I Tried to Get a ‘Leftover Dose’ of the Vaccine Last Night

https://www.thecut.com/2021/01/i-tried-to-get-a-leftover-dose-of-the-vaccine-last-night.html

by fortran77 • 6 years ago

77 147 6 years ago

You can tell what kind of pressures the local distribution systems (or lack of) are under, but the missteps are still shameful.

You have people over 75 years old who were waiting and registering on whatever reservation system was cobbled together on short notice, and then because the public health authorities now risked throwing out doses for want of people to inject them into, they just opened the floodgates to everyone over 65.

So what happens to the people over 75 who were waiting, and now are swamped by the crowds? If they keep on opening up bulk tranches of the population (instead of in small slices) before people of priority are reached, when will the most vulnerable ever get their turn?

This is a known problem. Multiple queues of priority and people on call to be given turns the next day if it looks like there's capacity.

Instead you have people wondering if they should walk in, visit a county next door, or wait around in case some mistake is made and there are actually extra doses at the end of a day. Or try to scheme/figure out the system however they can, out of desperation.

If it can't be done right, let everyone know that it's up to their willingness to wait wherever they can, according to some basic ground rules, and don't make a meaningless (or worse, deceptive) reservations system that gets bypassed at the last minute.

What a shameful clusterfuck.

ghaff6• 6 years ago

I'd be less concerned about people over 65 "sneaking in" over people more than 75 than systems that end up being a free for all anyone to get vaccinations because they're in the right place at the right time (and presumably getting second vaccinations as well).

A lot is really about overall volume. Even a million vaccinations a day means you're looking at well into the summer until you even approach 50% vaccinated.

votepaunchy3• 6 years ago

There are 260 million American adults. Already 12 million receiving a vaccine. Approaching 1,000,000 per day receiving first dose. At that rate we’ll need 118 days to have half the population vaccinated with a first dose in mid-May and the second dose in early/mid-June.

xwdv• 6 years ago

It’s a Byzantine Generals problem.

reissbaker2• 6 years ago

Opening vaccine eligibility up, and allowing walk-ins if doses will expire, is part of how Israel was so successful at distribution. Multiple priority queues are nice in computer science, but managing them with time-sensitive vaccine doses is hard. Simple, imperfect and fast is better than perfect, complicated, and slow.

Getting a large swath of people vaccinated is more valuable than perfectly getting prioritization right. Prior to this change, NY was attempting to perfect prioritization, and was discarding many doses as they expired.

FalconSensei• 6 years ago

and allowing walk-ins if doses will expire

Exactly. Any person getting a dose is better than vaccine expiring

babesh2• 6 years ago

This reminds me of how the Israeli military supposedly works. Top level goals and being flexible and creative at the operational level.

See https://www.jstor.org/stable/4531385?seq=1

In my opinion, the US’s top level goals were wrong (over focus on equity versus utility) and the US bureaucracy is neither flexible nor creative as evidenced by its refusal to buck top level orders and it’s continuing slowness. These are signs of a decaying system.

mola• 6 years ago

Well, at the begining it caused a lot of mess. And then it was much more controlled. I wouldn't say this is what help us in the efficient distribution.

What really helped is a very centralized healthcare system with a very long history of managing public emergencies.

This is because Israel was founded as a socialist welfare state, and the impressive healthcare system is one of the leftovers.

r00fus• 6 years ago

What is the current system is designed to let those who are connected get in first? Could the answer to “why does it suck” simply be corruption?

maxerickson9• 6 years ago

Also, they paid a lot to have early access to a lot of vaccine.

Michigan (my state) is doing about 35,000 doses on weekdays at this point, which is frustratingly slow. But if they had spun up twice as fast, we wouldn't be doing 70,000 doses a day, we'd be out of vaccine.

The most recent shipments have been ~120,000 vaccines/week for 2 weeks and then none for a third week. So if the tempo of Federal allotments is 120,000 a week, the 35,000 a day is not a bottleneck. They should of course be building capacity anyway, with the idea that deliveries will increase (and making a plan for what to do if/when the adenovirus vaccines are approved in the US; fortunately it looks like that can be "send it everywhere").

Anyway, wasting vaccines is obviously stupid, I'm not trying to argue about that.

disabled2• 6 years ago

Make sure to take a screenshot of whatever confirmation you get. Because servers are overloaded, some people in my area did not get confirmation texts or emails.

If somebody is elderly, the chances of them getting an appointment is extremely low without the help (and extreme vigilance) of their tech savvy children/nieces/nephews.

