ultraclyde (Forum Supporter)
ultraclyde (Forum Supporter) UltimaDork
1/21/21 3:04 p.m.
Robbie (Forum Supporter) said:
wae said:

Mom and dad got their first rounds of the Moderna today.  They were unable to give them an appointment for the second dose, though, since they don't actually have those doses in stock yet.

This is absolutely nuts. A lot of my work over the last couple months has been in the IT systems that schedule and document these things. Our take is 100% the opposite. 

You schedule the 2nd dose because you want the PATIENT to come back. The doses will come and we will cross the bridge when we get there if they don't. But if you have a ton of people who never choose to schedule the 2nd half, you risk wasting an insane amount of vaccine, or you have to do an insane amount of work to track down all the individuals with one half of a vaccine and call them, leave message, wait for call back, triage call, schedule patient (now short term because window for 2nd dose closing quickly), blah blah blah. 

Whoever made the above decision is a knucklehead.  

While I don't disagree that would have been a better way to handle it, I also think that the people getting the vaccine now when it's first available are unlikely to shirk the second dose. There may be some, but it won't be many. They've likely fought hard to be there getting it and won't want to miss the follow up.

In other news, my mom and her partner got it Wednesday. After running down all the leads I gave her on Tuesday and not getting an appointment, a past business contact of hers called out of the blue and asked if she wanted a dose. Mom used to coordinate a lot of clients with a local federal clinic, so when they came up with some unreserved doses that needed to be given, they thought of her and called. I'm truly thankful for their thoughtfulness.

Now I've got to figure out if there's anyway I can get my dad and his spouse in - he's in a rural county with E36 M3 infrastructure nearby.

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
1/21/21 4:09 p.m.
ultraclyde (Forum Supporter) said:
Robbie (Forum Supporter) said:
wae said:

Mom and dad got their first rounds of the Moderna today.  They were unable to give them an appointment for the second dose, though, since they don't actually have those doses in stock yet.

This is absolutely nuts. A lot of my work over the last couple months has been in the IT systems that schedule and document these things. Our take is 100% the opposite. 

You schedule the 2nd dose because you want the PATIENT to come back. The doses will come and we will cross the bridge when we get there if they don't. But if you have a ton of people who never choose to schedule the 2nd half, you risk wasting an insane amount of vaccine, or you have to do an insane amount of work to track down all the individuals with one half of a vaccine and call them, leave message, wait for call back, triage call, schedule patient (now short term because window for 2nd dose closing quickly), blah blah blah. 

Whoever made the above decision is a knucklehead.  

While I don't disagree that would have been a better way to handle it, I also think that the people getting the vaccine now when it's first available are unlikely to shirk the second dose. There may be some, but it won't be many. They've likely fought hard to be there getting it and won't want to miss the follow up.

The other argument is that a single dose looks like it is between 50% and 80% efficacy, with Moderna being better than Pfizer. Lets average it to 65%. Which one would you rather have?

  • 100 people who have a 65% chance at being immune, and some (most?) of that population getting another dose to bring them to ~95% chance of being immune?
  • Or 50 people who have a 95% chance at being immune, and 50 people for whom their only chance at being immune is having caught the virus?

 

NOTE: This is bad math, extremely oversimplified, and nothing is proven about the efficacy of a single dose. I'm just putting it there to argue the other side of the coin. Hopefully this is a problem for this year only; I'd hope that by August we have Pfizer and Moderna with increased production, Astrazeneca, Johnson and Johnson, and Novavax approved and in production, and we will just get it at the grocery store or annual check up, or even from our employers. 

Robbie (Forum Supporter)
Robbie (Forum Supporter) MegaDork
1/21/21 6:17 p.m.

In reply to mtn (Forum Supporter) :

Luckily for me I'm not the person who has to decide if we should be following the instructions laid out by the manufacturers, govts, and the CDC or if we should just "wing it".

I don't disagree you have a logical argument, but neither of us have all the information.

I do know I'd rather make one phone call to order 1000 more vaccines than try to track down 1000 individual patients (what's that take? 2500 phone calls?) to try and schedule a follow up visit with each.

