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How does one ration a COVID vaccine?

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How does one ration a COVID vaccine?

 
Old 11-27-20, 07:25 PM
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CliffordK
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How does one ration a COVID vaccine?

It may well take up to 6 months to roll out the coming COVID vaccine.

Who gets it first?

CDC's COVID-19 vaccine advisers set meeting to vote on who should get first doses


.

Governments around the world weigh thorny question: Who gets the vaccine first?



There is a discussion of putting nursing home patients at the top of the list. But, I'd drop 'em down a little bit. While they may be at increased risk, the potential for years life lost per individual would be lower.

Anybody that would get an early dose, and has had "The Flu" (without confirmation) since January would get an antibody test.

I'd propose something like this:
  1. Practicing Doctors, Nurses, Dentists, Nursing Home Staff, and other health professionals OVER 50, or with serious personal health risk. Plus those at any age with high risk close secondary contacts.
  2. Non nursing home individuals with significant risk of complications. Those > 65, plus generally individuals > 40 or 50 with Diabetes, Morbid Obesity, Severe Asthma, pacemakers or history of heart problems, COPD, etc (not just high blood pressure or high cholesterol, but some serious diagnosed condition).
  3. Pick up the rest of the health professionals including students admitted to a medical program.
  4. Teachers and Day care with in-class instruction.
  5. Nursing Home Patients.
  6. Bus Drivers, Taxi Drivers, Checkers in high volume stores, etc.
  7. Start working back with age groups to 50.
  8. K12 Students plus college students, and college employees.
  9. Everyone Else.

To some extent, I'd put individuals with occupations working with the public and home contact with unvaccinated individuals at high risk to be equal to someone with that risk. As the high risk individuals get picked up with the second or third groups to be vaccinated, this group would go away soon.

Last edited by CliffordK; 11-27-20 at 07:29 PM.
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Old 11-28-20, 01:09 AM
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Yup, I'd agree with that priority.
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Old 11-28-20, 07:50 AM
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You left out the ultra wealthy and power brokers in Washington and elsewhere who will most certainly move to the front of the line due to their essential-ness. I will be 65 by the time this all happens, willing to quietly wait my turn. I agree with your list but it will take some very powerful legislation with the teeth to back it up. Does public shaming even work anymore?

Meanwhile I return to work Monday to my "essential" job on a campus with mandatory masking well posted with absolutely zero enforcement. All fun and games 'til you can't breath.
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Old 11-29-20, 11:48 PM
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I would hope there even once the "rules" are laid down, they will allow special cases to be prescribed the vaccine by doctors.

And there will be some abuse. It is hard to say how to keep that at a minimum.

Perhaps require doctors and clinics to "code" every dose given according to a priority coding. Then give up to 10% of the doses as "optional discretionary".
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Old 11-30-20, 01:27 PM
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I hate to be cynical, but the same people who were able to get the test early on in the crisis will be the same ones who get the vaccine. Rich people, politicians and sport stars.

Heck, they can't even get proper PPE supplies to nurses as it is.
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Old 11-30-20, 01:50 PM
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I tested positive for the covid antibodies so I am in no hurry to get the vaccine. Time and more research should tell if it is even needed with someone that has or had the antibodies. Now since I travel for work domestically and internationally it might be a requirement.
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Old 11-30-20, 02:40 PM
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Take the vaccine even if you’ve already had coronavirus, Fauci says

https://www.mcclatchydc.com/news/pol...247454710.html
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Old 11-30-20, 02:44 PM
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I'd put gravel bike riders first, then mountain bikers, then roadies, then the healthcare workers.
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Old 11-30-20, 06:33 PM
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Originally Posted by CycleryNorth81 View Post

Take the vaccine even if youíve already had coronavirus, Fauci says

https://www.mcclatchydc.com/news/pol...247454710.html
So far the number of people getting two documented different infections seems to be low.

