I wanted to commend this article at STAT by Helen Branswell to your attention. It reviews the process of rolling out inoculations for COVID-19:
Vaccines that prevent symptomatic Covid infection in roughly 95% of people vaccinated — as the data from clinical trials of the Pfizer-BioNTech and Moderna vaccines suggest — should, over time, help the country and the world return to a life where we can travel without quarantining; where sporting events can be played before live audiences, not cardboard cutouts; and where snowstorms are the only reasons school gets canceled.
But if we’re not careful, we could fail to take full advantage of the opportunity scientists and governments, pharmaceutical companies and philanthropic foundations have created for us.
And there’s a possibility that the pandemic off-ramp doesn’t merge with a straight road back to Normalville, but instead becomes a meandering country lane with the occasional detour. We may need to choose the right turns and avoid the potholes as we make our way to our destination. It will require patience.
It goes on to describe some of those potholes including speedy “roll-out”, acceptance, strategization, vaccinating the pregnant, vaccinating children. This passage, for example, is pretty interesting:
A recent survey of 2,000 doctors and nurses in New Jersey found that 60% of doctors planned to take a Covid vaccine, but only 40% of nurses intended to, Health Commissioner Judith Persichilli said in a recent “60 Minutes†segment about Operation Warp Speed.
That jibes with the experience during the 2009 H1N1 flu pandemic, when many health workers eschewed the new flu vaccine when it became available.
That’s interesting since studies have shown that front-line health care workers have experienced a higher incidence of COVID-19 than the general public. That would seem to suggest that the most important mitigation strategy might well be avoidance, i.e. those who intrinsically can’t avoid are at higher risk regardless of other mitigations.
My takeway from this article is that even with an efficient roll-out of a safe and effective vaccine returning to normal may take a lot longer than many people seem to think. Certainly not weeks. Possibly months but just as possibly years.
IMO it’s vitally important that we know whether the vaccine prevents transmission as well as symptomatic COVID-19 if we are to strategize those who will be the first to be inoculated appropriately.
Had a big Zoom meeting with my staff to talk about, among other things, vaccination. A couple of spouses joined since they are PhD pharmacy people who have been working on this for several months. The studies were not big enough to catch some of the unusual stuff. While M-RNA has theoretical advantages we dont know about the manufacturing process and how that will hold up. As you note we dont know if it is sterilizing. For most of my people their big concern is taking this home. So it needs to be an individualized decision based upon each individual’s risks.
It was interesting that the PhD pharmacist in charge of the vaccine for a network says he is going to wait a bit. He said he and his wife are both still pretty young and they have no kids ro no older family in the area. For my part since I am old and the wife is older I will probably go with it. I am taking care fo quite a few COvid pts and am going to just hope that it is sterilizing.
On nurses I would note that quite a few are pretty angry. They think, sometimes with justification, that hospital administrators have not prioritized their safety and are suspicious of the vaccine.
Steve
When you reach a certain age long range side effects just aren’t that frightening to you any more. 😉
Initially, demand will completely outstrip supply so those who are iffy about vaccinations are pretty irrelevant.
Illinois has identified eight hospitals that will make the initial distribution to front line workers, which includes one locally, but not my wife’s employer. But allocation will go to counties with high death rates per capita.
So no local healthcare workers will get “first shot” at the vaccine even though their service area includes rural counties with high rates, who send their difficult cases to regional medical facilities. Makes no sense, probably see a correction coming. But the initial distribution here isn’t going to cover very many front line healthcare workers that want the vaccine.
I guess it depends on whether the vaccine is “sterilizing” as the jargon puts it and whether authorities are actually serious about prioritizing front-line health care workers which makes a certain amount of sense, assuming it’s safe and as effective as they say. If it’s first come first served, you’re right but if the priorities have been as they’ve said, if the U. S. is limited in the number of doses it receives in the first few months, and if fron-line health care workers are as hesitant as is being said, it could create a serious bottleneck.
This is the time line for vaccinations from This Week in Virology podcast, which I understood to be a somewhat blended, overlapping first phase:
1A December: healthcare workers and long-term care residents
1B January: workers in education, food & agriculture, police & fire departments, corrections and transportation
1C Late January/ early February: 65 and older
March: start wider population over 18
Given the information at hand, giving priority to inoculating workers in K-8 education makes little sense—based on what we know at this point they’re at no greater risk than the general population.
There are about 18 million health care workers in the U. S. Assuming the figures that have been published are accurate and the U. S. doesn’t receive the entire inventory of vaccine presently available, they’ll allocate the entire inventory to health care workers for the first few months.
Some other population figures (approximate):
Police officers: 750,000
Firefighters: 1.1 million
Corrections officers: 400,000
K-12 teachers: 3.7 million
In our network people who do face to face with pts will get priority. I would prioritize EMS, police, transportation workers over billing people who just happen to work for a hospital. I know the people making decisions for us but not sure who is making decisions at the state level.
Steve
Be assured that being easy to administer will weigh in the decision-making.
It’s time to stop producing so many drugs we don’t need and to force companies to convert and produce vaccines instead. Viagra can take a back seat for a while.
U. S. military:
1.3 Million active, 800,000 reserve.
Can Moderna or Pfizer prioritize parties interested in bidding for vaccine,
I’m thinking NFL, NBA, Disney theme park employees, cruise lines, etc.
At least in Illinois it looks like local public health departments will ultimately prioritize who gets the vaccine based upon federal guidance (which looks flexible) and how much the state distributes to each county (or city, I assume Chicago has its own independent public health department). A location with a meat packing plant may make different choices than one with significant public transportation systems.