Snowdoggie (Forum Supporter)
Snowdoggie (Forum Supporter) Dork
1/21/21 6:21 p.m.

Two more employees tested positive at Mom's nursing home after the first doses were given out. Looks like the second dose is really needed. 

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
1/21/21 7:00 p.m.
Robbie (Forum Supporter) said:

In reply to mtn (Forum Supporter) :

Luckily for me I'm not the person who has to decide if we should be following the instructions laid out by the manufacturers, govts, and the CDC or if we should just "wing it".

I don't disagree you have a logical argument, but neither of us have all the information.

I do know I'd rather make one phone call to order 1000 more vaccines than try to track down 1000 individual patients (what's that take? 2500 phone calls?) to try and schedule a follow up visit with each.

The only thing I have to say to this is that I'm not sure that winging it is a fair description. 
 

I don't have a strong opinion one way or another on it, and I'm very glad I don't have to be involved in the decision making. 

Jim Pettengill
Jim Pettengill HalfDork
1/22/21 7:46 p.m.

My wife and I got our first Moderna shot yesterday, so far no ill effects.  I'm 75, she is 72.  Our small town (population 900, no hospital or pharmacies, closest ones are 35 miles away in the next county so we are limited to our county health department), who are doing all they can) just ran out of doses, hoping for more next week.  Second dose scheduled at the time of getting the first dose, no negotiation - you WILL get the second dose, and it WILL be on this day, at this time.  Be there.  Works fine for me.

aircooled
aircooled MegaDork
1/23/21 6:09 p.m.

My wife was just able to sign up her parents (80's) for the first shot in early February.  They are our primary concern in our circle.  With their shots done, we will at least not have to be terribly concerned about illnesses likely resulting in hospitalization.

We are near Los Angeles, so, as usually, it's a bit of an s-show in most ways.  Heck CA, last I heard was worst, for ALL states in percentage of vaccinations done vs doses received..... last.... lovely...  could be a while for me.

chaparral
chaparral Dork
1/23/21 9:15 p.m.

In reply to mtn (Forum Supporter) :

I think I would much rather have 50 people who are immune than 100 people who think they are. I know that three weeks after I get my second shot I will be on an airplane headed somewhere that's not Detroit.

joey48442
joey48442 PowerDork
1/24/21 9:27 a.m.

In reply to mtn (Forum Supporter) :

I remember reading that some of the old vaccines years ago were only 35 percent effective or something and it was considered a success?  I don't know if I'm remembering it correctly. I don't know really but to my uneducated mind 65 out of 100 people who are not likely to get me sick is better than 50 out of 100 that will almost positively not get me sick. Because even if I do run into a sick unvaccinated person it's not a slam dunk that I will get sick, if I practice good habits anyhow, wearing a mask, hand washing, social distancing and such. So 35 that *might* get me sick is better to me than 50 that *might* get me sick. 
modes tgat make sense or am I talking poop right now?  Highly likely it's all poop

Wally (Forum Supporter)
Wally (Forum Supporter) MegaDork
1/24/21 10:57 a.m.

The way NYS scheduled them is that when I got my first dose they gave me a card with the date I'm due for the second.  I can return to the same center that did the first on that day, show my card and get the second. They're supposedly booking appointments daily to ensure everyone gets a second from the known supply. The vaccination centers are massively over built so if supply ever ramps up they'll be able to run through people quickly, something like 100,000 per day statewide.  

No Time
No Time SuperDork
1/24/21 9:14 p.m.

My wife got the second shot of Pfizer vaccine yesterday.

So far nothing out of the ordinary beyond some arm soreness. She took some Acetaminophen before heading to her appointment. 

SVreX (Forum Supporter)
SVreX (Forum Supporter) MegaDork
1/25/21 9:22 a.m.

This is totally anecdotal...

A friend got the first dose on Tuesday. He was feeling sick on Thursday.  Tested positive on Friday.

I'm not suggesting they are related.  

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
1/25/21 9:43 a.m.
SVreX (Forum Supporter) said:

This is totally anecdotal...

