Vaccine rollout in the UK

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lpm
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Re: Vaccine rollout in the UK

Post by lpm » Wed Dec 30, 2020 1:37 pm

Of your town of 200,000 people, the nine categories of >50 year old + vulnerable are about 35-40%. That's 75,000 people and 150,000 jabs in total. Can worry about the under 50s in April or May.

So in York or similar there will be:

About 1,000 elderly people in care homes - need to get out there but some already done.

About 9,000 people >80 years - again already started.

About 5,000 extremely vulnerable people - could be tricky and need individual solutions.

I'd say that's around 15,000 jabs where GPs etc need to pay attention and spend a bit of time. A "handcrafted" approach.

But the remaining 60,000 can be funnelled through mass vaccination centres or a joint GP surgery arrangement. The "production lines" approach. These are aged 50-80, many will have private cars or be readily mobile, no problem to drive to York racecourse and queue up for a couple of hours. 40,000 will be working age, 10,000 will be young retired. Most of us don't need anything other than an appointment time and place.

60,000 jabs can be done in a week or two. Get twenty jabbers to set up at York racecourse or wherever and just get sheer volume done. Come back 12 weeks later for round two.

I'd say there needs to be a clear two pronged approach - take the vaccine to people for a minority but take people to the vaccine for the majority.
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Re: Vaccine rollout in the UK

Post by shpalman » Wed Dec 30, 2020 5:49 pm

Van-Tam warns against “kitchen table mathematics” scaling up the vaccine rollout thus far, as it is likely to rise exponentially.

Only if you get people who've just been vaccinated to then vaccinate more than one person each.
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Re: Vaccine rollout in the UK

Post by monkey » Wed Dec 30, 2020 6:50 pm

shpalman wrote:
Wed Dec 30, 2020 5:49 pm
Van-Tam warns against “kitchen table mathematics” scaling up the vaccine rollout thus far, as it is likely to rise exponentially.

Only if you get people who've just been vaccinated to then vaccinate more than one person each.
Yeah, but they'll start finding it harder to find people to vaccinate and the rate of vaccinations would come down. You'd reach herd susceptibility.

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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 6:24 am

What fresh fuckery is this? https://twitter.com/HelenRSalisbury/sta ... 42797?s=09

The Oxford vaccine "works" with a longer wait between doses so let's extend the interval between Pfizer doses too?

Is this a failure of more doses to arrive or a lack of capacity to give them?
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 7:08 am

https://www.theguardian.com/society/202 ... -regulator
But the MHRA and the government’s advisory Joint Committee on Vaccinations and Immunisation delivered a surprise by announcing approval of a regime that was not trialled. Both the Oxford vaccine and the Pfizer/BioNTech jab which is already in use will be given to people as one shot, followed by another up to 12 weeks later, in order to extend some protection to as many people as possible as quickly as possible.
What they mean is "we rushed through approval to start vaccination too early, used up all the doses we had, maxed out our capacity to give them, and f.cked ourselves, so now we're going to f.ck all of you".
Pfizer/BioNTech said that their vaccine was not designed to be used in two shots 12 weeks apart. In a statement, the firms said there was no evidence the first shot continued to work beyond three weeks.

“Data from the phase 3 study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95%. There are no data to demonstrate that protection after the first dose is sustained after 21 days,” they said.
Pure fuckery.
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 7:12 am

Not content with breeding a more contagious variant now you also want to breed a vaccine-resistant variant?
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 7:44 am

lpm wrote:
Wed Dec 30, 2020 1:37 pm
Of your town of 200,000 people, the nine categories of >50 year old + vulnerable are about 35-40%. That's 75,000 people and 150,000 jabs in total. Can worry about the under 50s in April or May.

So in York or similar there will be:

About 1,000 elderly people in care homes - need to get out there but some already done.

About 9,000 people >80 years - again already started.

About 5,000 extremely vulnerable people - could be tricky and need individual solutions.

I'd say that's around 15,000 jabs where GPs etc need to pay attention and spend a bit of time. A "handcrafted" approach.

