonna go with shades of clickbait.  That said I think we should all fully expect that like the flu this virus will mutate and reduce vaccine "effectiveness". That said effectiveness I believe is measured in terms of yes/no does it stop you from getting it.  I think like people can still get certain strains of the flu after vaccination that often the vaccine does help mitigate the severity (for example my daughter was vaccinated for flu in 2019...got it TWICE in late 19 and early 20 and neither time was of much consequence) Not to mention I am sure like flu they will continue to reformulate the vaccine to the latest and greatest strains that pose the most risk

I'm gonna withhold running around naked and screaming we are all gonna die for now.  Who is with me?

I think the issue is that there's no selective pressure to push for a higher prevalence of this potentially new mutated strain, which is why perhaps it hasn't increased in frequency since first identified. If it continues to increase following wide-spread vaccination, that's probably quite telling. 

For example, it wasn't initially clear what the impact of the other mutant strain which was also first identified this summer, but the fact that it was increasing in prevalence suggested at the time that this was happening for a reason, and in fact we know now there's some advantageous biology at play here with regard to much higher transmittability. 

That's the most frustrating thing for me with the vaccines - we have to knock this thing down, because the longer it gets passed around, the greater the chance we see something like a mutant spike protein which confers resistance to the vaccines at hand. I don't think we know that yet with this bugger, though. 

The top 5 states in % vaccines administered aren’t dominated by urbanized states.  It was a Houston hospital, not some rural folks, paying healthcare workers to incentivize getting the vaccine.  
 

North Dakota	68,675	52,955	77.1
West Virginia	205,475	153,692	74.8
New Mexico	204,750	137,531	67.2
Oregon	335,075	216,924	64.7
Kentucky	337,450	213,567

 

New Mexico and Oregon are both among the most urbanized states in the country.

Over half of NM lives in the three largest counties, two of which are adjacent to one another. Good chunk of the rest live in the counties immediately surrounding ABQ.

Nearly half of Oregon lives in the Portland MSA and after you throw in Salem, Eugene, and Corvallis, well over half the state lives on the I-5 corridor in the NW portion of the state.

West of I-35 is heavily, heavily urbanized in this country. Very few out living in small towns like you have to the east.

19 hours ago, gmr548 said:

Real talk, what?

Medicaid has existed since the 60’s, so the very bottom has been covered for a while. The closest thing to what you’re saying would be Medicaid expansion, but Texas has not done so, so that doesn’t apply here. Most people between the Medicaid threshold, which again in Texas is still at the base level and quite low (not that the expanded threshold is very high but that’s beside the point), and quite comfortable have not given shutting remotely close to free insurance.

There are working poor that qualify for a 100% subsidy for an ACA plan in some states.  The subsidy bleeds off at you approach a household income of around $75k.

Another idea I saw somewhere I liked was that once supply increases a bit more, start allocating to large ER depts and/or hospitals and have them administer to anyone 16+ NOT admitted for COVID that is willing to take it.  Boom.  Another distribution arm that doesn't require additional vax locations or resources.  Maybe a better idea for the 1 dose JNJ vaccine once it comes online.  Also, at the large vax sites, I would be interested to see if they are tracking no shows or day of cancellations and see if they could fill that void.  For example, If they average 50 no shows/cancellations per day with excess doses either being saved for next day (or god forbid thrown away), allow anyone 16+ to sign up for 50 "wait list" spots at end of day to make sure that days supply is used.   

24 minutes ago, gmr548 said:

New Mexico and Oregon are both among the most urbanized states in the country.

Over half of NM lives in the three largest counties, two of which are adjacent to one another. Good chunk of the rest live in the counties immediately surrounding ABQ.

Nearly half of Oregon lives in the Portland MSA and after you throw in Salem, Eugene, and Corvallis, well over half the state lives on the I-5 corridor in the NW portion of the state.

West of I-35 is heavily, heavily urbanized in this country. Very few out living in small towns like you have to the east.

So 2 of 5?  So it isn’t DOMINATED by urbanized states. It isn’t  solely the urban centers driving the high vaccine numbers, or dragging them down. It is going well in some rural areas and not others. It is going well in some urban areas and not others. 

34 minutes ago, Skipper said:

Another idea I saw somewhere I liked was that once supply increases a bit more, start allocating to large ER depts and/or hospitals and have them administer to anyone 16+ NOT admitted for COVID that is willing to take it

If you are going to do this why wouldn't you just distribute them to every pharmacy instead? Because no one wants to go to an ER or hospital.   Hell just turn this whole freaking thing over to Walmart.    There is not an institution in the US or world for that has more efficient and advanced supply and distribution system in place.  They have physical locations with parking lots, they have qualified pharmacists, they have refrigerated trucks, distribution warehouses, shit you could even convert their grocery pick up to give a shot. 

