Scrutable

If we agree that in the UK, vaccines should first go to the >80's (for example) because they are at the most risk of death, then on a global scale I think it's valid to argue that the countries which should have priority for the vaccine are the ones in which the deaths per population are the highest.*

If we agree that health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK) because that puts them in a better position to then help covid sufferers instead of becoming covid sufferers or infecting new ones, then we could also argue that the countries in which vaccines are designed and made should be allowed to sort out their own covid problems before trying to help others.

Apart from yourself, the other people you'd want vaccinated from a personal point of view would be the people you're likely to come into contact with. I.e. with free travel within the EU for example you'd need to do all the countries uniformly.

Covid spread all over Europe a year ago basically because of business and tourist travel. I doubt there were the same sorts of numbers travelling between Europe and Africa a year ago at half term.

* - caveat here is that I have no idea how unreliable the data in Africa might be.

From what I've read, it's partly to do with mutations as well.

No good vaccinating your entire population if Covid is ripping through other countries who don't have as much access to the vaccine and develops a mutation that doesn't respond to the vaccine. They can adjust the vaccine fairly quickly, but it would be a bit of a waste of the vaccines already in arms and still waiting to be put in arms. It already looks as if the Novovax is less effective against 1 of the SA strains.

Depends on demographics mostly?

The UK has 3.5 million over 80s - so a huge potential death toll if you ignore them. But the years of life saved really kicks in for the 10 million 50-70 age bracket.

I suspect a more callous dictatorship with a younger average age population would look at demographics and decide to prioritise 50-70, leaving out the 80s and clinically extremely vulnerable. Let's face it, mutations don't happen in the vulnerable who die promptly, they occur in the wider population who survive illness for weeks.

OffTheRock wrote: ↑

Sun Jan 31, 2021 2:19 pm

From what I've read, it's partly to do with mutations as well.

No good vaccinating your entire population if Covid is ripping through other countries who don't have as much access to the vaccine and develops a mutation that doesn't respond to the vaccine. They can adjust the vaccine fairly quickly, but it would be a bit of a waste of the vaccines already in arms and still waiting to be put in arms. It already looks as if the Novovax is less effective against 1 of the SA strains.

The world doesn't really know where the next variant will arise. (Just like we can't just give the vaccine to the young "superspreaders" because we've no idea who the person who brings the infection to the party is going to be, i.e. it would mean just vaccinating all the young people, and we decided that a better way to protect old people was to vaccinate them directly.)

Or course you eventually want to vaccinate everyone, but right now if you had just enough doses to vaccinate your entire population what's the argument for instead spreading the doses around the rest of the world? A partially vaccinated population is a great place to breed a vaccine-resistant strain.

shpalman wrote: ↑

Sun Jan 31, 2021 1:43 pm

If we agree that in the UK, vaccines should first go to the >80's (for example) because they are at the most risk of death, then on a global scale I think it's valid to argue that the countries which should have priority for the vaccine are the ones in which the deaths per population are the highest.*

If we agree that health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK) because that puts them in a better position to then help covid sufferers instead of becoming covid sufferers or infecting new ones, then we could also argue that the countries in which vaccines are designed and made should be allowed to sort out their own covid problems before trying to help others.

Apart from yourself, the other people you'd want vaccinated from a personal point of view would be the people you're likely to come into contact with. I.e. with free travel within the EU for example you'd need to do all the countries uniformly.

Covid spread all over Europe a year ago basically because of business and tourist travel. I doubt there were the same sorts of numbers travelling between Europe and Africa a year ago at half term.

* - caveat here is that I have no idea how unreliable the data in Africa might be.

It's a good argument, which I hadn't considered, that on a purely ethical basis, our priorities should be "border blind". Of course, that would imply prioritising foreign group N over home country group N+1 which I can't really see happening.

By the way, " health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK)" is wrong - in the UK "frontline health and social care workers" are in priority group 2 (link).

KAJ wrote: ↑

Sun Jan 31, 2021 2:44 pm

shpalman wrote: ↑

Sun Jan 31, 2021 1:43 pm

If we agree that in the UK, vaccines should first go to the >80's (for example) because they are at the most risk of death, then on a global scale I think it's valid to argue that the countries which should have priority for the vaccine are the ones in which the deaths per population are the highest.*

If we agree that health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK) because that puts them in a better position to then help covid sufferers instead of becoming covid sufferers or infecting new ones, then we could also argue that the countries in which vaccines are designed and made should be allowed to sort out their own covid problems before trying to help others.