Some states have also opened up their registrations to people 16+ with serious chronic health conditions that put them at high risk of severe COVID-19. In a handful of these states, many of these people have received a vaccine. But, it is first come first serve, which is an absolute disaster along with being inequitable.

ampdepolymerase2• 6 years ago

Why are healthcare servers still getting overloaded when HIPAA compliant "infinitely scalable for a price" cloud systems like AWS exist.

thebigman4334• 6 years ago

The missteps suck, but I really dont think it is on the local health departments very much. The federal government shouldve really been taking a lot of the load themselves. My local health department has a dozen workers and has had to handle the pandemic basically on their own the whole way through. The outbreak was so bad in October/November that they literally couldnt finish counting all the cases in a day multiple times. Now, in addition to trying to handle the outbreak, theyre also being tasked with distributing a vaccine in record times. And through all this, theyve been underpaid and harassed by a significant portion of the population

mikem1706• 6 years ago

What about your state? They are the ones who are supposed to handle stuff like this.

To me it is a cop-out to blame the feds. There is nothing to stop any state in our union from addressing this pandemic as they see fit. The states making up the Euro aren't blaming Brussels for their problems.

The converse would be to have one world government make decisions for everybody, right? That would work if we all agreed on everything, but we don't. So it is good to have different states try different solutions, and copy what works. Better then having a bad federal solution imposed on everyone.

Mediterraneo102• 6 years ago

The point of the vaccine is to keep the health system from being overloaded. Over 75s are already being triaged out of intensive care in many countries, so it matters little on a society-wide scale whether they get the vaccine or not. In fact, somewhere in the news today I read an official claiming that it is 60-75 year old people who are the most important vaccination target to begin lifting lockdowns.

maxerickson9• 6 years ago

The point of the vaccine is to end the pandemic. An early benefit of the vaccine is reduced load on the health system.

wussboy• 6 years ago

I mean, it’s not like we knew this was coming or had any time to prepare for it...

hprotagonist• 6 years ago

I’d done exactly the same, even against the particular absurdity that tightly controlled vaccine doses could be found by word-of-mouth and the general New York knowledge that, no matter how early you think you are, there will always be masses of your neighbors that beat you to the punch.

Though the circumstances of the rush gave it an apocalyptic flavor, there didn’t seem to be any real human descent into chaos. No fistfights or shouting matches about who was in line, no storming of the gates. Just a lot of cold people, all desperate enough to chase down a lead so unlikely it could have been — and actually was — real.

That’s the spirit of my city alright. The “general new york knowledge” line strikes very true.

tialaramex5• 6 years ago

The UK is experimenting with 24 hour clinics which presumably avoids the "left over" phenomenon. If you're never shutting for the day any doses you have right now are for the next patients, if you're vaccinating patients more quickly than anticipated you can bring forward some appointments but you never have this hard cut off.

After all, under total lockdown it's not as though you're likely to be anywhere except at home waiting to get an appointment.

An interesting contrast will be New Zealand. Since they have community elimination they didn't seek emergency use authorisation, why not wait and study what happens to the millions of people from other developed countries who needed urgent vaccination? They will do mass population vaccination during 2021 but this month or next doesn't mean thousands or even handfuls of deaths, so there is no hurry.

This might reduce take up. If you live in New York you probably at least know somebody who got badly sick, maybe died - but if you live in Wellington you likely have stopped even thinking about the pandemic most days unless you work in quarantine or the tourist industry.

deadlyllama• 6 years ago

In Wellington (I live there) there's a QR code on every shop you're supposed to scan with your phone for contact tracing. Most people don't but they still see them - so yes it's still on our minds.

tialaramex5• 6 years ago

Good point.

There are supposed to be QR codes here. I only visit one place, to buy food every 7-9 days, they don't have a QR code and employees seemed confused about what one was or why I might be surprised not to see one. I gave up rather than expend any more time trying to have a conversation through masks with confused people about something they can't fix.

They did, I noticed when I last visited yesterday, begin explicitly telling people that "One adult shopper" does not mean, "What a fun outing, let's all go to the store as a family and increases everyone's exposure for no reason".

solveit2• 6 years ago

That's insane. Here in Korea you're required to scan the code (or write your contact info on paper) in order to enter the premises.

lostlogin• 6 years ago

Most people don't but they still see them - so yes it's still on our minds.

It was striking to me how few masks and how little QR scanning was going on in Wellington when I went there from Auckland.

