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Author Topic: Covid Vaccine  (Read 13576 times)

jeremyrh

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Re: Covid Vaccine
« Reply #80 on: January 24, 2021, 12:13:17 pm »

I’m sorry, but I read your response the same way.

I’m not Jezza’s biggest fan but I dont see how you get there. NOBODY has suggested not giving the second dose, and I think it would be grossly unethical to do so.
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jrsforums

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Re: Covid Vaccine
« Reply #81 on: January 24, 2021, 12:48:37 pm »

I’m not Jezza’s biggest fan but I dont see how you get there. NOBODY has suggested not giving the second dose, and I think it would be grossly unethical to do so.

You get there by looking forward, as I said in my post, that without increased supply, delaying only gives a very short interval of increased 1st shots, which must be ‘paid back’ a few weeks later.

The statement was “...  I trust, as you receive your second dose, you will give a thought to the 80-year-old who may die because you are depriving him of his first.

The job of public health officials is to maximise public health. That is done...not by giving second doses to people who selfishly think they are more deserving than others.”

Without further explanation or statement of near term supply increase, one must assume that his statement was recommending long term delay of second shot....or the statement was improperly stated or thought out.

EDIT:  while I have not followed the reporting, I believe the UK JCVI has suggested doses should be given 12 weeks apart in order to give the maximum number of people some protection while supplies are limited.  This is based a small Israeli study on people over the age of 60 suggested a first dose gave just 33% protection from coronavirus.  The Israeli data is preliminary data. It does involve PCR testing, which is of course asymptomatic cases as well as symptomatic cases. They have not followed up for more than three weeks and the statistical methods they used are not clear. 
« Last Edit: January 24, 2021, 01:10:42 pm by jrsforums »
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John

jrsforums

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Re: Covid Vaccine
« Reply #82 on: January 24, 2021, 12:53:43 pm »

Because the second shot would do more good to someone else than to you. If there are (for now) only 2 shots available, shall we give one each to you and your wife, or shall we give both to you?

Personally, I’d give it to my wife.  There is no data on the efficacy of a single shot, nor if that shot will diminish any symptoms of a COVID-19 infection.
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John

Alan Klein

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Re: Covid Vaccine
« Reply #83 on: January 24, 2021, 01:41:15 pm »

No, I didn't. I suggested that it might be appropriate to use a finite resource to maximise the benefit to be derived. That may mean delaying the second dose to some in order that others can get a first. I have neither the knowledge of vaccines nor the background in public health necessary to reach a decision as to which course of action would be preferable from a public health point of view. Of course, those individuals who are able to obtain a second dose benefit themselves; but the purpose of public health is to benefit the population, not individuals. Comments on obesity are moral judgments, implying that those who are at risk because of their self-indulgence (if that is the cause of their obesity) despite their youth are somehow less entitled to protection. There are no doubt some who hold this view - Alan clearly does - but it's not universal and again is not the concern of public health decision-makers.

Jeremy
I'll accept that's not what you meant.  However, giving first shots to everyone before anyone gets a second shot means delays of many months not a couple of weeks.  My hyperbolic comment of an obese 16-year-old was not to besmirch that person. It was to satirize the foolishness of placing a 16-year-old ahead of 65 year old who most also have comorbidities as well by the time they reach that age. 

There was no effort it seems by the CDC or others to triage the appointments and order.  By lumping all the younger people who are less vulnerable even with these comorbidities, than older people, they put the most vulnerable at risk.  If you care about your fellow man so much, and I'm sure you do, then you'd want to apply the best methods.  The ones we're currently working on were made at the last minute, with no public discussion, no advice as to triage to the organizations directly responsible for vaccinating people, and no peer-reviewed studies as to the efficacy of this new plan.  At least in the US, it was unilateral declared by President Biden, that all second shots would be used as first shots. While there's to be no politics in this thread, one can't escape the fact the decision seems to hinge on politics, not good epidemiology.

Alan Klein

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Re: Covid Vaccine
« Reply #84 on: January 24, 2021, 01:49:51 pm »

I’m sorry, but I read your response the same way.  In addition, without an increase in weekly supply, delaying 2nd dose for 2/3 weeks only gives a short term advantage to 1st dose supply, but creates, then, an expansion of 2nd dose demand, downstream, which will reduce doses available for 1st shot.

While Alan’s example could be chosen better (😀 he’s from Jersey, so English is not his first language 😀 ), the fact is ‘...the single largest predictor of death is clearly age, and single comorbidities are lower than that...” (https://www.newyorker.com/news/q-and-a/deciding-who-should-be-vaccinated-first)
I only recently moved to Nu Joisey.  I was raised in Da Bronx and lived in Nu Yoik all my life.  Now my wife who's from Brooklyn, now she's the one who speaks a foreign language. Fergetaboutit.

faberryman

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Re: Covid Vaccine
« Reply #85 on: January 24, 2021, 01:56:14 pm »

I'll accept that's not what you meant.  However, giving first shots to everyone before anyone gets a second shot means delays of many months not a couple of weeks.  My hyperbolic comment of an obese 16-year-old was not to besmirch that person. It was to satirize the foolishness of placing a 16-year-old ahead of 65 year old who most also have comorbidities as well by the time they reach that age.

