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COVID-19 vaccine discussion

Texas Jeff

By Texas Jeff
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Anastasis

Anastasis 23463

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41 minutes ago, Nice Guy Eddie said:

I think you both are saying the same thing. The provider is going to be able to charge for administering the vaccine but either the insurer or govt will pick up the tab. I’m not sure the govt has set the amount to be paid.

my guess that the highest profit motivated organizations like the private urgent care centers will avoid having the vaccines. 

Right.  I was referring to patient out of pocket.  People need to know that they should not have to pay anything for the administration.  CMS has set the Medicare rates for reimbursement, but insurance rates are dependent on either their negotiated rates or a reasonable reimbursement for out of network, and none of the above should result in any out of pocket cost. 

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Dontshootrude
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Reading the last couple pages of this thread, I can't help but jump in here.  I'm a molecular biologist.  I'm happy to verify with the mods, just PM me so I don't dox myself.  I have not read most of

EE2B
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This was posted by an ER doc from a local hospital: I have been mostly silent on the COVID surge but I feel it’s a duty and responsibility for healthcare professionals to report what we are seeing an

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You're a fascist who wishes death and suffering upon people.  You're why genocide has happened throughout history.  I've seen your vile posts before.  You need help.  Seriously, I'll swallow my pride

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Nice Guy Eddie

Nice Guy Eddie 13509

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22 minutes ago, InkaUtexas said:

Special IRS deduction for each member of your household? 

Maybe. Unfortunately I think that wouldn't get the money in people's pocket until April 2021 if not 2022.  I like the idea of giving people a financial incentive but honesty I don't know the best way to achieve it unless there is a clear method of tracking each person that gets the vaccine. And Americans don't like being tracked.

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Pato del Muerto

Pato del Muerto 52485

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8 minutes ago, Nice Guy Eddie said:

Maybe. Unfortunately I think that wouldn't get the money in people's pocket until April 2021 if not 2022.  I like the idea of giving people a financial incentive but honesty I don't know the best way to achieve it unless there is a clear method of tracking each person that gets the vaccine. And Americans don't like being tracked.

Won’t the rfid in the vaccine take care of that?

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Nice Guy Eddie

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We don't have other options but it's unfortunate that we don't fully understand the effectiveness of the vaccines so far. Time will tell but it seems to me that we only know how well the vaccines keep someone from developing covid symptoms. Are for actually preventing you from getting COVID, I don't think we know yet. 

I think most of the public think these vaccines will protect them from getting COVID. 

Edited by Nice Guy Eddie
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Patron

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21 hours ago, Texas Jeff said:

The Travis County Medical Society and Dell Medical School hosted a town hall on vaccines featuring local leaders Mark Escott and Stephanie Hayden.  It's about 30 minutes of powerpoint followed by 30 minutes of Q&A.  Some takeaways:

  • They are developing a points based ranking system to determine priority for the vaccine -- it is still under development.  They didn't specify if this was countywide, statewide, or nationwide.
  • The vaccine will be free, but providers may charge an admin fee similar to an office visit to cover their costs.  The amount might be set by the provider, still TBD.
  • The AstraZeneca vaccine is cheaper than the mRNA vaccines (like $4 a dose vs $20 a dose) and may be available in higher quantities worldwide.
  • Guidance for those under 18 and those who are pregnant/lactating is not complete.  Maybe adults get vax but kids do not?
  • I would not expect large vaccination centers.   The state is enrolling existing providers (pharmacies, hospitals, etc) instead.

 

    So we're asking millions of people who have been holed up in their homes to go into confines where the mother of all super spreader potential awaits, to get vaccinated.?

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Pato del Muerto

Pato del Muerto 52485

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2 hours ago, Nice Guy Eddie said:

We don't have other options but it's unfortunate that we don't fully understand the effectiveness of the vaccines so far. Time will tell but it seems to me that we only know how well the vaccines keep someone from developing covid symptoms. Are for actually preventing you from getting COVID, I don't think we know yet. 

I think most of the public think these vaccines will protect them from getting COVID. 