Auckland has slipped a lot, but it seemed way slacker in Wellington.

sellyme• 6 years ago

This might reduce take up. [...] if you live in Wellington you likely have stopped even thinking about the pandemic most days

It would certainly reduce the urgency of take-up, but I would expect there to be a pretty strong correlation between how well a city/country deals with the pandemic, and the proportion of residents in that region who think that getting the vaccine is important, even if it's a vaccine for a virus that's not directly affecting them right at this moment.

I live in a region that eradicated the virus a long time ago, but I still think about it almost every day because the world's so interconnected. It has had almost zero effect on my personal life since March, but the vast majority of my friends overseas are in unending lockdown cycles, and international news is almost exclusively about the latest death tolls or what the vaccine progress is like. It would be pretty difficult to not know what's going on.

flukus• 6 years ago

An interesting contrast will be New Zealand. Since they have community elimination they didn't seek emergency use authorisation, why not wait and study what happens to the millions of people from other developed countries who needed urgent vaccination?

Keeping it out is proving to be quite hard, an exception for quarantine workers, flight crew, returning citizens and anyone connected to them would make it much easier.

It seems like the world is already learning though and countries that have eliminated the virus may find vaccinating the extremely frail to be a net negative and rely on herd immunity to protect this group.

chrismcb• 6 years ago

If we only vaccinated every one over 65 then we can basically go to normal, while the rest get vaccinated. That would prevent something like 80% of the deaths and hospitalizations. Some people would do get it but we would have more resources to handle it.

Tokkemon2• 6 years ago

Don't forget about the folks with comorbidities though. So much of society is obese so they are all at risk.

fortran772• 6 years ago

This is true, of course, but how fair is it to be able to eat your way to the front of the line?

They should do nursing homes and health workers first, then open it up to all. If they're afraid of crowds, divide up days by birth month, etc.

ryandrake2• 6 years ago

I think the idea that once a few at-risk populations get vaccinated we can “go back to normal” is pretty naive. You still get it mildly and can spread it once vaccinated. People outside at-risk groups who aren’t vaccinated yet can die. We don’t know how long the vaccine is good for—maybe we have to get it once a year like the flu, who knows? I’m a gambler and I’d bet we’ll be wearing masks for years, and possibly forever, depending on how the thing mutates and behaves.

My parents think they are gonna get jabbed then it’s off to happy hour, and that just seems incredibly simplistic.

ls6122• 6 years ago

Jesus man, I sure hope there aren’t many people like you who want to keep living like this forever.

slaymaker1907• 6 years ago

How many micromorts do we need to be at for it to be acceptable? If you can't name a probability of death that is acceptable then your opinion is worthless (don't worry, lots of people seem to be in this camp). We accept risks for far dumber stuff every day. Maybe its 1 micromort or 100, but there must be some point at which making everyone wear a mask is more trouble than it is worth.

ghaff6• 6 years ago

It's also naive to think that, once a vaccination program has been in full swing for four or five months in the US (which is still only going to hit ~50% of the population unless it can be ramped to substantially above one million doses a day), when the warmer weather hits, most people aren't going to be going to the beach, restaurants, flying, etc.

sillysaurusx• 6 years ago

I'm interested in evidence that the vaccine works. Where should I start?

(I know how this sounds, but it's not like that. It's more like, it's a modern miracle that we have any vaccine at all within a year of an outbreak, and I am extremely keen to understand how this is possible rather than just accepting it as a thing that exists now, like airplanes.)

EDIT: No complaints, but it's fascinating how polarizing this topic is. One wouldn't expect a straightforward request for information to generate such feelings. Thank you to everyone who provided resources!

Uehreka• 6 years ago

I’m not an expert, so heaping tablespoon of salt and all that, but it seems like we were on the cusp of a revolution in vaccine development due to this mRNA method of making vaccines, and Covid came around at just the right time where a big infusion of cash into mRNA vaccine research could get the technology over the hump.

Again, totally not an expert at all, but from what I’ve gleaned this whole novel mRNA thing is key to understanding why this was so fast and why other vaccines in the future could come really fast as well.

mindcrime• 6 years ago

This jibes with my understanding as well. I believe that research into mRNA vaccines began somewhere around the very early 1990's or very late 1980's, so the idea itself is not new. And vaccines (or candidate vaccines) were developed for earlier illnesses like MERS, but none ever made it as far as approval for widespread human use, for various reasons. Mostly, AIUI, because the outbreaks ended before they got that far and so it was no longer economically justifiable to continue the process.

