Are vaccines the light at the end of the tunnel?

[terrydtx]

I still believe once any vaccines are proven and made available to the masses, the travel industry including air and cruise ones will require a proof of vaccinations before travel. Those who refuse to fix stupid  and vaccinate, will be left behind with no place to travel. 

[Ken the cruiser]

Here's an interesting article which highlights some of the complexities associated with "who gets the vaccine first".

 

https://www.nbcnewyork.com/news/coronavirus/debate-begins-for-whos-first-in-line-for-covid-19-vaccine/2546671/

[npcl]

12 hours ago, ldubs said:

 

By harmonize, I'm going to think that means standardized regulatory req's.  Kind of like International Organization of Standards.   Great idea.  After 15 years I hope was there some headway?  

 

And X2 - thanks for sharing.  

 

 

 

  

There was a lot of headway made, but it was a slow process.  The group is still on going today and I left it in 1997. So it has been in operation over 40 years.  There many different working groups in the areas of safety, efficacy, quality and multidisciplinary.

 

This is a link to the groups web site if you are interested in reading any more about it.

https://www.ich.org/

[npcl]

38 minutes ago, Ken the cruiser said:

Here's an interesting article which highlights some of the complexities associated with "who gets the vaccine first".

 

https://www.nbcnewyork.com/news/coronavirus/debate-begins-for-whos-first-in-line-for-covid-19-vaccine/2546671/

Expect chaos.

 

No matter how this is handled, there will be chaos.  You will almost have to do the first rounds on vaccination (health care works, first responders, nursing homes, etc) in secret.  Any rumors about vaccination availability and you will have crowds massing.

 

No matter how well the system is designed there will be criticism of it.  Not enough to those at risk, not enough to the poor, not enough to minorities, not enough to the rich that want to travel and just paid for the new hospital wing who wants 50 of their friends vaccinated.

 

It will be chaos, or at least me reported as chaos and unfair no matter how it is done.

 

Then you will have those that feel that since they have been vaccinated they no no longer have to deal with any restrictions, no masks, no social distancing. Even though the virus may still be present with many cases.  The restrictions can only drop when  supported by the case numbers, after all vaccines are not 100% effective and there may be many that cannot take it (we will have to see what the data shows) that will depend upon those restrictions until the case numbers drop pretty low. Otherwise we might see the vaccine come out and the numbers actually get worse during the first 12 months.

 

The first year after the vaccine is available will be interesting

[K.T.B.]

48 minutes ago, Ken the cruiser said:

Here's an interesting article which highlights some of the complexities associated with "who gets the vaccine first".

 

https://www.nbcnewyork.com/news/coronavirus/debate-begins-for-whos-first-in-line-for-covid-19-vaccine/2546671/

 

In order, and this is without reading the article and it's only MY opinion, healthcare personnel (including EMTs and paramedics), people who are in the "at risk group", teachers, police & firemen, everyone else.

[K.T.B.]

By the way, people will really have no excuses for not getting a vaccine.  Its cost?  $0.

 

LINK

[Ken the cruiser]

1 hour ago, npcl said:

Expect chaos.

 

No matter how this is handled, there will be chaos.  You will almost have to do the first rounds on vaccination (health care works, first responders, nursing homes, etc) in secret.  Any rumors about vaccination availability and you will have crowds massing.

 

No matter how well the system is designed there will be criticism of it.  Not enough to those at risk, not enough to the poor, not enough to minorities, not enough to the rich that want to travel and just paid for the new hospital wing who wants 50 of their friends vaccinated.

 

It will be chaos, or at least be reported as chaos and unfair no matter how it is done.

It will definitely be interesting. But aren't there already well defined distribution channels in place to funnel the first set of vaccines to those deemed most in need?

 

After that and if the applicable manufacturers have continued to gear up the production of their "to-be-approved" vaccine in parallel to its current testing cycle, as many have suggested they would, you would think by the Nov/Dec timeframe those distribution channels will be loaded up and headed to your nearby dispensing locations (e.g., clinics, pharmacies and other approved locations). Sounds like a daunting task, but I'm sure those those in the business of doing this will be ready when the time comes.

Edited August 2, 2020 by Ken the cruiser

[kearney]

20 hours ago, Ken the cruiser said:

My son taught me something a little while ago that helped quite a bit when I would want to unload on someone for posting something I totally disagreed with. Here's what he said.

