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I feel that the mood has shifted more provaccine. I have seen several patients who were anti flu shot but traveled across the state to get the covid vaccine a few weeks sooner. Maybe it is just my limited window but things look more positive to me in regards to patient acceptance
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i believe covid vaccine, since the influenza vaccine already has shown only this much penetration into the general population.Originally posted by Lithium View PostComment
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Pure speculation. Looks like San Diego was expanding to 1C! Great accomplishment and the 2nd shots to finish up. "more than 500,000 teachers, law enforcement and food workers were able to begin to receive vaccinations on Saturday."
This was in California and would have gone a long way to encourage school openings and appease groups that were pushing to get a higher priority.
Nope, FEMA Oakland and Los Angeles are now the higher priorities. These were based on "science". The science was Federal control, not state control. Period.
Vaccines under the "old system" were at 1.74 million per day, the highest 7 day average. Tear it down, put it under FEMA's control. Sorry, I have had much experience with FEMA from Katrina on. To be honest, I can't tell whether this is the same funding or different. Vaccines are going different places and there is a change of control. Of course a state will say, OK. Republican or Democrat have to say yes because there is not published plan. Basically one month into vaccine distribution and the already built vaccine sites are being reworked or eliminated. Activity trap. No more vaccines distributed. Just disappointed people with appointments that need to get back in line someplace.
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I am not an epidemiologist, but based on the original study in nejm as well as the recent lancet study regarding effectiveness of a single
single pfizer dose, it appears one dose of the pfizer vaccine offers superior protection compared to the one dose J&J vaccine though there seems to be a lot of excitement about J&J being a single dose vaccine. Am I missing something? Also I understand J&J reduces severe covid but what about downstream pulmonary, cardiac or thromboembolic effects from a nonsevere case?Comment
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You’re missing the fact that the J&J vaccine only requires normal refrigeration so it’ll be able to go to more underserved areas easier. It has great performance on preventing severe infection, hospitalization, and death. It was studied against some of the variants and did well while the Pfizer and Moderna vaccines weren’t studied in that way. It’ll also give more people an earlier opportunity to be vaccinated.Originally posted by tailwind225 View PostComment
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I had some similar questions:Originally posted by tailwind225 View Post
1. If one had a choice between a vaccine that blocked symptomatic COVID completely vs one that made infections less severe, all other things being equal why would you choose the second one?
2. if the risk of post-vaccine transmission is a concern, wouldn't there theoretically be a higher-risk of transmission with the J&J vaccine? Intuitively a vaccine that blocked COVID-related coughing, sneezing, etc should do a better job of preventing transmission.
3. We all have patients that end up in the hospital with even minor URI's (pts with severe COPD, CHF, etc) - ideally we don't want them to get sick at all, making the J&J vaccine less attractive.
4. As you say, even moderate COVID infections can have serious sequelae. I would add to that in a high-risk patient as in #3, bad things happen in a hospital - nosocomial infections, iatrogenic harm, non-COVID thrombotic events.
Other than J&J being a one-shot vaccine and not needing special handling I'm not seeing the attraction. Add to that it looks like Pfizer is ramping up supply and vaccination sites are now equipped to handle the necessary super-cooling.
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Exactly - oranges to applies comparison on the hard stats between J+J and Moderna/Pfizer. The logistics really are game changers. Single shot is huge. No cold chain storage is huge.
Being able to handle Pfizer and Moderna at metropolitan area is one thing. Being in county with population 2500 and nearest pharmacy is 2 hours away -- a lot harder to vaccinate that entire population effectively -- same for other countries without large scale infrastructure.
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There will be some logistics issues. 2m initial and 100m Total through June.Originally posted by CordMcNally View Post
”J&J’s contract with the federal government, inked last summer, calls for the drugmaker to deliver 100 million doses by the end of June. But it's now looking like deliveries will be “back-end loaded,” Zients said”
The first 50% of vaccinations in the US will be much easier than the remaining simply due to the ability to use the mega vaccination centers. Each of the additional 10% will be harder, slower and this will be a long tail.
This will require more than making it available in pharmacies and doctors offices.
Some segments are difficult. If you can’t get people to vote or fill out a census form, what makes you think they will go out of their way to get a vaccine? Depends on the approach taken. For voting and census, knocking on doors is required. So much less efficient. J&J is the only vaccine that is possible with mobile vans.
The US is way ahead of the rest of the world, I can see problems trying to mitigate WHO and the other countries. Have’s vs the have nots.
It feels so optimistic, until one realizes how difficult the task of vaccinating the world really is.
It’s so easy to say go vaccinate 1000 people. Much different if they all aren’t standing in line.
Serious consideration needs to be given to attacking the hard to reach areas starting in May and June with the J&J vaccine. It is on the critical path. A second plan of attack. The numbers won’t be impressive, but it is necessary for success.Comment
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Originally posted by StarTrekDoc View Post
I read recently that Pfizer vaccine can be now stored at normal freezer temperature, which should be more widely available.
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I would rather have JnJ than nothing. I think reserving the mRNA vaxes for high risk patients is reasonable but we just need to get more people immune quickly to avoid another fall surge.Originally posted by Rando View PostComment
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That'll help allow large CVS/RiteAid pharmacies to stock PfizerOriginally posted by Kamban View Post
I read recently that Pfizer vaccine can be now stored at normal freezer temperature, which should be more widely available.
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Unless you're out in the boonies I think the choice might be more like do you get the J&J now or the Pfizer/Moderna in a month. Or drive to a bigger city to get the Pfizer/Moderna.Originally posted by triad View Post
Another factor I thought of - if you buy into the whole "long hauler" possibility then J&J would be less desirable. I don't think the long hauler thing has been discussed much here, my guess is it's a combination of diagnoses not necessarily related to COVID.Comment
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Oh very interesting. I had just assumed it was mostly microthromboembolic hits to lungs, heart, brain and other organs from the awful coagulopathy we see so often in COVID. Are there specific unrelated disease processes that you suspect or more of a general feeling that this isn’t lining up quite right?Originally posted by CordMcNally View PostComment
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It will be interesting to see if the majority have measurable pathological disease or if this becomes the new chronic fatigue/ fibromyalgia like syndrome for some.Originally posted by PedsCCM View PostComment
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