I don't doubt potential benefits of vaccinating those that have had a previous infection, but I'd move them down a bit on the list of vaccine recipients when rationing. Except for certain individuals that might have some extreme risk, and/or extreme exposure risk.
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Old 11-30-20, 06:39 PM
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Originally Posted by CycleryNorth81 View Post

Take the vaccine even if youíve already had coronavirus, Fauci says

https://www.mcclatchydc.com/news/pol...247454710.html
I will wait for a second and third opinion. Information and understanding about this virus seems to change daily.
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Old 11-30-20, 07:17 PM
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This is the LAST thing I am concerned with. I'm prepared to wait my turn to let people at a higher risk go first.

My concern isn't who will be first to get the vaccine ... but who and how many will refuse.
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Old 12-01-20, 11:53 AM
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1st tier- politicians, wealthy, athletes.
2nd tier- those over 65 years old.
3rd tier- doctors, nurses, healthcare workers
4th tier- those with dr established comorbidities like cancer, asthma, obesity, etc etc. This assumes dr offices are giving the shot and people with established issues can be identified.
5th tier- everyone else.

There, done. Someone send this to the guvmnt.
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Old 12-01-20, 02:16 PM
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Originally Posted by Biker395 View Post
This is the LAST thing I am concerned with. I'm prepared to wait my turn to let people at a higher risk go first.
It is hard to judge my absolute risk of what the infection would do to me. But, as long as I can keep myself in a relatively low risk group from getting the disease, I'll wait my turn.

I had wondered if I was to take a job requiring greater travel and interaction with others, then a vaccine might be good.
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Old 12-02-20, 08:59 AM
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The UK has approved the Pfizer vaccine for emergency use. It doesn't sound like they spent much time considering it.
The UK has become the first country in the world to approve the Pfizer/BioNTech COVID-19 vaccine for use.

The government says the jab, which has been given the green light by independent health regulator MHRA, will be rolled out across the UK from early next week.
https://news.sky.com/story/covid-19-...ccine-12148786
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Old 12-02-20, 09:03 AM
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The UK's priority for vaccination.
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Old 12-02-20, 10:57 AM
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Iím waiting for the Bubbas and Bubettes to start harassing people waiting in line at medical facilities to receive a vaccine. Hopefully I am wrong! But I see some nut jobs protesting and trying to interfere with distribution of a vaccine. The typical screaming and yelling with ridiculous picket signs and attempts to block people from a medical center. I will be patient and wait my turn and be civilized but Iím concerned about my enlightened community.
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Old 12-02-20, 11:24 AM
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Originally Posted by skookum View Post
The UK has approved the Pfizer vaccine for emergency use. It doesn't sound like they spent much time considering it.

https://news.sky.com/story/covid-19-...ccine-12148786
I'm surprised the USA has been dragging their feet on "Operation Warpspeed" for so long.

Of course there still is the issue of too many people and not enough doses.
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Old 12-02-20, 11:53 AM
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Originally Posted by CliffordK View Post
I'm surprised the USA has been dragging their feet on "Operation Warpspeed" for so long.

Of course there still is the issue of too many people and not enough doses.
I have read suggestions that the UK regulators just rubber stamped the Pfizer application and didn't anlyze it in any rigorous way. The US is poised to approve it next week and start vaccinating the next day. The EU may approve it by January.

Here in Canada, approval may come this month and the first vaccinations will be in the first quarter of 2021. Its all very vague.
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Old 12-02-20, 11:58 AM
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Originally Posted by skookum View Post

The UK's priority for vaccination.
I have no problem giving Nursing staff the vaccine. And doing so may help prevent them from bringing the disease into facilities, as well as reduce the need for repeated testing.

Perhaps hospital staff that work with COVID patients if they haven't had the disease.

But I am still not convinced that Hospice Patients, or patients with DNR orders should be at the top of the list.

It is complicated. I met a very vibrant couple living in an upscale assisted living facility a few years ago. Basically enjoying the meals and entertainment, but otherwise relatively independent.

On the other hand, I've seen Alzheimer's Patients that were so bad that they couldn't speak, eat, or remember where their room was.

One of the issues, of course, is social isolation from the families that can't visit for one reason or another.