 

Type up a draft response with everything you would want to say. I mean unload it all. Then check your grammar and edit it until it's exactly what you want to say. Then, once you have it just right with all of your emotions included, DELETE it. You will be surprised how relaxed you will become once it disappears from the screen. I've done that a few times and just before hitting Submit, I think of what my son told me. Just a thought ...

I had to laugh at this. Back in the olden days (mid 70s)... we shared a secretary among 3-4 people. you would hand write your memo.. and in a day or two you would get it back and then modify... the secretary would literally take an exacto knife and cut out the offending or incorrect lines. By the time your memo was done.. it was weeks later, with a lot of taped sections... you ran a copy ... signed and then forwarded. .... fast forward to the mid 80s. I worked for MCI. This was the first time I experienced email being used in a business and suddenly.. there were really offensive communications flying around feelings being hurt .... and I recalled my first days where it took forever to get a memo issued... I think the advise is very wise and will avoid lots of problems. I wish others would consider this advise on twitter and Facebook.

[zeberdee]

1 hour ago, K.T.B. said:

By the way, people will really have no excuses for not getting a vaccine.  Its cost?  $0.

 

LINK

There will always be people who are unable to have some vaccinations due to medical reasons.
Lets hope that an effective vaccine is found and that most people can have it.

[npcl]

1 hour ago, Ken the cruiser said:

It will definitely be interesting. But aren't there already well defined distribution channels in place to funnel the first set of vaccines to those deemed most in need?

 

After that and if the applicable manufacturers have continued to gear up the production of their "to-be-approved" vaccine in parallel to its current testing cycle, as many have suggested they would, you would think by the Nov/Dec timeframe those distribution channels will be loaded up and headed to your nearby dispensing locations (e.g., clinics, pharmacies and other approved locations). Sounds like a daunting task, but I'm sure those those in the business of doing this will be ready when the time comes.

Depends upon who you ask about who is the most in need.  Each interest groups will have their advocates.  Then you get those that will criticize just because it might give them an advantage.

 

You can go ask 10 different people and get 10 different answers about who is the most in need.  Even if you can agree on major categories such as health care workers do inner city hospitals get it before rural?  Do at risk patients get it before military? 

 

No matter what the process is, no matter how well defined, how well thought out it will be criticized. Any hiccup will be portrayed as a major failure by someone.  It is just the way our system works.

 

The question is do you use the commercial distribution system, for a product that will be in short supply and where you want to focus the use.  I can be pretty certain that if you load the commercial distribution system, a lot of it will go out to current customers. Not a focused list of targets.

 

It is not set up to prioritize in the way that the product will need to be distributed.  Better off to drop ship directly to the medical institution or set up a process using the departments of public health in each state with the allocation done by information received and approved centrally.

Edited August 2, 2020 by npcl

[Ken the cruiser]

1 minute ago, npcl said:

Depends upon who you ask about who is the most in need.  Each interest groups will have their advocates.  Then you get those that will criticize just because it might give them an advantage.

 

You can go ask 10 different people and get 10 different answers about who is the most in need.  Even if you can agree on major categories such as health care workers do inner city hospitals get it before rural?  Do at risk patients get it before military? 

 

No matter what the process is, no matter how well defined, how well thought out it will be criticized. Any hiccup will be portrayed as a major failure.  It is just the way our system works.

Sure glad I'm sitting over in the peanut gallery and not on one of those committees. I truly feel for them, as it's not going to be easy, but whatever they decide, we'll be happy with and continue to use our masks when in public, social distance and pretty much quarantine on our farm until it's deemed our time to get the vaccine.

[npcl]

10 minutes ago, Ken the cruiser said:

Sure glad I'm sitting over in the peanut gallery and not on one of those committees. I truly feel for them, as it's not going to be easy, but whatever they decide, we'll be happy with and continue to use our masks when in public, social distance and pretty much quarantine on our farm until it's deemed our time to get the vaccine.

I figure that it will be 6 to 12 months after release before I even try to get a vaccine.  While my age puts me in the somewhat at risk group I do not have any underlying conditions and can wait.

 

The need for recreational travel is not or at least should not give someone priority for the vaccine, no matter how urgent someone wants to schedule a cruise.

