Seriously thoughtful The Covid Vaccination Poll

[meeera]

Originally Posted by haertig

As does dementia. I think the problem there is not understanding why things are different, why you cannot touch everything you used to, the need to wash hands more frequently, the need to avoid close personal contact, etc. I would imagine that intellectual disability increases the risk of getting any disease, as well as the risk of having an accident, pretty much it would increase the risk of unintentional bad things happening to you from any cause.

Down Syndrome is the most common known cause of intellectual disability, and carries with it specific immune deficits that predispose to severe COVID. In addition, many people with intellectual disability rely on having support workers, and cannot self-isolate effectively. They are also frequently forced into congregate settings both for living and working, which far too often have been managed poorly from a COVID prevention point of view.

[Catlady]

My peeve is access. Mega sites are not helpful for people who don't have a car or who are reluctant to use public transportation for fear of being exposed to the virus while on the way to a site. The focus--at least in urban areas--should be on increasing neighborhood sites.

[Almamida]

Originally Posted by haertig

And then there are the ones who think they are special and more deserving than others, and thus should be moved to the front of the line.

The problem is, there's an "I'm more special than you" person coming out from every nook and cranny. You can't sort through all the reasons for entitlement that are being claimed. There's no path to victory when you have to navigate that mess.

If you're trying to get at me, that is a pretty inaccurate, lame and inconsiderate attempt.

Originally Posted by haertig

"By age" is really the only way to handle things, since age is the biggest factor in predicting outcome from the disease.

Well, you're wrong. Hard hit areas, pre-existing conditions and overall risk of exposure / expose others are other criteria that are considered in the vaccination rollout in most places.

[haertig]

Originally Posted by Almamida

If you're trying to get at me, that is a pretty inaccurate, lame and inconsiderate attempt.

Compared to what? Your accurate, non-lame and considerate attempt to get at me with your earlier comment? Why don't you go back and read your own previous words? I merely provided you a mirror to look into.

Be at peace. You threw an insult at me, I returned the favor to you. Now let's move on - I am fine to skip the snipes if you are.

Well, you're wrong. Hard hit areas, pre-existing conditions and overall risk of exposure / expose others are other criteria that are considered in the vaccination rollout in most places.

I never said those things were not, or should not, be considered. However, they should not be the primary consideration. It is very difficult to get a handle on who has what pre-existing condition, which pre-existing condition is worse than other pre-existing conditions, etc. Collecting all that data, sorting through it, devising rules of who comes first - all that takes quite a bit of time and would delay the vaccine rollout for everyone. Then you have other groups that many want vaccinated sooner, like teachers. So who comes first - the teacher or the one with a pre-existing condition? The answer will depend on which of those two people you ask. Sometimes fighting over who gets to go first accomplishes nothing useful, and just delays the rollout for everybody. I have seen it published many times that age is the primary predictor of how well you will do if you catch the virus. Of course some elderly will do better than others. That is a given. But age is still the best predictor we have available to us. So it makes sense to use age as the primary thing to look at when scheduling vaccination. And that is what most, if not all, jurisdictions are doing. Other things can certainly be looked at, but as minor tweaks to the scheduling, not as the primary focus. They are trying to do that in my own state. They have taken it to the ridiculous level that I allude to above. We are on - I am not kidding - Phase 1B.4 right now (or at least that's where we were last week). What in the heck does that mean? What they are doing is trying to cram new levels between the old levels, which themselves were crammed between the older levels. It's like playing chess while changing the way pieces are allowed to move on every turn. It makes a real mess of the game, and ultimately, despite your best efforts, you really don't end up with a more "fair" game of chess in the end.

[Almamida]

Originally Posted by haertig

Compared to what? Your accurate, non-lame and considerate attempt to get at me with your earlier comment? Why don't you go back and read your own previous words? I merely provided you a mirror to look into.

Be at peace. You threw an insult at me, I returned the favor to you. Now let's move on - I am fine to skip the snipes if you are.

And you're just love and consideration for others.

Be assured that I'm at peace though.