A friend got the first dose on Tuesday. He was feeling sick on Thursday.  Tested positive on Friday.

I'm not suggesting they are related.  

His doctor should have told him, but he should NOT get the 2nd dose. 
 

A coworkers husband - a firefighter - got the first dose, and tested positive 2 days later. Extremely bad luck, but the vaccine takes a few days/weeks to work. 

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
1/25/21 9:44 a.m.

In some bad news, Merck has dropped out as their candidate is showing low efficacy. I'd never heard them to be among the top contenders, but it would have been nice to have another candidate, especially as Merck could ramp up production quickly. 

SVreX (Forum Supporter)
SVreX (Forum Supporter) MegaDork
1/25/21 10:06 a.m.

I'm curious about thoughts about equitable distribution on a WORLDWIDE basis.

Right now, the rich folks are winning. Looks like there are more than 150 countries that will not be able to secure ANY doses until 2022.  Meanwhile, Canada has secured almost 9 doses per citizen (enough for more than 4 full rounds for every single citizen).  US has secured about 7 doses per citizen.
 

There's a lot of uncomfortable in there. 
 

Thoughts?

barefootskater (Shaun)
barefootskater (Shaun) UberDork
1/25/21 10:10 a.m.
mtn (Forum Supporter) said:
SVreX (Forum Supporter) said:

This is totally anecdotal...

A friend got the first dose on Tuesday. He was feeling sick on Thursday.  Tested positive on Friday.

I'm not suggesting they are related.  

His doctor should have told him, but he should NOT get the 2nd dose. 
 

A coworkers husband - a firefighter - got the first dose, and tested positive 2 days later. Extremely bad luck, but the vaccine takes a few days/weeks to work. 

Something I've realized lately, and this probably isn't a revelation to most here, but it sticks in my mind. 
 

A part of my evolving outlook came from a message shared on IG. A very highly regarded but retired medical professional said that after speaking with his personal doctor, he and his wife had received their first dose. 
Most in my community seem to have missed the most important part of that message, which wasn't the action of getting poked, but the part "after speaking with our doctor"

ive been talking with my sister a lot about this lately. She doesn't feel like her doctor ever listens to her. I said to get a new doctor. Off on a bit of a tangent here but something else I've realized lately. Doctors are a lot like teachers. Most are spread too thin and finding a really good personal fit is often difficult. I never had a really good teacher until I was 28 doing a college English course. 

Anyway, that's what I'll share today. Doing our own research and watching reports and statistics is part of being responsible and informed and educated, but finding a good doctor(teacher) and talking to that person(s) is likely the most important part of the equation. 

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
1/25/21 10:37 a.m.
barefootskater (Shaun) said:
mtn (Forum Supporter) said:
SVreX (Forum Supporter) said:

This is totally anecdotal...

A friend got the first dose on Tuesday. He was feeling sick on Thursday.  Tested positive on Friday.

I'm not suggesting they are related.  

His doctor should have told him, but he should NOT get the 2nd dose. 
 

A coworkers husband - a firefighter - got the first dose, and tested positive 2 days later. Extremely bad luck, but the vaccine takes a few days/weeks to work. 

Something I've realized lately, and this probably isn't a revelation to most here, but it sticks in my mind. 
 

A part of my evolving outlook came from a message shared on IG. A very highly regarded but retired medical professional said that after speaking with his personal doctor, he and his wife had received their first dose. 
Most in my community seem to have missed the most important part of that message, which wasn't the action of getting poked, but the part "after speaking with our doctor"

ive been talking with my sister a lot about this lately. She doesn't feel like her doctor ever listens to her. I said to get a new doctor. Off on a bit of a tangent here but something else I've realized lately. Doctors are a lot like teachers. Most are spread too thin and finding a really good personal fit is often difficult. I never had a really good teacher until I was 28 doing a college English course. 

Anyway, that's what I'll share today. Doing our own research and watching reports and statistics is part of being responsible and informed and educated, but finding a good doctor(teacher) and talking to that person(s) is likely the most important part of the equation. 

 

I'm not sure if I posted this here or not, but I agree entirely. 