I should think that might depend on whether vaccine production remained level or was increasing.
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Alan Klein

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Re: Covid Vaccine
« Reply #86 on: January 24, 2021, 01:57:38 pm »

Because the second shot would do more good to someone else than to you. If there are (for now) only 2 shots available, shall we give one each to you and your wife, or shall we give both to you?
That actually came up before the first shot and there may have been only one for both of us. At first, I was the only one who got the appointment.  They called me to set it up and I told the girl that my wife needs one too and she filed for an appointment.  I asked to set it up for her as well, which she did, at the same time.  They were very nice about it.  The whole process was done very well at the hospital as well.   

Had that not happened, I planned to give her mine.  I'm sure you would have done the same for your wife.  However, despite what the Administrator says, I don't think anyway else would give up their shot for you or my wife.  :)

jrsforums

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Re: Covid Vaccine
« Reply #87 on: January 24, 2021, 01:58:05 pm »

I only recently moved to Nu Joisey.  I was raised in Da Bronx and lived in Nu Yoik all my life.  Now my wife who's from Brooklyn, now she's the one who speaks a foreign language. Fergetaboutit.

Love it, buddy 😀
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John

jrsforums

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Re: Covid Vaccine
« Reply #88 on: January 24, 2021, 02:33:04 pm »

  At least in the US, it was unilateral declared by President Biden, that all second shots would be used as first shots. While there's to be no politics in this thread, one can't escape the fact the decision seems to hinge on politics, not good epidemiology.

I have not seen any declaration such as that.  Do you have a reference?

Best I have seen is a restatement of the prior administration’s info that there was no reserve of 2nd shots at the federal level. 

The states control the supply at their level and, I believe, are expected to balance supply for 1st & 2nd doses.  Each state does it different, but I suspect all/most have some herky-jerky aspects to their implementation.  Just this weekend, a ‘surprise’, aka new news, mass vaccination event in the Charlotte area caused a last minute redistribution of supply, which caused the Cone Medical center to cancel 10K appts (unknown if just 1st or if 2nd included).

In addition, on 1/21, the CDC updated their vaccine guidance “... The second dose should be administered as close to the recommended interval as possible. However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose...”
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
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Slobodan Blagojevic

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Re: Covid Vaccine
« Reply #89 on: January 24, 2021, 02:42:54 pm »

Gee, you guys are lucky. You make appointments. In Belgrade, lines are half a mile long:

P.S. To be fair, we also make appointments. So, there are two lines actually, those who made appointments and those without  :D

Alan Klein

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Re: Covid Vaccine
« Reply #90 on: January 24, 2021, 03:21:21 pm »

I have not seen any declaration such as that.  Do you have a reference?

Best I have seen is a restatement of the prior administration’s info that there was no reserve of 2nd shots at the federal level. 

The states control the supply at their level and, I believe, are expected to balance supply for 1st & 2nd doses.  Each state does it different, but I suspect all/most have some herky-jerky aspects to their implementation.  Just this weekend, a ‘surprise’, aka new news, mass vaccination event in the Charlotte area caused a last minute redistribution of supply, which caused the Cone Medical center to cancel 10K appts (unknown if just 1st or if 2nd included).

In addition, on 1/21, the CDC updated their vaccine guidance “... The second dose should be administered as close to the recommended interval as possible. However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose...”
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
I heard him say it on TV weeks ago.  Here's an article.  There was no real public discussion; it was unilateral on his part.  Where are the peer-reviewed studies?

Biden Says He Will Release All Vaccine Doses After Taking Office
FRIDAY, Jan. 8, 2021 (HealthDay News) -- President-elect Joe Biden plans to release nearly all available doses of COVID-19 vaccine when he takes office, reversing the Trump administration's strategy of holding back half the supply to ensure second doses are available.

The potentially risky move is meant to boost a nationwide COVID-19 vaccination program that has gotten off to a slow start, with only about 5.9 million doses administered out of 29.4 million distributed, according to the U.S. Centers for Disease Control and Prevention.


The President-elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible," T.J. Ducklo, a spokesperson for Biden's transition, told CNN.

Biden "will share additional details next week on how his administration will begin releasing available doses when he assumes office on January 20th," Ducklo added.

One infectious diseases expert noted that supply is not the only issue hampering the vaccine rollout.

"I do think it is important to get all of those out as fast as possible so we can accelerate the process of vaccination," said Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, in Baltimore. "However, it's not just an issue of doses, it's about turning those doses into actual vaccinations, so we do still need more support at the state level to actually implement vaccination programs. We are in a race with this virus, so anything that speeds vaccination should be applauded."

Both the Pfizer and Moderna vaccines require two doses administered a few weeks apart. The risk is that some people will get their first dose, then be unable to find a follow-up dose.