Apart from yourself, the other people you'd want vaccinated from a personal point of view would be the people you're likely to come into contact with. I.e. with free travel within the EU for example you'd need to do all the countries uniformly.

Covid spread all over Europe a year ago basically because of business and tourist travel. I doubt there were the same sorts of numbers travelling between Europe and Africa a year ago at half term.

* - caveat here is that I have no idea how unreliable the data in Africa might be.

It's a good argument, which I hadn't considered, that on a purely ethical basis, our priorities should be "border blind". Of course, that would imply prioritising foreign group N over home country group N+1 which I can't really see happening.

Ethically you would probably want to maximize the effect of each dose in terms of lives saved. Distributing vaccines equally around the whole world's priority group N instead of passing to your own group N+1 may seem more "fair" but may not actually achieve this.

KAJ wrote: ↑

Sun Jan 31, 2021 2:44 pm

By the way, " health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK)" is wrong - in the UK "frontline health and social care workers" are in priority group 2 (link).

Ok. I was just confused because they weren't in group 1, and the UK is going much faster through its groups than the EU is.

Stupidosaurus wrote: ↑

Fri Jan 29, 2021 8:54 pm

I had the AZ vaccine a few days ago, I was lucky enough to be bumped up the queue a bit due to my job. The Manchester mass vaccination centre was very well run (the ladies who gave me the jab were charming despite their production-line role), but it was a bit alarming to be breathing the same air as about a hundred other people, even masked up. Still, fingers crossed that I dodged the covids. One thing I didn't bargain for was my reaction to the vaccine, about 36 h of moderate fever with muscle aches and loss of appetite. It fits with the list of reactions on the leaflet but I've never experienced that kind of reaction with a flu jab. Duly Yellow-Carded, although the MHRA website is a bit counter-intuitive in places.

Had ours yesterday morning at my local Health Centre (appt made via their web site after receiving a text). No side effects for me so far, apart from a mild ache in the upper arm, though my wife felt quite rough this morning (mild headache, fatigue), although that may be down to the amount of celebratory Bordeaux we hoovered up last night. Be interested to know how quickly your reactions surfaced.

shpalman wrote: ↑

Sun Jan 31, 2021 2:55 pm

KAJ wrote: ↑

Sun Jan 31, 2021 2:44 pm

By the way, " health-care workers should be prioritised for the vaccine (which is the case in Italy but not in the UK)" is wrong - in the UK "frontline health and social care workers" are in priority group 2 (link).

Ok. I was just confused because they weren't in group 1, and the UK is going much faster through its groups than the EU is.

At least partly because of the practical difficulties of getting the Pfizer vaccine into care homes (priority group 1), group 2 was vaccinated more or less at the same time.

FredM wrote: ↑

Sun Jan 31, 2021 3:18 pm

Stupidosaurus wrote: ↑

Fri Jan 29, 2021 8:54 pm

I had the AZ vaccine a few days ago, I was lucky enough to be bumped up the queue a bit due to my job. The Manchester mass vaccination centre was very well run (the ladies who gave me the jab were charming despite their production-line role), but it was a bit alarming to be breathing the same air as about a hundred other people, even masked up. Still, fingers crossed that I dodged the covids. One thing I didn't bargain for was my reaction to the vaccine, about 36 h of moderate fever with muscle aches and loss of appetite. It fits with the list of reactions on the leaflet but I've never experienced that kind of reaction with a flu jab. Duly Yellow-Carded, although the MHRA website is a bit counter-intuitive in places.

Had ours yesterday morning at my local Health Centre (appt made via their web site after receiving a text). No side effects for me so far, apart from a mild ache in the upper arm, though my wife felt quite rough this morning (mild headache, fatigue), although that may be down to the amount of celebratory Bordeaux we hoovered up last night. Be interested to know how quickly your reactions surfaced.

Just out of interest, did you also get an information leaflet with the vaccine saying your second dose may be a different vaccine? Or was that just reserved for those of us who had the Pfizer jab? I'm guessing there's not much (or any) data to support this policy either.