So yeah, basically, COVID came along and suddenly there was money and impetus to push the thing over the finish line, and so here we are. That's my lay-person's understanding anyway.

asiando• 6 years ago

If there wasn’t evidence, they wouldn’t approve it. Just find the vaccines’ homepage and follow the footnotes.

nextlevelwizard2• 6 years ago

You can see why some people might think the vaccine is somehow fake since people went (and are still going) ape shit over masks even though right on all of the boxes it clearly states that masks do not protect against Covid.

And before I get lynched: I am all for the vaccine since that has been tested to work and I still wear a silly mask even as it does nothing since I'm tired of people complaining.

wl• 6 years ago

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

They had a placebo arm and a vaccine arm. Look at figure 2 on page 30. You can see that new COVID cases in the vaccine group virtually stop on day 12 while the placebo arm continues to grow.

andi9994• 6 years ago

This is the right answer. This is the only reason that we know that it works. The other answers are more like the history of this vaccine (which are really interesting though)

divbzero2• 6 years ago

Figure 6 on page 50 of this FDA document [1] provides similar data for the Moderna vaccine.

[1] https://www.fda.gov/media/144452/download

thebigman4334• 6 years ago

If you dont want to go to the Pfizer/Moderna/etc papers, go to your local county health department website and they will probably have links.

oostevo• 6 years ago

I’m not sure where you’re starting from, but this seems like a reasonable progression to start with:

(1) A video about how the immune system works: https://youtu.be/fSEFXl2XQpc

(2) An infographic from FDA explaining the EUA process: https://www.fda.gov/media/143890/download

(3) Reports from the Advisory Committee on Immunization describing evidence of effectiveness for the various vaccines. For example, Moderna’s: https://www.cdc.gov/mmwr/volumes/69/wr/mm695152e1.htm

(Important caveats: I have family and friends who work in healthcare and drug discovery, so I’ve got a tiny bit of layperson background on this, but this is far from my field and I’m far from an expert)

bobbylarrybobby• 6 years ago

You can read up on the background here: https://en.wikipedia.org/wiki/COVID-19_vaccine#Background but the tl;dr is that we were very lucky to be hit with the less serious SARS and MERS diseases years ago, as they got the world started on coronavirus vaccines that ultimately were turned into the covid vaccine.

sshumaker• 6 years ago

There’s a great interview of Fauci explaining exactly how we got it done so fast. But basically - years of precursor work had been done on both other coronaviruses and mRNA vaccines. So they were in phase 1 trials in 6 weeks.

https://podcasts.apple.com/us/podcast/in-the-bubble-with-and...

CuriousCosmic• 6 years ago

This article goes into how and why the vaccine works by reverse engineering the vaccine RNA itself:

https://berthub.eu/articles/posts/reverse-engineering-source...

maxerickson9• 6 years ago

You are not that keen to figure it out, the information has been readily available for a couple of months, and it was headline news for a week when the info for each approved vaccine was released.

scotty795• 6 years ago

Part of the backlash against your question might be that this information is very easy to find, like LMGTFY easy.

specialist• 6 years ago

Upvoted. I have same noob questions. Appreciate the many good replies. I'll get my shot(s) asap. Am also trying to persuade family members who are more reluctant.

steveBK1232• 6 years ago

Live in NY and have been tracking the slow jab rate with disappointment to now find we are running up against inventory&deliveries now. Though our daily jabs have gone from appallingly low to only embarrassingly low, we are actually going to go backwards now that it turns out the “strategic reserve” Trump promised to release last week is a phantom.

Being under-40 with no kids or seniors in my home, easily working from home, I expect to get vax sometime this summer. This is fine, I’m happy to let seniors, medical and frontline workers get it first. This of course includes teachers so they can open schools for good come August.

Glad to see it’s been opened to most of these prioritized people now, and it is intelligent to have a mix of appointments & walk-ins to take out the excess inventory daily.

That said, the whole distribution is a shitshow. And this started even before it moved beyond initial phase of medical workers getting it at work from their employers. I know a lot of non-patient facing people in medical or medical-adjacent jobs who got it well before most nurses, EMTs, etc got it. It seems if you are in management or have a PHD you could jump all the way to the front.. of course.

RspecMAuthortah• 6 years ago

I don't live in NY so I am curious. NY is one of the worst hit states in the country and had 8 months to prepare for this. What do you think went wrong?