[/b]https://www.usnews.com/news/health-news/articles/2021-01-08/biden-says-he-will-release-all-vaccine-doses-after-taking-office

LesPalenik

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Re: Covid Vaccine
« Reply #91 on: January 24, 2021, 03:22:38 pm »

I'll accept that's not what you meant.  However, giving first shots to everyone before anyone gets a second shot means delays of many months not a couple of weeks.  My hyperbolic comment of an obese 16-year-old was not to besmirch that person. It was to satirize the foolishness of placing a 16-year-old ahead of 65 year old who most also have comorbidities as well by the time they reach that age. 

There was no effort it seems by the CDC or others to triage the appointments and order.  By lumping all the younger people who are less vulnerable even with these comorbidities, than older people, they put the most vulnerable at risk.  If you care about your fellow man so much, and I'm sure you do, then you'd want to apply the best methods.  The ones we're currently working on were made at the last minute, with no public discussion, no advice as to triage to the organizations directly responsible for vaccinating people, and no peer-reviewed studies as to the efficacy of this new plan.  At least in the US, it was unilateral declared by President Biden, that all second shots would be used as first shots. While there's to be no politics in this thread, one can't escape the fact the decision seems to hinge on politics, not good epidemiology.

I put the worry about not getting the second shot into the same category as worrying about running out of the toilet paper. Both are totally irrational.
The new doses are now being manufactured in large volumes and are shipped to most countries every few weeks. If anything, then a fresh vaccine bottle is more effective than an old one, stored somewhere for weeks under questionable conditions.

I haven't received my shot yet and don't fret whether I get it in February or March. I am being careful, keep away from crowded places and so far, I managed to avoid the virus. There are many other individuals who are not as careful or get exposed more frequently to possible virus carriers, I'd rather see them getting vaccinated first.
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Alan Klein

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Re: Covid Vaccine
« Reply #92 on: January 24, 2021, 03:25:33 pm »

So now, millions of people will never see their second doses because a political decision was made backed up by CDC bureaucrats who don't want to go against the new president.

Alan Klein

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Re: Covid Vaccine
« Reply #93 on: January 24, 2021, 03:37:34 pm »

I put the worry about not getting the second shot into the same category as worrying about running out of the toilet paper. Both are totally irrational.
The new doses are now being manufactured in large volumes and are shipped to most countries every few weeks. If anything, then a fresh vaccine bottle is more effective than an old one, stored somewhere for weeks under questionable conditions.

I haven't received my shot yet and don't fret whether I get it in February or March. I am being careful, keep away from crowded places and so far, I managed to avoid the virus. There are many other individuals who are not as careful or get exposed more frequently to possible virus carriers, I'd rather see them getting vaccinated first.
Apparently you know more than Pfizer and Moderna. Their protocol is for two shots.  Would you think this plan for releasing the second does as the first was so good if Trump did it? Be honest.  :)

I agree that those most vulnerable should get it first.  That's the old, not the young. But the CDC set up no procedure for giving shots within the same group based on susceptibility and outcome.  They're all lumped together. Typical government incompetence. 

Regarding toilet paper, half my garage is full of it.  Along with paper towels. It's my wife, though.  I swear.  :)

jeremyrh

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Re: Covid Vaccine
« Reply #94 on: January 24, 2021, 03:51:48 pm »

That actually came up before the first shot and there may have been only one for both of us. At first, I was the only one who got the appointment.

That’s not at all the situation that I hypothesised. I asked what you’d do if you had TWO shots for you and your wife.
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Robert Roaldi

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Re: Covid Vaccine
« Reply #95 on: January 24, 2021, 03:52:55 pm »

So now, millions of people will never see their second doses because a political decision was made backed up by CDC bureaucrats who don't want to go against the new president.

Why do you say "never"?
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jeremyrh

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Re: Covid Vaccine
« Reply #96 on: January 24, 2021, 03:55:27 pm »

So now, millions of people will never see their second doses because a political decision was made backed up by CDC bureaucrats who don't want to go against the new president.

Wrong on every point. Good going!!
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Alan Klein

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Re: Covid Vaccine
« Reply #97 on: January 24, 2021, 04:28:03 pm »

That’s not at all the situation that I hypothesised. I asked what you’d do if you had TWO shots for you and your wife.
We'd take both doses.  We currently have appointments for our second doses in four weeks, the recommended wait period for the Moderna vaccine we were given.  But who knows if we'll get the second dose.  The nurse said they're holding those for us and everyone else who got the first shots.  But I suppose that could change.   

jeremyrh

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Re: Covid Vaccine
« Reply #98 on: January 24, 2021, 04:31:06 pm »

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Alan Klein

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Re: Covid Vaccine
« Reply #99 on: January 24, 2021, 04:32:54 pm »

I also have a second first shot that was scheduled for me at another place for Feb 10th. I filed at a number of places as was recommended and two places made appointments for me.  But I haven't cancelled the other one yet.  Monday when their office opens, I'm going to try to get them to change it to my 80 year-old friend who hasn't been able to get an appointment and there are no shots available at this time anywhere.  I doubt if I'll be able to make the switch for him.  But I'm going to try. 
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