 

If you have a position of responsibility in one of the government agencies the only thing you can count on is lots of criticism, no matter how good of a job that you might do.  Some might be deserved, some political, some because someone is looking for advantage for themselves or some group, some because some people just like to criticize.  That fact that you will get a lot of it is a certainty.

 

 

 

Edited August 2, 2020 by npcl

[markeb]

44 minutes ago, npcl said:

I figure that it will be 6 to 12 months after release before I even try to get a vaccine.  While my age puts me in the somewhat at risk group I do not have any underlying conditions and can wait.

 

The need for recreational travel is not or at least should not give someone priority for the vaccine, no matter how urgent someone wants to schedule a cruise.

 

If you have a position of responsibility in one of the government agencies the only thing you can count on is lots of criticism, no matter how good of a job that you might do.  Some might be deserved, some political, some because someone is looking for advantage for themselves or some group, some because some people just like to criticize.  That fact that you will get a lot of it is a certainty.

 

 

 

 

Yes to all of the above!

 

With the added pressure that there will be some, potentially unknown and unknowable, group most at risk that is also going to be least likely to respond to a vaccine. Which of course just complicates things even more, and there probably won't be any good answers early on. Will kids with leukemia respond to one of the vaccines? How about adults with lymphoma or myeloma? There are almost always relative, and sometimes absolute contraindications for some groups of people, but those groups in this case are also probably most at risk of severe disease.

 

Whatever policy recommendations are made, they are guaranteed to be unpopular with some group. And if 18-24 months from now there are plenty of doses of an effective vaccine to vaccinate everyone, a decision to vaccinate everyone will also be unpopular...

[cangelmd]

3 hours ago, npcl said:

Expect chaos.

 

No matter how this is handled, there will be chaos.  You will almost have to do the first rounds on vaccination (health care works, first responders, nursing homes, etc) in secret.  Any rumors about vaccination availability and you will have crowds massing.

 

No matter how well the system is designed there will be criticism of it.  Not enough to those at risk, not enough to the poor, not enough to minorities, not enough to the rich that want to travel and just paid for the new hospital wing who wants 50 of their friends vaccinated.

 

It will be chaos, or at least me reported as chaos and unfair no matter how it is done.

 

Then you will have those that feel that since they have been vaccinated they no no longer have to deal with any restrictions, no masks, no social distancing. Even though the virus may still be present with many cases.  The restrictions can only drop when  supported by the case numbers, after all vaccines are not 100% effective and there may be many that cannot take it (we will have to see what the data shows) that will depend upon those restrictions until the case numbers drop pretty low. Otherwise we might see the vaccine come out and the numbers actually get worse during the first 12 months.

 

The first year after the vaccine is available will be interesting

I would assume that healthcare workers will get vaccine distributed in the same way that we get flu shots - through our affiliated hospital or health system. This takes care of everyone except the actual physicians many of them offer flu shots and get a shot from their office supply. In this case though, I foresee the government acting in lieu of or perhaps through the pharmacy distributor, and sending X thousand doses to the hospital for distribution.

i also wondered if they would lobby healthcare workers to be part f the Phase 3 trial, but that does not appear to be the case,  think the trials are getting volunteers.

[gerelmx]

I will wait until the results of the massive applications are known, no matter if the vaccine is Chinese, Russian, American or British. An uncle of mine died years ago when he was a child. He received a smallpox vaccine at school.

[cangelmd]

1 hour ago, npcl said:

 

The question is do you use the commercial distribution system, for a product that will be in short supply and where you want to focus the use.  I can be pretty certain that if you load the commercial distribution system, a lot of it will go out to current customers. Not a focused list of targets.

 

It is not set up to prioritize in the way that the product will need to be distributed.  Better off to drop ship directly to the medical institution or set up a process using the departments of public health in each state with the allocation done by information received and approved centrally.

HHS (CMS) has been sequestering lab supplies for a few months now - to the point that I think their stockpiling for the fall is part of why we are so short of reagents right now.

Our allocation has to be approved by both CMS and our large corporate hospital entity, then the commercial distributor ships it to us. Early on, it was a free for all like you describe. I would think that CMS will use a version of the current system for lab supplies, Remdesivir and the antibody allocation (the T,,,mab drug), as a framework for vaccine distribution in healthcare. State public health will likely work with local government  for first responders

Edited August 2, 2020 by cangelmd

[jotjot]

Word of advice, read the waiver you have to sign. I read the one for DT and got very upset I almost didn't take it . I can understand why someone would not take it .