Hopefully the tier 1 will provide that data before too many down the line are inoculated, so that the proper guidance can be provided concurrently. 

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Texas Jeff

Texas Jeff 1945

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5 hours ago, Patron said:

    So we're asking millions of people who have been holed up in their homes to go into confines where the mother of all super spreader potential awaits, to get vaccinated.?

From the talk I watched, most places will be pharmacies or hospitals.  Maybe you will make an appointment online, then go in for your first shot, then get a reminder when it is time to go back for your second shot.  You are likely to only be exposed to a few people at the pharmacy.  CVS has described this as a likely process.

Booking these online appointments might be the 2021 version of searching for toilet paper last spring.  Maybe there will be a process for determining if you "qualify" for a shot ... maybe there will be enforcement of the priority groups or maybe it will be on the honor system.  Who knows?  It would be nice to sort these things out.

Our leaders should ensure that no doses are wasted because shots were available but no one was there to get it and the vaccine spoiled.

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Texas Jeff

Texas Jeff 1945

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On 12/5/2020 at 9:12 PM, Anastasis said:

I am not sure this is totally accurate. Insured and Medicare members have no out of pocket and there is a fund for uninsured. I don’t think anyone is suppose to have to pay for the admin and balance billing is specifically prohibited. There may be some narrow gap, the they vast majority of Americans if not all should have no out of pocket. Admin costs are covered by either the insurer, CMS or the Medicaid program. 

Yes, I think you are correct ... insurance or some other program is likely to cover the admin fee in many cases.  Stephanie Hayden was asked a question like "Is the vaccine free and who is going to pay for giving the injection?" and she answered something like "the vaccine is free but the provider can charge an admin fee".  She didn't go into who ultimately would pay that fee.  Sorry if I mislead anyone...

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BradInATX

BradInATX 9208

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From what I'm hearing some of the hospitals are recruiting internally to create little vax teams. So a lot of healthcare providers are going to do it all in-house. Pretty cool and it takes some stress and effort off of the plate of the healthcare folks. I'd assume that the old folks' homes will either do it internally or utilize mobile vax providers to do the whole place at once. So distribution should be largely taken care of for the first couple of stages. It's the big public rollout after that sometime in 2021 where drive-throughs and Walgreens/CVS are going to come into play in a major way.

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InkaUtexas

InkaUtexas 25862

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13 hours ago, Patron said:

In my opinion the safest way to administer the vacs would be drive thru set-ups. I know Arizona and a few more states are planning big drive thru events to vaccinate large number of populations. 

Germans already ahead of the planning. Efficient bastards.

Hundreds of vaccination centers will be created across Germany to administer the new coronavirus vaccine, according to a media report. The distribution of millions of doses is likely to present a huge challenge.

https://www.dw.com/en/germany-to-set-up-hundreds-of-vaccination-centers-from-december-report/a-55605652

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Anastasis

Anastasis 23463

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13 hours ago, Patron said:

In my opinion the safest way to administer the vacs would be drive thru set-ups. I know Arizona and a few more states are planning big drive thru events to vaccinate large number of populations. 

We did our flu shots in a drive through at the local hospital this year.  Very easy, very covid friendly. 

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Armybrat

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13 hours ago, Texas Jeff said:

From the talk I watched, most places will be pharmacies or hospitals.  Maybe you will make an appointment online, then go in for your first shot, then get a reminder when it is time to go back for your second shot.  You are likely to only be exposed to a few people at the pharmacy.  CVS has described this as a likely process.

Booking these online appointments might be the 2021 version of searching for toilet paper last spring.  Maybe there will be a process for determining if you "qualify" for a shot ... maybe there will be enforcement of the priority groups or maybe it will be on the honor system.  Who knows?  It would be nice to sort these things out.

Our leaders should ensure that no doses are wasted because shots were available but no one was there to get it and the vaccine spoiled.

Maybe Patron would prefer to get his shot from a white van in an alley behind 6th Street?

Our CVS lets the patient in a side door to get the Covid testing without having to walk through the store. Same can be done for the vaccine... or maybe stick your arm through the drive in window.

