bob sterman wrote: ↑Sun Jan 17, 2021 11:15 am
Having visited a smaller vaccine delivery "hub" I think someone needs to do a serious risk vs benefit analysis for the post-vaccine observation arrangements.
To look out of anaphylaxis presumably - people who have just been vaccinated are asked to sit for 15 minutes in a room that
may be quite crowded and is poorly ventilated, with other recently vaccinated people.
At a time when community prevalence of COVID-19 could be around 1 in 20 - and the vaccine is not likely to protect you against an infection picked up on the same day you receive it - this seems far from ideal.
In terms of pure risk-benefit , it's a marginally better not to to wait together in a poorly-ventilated room, but better to wait together in a well-ventilated room:
Fatality rate of COVID ~ 2k in 100k (2%)
Risk of catching COVID
per microcovid project (assuming 10 people who don't know each other in the room at a time, spaced out at 2m each and nobody is wearing masks = 400 microcovids. If they all wear one, 90 microcovids. Figures based on NewYork 'cos I couldn't see any UK option.
So risk of catching it there in that 15 mins and dying from it = 1.8 in a million or 0.18 in 100k.
Rate of anaphylaxis to Comirnaty ~=1 in 100k (0.001%), of which ~70% in the first 15 minutes, so 0.7 in 100k could be at risk.
According to
this article Fatality rate of Anaphylaxis ~=1 in 100k too. Which should mean 1 in every 10 billion doses causes fatal anaphylaxis and 1 in every 14 billion or so would be caught by the 15 mins delay.
However, I bet the fatality rate is based on current medical practice, in which people at risk of anaphylaxis have epi-pens and people wait 15 mins after vaccination in case. I bet the fatality rate would be far higher without available treatment. Severe anaphylaxis is almost always fatal. In the first minutes of the reaction, severe and mild anaphylaxis are very similar, so all anaphylactic reactions should be treated as a medical emergency.
If 10% of anaphylactic reactions were fatal without treatment, then about 0.1 in 100k lives would be saved.
That gives, with your unventilated room, a net 0.08 extra in 100k who would die (or 8 in 10 million doses).
If a door or large window were open to the outside, then the 90 microcovids drops to 20 and your risk drops to 0.04 in 100k (4 in 10 million, net benefit 96 in 10 million from waiting). If it's outdoors, then it's 4 microcovids & it's a complete no-brainer to wait - 0.008 in 100k or 8 in 100 million chance of catching & dying from it in that 15 mins (net 99.2 in 10 million lives saved).
That's why I highlighted your "may be quite crowded and is poorly ventilated". Do you have any evidence of this being the case? Because this is a pretty easyish thing to fix. Look at the comments elsewhere about GPs installing gazeboes for the post-vax waiting area. And I don't believe for a moment that they would allow it to be
that crowded. If your post-vax wait time is 15 mins, then there can't be that many people in the post-vax waiting area. I don't think I've ever had a vaccine that took less than 3 mins from entering the room to leaving it. Even when I'm prepped with my sleeve rolled-up, there's still consent & allergy questions & safety info & wiping & cotton wool & rolling down the sleeve & putting my sweater back on etc. Even with 2 vaccinators, that's 10 people in a room, and any place will plan it so that there's enough space for people to be safe.