OffTheRock wrote: ↑

Sun Jan 31, 2021 4:03 pm

FredM wrote: ↑

Sun Jan 31, 2021 3:18 pm

Stupidosaurus wrote: ↑

Fri Jan 29, 2021 8:54 pm

I had the AZ vaccine a few days ago, I was lucky enough to be bumped up the queue a bit due to my job. The Manchester mass vaccination centre was very well run (the ladies who gave me the jab were charming despite their production-line role), but it was a bit alarming to be breathing the same air as about a hundred other people, even masked up. Still, fingers crossed that I dodged the covids. One thing I didn't bargain for was my reaction to the vaccine, about 36 h of moderate fever with muscle aches and loss of appetite. It fits with the list of reactions on the leaflet but I've never experienced that kind of reaction with a flu jab. Duly Yellow-Carded, although the MHRA website is a bit counter-intuitive in places.

Had ours yesterday morning at my local Health Centre (appt made via their web site after receiving a text). No side effects for me so far, apart from a mild ache in the upper arm, though my wife felt quite rough this morning (mild headache, fatigue), although that may be down to the amount of celebratory Bordeaux we hoovered up last night. Be interested to know how quickly your reactions surfaced.

Just out of interest, did you also get an information leaflet with the vaccine saying your second dose may be a different vaccine? Or was that just reserved for those of us who had the Pfizer jab? I'm guessing there's not much (or any) data to support this policy either.

Our leaflet didn’t say that, just that we’d have the second jab in up to 3 months.

Figured as much. Fingers crossed we've still got some Pfizer vaccine left in 11 weeks then.

Mrs Y got Pfizered yesterday, and has a sore arm but nowt else. Has been tracking temperature just out of curiosity but nothing to report. Which is nice.

Yeah, that lasted a couple of days but nearly a week later it's gone completely. I've had worse flu jabs.

Got appointments for 1st dose (3 Feb) and 2nd dose (23 April), 11+ weeks gap.

^ Presumably the UK vaccine program will hit the buffers at the end of March when suddenly a massive backlog of 2nd doses need administering. Is that's how it's mainly going to work - mainly alternating between periods of 1st doses and 2nd doses - or will it be a bit smoother than that somehow?

TimW wrote: ↑

Sun Jan 31, 2021 5:45 pm

^ Presumably the UK vaccine program will hit the buffers at the end of March when suddenly a massive backlog of 2nd doses need administering. Is that's how it's mainly going to work - mainly alternating between periods of 1st doses and 2nd doses - or will it be a bit smoother than that somehow?

My understanding from my friend who works at NHS Emergency Planning is that all of this is fully planned and there are adequate doses in place. I'm not sure how much of this is already in storage or on order though...

I think the plan is to get first jabs for phase one done (that's groups 1-4: the over 80s, health & social workers,care home residents & staff, the 70-80 cohort, shielders); and then start on second doses for them in parallel to first doses for the next set of groups. Or something.

This seems to be the plan. It says:

Looking forward, the UK’s vaccine supply and scheduled deliveries will fully support vaccination of JCVI priority cohorts 1 to 4 by 15 February. The government has signed deals for substantial future supply of both the Pfizer/BioNTech and Oxford/AstraZeneca vaccines to replenish the UK’s stocks and enable swift vaccination of first and second doses across the UK in the weeks and months ahead. The government has also ordered an additional 10 million doses of the Moderna vaccine, taking its total to 17 million.

mediocrity511 wrote: ↑

Sat Jan 30, 2021 1:49 pm

Sciolus wrote: ↑

Fri Jan 29, 2021 7:51 pm

KAJ wrote: ↑

Fri Jan 29, 2021 5:56 pm

ONS Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020

Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex.

Surprising, but still.

The time period covered was from March to December. From March to July schools were closed to all but a handful of keyworker children, most staff were in very part time. From July until the start of September, they were closed totally. It isn't surprising that they weren't at increased risk when for a large part of the time period they were barely open.

Good point. Should've thought of that.

If we get to a point where we're not just vaccinating to prevent deaths/hospitalisation, and we can widen criteria to high-contact professions/preventing essential workers having to self isolate, then we should probably start with taxi & bus drivers.

If that's doable. I mean, GP records include age and health conditions, but not occupations afaik. And you'd need an easy way to target people. It might be quicker & more efficient to just do it by age.