We will probably get ours from our primary care doc’s office.

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gyroprotagonist

gyroprotagonist 2592

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1 hour ago, Armybrat said:

Maybe Patron would prefer to get his shot from a white van in an alley behind 6th Street?

Our CVS lets the patient in a side door to get the Covid testing without having to walk through the store. Same can be done for the vaccine... or maybe stick your arm through the drive in window.

We will probably get ours from our primary care doc’s office.

dvJPoa5.gif

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Bevo

Bevo 13566

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On 12/5/2020 at 7:41 AM, Heme Doc said:

I think it becomes endemic.  But let’s at least get shit under control before we talk about eradication.  

I think protective immunity will last at least a year.  Antibody levels may decline to a point where you are susceptible and need a booster.  But even if your antibodies wane and you get it, your disease will likely be mild or asymptomatic because your body already knows how to mount an immune response against it (thanks memory B cells and T cells!) so you’ll ramp up antibody production very quickly before it can cause as much trouble

My hospital (2nd largest in large Texas city) says they will have vaccine Dec 14 and be off to the races.  

I heard some not so great news so I hope your information is more accurate. My GP's office is pretty large and has a good sized lab with Quest on the premises. I asked to speak with a PA today and the PA told me that they haven't been told the exact date that they will be receiving the vaccine and no one has been trained on it and they don't have any sort of a list on who to give the vaccine. And the PA had no clue when she was going to be able to get the vaccine herself. So, based on that, at least at their facility, there is no way that they will be able to administer it in a week.

Then I called my dad (I was still commuting home) and told him the story and he was told by the Chief of CV Med at UT that they wouldn't be administering it to MDs until mid-January. I asked him about Methodist and St. Luke's and he said that he hadn't spoken to anyone there. I assume you are at MD Anderson. Are y'all really getting it on the 14th? Just curious what you are hearing and when you can get vaccinated.

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Bevo

Bevo 13566

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10 minutes ago, Anastasis said:

 it's more than a guess at this point. 

Man, the CDC has been pretty bad at their job this year. I did a few grants with the director of infectious disease at the CDC 20 years ago, and I was pretty impressed with their capabilities. I guess things have changed.

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Nice Guy Eddie

Nice Guy Eddie 13509

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On 12/6/2020 at 11:34 PM, Patron said:

In my opinion the safest way to administer the vacs would be drive thru set-ups. I know Arizona and a few more states are planning big drive thru events to vaccinate large number of populations. 

 

20 hours ago, Anastasis said:

We did our flu shots in a drive through at the local hospital this year.  Very easy, very covid friendly. 

The challenging administrative part of these vaccines will be the second shot. The patient needs to be verified when and which vaccine they had in the first round. I gather that if you get a first shot, there is some level of a guarantee the second shot will be reserved for you, for at least a certain period of time.

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Anastasis

Anastasis 23463

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8 minutes ago, Nice Guy Eddie said:

The challenging administrative part of these vaccines will be the second shot. The patient needs to be verified when and which vaccine they had in the first round. I gather that if you get a first shot, there is some level of a guarantee the second shot will be reserved for you, for at least a certain period of time.

Agree. 

@PsychMike posted the FDA briefing materials for the AdComm in the other thread, but thought I would drop it here too...

https://www.fda.gov/media/144245/download

 

This is one table that jumped out at me.  Case counts are very small, so cannot make any definitive conclusions, but it appears to suggest a protective effect against severe disease after first dose. 

Screenshot-2020-12-08-092620.jpg

 

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Heme Doc

Heme Doc 417

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On 12/7/2020 at 5:32 PM, Bevo said:

I heard some not so great news so I hope your information is more accurate. My GP's office is pretty large and has a good sized lab with Quest on the premises. I asked to speak with a PA today and the PA told me that they haven't been told the exact date that they will be receiving the vaccine and no one has been trained on it and they don't have any sort of a list on who to give the vaccine. And the PA had no clue when she was going to be able to get the vaccine herself. So, based on that, at least at their facility, there is no way that they will be able to administer it in a week.