But the remaining 60,000 can be funnelled through mass vaccination centres or a joint GP surgery arrangement. The "production lines" approach. These are aged 50-80, many will have private cars or be readily mobile, no problem to drive to York racecourse and queue up for a couple of hours. 40,000 will be working age, 10,000 will be young retired. Most of us don't need anything other than an appointment time and place.

60,000 jabs can be done in a week or two. Get twenty jabbers to set up at York racecourse or wherever and just get sheer volume done. Come back 12 weeks later for round two.

I'd say there needs to be a clear two pronged approach - take the vaccine to people for a minority but take people to the vaccine for the majority.
Red tape puts off volunteer vaccinators
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 8:01 am

More than 500,000 people who have been vaccinated against Covid-19 will have their second dose delayed for up to 12 weeks
Sir Simon Stevens, chief executive of NHS England, disclosed the move in a letter to health service leaders in England on Wednesday... The move has been prompted by the Medicines and Healthcare products Regulatory Authority changing its guidance on how the vaccines can be deployed.
Well, you can deploy the vaccine that way, if you've f.cked your rollout so hard that you can't follow the proper protocol, but we don't have the evidence that it will work.
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Re: Vaccine rollout in the UK

Post by Sciolus » Thu Dec 31, 2020 9:53 am

How long does it take to (a) lose and (b) regain a reputation for being independent and evidence-led? I guess MHRC are finding out.

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Re: Vaccine rollout in the UK

Post by Chris Preston » Thu Dec 31, 2020 9:59 am

shpalman wrote:
Thu Dec 31, 2020 8:01 am
More than 500,000 people who have been vaccinated against Covid-19 will have their second dose delayed for up to 12 weeks
Sir Simon Stevens, chief executive of NHS England, disclosed the move in a letter to health service leaders in England on Wednesday... The move has been prompted by the Medicines and Healthcare products Regulatory Authority changing its guidance on how the vaccines can be deployed.
Well, you can deploy the vaccine that way, if you've f.cked your rollout so hard that you can't follow the proper protocol, but we don't have the evidence that it will work.
This is what panic does.

If there had been better management first, there would be no need for this mess. When vaccines become your only line of defence, you need to get them out as fast as possible. However, that often proves impossible when you need a booster.
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Re: Vaccine rollout in the UK

Post by Blackcountryboy » Thu Dec 31, 2020 11:26 am

I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.

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Re: Vaccine rollout in the UK

Post by headshot » Thu Dec 31, 2020 11:35 am

Well..
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 11:37 am

That's the tweet which this links to:
shpalman wrote:
Thu Dec 31, 2020 6:24 am
What fresh fuckery is this? https://twitter.com/HelenRSalisbury/sta ... 42797?s=09

The Oxford vaccine "works" with a longer wait between doses so let's extend the interval between Pfizer doses too?

Is this a failure of more doses to arrive or a lack of capacity to give them?
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Re: Vaccine rollout in the UK

Post by sTeamTraen » Thu Dec 31, 2020 1:34 pm

shpalman wrote:
Thu Dec 31, 2020 6:24 am
What fresh fuckery is this? https://twitter.com/HelenRSalisbury/sta ... 42797?s=09

The Oxford vaccine "works" with a longer wait between doses so let's extend the interval between Pfizer doses too?

Is this a failure of more doses to arrive or a lack of capacity to give them?
I've seen a suggestion on Twitter that this move, especially combined with Pfizer's lack of support for it, may constitute a violation of consent. Patients arguably signed up for a package based of clinical trial results with certain parameters, and might not have consented if the government had said up-front "Pfizer says 3 weeks but we reckon 12 is OK". This may be a little over-egged as a reaction, but the whole thing does look utterly incompetent. I presume Hancock and co know that the numbers coming down the line are horrific, but this really feels like what Americans call a Hail Mary.
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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 1:43 pm

Salisbury asked the General Medical Council to give advice. “I have been instructed to break my promise to my elderly patients & use a vaccine outside its evidenced and approved schedule, probably placing them at risk. Please advise.”