 

Edited because I was looking for this stat...90% yes 90% of Americans live within 10 miles of a Walmart. 

Edited January 19, 2021 by midtown

10 minutes ago, midtown said:

If you are going to do this why wouldn't you just distribute them to every pharmacy instead? Because no one wants to go to an ER or hospital.   Hell just turn this whole freaking thing over to Walmart.    There is not an institution in the US or world for that has more efficient and advanced supply and distribution system in place.  They have physical locations with parking lots, they have qualified pharmacists, they have refrigerated trucks, distribution warehouses, shit you could even convert their grocery pick up to give a shot. 

 

Edited because I was looking for this stat...90% yes 90% of Americans live within 10 miles of a Walmart. 

Fantastic idea. 

2 minutes ago, midtown said:

If you are going to do this why wouldn't you just distribute them to every pharmacy instead? Because no one wants to go to an ER or hospital.   Hell just turn this whole freaking thing over to Walmart.    There is not an institution in the US or world for that has more efficient and advanced supply and distribution system in place.  They have physical locations with parking lots, they have qualified pharmacists, they have refrigerated trucks, distribution warehouses, shit you could even convert their grocery pick up to give a shot. 

I'm not disagreeing that Wal Mart or others would be efficient.  But if you turned a Wal-Mart pharmacy into a vax center they would inherently need to hire employees for this sole purpose as it's a full time job, designate a special area within the store, etc..  In other words there are additional resources needed for that site just like any other designated vax site.   To be clear, I'm not saying you designate an ER or hospital as a walk-up vax site.  I'm saying you give them supply to vaccinate people that are already there for reasons other than COVID.  So a 25 year old has a broken leg, get your cast and boom here is a vaccine as well. The thought behind turning supply over to the ER or hospital dept is the only thing potentially needed is the storage space and maybe one person in charge of managing supply as it's otherwise fully staffed.  To be clear, this wasn't my idea.  I believe I saw it posted by a Dr.  They already do this regularly with flu and other vaccines.   We aren't at a point right now where this would necessarily be helpful as we need to iron out the distribution issues at the local levels and get those running at peak efficiency.  From what I've read, at least around DFW area, in short order the large centers will be running through their allocated dosage by Fri/Sat with no excess until they get the next shipment on Sunday/Monday which is how it should be.  But eventually we will have a lot of extra supply.   Turning some of that supply over to ER or hospitals (again single dose JNJ makes sense) seems like a good way to get shot in arms of all ages IN ADDITION TO designated walk up vax sites to slow the spread.

I'm not disagreeing that hospitals and ERs should have vaccines on hand.  I also expect most GPs will have them when they don't require special storage but its so much easier and efficient to have them where they are easy to get.  It's a pain in the ass to see my GP.  Appts aren't easy to come by.  Way more overhead to pay for etc.  My last flu shot at my walmart took a grand total of 10 mins including paperwork, insurance, and injection.  And if it wasn't a walk up situation with my grocery cart and I had done all the paperwork before hand it would have been 2 mins.

Walmart could probably tweak their grocery ordering software and reservation system in a day and since so many people live so close I bet they could have a pretty reliable stand by list for any no shows vs throwing those in the trash.    They could have app alerts.  Or tell the next 10 people to just park in the large parking lot or shit tell them to shop.

Edited January 19, 2021 by midtown

Just now, midtown said:

I'm not disagreeing that hospitals and ERs should have vaccines on hand.  I also expect most GPs will have them when they don't require special storage but its so much easier and efficient to have them where they are easy to get.  It's a pain in the ass to see my GP.  Appts aren't easy to come by.  Way more overhead to pay for etc.  My last flu shot at my walmart took a grand total of 10 mins including paperwork, insurance, and injection.

I think Wal-Mart is administering some vaccines currently as are CVS and others but not at large scale.  I'm not disagreeing the US Govt should have coordinated with Wal Mart or CVS, etc. and given them a lucrative contract for 100% of the initial vaccine roll out and put them in charge of figuring out the logistics 6+ months ago.  But that ship has sailed.  But ER's and hospitals are a way of knocking out patients without any need to coordinate appointment times, sign ups etc.  Again, once additional supply is available in the coming weeks.

Until we can have a 1 shot vaccine, tacking it on at the ER is not the way to go. You don’t want them showing up in 3 weeks to the ER for shot 2, and managing the follow up shot is not something to stress the ER staff with. Agree it would be a good idea once 1 shot vac is out. 