Originally Posted by haertig

I never said those things were not, or should not, be considered. However, they should not be the primary consideration. It is very difficult to get a handle on who has what pre-existing condition, which pre-existing condition is worse than other pre-existing conditions, etc. Collecting all that data, sorting through it, devising rules of who comes first - all that takes quite a bit of time and would delay the vaccine rollout for everyone. Then you have other groups that many want vaccinated sooner, like teachers. So who comes first - the teacher or the one with a pre-existing condition? The answer will depend on which of those two people you ask. Sometimes fighting over who gets to go first accomplishes nothing useful, and just delays the rollout for everybody. I have seen it published many times that age is the primary predictor of how well you will do if you catch the virus. Of course some elderly will do better than others. That is a given. But age is still the best predictor we have available to us. So it makes sense to use age as the primary thing to look at when scheduling vaccination. And that is what most, if not all, jurisdictions are doing. Other things can certainly be looked at, but as minor tweaks to the scheduling, not as the primary focus. They are trying to do that in my own state. They have taken it to the ridiculous level that I allude to above. We are on - I am not kidding - Phase 1B.4 right now (or at least that's where we were last week). What in the heck does that mean? What they are doing is trying to cram new levels between the old levels, which themselves were crammed between the older levels. It's like playing chess while changing the way pieces are allowed to move on every turn. It makes a real mess of the game, and ultimately, despite your best efforts, you really don't end up with a more "fair" game of chess in the end.

"Details" you seem to ignore :

1 - pre-existing conditions at risk with COVID are known (and they are classified in the ones that are more at risk than other, without forgetting some people can have multiple conditions)
2 - People with pre existing conditions are identified and known (They usually have health center / specialized clinics to deal with their conditions)
3 - Higher risk areas / setup are known
4 - Science and data modelling have shown that some ways (vaccination rollout) are better than others in saving lives, and prioritizing only based on age is clearly not the best solution.

[Tarana]

Originally Posted by haertig

I never said those things were not, or should not, be considered. However, they should not be the primary consideration. It is very difficult to get a handle on who has what pre-existing condition, which pre-existing condition is worse than other pre-existing conditions, etc. Collecting all that data, sorting through it, devising rules of who comes first - all that takes quite a bit of time and would delay the vaccine rollout for everyone. Then you have other groups that many want vaccinated sooner, like teachers. So who comes first - the teacher or the one with a pre-existing condition?

In my state, they have been resorting stuff without slowing down the rollout. The only slowdown in vaccination they had was because of delays receiving vaccine because of weather. Right now teachers, school staff, child care workers are getting vaccinated along with the rest of the 75+ (and 65+ with certain co-morbidities).

[OtinG]

Originally Posted by pdurrant

The UK has just started accepting bookings for people over 55 (was over 60). My two vaccination doses are now booked in.

[OtinG]

Originally Posted by Catlady

My peeve is access. Mega sites are not helpful for people who don't have a car or who are reluctant to use public transportation for fear of being exposed to the virus while on the way to a site. The focus--at least in urban areas--should be on increasing neighborhood sites.

I totally agree. Getting the vaccines to the people in their neighborhoods and work centers should be a top priority.

Where I live in the suburbs, there is no public transportation. There are no subways in my area at all, not even in the center of towns, and above ground trains for public commuting are very limited or non-existent. Those who cannot drive must either find someone to take them or hire a cab/Uber, which is expensive. Disabled people and the elderly might be able to drive, but going to a walkthrough mega site will be difficult or impossible if they have very limited mobility. We can not expect a mobility challenged person to walk several hundred yards through a mega site and also have to stand up for perhaps hours at a time. We have a few drive-through mega sites which are way more accessible, but most of the mega sites are walk through types in my area.

Here in north Texas we have community centers, American Legion Halls, convention centers, etc. in nearly every town, even small towns have some gathering place that can accommodate 100 or more people, so we should be using more of those places to get the vaccines to local people.

[Almamida]

The thing is, they might have protocols and logistic for flu shots, to make sure everybody who needs / want it can get access to it, why not use this existing resources?

[haertig]

Around here, you can get vaccinated in the grocery store, at the pharmacy counter. I imagine that not all groceries stores have a pharmacy though (but all the ones near me do). Same thing for Walgrens stores - you can get vaccinated there. And they are going out to vaccinate people where they live too, but I only know about that happening at senior living places. I don't think they go to individual houses (yet).

It would not be workable to try to go out to everybody's individual house. We just don't have the resources. We will continue to need group vaccination areas. I'm thinking churches, community centers, and the like. Not an hours commute to some downtown stadium parking lot (there are plenty of those now, but they're of limited use for some recipients). For specific individuals, at home vaccination might be the only choice. And we should support that as much as possible. The logistics of super cold storage requirements and limited viability of the vaccine after opening the multi-dose vials (with Pfizer and Moderna) made vaccination at home mostly impossible. But with the Johnson & Johnson becoming available now, that should open up a lot of new doors for vaccine distribution. I'm not sure you can leave a J&J shot just laying out in the open for long, but apparently you can do that for longer than you can with Pfizer or Moderna.