Her comments unleashed a flurry of responses from other GPs, with some questioning whether it was ethical to delay a second dose when patients had given consent for the first dose on the premise that they would receive the second three weeks later.
https://www.theguardian.com/society/202 ... cond-doses

At least they managed to find someone who tweeted that it wasn't all a total f.cking shitshow to put in at the end for "balance".
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Re: Vaccine rollout in the UK

Post by jimbob » Thu Dec 31, 2020 2:29 pm

shpalman wrote:
Mon Dec 28, 2020 9:08 am
predictable backlash from those who are supposed to give the vaccine without receiving it themselves
ministers decreeing that 75% of supplies of the Pfizer jab should be given to those over 80 and 20% to care home personnel, leaving just 5% – or 48 doses from a batch of 975 – for NHS staff.
“Vaccines stop people from passing viruses on. We have limited vaccines available. Who is most in need of a vaccine? The people who are forced to mix with others. And those people are the frontline healthcare staff looking after Covid-19 patients, who encounter Covid-19 continually.”
Except of course we don't know if this vaccine stops people from passing this virus on, because we haven't checked (personally, I think it does).

But realizing that if your health care workers get ill there'll be nobody to deliver the vaccines should be a good enough reason to suggest they're allowed to get vaccinated first.
It's wrong on many levels. People are not emotionless robots. It's not just the actual (far-higher than background) risk of the virus that is a problem, but the additional stress of being expected to go into a dangerous workplace without the best-known protection, because others are in front of you.

And of course, as you say, every healthworker with Covid is a double-hit as far as the capacity of the health service.
Have you considered stupidity as an explanation

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Re: Vaccine rollout in the UK

Post by border_reiver » Thu Dec 31, 2020 2:48 pm

My mum due her 2nd dose on Tues 5th. She has had a letter, a reminder letter and a reminder phone call in the intervening 3 weeks. So today, the GP has to contact 900+ patients to tell them not to come next week. They also have to find 900+ new patients to give appointments to. Some of whom will only be able to attend if they can arrange for someone to take them. Also mum got her questions and consent form sent in advance to complete at home and take with her, which isn't going to happen for next week's new people so they will have to factor in the logistics of form filling at the surgery. This all represents a huge amount of wasted time for the GP practice.
And what happens in 9 weeks time when these delayed patients must get the 2nd dose? Are vaccination centres expected to double their capacity or do 1st doses stop for 12 weeks till first cohort is completed?
Or by then will the medically qualified Matt Hancock have decided that after all one dose is enough?

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Re: Vaccine rollout in the UK

Post by shpalman » Thu Dec 31, 2020 5:43 pm

944,539 have received a first dose as of Sunday the 27th, i.e. they did about 300,000 in a week with Christmas in the way.

https://twitter.com/UKCovid19Stats/stat ... 8693387272
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The numbers at https://coronavirus.data.gov.uk/details/healthcare have also been updated.
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Re: Vaccine rollout in the UK

Post by Gfamily » Fri Jan 01, 2021 12:40 pm

shpalman wrote:
Thu Dec 31, 2020 11:37 am
That's the tweet which this links to:
shpalman wrote:
Thu Dec 31, 2020 6:24 am
What fresh fuckery is this? https://twitter.com/HelenRSalisbury/sta ... 42797?s=09

The Oxford vaccine "works" with a longer wait between doses so let's extend the interval between Pfizer doses too?

Is this a failure of more doses to arrive or a lack of capacity to give them?
A Twitter thread on why a delayed second dose may be justified
https://mobile.twitter.com/sandyddougla ... 8483621888
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Re: Vaccine rollout in the UK

Post by shpalman » Fri Jan 01, 2021 12:50 pm

Why do we even waste time doing Phase-III trials...

