Medical Discussion of Coronavirus

[Tim]

Direct-to-pharmacy will help remove a barrier; but it also will create the just-in-time resupply issue for #2 shot. With the J+J vaccine being 1 shot it'll be a lot easier and that's why it's such a game changer despite the lower reported efficacy.

Correct me if I am wrong. Vaccines were always shipped directly to the pharmacies. What has changed is that Walgreen's and CVS used their national clout to bypass the state allocation process. This allocation is actually subtracted from the state which is based upon population. At this point, the choice of usinpg a Walgreen's which might be the only location in a rural location is simply up to Walgreens. Give me 10k doses and they ship them to 10 locations in a city and the rural areas at shipped what?
A separate allocation system is by design will have gaps. Two chiefs do not come up with the same distribution. I have not idea if the allocations of Walgreen's and CVS in the allocation mode will even be coordinated with the state allocations. I have gone through global allocations. Unless they are working from one set of numbers and have agreed upon rules, the system will result is shortages and oversupply. There is one pipeline for the physical product, break down the bulk shipments into smaller packages and deliver them the next day. Primarily FedEx to the airport and UPS to the actual shipping location.

What happens if the State floods the HUB's in the cities, and CVS and Walgreen's ramp up their "super pharmacies" in the same cities? A flood of vaccine and a drought in rural areas. Next week, the issue is corrected and the rural area gets flooded. The shipment is not the issue, it is the allocation control. Needs to be one set of requests for product and one set of allocation rules.
Drop shipment is the actual terminology. Shipped directly from a third party manufacturer to the customer. That is already in place.
There are alternate demand allocation processes. HUB's vs pharmacies for example. The problem is they do not have an order backlog system to allocate to at this time.
You actually need order demand by location and work from that. Multiple hands in the pot for vendors will not result in accurate forecasted delivery times. They can enhance this if all pharmacy vendors can forecast demand and the allocations be made to achieve #2 doses, and geographic and distributor supply.

I view Direct-to pharmacy as marketing messaging that solves nothing but gets Walgreen's and CVS finally agreeing to start vaccinating. Centralized control, is very efficient. Or it can create a mess we don't need at this time. If the big chains can provide a service and vaccinate rather than control the priorities which they have demonstrated a failure so far, that would be an improvement.

[StarTrekDoc]

CVA and Walgreens had separate contracts with Fed to vaccinate nursing home populations.

They may very well expand on that specific program and direct shipments to pharmacies.

Otherwise local pharmacies/chains have been getting supplies from state-county from my understanding.

[artemis]

The dichotomy of physicians to support staff and their associated rates of vaccination are very interesting. Seems like vast majority of docs are getting vaccinated while the opposite is true for the supporting staff.

I don't think that's surprising. Physicians have a much better basic science foundation than most support staff, which means a better understanding of how these vaccines actually work.

[Hatton]

I don't think that's surprising. Physicians have a much better basic science foundation than most support staff, which means a better understanding of how these vaccines actually work.

If you think about it I believe nurses and other support staff are also more likely to smoke. No data just an observation.

[Tim]

CVA and Walgreens had separate contracts with Fed to vaccinate nursnng home populations.

They may very well expand on that specific program and direct shipments to pharmacies.
.giv
Otherwise local pharmacies/chains have been getting supplies from state-county from my understanding.

https://news.walgreens.com/covid-19/...p-program-.htm
Every allocation for every hospital and every pharmacy and every hub was allocated by the state. The contracts for vaccinating nursing homes was a labor deal. The state controlled the vaccines. When 1B was opened up, Walgreens and CVS refused the state allocations and priorities.

They still would vaccinate any 1A. I sent an xray tech to the pharmacy and they vaccinate him. Previously had refused 1B or even a list. Corporate directive. Each pharmacy had signed up as a provider but they were told to NOT follow the state mandate on priorities. The state director even put out press releases and requests on the DHHS website. Don't hold vaccines use it on 1B to every provider they had sent the supply too. Most did, not CVS and Walgreen's. Face to face, I have the vaccine and it was allocated based upon data of 1A and 1B population stats in this area, but Corporate will not allow me to schedule and appointment and give you a shot even though you are qualified. I can't put a 1B into the 1A category, or they actually can fire me. Rock and a hard place due to the Corporate suits. This is not a distribution problem, this is a corporate deal. Simple, are you on medicare show me your card, you are eligible. No dice. Corporate arrogance that withheld vaccination capacity intentionally. It has been nearly a month that the withheld from the nation vaccinations that followed the state guidelines. Intentional withholding of available vaccines based on Corporate directives. Sorry, a pharmacist knows the state guidelines and was prevented from following them until mid-February. Not cool. A 1 month of vaccination capacity flushed down the toilet. That is the facts.
An intentional withholding of capacity for what? To join the vaccination party? These idiots committed this since 1/06/21. Hey Walgreen's and CVS, do you know people are prioritized and need vaccines? Walgreens is in Chicago, and CVS in RI. Am I surprised? Might need the approval of the teachers union. This is not logistics or science, this is a willful intent to "hold off" is my suspicion. Maybe not.