Unfortunately the nursing home data has been obscured by the State of Oregon (and apparently elsewhere too). The daily COVID reports list either "died at residence" or "died in X hospital", but never say that the person died at a nursing facility. One only presumes that they've lumped prisons and nursing facilities as "residence".

Nonetheless, there are a lot of people at risk in the community. My mother will be turning 80 this month, and is terrified of the disease. And, if she was to get it, I would likely have to provide her assistance, putting myself at risk. Yet her neighbor is an obese diabetic that may well be at greater risk despite being about 15 years younger.

And, even with an effort for Social Distancing, everyone has some contacts.
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Old 12-02-20, 12:15 PM
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Originally Posted by skookum View Post
I have read suggestions that the UK regulators just rubber stamped the Pfizer application and didn't anlyze it in any rigorous way. The US is poised to approve it next week and start vaccinating the next day. The EU may approve it by January.

Here in Canada, approval may come this month and the first vaccinations will be in the first quarter of 2021. Its all very vague.
Hopefully they have consultants that can read the study in a day or two, and discuss it quickly. Also an insider view of the vaccine development, and trials while in progress would help with knowing what to expect.

Part of the fallacy of this whole thing is that the USA ordered 100 million doses back in July, but it appears to have been pending approval which hasn't happened yet.

So we'll likely get a few million doses when it is approved. The UK is getting just short of a million doses.

And with two doses per person, the number of people receiving the vaccine will be half of that.
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Old 12-02-20, 12:55 PM
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Originally Posted by CliffordK View Post
Hopefully they have consultants that can read the study in a day or two, and discuss it quickly. Also an insider view of the vaccine development, and trials while in progress would help with knowing what to expect.

Part of the fallacy of this whole thing is that the USA ordered 100 million doses back in July, but it appears to have been pending approval which hasn't happened yet.

So we'll likely get a few million doses when it is approved. The UK is getting just short of a million doses.

And with two doses per person, the number of people receiving the vaccine will be half of that.
I have no opinion on whether rapid approval is adequate or not. I simply do not know enough about it.

I did see some figures about how many doses the US expected to have available in December. Unfortunately I can't find the source now, but it did seem like a reasonable number
in the millions. I know its not a lot compared to the population, but you have to start somewhere.

In Canada, we don't have excess capacity to manufacture any of these vaccines, so we have to obtain them from outside the country, which would not be a problem if our governments had their
ducks in a row, but they don't, so we are somewhere down the list.
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Old 12-02-20, 01:40 PM
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Hopefully 80+ will be near the top of the list. It should not matter if in care facility or not.
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Old 12-02-20, 02:04 PM
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all you one man one voters out there have suddenly become AUTHORITARIAN now that there is a glimmer of survival ... if everyone was really EQUAL and this really was a DEMOCRACY the vaccine recipients would be ordered by randomly chosen social security numbers from a list of people residing in a specific area of distribution ......... NO EXCEPTIONS > everyone is finally equal in the USA .... no more BLM no more ANTIFA no more people being being better than you and no more me 1st ..................................... of course the simple fairness of this is also why no one would want it
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Old 12-02-20, 02:12 PM
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Originally Posted by skookum View Post
In Canada, we don't have excess capacity to manufacture any of these vaccines, so we have to obtain them from outside the country, which would not be a problem if our governments had their
ducks in a row, but they don't, so we are somewhere down the list.
Can we purchase the vaccine from Canada?
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Old 12-02-20, 02:14 PM
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Originally Posted by jack pot View Post
all you one man one voters out there have suddenly become AUTHORITARIAN now that there is a glimmer of survival ... if everyone was really EQUAL and this really was a DEMOCRACY the vaccine recipients would be ordered by randomly chosen social security numbers from a list of people residing in a specific area of distribution ......... NO EXCEPTIONS > everyone is finally equal in the USA .... no more BLM no more ANTIFA no more people being being better than you and no more me 1st ..................................... of course the simple fairness of this is also why no one would want it
Oh.... Perhaps dig up the Vietnam Draft Notices to start?
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