TimW wrote: ↑

Sun Jan 31, 2021 5:45 pm

^ Presumably the UK vaccine program will hit the buffers at the end of March when suddenly a massive backlog of 2nd doses need administering. Is that's how it's mainly going to work - mainly alternating between periods of 1st doses and 2nd doses - or will it be a bit smoother than that somehow?

First doses will inevitably slow from the current pace.

But second doses only need to match the number from 12 weeks earlier. It's easy to take the stats - e.g. 1 million first week of Jan - and budget that for first week of April. This week's 2.6 million means budgeting the same for end April.

Of course, if jabs per week rises to 5 million then it's easy to keep first doses going - but at some point doses per week will max out and when lapped 12 weeks later the first doses will stall.

shpalman wrote: ↑

Sun Jan 31, 2021 2:55 pm

KAJ wrote: ↑

Sun Jan 31, 2021 2:44 pm

It's a good argument, which I hadn't considered, that on a purely ethical basis, our priorities should be "border blind". Of course, that would imply prioritising foreign group N over home country group N+1 which I can't really see happening.

Ethically you would probably want to maximize the effect of each dose in terms of lives saved. Distributing vaccines equally around the whole world's priority group N instead of passing to your own group N+1 may seem more "fair" but may not actually achieve this.

Lives saved or years saved? What if different people disagree? Is it ethical to impose our ethics on others?

And I find it much more plausible that the best approach is to tackle it like a forest fire - you don't try to reduce it everywhere simultaneously, you try to eliminate it completely in some locations and then expand them to meet and isolate the last affected places.

But the other consideration is how the vaccines work. If they prevent people passing on the disease, it is better to vaccinate some people at low risk who would pass it on - e.g. taxi drivers, while if it only protects the vaccinated person against the effects, then it is better to vaccinate those at greatest personal risk (e.g. elderly) and those whose incapacity would put others at gretest risk (e.g. doctors and nurses).

Millennie Al wrote: ↑

Mon Feb 01, 2021 3:41 am

shpalman wrote: ↑

Sun Jan 31, 2021 2:55 pm

KAJ wrote: ↑

Sun Jan 31, 2021 2:44 pm

It's a good argument, which I hadn't considered, that on a purely ethical basis, our priorities should be "border blind". Of course, that would imply prioritising foreign group N over home country group N+1 which I can't really see happening.

Ethically you would probably want to maximize the effect of each dose in terms of lives saved. Distributing vaccines equally around the whole world's priority group N instead of passing to your own group N+1 may seem more "fair" but may not actually achieve this.

Lives saved or years saved?

Lives saved and years saved seem to be correlated in the case of covid; catching it seems to compress your risk of death in the next N years (N=5? I don't remember) into the next few weeks. Yes, it can cut down a young adult in their prime, but you would have to vaccinate a lot of young adults before you were sure to cover the very small proportion which that would have happened to.

Millennie Al wrote: ↑

Mon Feb 01, 2021 3:41 am

What if different people disagree? Is it ethical to impose our ethics on others?

Different people would have to explain what their ethics are before we could discuss this. Otherwise it's just "I think the group which I completely coincidentally happen to be a member of should be higher up in the priority list".

Millennie Al wrote: ↑

Mon Feb 01, 2021 3:41 am

And I find it much more plausible that the best approach is to tackle it like a forest fire - you don't try to reduce it everywhere simultaneously, you try to eliminate it completely in some locations and then expand them to meet and isolate the last affected places.

Well it depends if you want to go after the cases, or the deaths. If nobody died (or suffered severe long-term effects) from covid then we wouldn't care, it would be like any other common cold virus.

And you can't really vaccinate during the flare-up of an outbreak without taking lockdowny measures because people would get infected before you had time to give them the second dose and for them to develop protection from it.

Millennie Al wrote: ↑

Mon Feb 01, 2021 3:41 am

But the other consideration is how the vaccines work. If they prevent people passing on the disease, it is better to vaccinate some people at low risk who would pass it on - e.g. taxi drivers, while if it only protects the vaccinated person against the effects, then it is better to vaccinate those at greatest personal risk (e.g. elderly) and those whose incapacity would put others at gretest risk (e.g. doctors and nurses).

So far, we only think it's the latter.