ETA https://mobile.twitter.com/jamesannan/s ... 2315722754
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Re: Vaccine rollout in the UK

Post by raven » Sat Jan 02, 2021 12:28 am

Someone on twitter says:
Far better to have 100M people who are 80% protected than 50M people who are 95% protected ...
So... Just to check my understanding, I think that means:

50m people get two doses, 47.5m of them are protected, 2.5m aren't and perhaps don't realise it.
100m people get one dose, 80m are protected, 20m aren't and perhaps don't realise it.

On the face of it, from a general herd immunity perspective, the population as a whole would seem to be better off with 80m people walking around with immunity. But idk how having 20m people who think they're immune but aren't will play out. If they feel safe enough to socialise, that could mean more spread. And if there's more cases of 'I had the shot but I still got the virus', that could also lowers confidence in the vaccine. So, not good.

But maybe we're at the point where there are no good choices, just least bad ones.

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Re: Vaccine rollout in the UK

Post by Vertigowooyay » Sat Jan 02, 2021 12:43 am

I really hope this is the NYT getting it wrong. Because mix and match vaccine rollout seems crazy.

https://www.nytimes.com/2021/01/01/heal ... itain.html
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Re: Vaccine rollout in the UK

Post by Millennie Al » Sat Jan 02, 2021 2:30 am

Vertigowooyay wrote:
Sat Jan 02, 2021 12:43 am
I really hope this is the NYT getting it wrong. Because mix and match vaccine rollout seems crazy.

https://www.nytimes.com/2021/01/01/heal ... itain.html
It's not quite as crazy as it looks. The Pfizer, Moderna, and Oxford/AstraZenica vaccines all work by targetting the spike proteins, so it's highly plausible that presenting the body with spikes in different ways will cause a good immune response.

However, If any vaccines are administered in a manner which deviates from the manner used in the clinical trials, we should at least record for each patient the exact details of what they got, monitor them for subsequent infection and its seriousness, and keep an ongoing analysis so that if one particular variant is exceptionally good or bad the treatment can be adapted. It wouldn't be anything like as good as a normal trial, but given the urgency of the situation could be justified.

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Re: Vaccine rollout in the UK

Post by Woodchopper » Sat Jan 02, 2021 8:54 am

Dr. Anthony S. Fauci, the nation’s top infectious disease expert, told CNN on Friday that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses.

Britain announced a plan this week to delay second shots of its two authorized vaccines, developed by Pfizer and AstraZeneca, in an attempt to dole out to more people the partial protection conferred by a single dose.

“I would not be in favor of that,” Dr. Fauci told CNN’s Elizabeth Cohen. “We’re going to keep doing what we’re doing.”

His opinion was met with approval by some experts, including Dr. Eric Topol, a clinical trials expert at the Scripps Research Translational Institute in California, who tweeted, “That’s good because that it’s following what we know, the trial data with extraordinary 95 percent efficacy, avoiding extrapolation and the unknowns.”

While clinical trials tested the efficacy of second doses delivered three or four weeks after the first, British officials said they would allow a gap of up to 12 weeks. Such delays have not been rigorously tested in trials. The Pfizer-BioNTech vaccine, for instance, was shown to be 95 percent effective at preventing Covid-19 when administered as two doses, three weeks apart.

Straying from this regimen “is like going into the Wild West,” said Dr. Phyllis Tien, an infectious disease physician at the University of California, San Francisco. “It needs to be data driven if they’re going to make a change.”

Widening the gap between vaccine doses could risk blunting the benefits of the second shot, which is intended to boost the body’s defenses against the coronavirus, increasing the strength and durability of the immune response. In the interim, the protective effects of the first shot could also wane faster than anticipated.

“We don’t really know what happens when you only have one dose after, like, a month,” said Natalie Dean, a biostatistician at the University of Florida. “It’s just not the way it was tested.”
https://www.nytimes.com/2021/01/01/worl ... ccine.html

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Re: Vaccine rollout in the UK

Post by Woodchopper » Sat Jan 02, 2021 8:55 am

Given the rapid spread of the new variant in the UK this looks like desperation. A gamble because they didn’t lockdown earlier.

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