I'm the last person that you'll hear tout any kind of homeopathy or osteopathy. But I also don't want doctors to be pill pushers. I kept going to my pediatrician through college, because I trusted him and he knew me well. I went to 3 different PCP (Primary care phsyicians) after college for annual checkups. Didn't like any of them so I kept looking. I finally found one I was comfortable with - a DO, Doctor of Osteopathic Medicine. Do not mistake this for osteopathy; despite the name, in the US they're nearly identical to MDs. Why did I decide that this DO was my Doctor? 

Well, first, she is in practice with her Dad. She's my age, has ownership in the practice, so will probably be around and practicing for most of my adult life. Her Dad is an MD. This matters to me. It means that she has been around medicine her whole life.

Second, they're private practice does not employ a single RN. Before people get up in arms, my mom, MIL, aunt, grandmother, great aunt who was like a grandmother, and cousin are or were all RNs. Some of them APNs, some of them professors of nursing. But what is an RN really going to do for them in a private practice setting? No, instead of RNs, they employ 2 RDs - registered Dietitians, and a Masters of Public Health who is becoming a Diabetes educator. I happen to think that for preventative health, an RD is way more valuable than just about anyone else. 

Third, she listens to me. I said I want to get an Echocardiogram, for these specific reasons. She listened asked some questions, and agreed with me. I asked about my blood pressure and if she would recommend medication that I did not want to start on. She said no, no medication yet because XYZ, and I agreed, but she said that if it wasn't down in 4 months, she was going to start me on it. 

And, Fourth, she is adamant that the general public should be getting the influenza vaccine, and now Covid vaccine - she literally said "you'll be low on the priority list, but you should get it ASAP".

wae
wae UberDork
1/25/21 10:57 a.m.
SVreX (Forum Supporter) said:

I'm curious about thoughts about equitable distribution on a WORLDWIDE basis.

Right now, the rich folks are winning. Looks like there are more than 150 countries that will not be able to secure ANY doses until 2022.  Meanwhile, Canada has secured almost 9 doses per citizen (enough for more than 4 full rounds for every single citizen).  US has secured about 7 doses per citizen.
 

There's a lot of uncomfortable in there. 
 

Thoughts?

Wow.  That's a nasty can of worms to open up and I don't know that I really know how I feel about it.  My quick points on it, though:

  • This is nothing new.  Throughout all of human history, wealth and/or political status (which is typically tied to wealth) equals greater access to better goods and services.  So it's not surprising that those of means have ways to get medicine before "the poor".  I'm not making a value judgement here, just observing that this is not something that is unique.
  • In a perfect world, everyone would have equal access to every aspect of healthcare.  It pains me to know that there are diseases and injuries which I could basically shrug off thanks to my access to cheap doctors and medications but which would be life-altering or -ending for someone else just by the basis of where we all happened to be born.
  • I've always held the belief that before you can offer charity, you need to have a strong home.  I wouldn't take medication away from my own child, for example, to give to someone else's child.  (making the assumption that the lack of medication would have a bad outcome for either child, of course).  And I can't support my local food pantry when I can't afford to pay for my own groceries.
  • Generally speaking, the person that creates something should be the person who gets to enjoy the fruits of that creation.  We've put a bunch of our tax dollars in to creating this vaccine.  Well, we put our grandkids' tax dollars on the line, really, but that's a different show.  Based on that, the wealthy countries should be able to line up as they see fit, right?  Not to be callous, but if the whole world was "3rd world", we wouldn't have a vaccine at all.  Not that it's fair that some people get born in rich countries and some people get born in poor countries, but there we are.
  • On the other hand, since we have better sanitation and more opportunities for social distancing and remote work, would it make more sense to get the poorer countries vaccinated first?  By that, I mean would that slow down the mutations and reduce the spread to the point that it would actually provide a net benefit to the wealthier countries as well?
  • Given the supply chain disruptions that exist, would it bring us a better economic outcome to get offshore manufacturing back to normal faster by pushing the vaccine to the poorer nations where all our stuff is made?
  • Would the global rollout of the vaccine happen more quickly if wealthy nations like ours were to get fully vaccinated first?  Meaning if we could get our population back to "normal" (whatever the hell that is!) faster, would that enable us to be able to manufacture more vaccine faster and also generate more economic activity that would then generate more tax revenue to pay for the creation and distribution of the vaccine to the poorer nations?