[Ken the cruiser]

10 minutes ago, jotjot said:

Word of advice, read the waiver you have to sign. I read the one for DT and got very upset I almost didn't take it . I can understand why someone would not take it .

Just curious, what waiver are you referring to, what were some of the negatives you encountered on the one you were reviewing, and what does DT stand for?

[Captain Rob]

Perhaps this rapid test with results in 90 minutes could be the answer. Passengers could be tested when boarding, and the crew once a week.

 

https://www.bbc.co.uk/news/uk-53632043

[bouhunter]

All the talk about "a vaccine" is getting silly.  There won't be some magical shot that puts this all behind us in a few months.

 

https://www.msn.com/en-us/health/medical/a-coronavirus-vaccine-won-t-change-the-world-right-away/ar-BB17u7JQ?ocid=msedgdhp

[TeeRick]

20 hours ago, terrydtx said:

I still believe once any vaccines are proven and made available to the masses, the travel industry including air and cruise ones will require a proof of vaccinations before travel. Those who refuse to fix stupid  and vaccinate, will be left behind with no place to travel. 

I think you are correct in particular about cruise lines requiring vaccination for boarding their ships.  I am not so convinced about airlines.  I think airlines will be less definitive.  Some will.  Most will  defer to the rules of the countries that they travel to and from.  For example, flights within a country might not require a vaccine.  But international flights might require one.  We shall see.

[terrydtx]

1 hour ago, bouhunter said:

All the talk about "a vaccine" is getting silly.  There won't be some magical shot that puts this all behind us in a few months.

 

https://www.msn.com/en-us/health/medical/a-coronavirus-vaccine-won-t-change-the-world-right-away/ar-BB17u7JQ?ocid=msedgdhp

And you think MSN is correct on this? Any possibility of a proven and effective vaccine  or cure that could end the Covid threat doesn't fit the political narrative of the media in the US. 

[TeeRick]

20 hours ago, Ken the cruiser said:

Here's an interesting article which highlights some of the complexities associated with "who gets the vaccine first".

 

https://www.nbcnewyork.com/news/coronavirus/debate-begins-for-whos-first-in-line-for-covid-19-vaccine/2546671/

Thank you.  A lot to think about for sure. A couple more thoughts to ruminate on here.

 

- With a vaccine in hand, there is a strategy well known to pandemic planners called ring immunity or ring vaccination if doses are far less than the actual supply need for mass vaccination.  Here you would vaccinate in circles around hot spots and clusters of infection.  But it would require a pretty strict restriction on travel from these clusters.  

 

- Pay attention to the clinical trial specifics and which groups get approved based on the trial data.  For example, the vaccine is effective in 18-65 year old healthy adults.  But it did not do as well in adults over 65 or immuno-compromised adults.  Or more clinical data/trials are needed in these groups.  Are there initial phase 3 groups that include say infants under 2 yr?  If not they will not be within the general initial approval.

 

- Everybody is assuming health care workers and first responders and perhaps teachers will get the first doses.  No debate from me on that.  But not sure about the (non-healthy) elderly in the population or in nursing homes or any immuno-compromised patients of any age.  It depends on the safety profile of the vaccine in these groups.  And the efficacy of the vaccine in folks with poor immune systems.  

[markeb]

1 minute ago, terrydtx said:

And you think MSN is correct on this? Any possibility of a proven and effective vaccine  or cure that could end the Covid threat doesn't fit the political narrative of the media in the US. 

 

The article first appeared in the Post yesterday. I'd say it's a very accurate reflection of what most public health professionals would say. It will take time, and the immediate return to normalcy so many on this board are looking for is highly unlikely. Eventually, yes. By Christmas? No.

 

Not politics. Science.

[bouhunter]

30 minutes ago, terrydtx said:

Any possibility of a proven and effective vaccine  or cure that could end the Covid threat doesn't fit the political narrative of the media in the US. 

I won't argue with that at all.  But I still think the people who think/hope there will be a miracle vaccine available in a few months to put an end to this are sadly mistaken.