Is it local/state officials' colossal incompetence, something that they are quite known for? For a state with one of the highest tax rates, you would expect better from them.

Tokkemon2• 6 years ago

The constant infighting between de Blasio and Cuomo certainly isn't helping things. Cuomo has a very "my way or the highway" style of management but then doesn't release details fast enough for there to be an effective ground game, so individual institutions or counties are stuck to do their own planning.

At least there's a somewhat-coherent PR response, but that doesn't help get jabs in arms.

steveBK1232• 6 years ago

I think you have 2 factors. Governor Cuomo & Mayor DeBlasio hate each other. BdB is all rhetoric and mildly incompetent but means well. Cuomo is a very clever political machine, and doesn’t want BdB to get any wins. Additionally there’s a lot of state vs local control issues for NYC where NYC either doesn’t have authority or the authority is nebulous so Cuomo can claim things aren’t BdB’s call. There have been numerous times during the pandemic where BdB called for something like closing schools, etc where Cuomo issued a stinging rebuke and then made the call himself 2-3 days later.

Secondly, this is a national issue. As much as NY is a basket case.. the state by state stats are quite similar. Depending on the week NY is outperforming lots of states in the vax distribution. Relative to Feds, State governments are not that big and do not have a lot of idle capacity. Whatever idle capacity we did have has been taken out by PPE distribution, testing roll out and dealing with all the sick.

Realistically this is a FEMA/NatGuard issue at this point. We can’t expect to have any nurse capacity for vax considering hospitals are all full. It’s a shame there was no planning for that in advance, but par for the course with DJT. Fortunately it sounds like Biden is going to pull the trigger on that in first 100 days.

jancsika• 6 years ago

Being under-40 with no kids or seniors in my home, easily working from home, I expect to get vax sometime this summer. This is fine, I’m happy to let seniors, medical and frontline workers get it first. This of course includes teachers so they can open schools for good come August.

I'd probably pay $29.95 per month to participate in a social network where the average comment is as normal as this paragraph.

Call it sensiblepeoplewhowearmasks.com or perhaps lowerbloodpressure.org

votepaunchy3• 6 years ago

The “strategic reserve” falsely reported to not exist is stored at the manufactures:

“Pfizer Inc has been holding on to second doses for each of its COVID-19 vaccinations at the request of the federal government and anticipates no problems supplying them to Americans, a spokeswoman said in a statement on Friday.

Pfizer’s comments run counter to a report in the Washington Post that the federal government ran down its vaccine reserve in late December and has no remaining reserves of doses on hand.”

https://www.reuters.com/article/us-health-coronavirus-vaccin...

maxerickson9• 6 years ago

The reporting was about things that Alex Azar said. Is he just stupid and doesn't understand what everyone else is talking about? Here's the article where he is quoted saying there is no Federal reserve:

https://www.washingtonpost.com/health/2021/01/15/trump-vacci...

If Pfizer is indeed storing the doses at the request of the government, something stupid is going on, because it is reasonable to call that a Federal stockpile.

icedchai• 6 years ago

I'm also happy to wait. I just want my parents and older relatives (all 75+) vaccinated sooner than later. That will make me worry less. If for some reason I can get an appointment sooner, I'll obviously take it, but I'm not counting on it. Unless the pace really picks up it's going to be a while...

transitorykris• 6 years ago

Does getting a leftover dose grant you the right to the second dose within the window?

supercanuck• 6 years ago

Yes.

gnicholas• 6 years ago

My understanding is that it's not especially important to get the second dose within a particular window. A surgeon friend got her first dose and said she was planning to delay the second one for a while so that more first doses could go out to others, and that it would be just as effective for her if she got it later. She's also relatively young (under 40), so she isn't as concerned as some people might be.

Honestly I don't know how she can be that confident that timing of the second dose doesn't matter, since this doesn't seem to have been tested with COVID vaccines. Perhaps it is a feature of vaccines in general?

WrtCdEvrydy• 6 years ago

In terms of individual results, having the second vaccine would be best, but in terms of getting partial immunity to most people, getting the first one only would be better for everyone.

aphextron3• 6 years ago

Honestly I don't know how she can be that confident that timing of the second dose doesn't matter, since this doesn't seem to have been tested with COVID vaccines. Perhaps it is a feature of vaccines in general?

Given that this is a completely novel vaccine, and there is zero clinical data to support that statement, there is literally no way she can know that for sure.