There are of course selfish reasons for why we wouldn't want covid to remain at large in areas of the developing world, but in the next few months I still think it's better to vaccinate your own population and have travel restrictions.

lpm wrote: ↑

Sun Jan 31, 2021 11:21 pm

TimW wrote: ↑

Sun Jan 31, 2021 5:45 pm

^ Presumably the UK vaccine program will hit the buffers at the end of March when suddenly a massive backlog of 2nd doses need administering. Is that's how it's mainly going to work - mainly alternating between periods of 1st doses and 2nd doses - or will it be a bit smoother than that somehow?

First doses will inevitably slow from the current pace.

But second doses only need to match the number from 12 weeks earlier. It's easy to take the stats - e.g. 1 million first week of Jan - and budget that for first week of April. This week's 2.6 million means budgeting the same for end April.

Of course, if jabs per week rises to 5 million then it's easy to keep first doses going - but at some point doses per week will max out and when lapped 12 weeks later the first doses will stall.

Exactly - and I don't know whether the dose rate is expected to increase from now on.
The Telegraph have some nice graphs showing cumulative first doses increasing in a straight line for months and months as more of the population get to the front of the queue, but apparently ignoring the fact that 2nd dosers will elbow their way in.
https://www.telegraph.co.uk/news/2021/0 ... when-mine/

Yes, the Telegraph isn't being mathematically literate.

A very quick glance at the numbers shows that 31 March is the key date. If, say, you are 55 years old, there's a big difference between being due your first dose in the last week of March vs getting it in April. If the program goes badly and you don't get your invite in March, you are going to be queuing at the vaccination centre in April alongside 80 year olds getting their second jab. A slowdown in the pace matters a lot to a 55 year old but not much to a 60 year old.

Fortunately the current pace is well over what's needed to get all first doses done by 31 March for all Cohorts 1-9. Even Cohort 9 should not be lapped by Cohorts 1 &2 coming in for their second dose.

Basic maths as at 1 Feb:

Total first doses in past 7 days: 2.6 million (plus a handful of second doses)
Total first dosed so far: 9.0 million

Cohorts 1-4: approx 15 million people.

By target date of 15 Feb at current 2.6m per week pace: 14.2m first doses = 95% of Cohorts 1-4

Cohorts 5-9: approx 17 million people.

Between 15 Feb and 31 March at current 2.6m per week pace: 15.6m first doses = 92% of Cohorts 5-9

I think the 2.6m per week current pace is very prudent. The govt was aiming for 2.5m by end of Jan so hit that target. Everything depends on supply out the factory gates rather than how many vaccination centres etc are open (a basic mistake many observers are making is assuming the bottleneck is at GP surgeries or vaccination centres, so we need more vaccination centres, when in fact the bottleneck is at the factories). I suspect that the UK will peak at 5 million vaccinations in a single week because that seems to be max factory output once all the various versions come in.

ETA: the other key stat is the number first dosed as at 3 Jan 2021, which was 1.1 million. These will start coming in for second jabs during March - but not such a large figure that will materially change the above basic maths. There's another 1.3 million first doses in the week beginning 4 Jan 2021 which is when the proper program started up. So there's around a week's worth of second doses that will need to be done by 31 March at the current 2.6m pace.

lpm wrote: ↑

Mon Feb 01, 2021 11:14 am

I think the 2.6m per week current pace is very prudent. The govt was aiming for 2.5m by end of Jan so hit that target. Everything depends on supply out the factory gates rather than how many vaccination centres etc are open (a basic mistake many observers are making is assuming the bottleneck is at GP surgeries or vaccination centres, so we need more vaccination centres, when in fact the bottleneck is at the factories). I suspect that the UK will peak at 5 million vaccinations in a single week because that seems to be max factory output once all the various versions come in.

Is the factory production rate something governments can control? Certain politicians seem to think that shouting at people, and waving bits of paper around, is how you get things done. Is there anything they can actually do, to remove obstacles or boost supply chains or whatever?

As I understand it, there's vats of the stuff mixed up to the correct recipe, and much of it is in vials, but it all needs checking and labelling and rechecking and packaged up and rechecked yet again before it can leave on a lorry. It exists inside the UK but it's a huge task to clear 5 million doses each week. Not sure if there's a huge backlog of vials all ready to go and merely waiting for a delivery address. Not sure when Moderna supply will actually reach arms.