Coronavirus in Massachusetts (Boston, Pittsfield, Franklin: insurance, homes, layoffs)

[GeoffD]

Originally Posted by mdovell

thousands have been over frozen. This is logistics at its finest. If you don't give states and local governments support for this they might not be able to do this. Berkshire county for example has only one hospital for 120,000 people and no drug store clinics. Personally I think the big E fairgrounds would be a great logistical center for all of this but I don't make the plans.Franklin county is going up and it's only 70k people.

Either people go to the vaccine or the vaccine goes to the people. Chances are we're going to need fleets of buses to make anything work.

Are you seriously trying to claim that I can't go to the CVS in Pittsfield and get a flu shot from the pharmacy tech? That's the same person who is going to jab me with the COVID-19 vaccine. The FDA has approved pharmacy techs for COVID-19 vaccinations weeks ago. Pittsfield also has a community nurse on staff. Google says it's Kayla Winters. There are two school nurses. Angelique Chaffee and Nadine Fox. You're insane if you think all of Western Massachusetts is going to have to drive to the Big freakin' E. Town Halls, schools, pharmacies, medical walk-ins, etc will all be administering the vaccine.



Even the Pfizer vaccine has a five day shelf life at 'normal' refrigeration temperatures of 2C to 8C. Anything that comes in the door at a pharmacy is going to get used long before the vaccine expires.



The United States vaccinated over half the country with flu vaccine last year. How is this any different? The hardest thing is going to be preventing queue jumping. It's not like a pharmacy tech is going to check if I announce I have 3 or 4 co-morbities or exceptions that run me to the top of the queue. I can tell them I'm a front line cashier at a grocery store and I have diabetes where I get my Rx filled through the mail by my insurance company. Once they get all the licensed health care workers and the nursing homes, it's likely to be a free-for-all.

[sawyer2]

Originally Posted by yesmaybe

J&J and AZ are going to be too late I think. At least in the US. The Feds already bought 200M doses of Moderna's and 100M of Pfizer's, and there's been talk about them buying another 100M of Pfizer's vaccine. That should be plenty to cover Adults in the US, presuming you will only get so much of the adult population to take it.

50% of that given that the mRNA vaccines require 2 doses.

The Feds also purchased 100M doses from Novavvax, 100M from J&J, and 300M from AZ.

Also, these more 'traditional' (non mRNA) vaccines will not have the same frozen supply chain constraints so distribution will be easier.

And some vaccines may work better in distinct patient populations - less first does adverse response in those with potential for an anaphylactoid reaction, or conversely more immunogenic in those with dampened immune response etc.

[yesmaybe]

Originally Posted by sawyer2

50% of that given that the mRNA vaccines require 2 doses.

400M doses is plenty for the adult population in the US. You're not going to get 100% to take the vaccine, that's just unrealistic. I do have a question about what will happen to kids but presumably one of the two mRNA will be first to kids too.

If they really bought a ton of J&J and AZ's vaccine, I don't know what's going to happen to it unless GeoffD is right that the immunity won't last long enough that people will need to get the vaccine again eventually. I am thinking they would just ship it to some overseas country.

[GeoffD]

Originally Posted by redplum33

The Pfizer must be stored at -70C (-94F), but from what I understand the Moderna can be stored at normal refrigerator temperature.

Buses sound like a really bad idea.

Why would any state "store" the vaccine? It shows up in a dry ice container. You open the container and defrost the vaccine. You have 5 days storing it at normal refrigerator temperatures to use it. If my state is sitting on any vaccine for more than 5 days, I'd be really pissed off. There are millions of people begging to be vaccinated.

[GeoffD]

Originally Posted by yesmaybe

If they really bought a ton of J&J and AZ's vaccine, I don't know what's going to happen to it unless GeoffD is right that the immunity won't last long enough that people will need to get the vaccine again eventually. I am thinking they would just ship it to some overseas country.

The flu shot is effective for less than 6 months. We're now seeing cases where COVID-19 people from last spring are getting it again. It seems to me that it's extremely unlikely that any COVID-19 vaccine will last much more than 6 months. If it does, that's a good problem to have. I'd plan of vaccinating all the front line health care workers and long term care people again in June. If the data is better than that, it's cheap compared to going another year with a crippled economy.

[msRB311]

https://www.boston.com/news/coronavi...usetts-reduced

[sawyer2]

Originally Posted by yesmaybe

If they really bought a ton of J&J and AZ's vaccine, I don't know what's going to happen to it unless GeoffD is right that the immunity won't last long enough that people will need to get the vaccine again eventually. I am thinking they would just ship it to some overseas country.

Only time will tell, but I think that the current working assumption is that additional boosters will be required to maintain immunity.

The most recent data from Moderna in early Dec. was positive re. durability - binding and neutralizing antibodies dropped as is typical but they were still elevated in all subjects 3 months out, which means that it has the potential to provide durable humoral immunity

Too soon to tell either way - need time to follow that trajectory in different patients (and for different vaccines).


As I posted earlier, durability and asymtomatic transmission/infectivity are two big unknowns for vaccines.

[GeoffD]

Originally Posted by sawyer2

As I posted earlier, durability and asymtomatic transmission/infectivity are two big unknowns for vaccines.

On the asymptomatic transmission issue, it's my understanding that the Oxford/AstraZeneca vaccine trial tested participants weekly. Pfizer and Moderna didn't and only captured people who developed symptoms. It's possible that the RNA vaccines aren't anywhere near as effective as reported.


I guess it will take many months to collect enough data on this to really fully understand it. I'm optimistic that the leadership that shows up at noon on January 20th knows this and will do everything possible to collect the data to make good decisions.

[BostonMike7]

As a note of positive news, my MILs second bout has been much better. Seems this time around not much more than a head cold really. She’s already improved to the point of itching to get back to normal life.


No idea if the first round was what made this a mild bout.

[rach5]

Originally Posted by BostonMike7

As a note of positive news, my MILs second bout has been much better. Seems this time around not much more than a head cold really. She’s already improved to the point of itching to get back to normal life.


No idea if the first round was what made this a mild bout.

So glad to hear! The other circulating human coronaviruses are usually colds - so it makes sense that eventually covid19 would be nothing but another cold for us.