[Panscan]

I don't think that's surprising. Physicians have a much better basic science foundation than most support staff, which means a better understanding of how these vaccines actually work.

Definitely but it seems like rates among the support staff are lower than general public which feels strange.

[Lordosis]

Everyone in my office got it.
Our hospital is "very encouraging" for everyone to get it. We are at about 75-85% right now. Of the people declining it is mostly nonclinical staff.

There are no punitive actions being taken for those who decline but they are asking for a declination form from everyone. I would not be surprised if there is something in the future.

[Tim]

A little knowledge can increase anxiety and fear.
All that safety training and how dangerous small missteps can be effective. There might be an educational aspect needed to fill in the blanks.

[Kamban]

Definitely but it seems like rates among the support staff are lower than general public which feels strange.

I was surprised that quite a few people stated they were concerned about microchip. I said Huh? Then I read up and found that Bill Gates had mused about microchip given with vaccinations to help track the vaccine, its type etc.

Conspiracy is alive and well. And occurred in both red and blue people.

[StarTrekDoc]

Conspiracy is alive and well. And occurred in both red and blue people.

And who said Martians and Na'vi can't find common ground

[Kamban]

So what is the recommendation for a health care worker who has had 2 doses of the vaccine and is 10 days out post 2nd vaccination and is asymptomatic but has just found out that her spouse has been tested positive and who has mild symptoms. No quarantining separately at home.

Should the health care worker now be quarantined for 5-7 days. Or take a test after 3 days and show it is negative. Or only quarantine if he/she is symptomatic.

[G]

So what is the recommendation for a health care worker who has had 2 doses of the vaccine and is 10 days out post 2nd vaccination and is asymptomatic but has just found out that her spouse has been tested positive and who has mild symptoms. No quarantining separately at home.

Should the health care worker now be quarantined for 5-7 days. Or take a test after 3 days and show it is negative. Or only quarantine if he/she is symptomatic.

Choice D--call out to take care of spouse! Second choice, quarantine if symptomatic.

[Tim]

A ray of sunshine due to a Kroger’s pharmacy.

I had signed up at Kroger’s that had a manual list on the very first day for 1B in person in late December or early January. I asked the pharmacist if I could “gift my spot in line to a friend. A little hemming and hawing I conferenced in the friend and they allowed me to give my place in line to them. With the vaccines resuming to the pharmacies next week, that puts he and his spouse at the front of the line. Friendly neighborhood pharmacist was greatly appreciated. I rationalize it as two doses reserved and delivered not cutting in line. Saved them a place. Probably months sooner. Hope it works.

[Dont_know_mind]

I'm honestly not entirely sure how you can grade something like this. Like you mentioned previously, this is something that nobody alive (spare me whoever is going to come in and say those >102 years old were alive during the last pandemic) has been through. We really don't have anything to compare it to. It's a good learning experience but I'm honestly not entirely sure how much we'll gain from this when the next pandemic rolls around considering the last one was 100 years ago and the medical, technology, etc. has increased exponentially since that time.

It’s not hard to grade response (by country) as every country has had to deal with the pandemic.

[fatlittlepig]

You can't make this stuff up. If you want to know why I gave FDA approval process an "F" on my covid report card, simply go to today's WSJ and read the article regarding the J&J vaccine (single shot vaccine). The company applied for EUA (emergency use authorization) yesterday.
https://www.wsj.com/articles/johnson...d=hp_lead_pos6

From the article:
The New Brunswick, N.J., company expects to have millions of doses available immediately upon authorization, federal officials have said.
...
J&J filed its request to the U.S. Food and Drug Administration, which has scheduled a Feb. 26 meeting of a committee of outside advisers to review the evidence for the vaccine’s safety and effectiveness, as it did in December for the first two vaccines. If the FDA follows the same timeline as for the first two vaccines, it could reach a decision on J&J’s vaccine by the end of the month. The FDA said Thursday it will review J&J’s request as quickly as possible.

So they applied for EUA yesterday, and the FDA scheduled a meeting on 2/26? This is the same thing they did for the Pfizer and Moderna vaccines. This vaccine should be in arms starting today. FDA: "Oh you have a vaccine that appears to work? OK we'll meet in 3 weeks and decide if we should use it." The FDA committee should have been reviewing data concurrently during development, or be reviewing data 24/7 until this is approved.

This is so bizarrely surreal, where is the urgency.