Then I called my dad (I was still commuting home) and told him the story and he was told by the Chief of CV Med at UT that they wouldn't be administering it to MDs until mid-January. I asked him about Methodist and St. Luke's and he said that he hadn't spoken to anyone there. I assume you are at MD Anderson. Are y'all really getting it on the 14th? Just curious what you are hearing and when you can get vaccinated.

I think initial doses will go to larger hospital systems and will be available next week.  I’m not at MDA, but I know they’re getting doses.  I think next week hospital employees taking care of COVID patients will start getting vaccinated.

Here’s a link to the Texas plan (not sure if already posted)

https://www.dshs.texas.gov/news/updates.shtm#Vaccine

And a link to week 1 vaccine allocation numbers

https://www.dshs.texas.gov/news/updates/COVIDVaccineAllocation-Week1.pdf
 

It’s not clear when exactly outpatient offices will begin getting doses, but I’d guess later in December or January at latest.  
 

I guess the Chief of CV med was uninformed.  

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Bevo

Bevo 13566

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8 hours ago, Heme Doc said:

I guess the Chief of CV med was uninformed.  

Or my dad is getting old - You got me thinking and it is quite possible that he was referring to a conversation a month ago instead of a recent conversation. Who knows? I'll defer to the DSHS. That link you provided though says "as early as the week of Dec. 14, depending on when the vaccine is authorized for use in the United States". So, not only could it be the end of the week, it could also be later. And any later than the 21st and you start running into the holidays. We will see. I am traveling on the 23rd and would love to get the first dose at least a week before traveling.

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TwiceHorn

TwiceHorn 31438

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So, I see NHS is warning off people from the Pfizer vax with "significant histories of allergies,"  Apparently a couple of cases of anaphylaxis with epipen types.

I've never been an epipen carrier, but I am allergic to everything airborne and can get sick af when stung, although it's been 30 years.

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Bevo

Bevo 13566

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13 minutes ago, TwiceHorn said:

So, I see NHS is warning off people from the Pfizer vax with "significant histories of allergies,"  Apparently a couple of cases of anaphylaxis with epipen types.

I've never been an epipen carrier, but I am allergic to everything airborne and can get sick af when stung, although it's been 30 years.

That doesn't make much sense. The Pfizer vaccine is naked mRNA. Moderna is the one that is using lipids and other carriers. Obviously, it is true. I just don't get it. Anyway, I'm in the same boat as you and I'm not too worried. Does it say if the cases were immediately after injection? Just curious whether it is due to the injection or when the body starts producing the spike protein.

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TwiceHorn

TwiceHorn 31438

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19 minutes ago, Bevo said:

That doesn't make much sense. The Pfizer vaccine is naked mRNA. Moderna is the one that is using lipids and other carriers. Obviously, it is true. I just don't get it. Anyway, I'm in the same boat as you and I'm not too worried. Does it say if the cases were immediately after injection? Just curious whether it is due to the injection or when the body starts producing the spike protein.

https://www.theguardian.com/world/2020/dec/09/pfizer-covid-vaccine-nhs-extreme-allergy-sufferers-regulators-reaction

Story is at several outlets, I picked Guardian as "closer to the source."

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Txzen

Txzen 498

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2 hours ago, Bevo said:

That doesn't make much sense. The Pfizer vaccine is naked mRNA. Moderna is the one that is using lipids and other carriers. Obviously, it is true. I just don't get it. Anyway, I'm in the same boat as you and I'm not too worried. Does it say if the cases were immediately after injection? Just curious whether it is due to the injection or when the body starts producing the spike protein.

Naked mRNA is a hell of an immune stimulant. 

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Bevo

Bevo 13566

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26 minutes ago, Txzen said:

Naked mRNA is a hell of an immune stimulant. 

The mRNA itself or the protein it translates? If it is the mRNA itself then I wonder if the transfection agents (ie Moderna approach) help or hurt as far as immune reactions. It would help hide the mRNA from the immune system but there would be a chance for immune reactions against the agents.

Edited by Bevo
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