20 minutes ago, UT_OB1 said:

Until we can have a 1 shot vaccine, tacking it on at the ER is not the way to go. You don’t want them showing up in 3 weeks to the ER for shot 2, and managing the follow up shot is not something to stress the ER staff with. Agree it would be a good idea once 1 shot vac is out. 

Right.  Why I thought it could be a good use for JNJ when it comes online as it's only 1 dose.  Hoping we get good news on it in the next couple of weeks although per that article linked a few pages back production is behind schedule.

1 hour ago, Skipper said:

I think Wal-Mart is administering some vaccines currently as are CVS and others but not at large scale.  I'm not disagreeing the US Govt should have coordinated with Wal Mart or CVS, etc. and given them a lucrative contract for 100% of the initial vaccine roll out and put them in charge of figuring out the logistics 6+ months ago.  But that ship has sailed.  But ER's and hospitals are a way of knocking out patients without any need to coordinate appointment times, sign ups etc.  Again, once additional supply is available in the coming weeks.

If I had the ear of the exec commissioner of Texas HHSC, this is the advice I would have given them:

1. Get on the horn with HEB yesterday, ask them to coordinate distribution, scheduling and admin across the state. If you need another secondary state wide grocery/rx partner to cover the regions they do not, identify them and let's fucking go, but everything runs through HEB's scheduling platform. 

2. Get Texas Pharmacy Association on the phone, and ask them to coordinate admin in rural areas through their independent pharmacy members, again leveraging HEB's scheduling platform. 

3. Get Brookshire, CVS, Walgreens, and Walmart involved as admin sites spanning urban surburban and rural, integrate them into the platform.

4. Using board resources, call to action for all retired and non-clinically practicing licensees (md, rph, rn, anyone with a pulse). Outreach service industry workers to staff up logistics and shot administration. Basically a trained monkey can administer the shots. Minimal clinical personnel are necessary to monitor the 15 min wait rooms/parking lots.

5. Using the state employee plan, texas medicaid, and any other state level data sources, model 60 day post-c19 mortality to determine factors and intersection of factors associated with mortality among the <65 population.  After you clear the institutionalized and 65+, move down the list based on risk profile.

6. Most crucially, just get fucking shots in arms as soon as the supply comes in. 

Anybody seen any recent data on people who say they don't want the vaccine?  I know at one point it was 50/50 at best and then I saw something a while back that said a little in excess of 60% of people wanted the vaccine.  Now I have my questions if everybody is really being truthful when asked "hell no I don't want that vaccine" but when push comes to shove "yea sure just hit me with it here real quick and don't tell nobody" BUT assume for a moment those numbers are still somewhat valid.  That's a lot of shit to sift through as you try to put your finger on where demand is going to be by different tranches and no unifying system identifying the areas of demand and distributing capacity to meet it.    

1 hour ago, Anastasis said:

Get on the horn with HEB yesterday, ask them to coordinate distribution

Other than HEB being a Texas company they have approximately 2/3's of the stores that Walmart does.    And in most cases I assume they don't even own their brick and mortar so each leased HEB would have to get permission to use their parking lots for a mass vaccination if they wanted to.  Crap like that.  Trying to reduce red tape.  Not add to it.  And if you think about the ability to shift supply from one state to the next depending on demand.  No other company has that reach.  Not even the military.   In theory of course because none of this is going to happen.

Edited January 20, 2021 by midtown

HEB probably does own most of their brick and mortar. They are one of the largest real estate companies as well since they build and own the attached strip centers...I’m pretty sure this is correct. They may not own some of the older stores though.

9 minutes ago, Surly Bevo said:

Anybody seen any recent data on people who say they don't want the vaccine?  I know at one point it was 50/50 at best and then I saw something a while back that said a little in excess of 60% of people wanted the vaccine.  Now I have my questions if everybody is really being truthful when asked "hell no I don't want that vaccine" but when push comes to shove "yea sure just hit me with it here real quick and don't tell nobody" BUT assume for a moment those numbers are still somewhat valid.  That's a lot of shit to sift through as you try to put your finger on where demand is going to be by different tranches and no unifying system identifying the areas of demand and distributing capacity to meet it.    

as people get the vax  and don't die, end up in the hospital, or start displaying Excel spreadsheets on their stomachs, more people are going to take it.  sure some will not but I think the number is going to be pretty low.

the govt is going to make it impossible to travel without it anyway.

Then that's a change over the last 10-15 years.   San Antonio is filled with empty shopping centers where HEB was once the anchor.   Neither of the 5-6 HEBs near me are stand alones and they do not own the shopping center but mute point. 

Edited January 20, 2021 by midtown

HEB usually buys the land and builds.  Then sells it and leases back.  Frees up capital.

HEB usually buys the land and builds.  Then sells it and leases back.  Frees up capital.

I did not know this. It makes sense though.