However, the Moderna vaccine confers an immunity approximately equivalent to convalescent COVID-19 patients within two weeks of the first dose, so she's probably fine.

hansthehorse• 6 years ago

This position is not supported by Pfizer: https://montreal.ctvnews.ca/pfizer-pushes-back-after-quebec-...

garmaine2• 6 years ago

There is no "window" for the second dose. It's a booster; it doesn't really matter when you get it, so long as it is more than 3-ish weeks from the first injection.

1-6• 6 years ago

I think the vaccine should go to people who want it the most. That way, on-lookers can sit back and take it once they realize that it's safe and effective.

scotty795• 6 years ago

I think it's exactly how it's done, but those "who want it the most" vastly outnumber the supply so you still have to prioritize and left overs come from failure of specific people to show at specific placed and specific time.

lwansbrough• 6 years ago

Drop all requirements for vaccination except age. This vastly simplifies logisitics and virtually guarantees you will not have vaccines expiring.

TylerE• 6 years ago

I have a extremely mixed feelings on this.

I’m in my 30s, but have several of the major comorbidities, including diabetes and asthma.

Should I have to wait at the very end of the line like the healthy 30 year olds?

ghaff6• 6 years ago

It's complicated and I generally trust the CDC recommendations to be reasonable judgements. But they're not infinitely fine-grained. The rules in lots of places have healthy-ish 64 year old being eligible at the same time as healthy 20 year olds.

ls6122• 6 years ago

Having comorbidities like obesity, diabetes, etc increases your risks from the virus by a factor of 2-4. Being old vs young increases your risks by a factor of 1000. You are at more risk than your peers but still at far less risk than even a person in their 60s.

nickysielicki• 6 years ago

If I've already had the virus, do I need to get vaccinated?

divbzero2• 6 years ago

According to the CDC: [1]

Yes. Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, you should be vaccinated regardless of whether you already had COVID-19 infection. If you were treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

[1] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

The underlying rationale is that vaccines elicit a more consistent immune response [2] and confer immunity with higher efficacy [3] than being infected with the real coronavirus.

[2] https://abcnews.go.com/Health/people-covid-19-vaccine-doctor...

[3] https://blogs.sciencemag.org/pipeline/archives/2021/01/14/jo...

mixmastamyk• 6 years ago

Out of over six thousand who have had the virus, there have been about 42 re-infections. Comparing that to the cohort of people who were never infected, that comes out to 83% efficacy. So there’s your comparison number – which means that being vaccinated with either of the mRNA agents provides better protection than being infected with the real coronavirus can.

The vaccine comes in two doses spaced by a month or two, and the second boosts immune response. Being exposed to the real thing twice should have a similar effect, but it would be hard to precisely dose and schedule another weak exposure.

However, `42/6000 = 0.007` sounds pretty low-risk to me, unless you are elderly and/or in poor health.

bagacrap• 6 years ago

It's still mind boggling to be that this isn't taken into account when deciding on the order of vaccine distribution. The incremental protection conferred to a recovered covid patient is far less than that conferred to someone who hasn't contracted the disease.

garmaine2• 6 years ago

Yes, but do your peers a favor and wait until there is no shortage.

treis• 6 years ago

I don't think people realize how bad the distribution problem is. My state is sitting on 800,000 doses. Four times than what they've given out. It's just craziness that after a year of this we can't handle rolling out a vaccine.

axaxs• 6 years ago

My current city has about 1 million people in the metro area. They are only doing doses at one indoor building, and to date done 4,000 shots. It's honestly appalling.

aidenn0• 6 years ago

Be aware also that the federal government immediately increments the "doses given to state" number, while states may not report the "doses given" number back to the federal government promptly, so seeing one number being much larger than the other isn't necessarily proof that there's a distribution problem

OliverGilan• 6 years ago

I understand the justification for having restrictions on who can be vaccinated but part of me thinks this is all extremely counterproductive. Yes, old people are at greater risk but also the more young people are vaccinated the harder it is for the virus to spread and the faster we reach herd immunity which also ends up protecting old people. I end up thinking about this great video [1] by CGP Grey where he explains that the most efficient boarding method for an airplane isn't actually front-to-back but just random. Surely if we just said anyone could get a vaccine then we'd be more successful in reaching herd immunity right?

Edit: You could also just make a portion of the day for older people only and the rest of the time open it up to everyone. I feel like right now we have the worst of all worlds

[1] https://www.youtube.com/watch?v=oAHbLRjF0vo

scotty795• 6 years ago

I think the main function of the vaccine in the initial stage is to lower the amount of people who need hospitalisation after contracting covid. So giving limited doses to the people who are most likeley to develop severe symptoms seems like best strategy to achieve that. Even if it pushes back date of achieving herd immunity a little.