I'm not sure what the right answer is, but I know there are a ton of questions.

EDIT:  Oh, and couch all of that in the guiding principle that was imparted upon me by my parents and which I am trying to impart upon my children:  Life isn't fair.  That doesn't mean we shouldn't do everything we can to make it more fair, but at the end of the day no matter what we do, life will still not be fair.

aircooled
aircooled MegaDork
1/25/21 11:16 a.m.
SVreX (Forum Supporter) said:

...Looks like there are more than 150 countries that will not be able to secure ANY doses until 2022.  Meanwhile, Canada has secured almost 9 doses per citizen (enough for more than 4 full rounds for every single citizen).  US has secured about 7 doses per citizen....

I know Canada purposely way over bought for the express purpose of distributing their extra to other countries that can't afford it:

https://www.reuters.com/article/us-health-coronavirus-vaccines-covax-exc/exclusive-canada-in-talks-to-donate-extra-covid-19-vaccine-shots-to-poorer-countries-sources-idUSKBN27Y2UU

I expect the US will do the same.

The reality is: how else would this work?  Who would pay for it otherwise?  There would need to be a massive world wide health fund.  To be a bit brutal, in some (obviously more extreme) countries, COVID may not even rise to the level of being their biggest fatality concern.

SVreX (Forum Supporter)
SVreX (Forum Supporter) MegaDork
1/25/21 11:40 a.m.

I think my perspective was a bit more nuanced than "OMG we should help the poor"...

First off, I don't understand the need for far more doses than your population. Is this indicating something about the perceived long term efficacy, and the need for booster shots?  The math says we can't get our country vaccinated in a year- how are we gonna do it annually?

Secondly, I'm trying to figure out what the actual effective efficacy will be like if a huge percentage of world remains unvaccinated.  Getting ourselves vaccinated is a small piece of the puzzle if we attempt to reopen business and tourism relationships with countries that have no effective solution. It's a real "stick my fingers in my ears and yell I can't hear you" moment to think that we will all be fine if we get vaccinated, but our world neighbors have not been. We will start traveling, and then continue spreading stuff we pick up in other places. 
 

I've lived in third world countries. I became comfortable with my own discomfort a long time ago. But this problem is not a problem best addressed in nationalistic ways.  It's like being a fish in an infected pond, and thinking we will be fine if we clean up our corner of the pond.

We need much bigger solutions.

pinchvalve (Forum Supporter)
pinchvalve (Forum Supporter) MegaDork
1/25/21 11:47 a.m.

All I know is that based on need and demographics and experience, I will be the last in line...and they  will run out on the person before me.

Wally (Forum Supporter)
Wally (Forum Supporter) MegaDork
1/25/21 4:36 p.m.

TIL that if you've had the vaccine you can't currently donate antibodies.  Left them some blood anyway. 

Advan046
Advan046 UltraDork
1/26/21 12:40 a.m.

In reply to SVreX (Forum Supporter) :

I think there is a duality of purpose.

  1. Have enough ordered just in case the science begins to show that we need a third, refresher, shot in the late fall of 2021.
  2. If all is as we think it is, we can donate any we don't need. 

The vaccine is just the next part of a pandemic response not necessarily a get your second shot and the pandemic is over situation.

SVreX (Forum Supporter)
SVreX (Forum Supporter) MegaDork
1/26/21 8:09 a.m.

The CDC says 20,537,999 doses have been administered, and 41,411,550 have been distributed.  
 

At the local level, health departments are saying they are running out. 
 

Where are the doses?

trigun7469
trigun7469 SuperDork
1/26/21 8:40 a.m.

behind 10.6 million in the US, guess I will be waiting in line for a while. 

 

EDIT 10.6 Million in the state of PA, per the NY times esimator.

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