[haertig]

Originally Posted by Almamida

2 - People with pre existing conditions are identified and known (They usually have health center / specialized clinics to deal with their conditions)

These specialized clinics would seem the ideal place to distribute vaccinations to the affected individuals, as long as there are enough qualifying patients available to make the difficult storage of Pfizer and Moderna feasible. I hope they are doing that at these clinics. The Johnson & Johnson vaccine may really change the landscape in regards to this however, with it's less stringent storage requirements. J&J may well open up lots of previously non-feasible locations to become distribution centers. I would support setting aside J&J vaccine to service people in special situations where it's storage benefits would really shine, and reserve Pfizer and Moderna for others who are more mobile, have fewer pre-existing conditions, etc. It seems that we have a natural division of vaccine recipients as well as a natural division of vaccines. That split was not intentionally created, but we should take advantage of it none-the-less.

and prioritizing only based on age is clearly not the best solution.

Once again, I'll point out that I never said only by age. I said primarily by age, with tweaks to scheduling to account for other factors and conditions.

[ownedbycats]

My province tried to explain its reasoning for not putting disabled people as a priority at all: it slows down the "race" for herd immunity. Because making a list makes too much time. Never mind that they're prioritizing other at-risk groups. And truck drivers.

[Almamida]

Originally Posted by haertig

These specialized clinics would seem the ideal place to distribute vaccinations to the affected individuals, as long as there are enough qualifying patients available to make the difficult storage of Pfizer and Moderna feasible. I hope they are doing that at these clinics. The Johnson & Johnson vaccine may really change the landscape in regards to this however, with it's less stringent storage requirements. J&J may well open up lots of previously non-feasible locations to become distribution centers. I would support setting aside J&J vaccine to service people in special situations where it's storage benefits would really shine, and reserve Pfizer and Moderna for others who are more mobile, have fewer pre-existing conditions, etc. It seems that we have a natural division of vaccine recipients as well as a natural division of vaccines. That split was not intentionally created, but we should take advantage of it none-the-less.

(Talking about Ontario, Canada)

They are actually used for the vaccination process (our province finally delivered a really well precise and clear document about it last Friday), they are assigned Pfizer/Moderna stock to High risk people as they have the best clinical protection.
It's also to the benefit of the province to use these resources, as it concerns up to 2.9M identifiable people here in Ontario.
That frees some places to vaccinate people between 60 to 80 in parallel in the regular vaccination spots they designated / created.

[OtinG]

Originally Posted by Almamida

The thing is, they might have protocols and logistic for flu shots, to make sure everybody who needs / want it can get access to it, why not use this existing resources?

In the USA we jokingly say we have the 3rd best healthcare system in North America! Do the math, that translates into “the worst” healthcare system on the continent.

Here in the USA we don’t have special plans for vaccinating for the flu per se. With flu shots there always seems to be a more than adequate number of vaccinations available ahead of flu season, therefore they get distributed all across the country to most doctors offices, pharmacies, hospitals, etc. Flu shot vaccinations are rather easy to find near to where you live. COVID-19 is a whole different situation altogether. We have limited supplies for COVID-19 vaccinations, and we have a poorly designed distribution system which is improving but still isn’t adequate. Plus we have bottom dwellers (politicians) on state and local levels that don’t have a clue how to manage this situation, or just don’t care.

[BetterRed]

Originally Posted by Almamida

The thing is, they might have protocols and logistic for flu shots, to make sure everybody who needs / want it can get access to it, why not use this existing resources?

The question was asked here, the federal authorities rejected using the same protocols because flu vaccines are one shot and shipped in ready to go syringes, whereas the SARS-Cov2 vaccines are two shot and shipped in multi-shot vials.

But somewhat incongruously they expect the same GPs and Pharmacists to inject the AZ vaccine into most peoples arms under a 60+ prerequisite protocol that could require extra staff, extra technology, and larger premises Ψ³

The local flu vaccine manufacturer is also manufacturing the AZ vaccine. One wonders if it could have been shipped in single shot syringes which would have also obviated the need for hard to get low dead space syringes.

BR