So prioritizing health care workers (they can easily contract and spread) and old people (a lot of them need hospitalisation) seems like a good idea.

solatic3• 6 years ago

Context: 30-year old living in Israel

The Israeli system is slow. It's centrally-planned, and even with central-planning taking advantage of pre-existing distribution networks and patient record digitization, the planners still make mistakes with dose distribution. There are four HMOs in this country, one of them has too many doses for the current age tranche and hands them out to younger walk-ins in peripheral areas, two of the HMOs don't have enough and are slowing down the progress of the age tranche for everyone else.

As bad as the Israeli system is, honestly, it's about the best that can be done considering that vaccine distribution in Israel is supply-constrained. They had to stop giving out first doses for about a week until they could negotiate with Pfizer to move up the shipments. What shipments do come in are quickly distributed. As of yesterday, 45+ can make appointments.

The US healthcare system is a nightmare. But for all of the US healthcare system's many, many, many weaknesses, vaccine distribution is supposed to be a strength. Doses are mass-manufactured and cheap, about $15/dose. Private providers are supposed to be able to make their own dosage orders through their own pre-existing suppliers and be distributed through ordinary private logistics networks. Intense competition insures a minimum of dose wastage. The state can minimally regulate to ensure that supply chain participants have adequate refrigeration etc. If the state wants to prioritize frontline workers, the elderly, fine. The state is more than welcome to buy as many (cheap) doses as it wants on the open market, and distribute for free to whoever the state deems to be a priority. But if the state cannot adequately take advantage of the relative supply glut, and efficiently manage the total supply that is available, then the state shouldn't freeze out the private market on the excess!

What's the goal here? The goal is not to immunize the elderly, or frontline workers. The goal is to end the pandemic. That means getting R under 1.0, and that means mass immunizations. That frontline workers or the elderly represent theoretical optimizations in pursuit of that goal is clearly demonstrating to not work out in reality. Let the free market work!

AndrewDucker• 6 years ago

Israel has vaccinated over four times the numbers (per 100k) that the USA has. It's the fastest vaccinating country in the world, by a long way!

https://ourworldindata.org/covid-vaccinations#country-by-cou...

solatic3• 6 years ago

Yeah I know that. Israel can be, at the same time, both the relatively fastest vaccinating country (relative to everyone else) and still be, in objective terms, slow.

smileybarry2• 6 years ago

(Context: 27 year old in Israel)

100-150k a day is not that slow in my opinion, especially when you consider the yearly flu shot mess. Honestly, the fact we reached ~2 million in a few weeks is insane. I thought vaccines would be delayed, then deployment would lag behind, then HMO systems would absolutely crash for weeks on end, but they didn't (except the first 2-3 days) and we indeed started in December.

If the current schedule holds, I could be vaccinated in March. Given my friends' experiences in the US and UK, I consider that very fast and fast enough, at least. Would I be happier if supply sped up and we doubled vaccinations per day? Of course, but given other countries, this is very acceptable.

solatic3• 6 years ago

Look, I think that it's acceptable considering the fact that the whole system is supply-constrained. Prioritizing healthcare workers, teachers, the elderly isn't just a theoretical optimization in Israel - it's a working one too. The only way it would be faster is if there wasn't a supply constraint. The fact that the whole world is mucking up doesn't mean that our model is some kind of ideal, and I certainly don't think that it's the right model for the US, for the reasons I listed.

permille422• 6 years ago

The person in the article doesn't seem to be in a high risk group. They state they pedaled their bicycle 5 miles to reach the scene. I get that the virus is dangerous for everyone, but I think those of us who are younger and generally more healthy should allow those in high risks groups / high exposure to get the vaccine first, regardless of whatever "leftover doses" exist or not.

Perhaps this person is in a high exposure group due to their job? I'm doubting it but I guess it is possible.

acje• 6 years ago

What is the chance of actually having left over doses in a densely populated area? The logistics are pretty simple with great numbers of consumers. It's another mater in a sparsely populated area.

permille422• 6 years ago

The claim in the article, which is believable, is that many people either don't want to get the vaccine or don't show for some other reason during a single day.

For some unknown additional reason, doses within that day are supposed to be used up. There seems to be an implied expiration for doses, but a single day doesn't make much sense.

The result of both these together is that they are supposedly letting people not scheduled to get the vaccine get it on some days. The article calls them "walk-ins".

Apparently word of this has been spreading slowly, and in this case went viral and a ton of people showed up to attempt to get some small number of "leftover doses".

It seems like chaos to me and a failing of sensible procedure. I am not though a doctor or involved in the distribution process so what do I know. Perhaps there is good reason this happens.

harg• 6 years ago

Surely it’s better to give doses to low risk groups than to throw them away. The main hurdles with vaccine rollouts seem to be logistics problem rather than scarcity of the vaccine itself

forgingahead2• 6 years ago

This is shameful - authorities knew the vaccine was en route to being made available towards the end of last year. COVID has been a persistent nightmare for many localities for the past 10 months. Nobody planned for this?

I can't help but feel that the media is responsible for this also - when being informed that vaccines were on the way in the 2nd half of last year, they resoundingly pooh-poohed it and refused to consider the possibility, instead preferring to wallow in the world's misery. It's good for their advertising!

Really shameful all around.

Vaslo• 6 years ago

Let’s be honest, that poo-pooing occurred because they are blinded by their hatred for a certain leader. That’s more important to them than integrity.

forgingahead2• 6 years ago

Definitely - see the downvotes on my other related comment about him today. Really sad how people have been conditioned to be so negative.

aphextron3• 6 years ago

As I got closer, though, I started to believe that if the rumor was true, I would never have been able to justify to myself that I had stayed at my desk and turned down an escape from the pandemic.

I just recently got my first shot of the Moderna vaccine last week. When I learned that I would be getting it, I went through the same euphoric excitement the author is describing. Then it slowly dawns on you that this is simply a bandaid. Something to stop the massive amounts of deaths. It's not going to miraculously end everything and make the world go back to normal. There is no "escape". You're not going to be hopping on flights, vacationing, and going to bars again any time soon.

This is a real mistaken mindset that I think people are going to have to come to terms with. The vaccine is not a silver bullet. It doesn't just make the virus magically bounce off of you like a force field. You will still get infected if you are exposed, and can very well still transmit it. The vaccine simply keeps you from developing severe disease.

We (the human race) have a long, slow, painful slog ahead of us to return to anything even resembling what things were like in Fall 2019. The virus is going to become endemic. Overall population vaccine uptake will most likely look like Flu vaccine rates (<50%). And that means life will never be quite the same.

bequanna• 6 years ago

There is no "escape". You're not going to be hopping on flights, vacationing, and going to bars again any time soon. We (the human race) have a long, slow, painful slog ahead of us to return to anything even resembling what life was like in Fall 2019.

Wow. You're entitled to that bleak outlook, but unless you're in a super-high risk group, I would advise you to snap out of it and resume living your life.

I've literally done all of the things you listed in the past month. Additionally, I'm at the gym 5x a week. If you're safe/responsible, there is absolutely no reason you can't do 99% of the things you want.

aphextron3• 6 years ago

I've literally done all of the things you listed in the past month. Additionally, I'm at the gym 5x a week. If you're safe/responsible, there is absolutely no reason you can't do 99% of the things you want.

The reason I'm not doing those things isn't because I can't. I'm at practically zero risk now that I've been vaccinated. The reason I'm not doing it is because I don't want to be around people like you.

In 6 months from now, when there's no excuse to not be vaccinated, that will be a different story. But people going about normal life right now as if nothing were happening are the reason we're seeing 4,000 deaths a day in the US, and they are objectively bad human beings.

blub• 6 years ago

Doing all those things and also going to the gym is by definition both unsafe and irresponsible...

jdashg• 6 years ago

It is because everyone else is being responsible that you have been able to enjoy your irresponsibilities without consequence so far.

maxerickson9• 6 years ago

The extent to which the mRNA vaccines prevent infection is unstudied, it is not conclusively known in either direction whether they confer sterilizing immunity.

The mechanism of action is reason to believe that they might.

compsciphd• 6 years ago

I'm 41, Israel opened up the vaccines to people over 40 yesterday. Called my HMO, made a same day appointment for their vaccination center at the local stadium, went there by bus in the rain. swiped in with my card when I got there and was given a number. waited close to an hour for my number to be called, got quickly stabbed in the upper arm an soon left.

It really shouldn't be that hard. My parents (i.e. 70ish) are now scheduled to get the vaccine towards the end of february in maryland.

I Tried to Get a ‘Leftover Dose’ of the Vaccine Last Night

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