All things CoronaVirus

[njbill]

What is the time window for the second shot? When I got my shingles shot a few years ago, I was supposed to get the second shot between two and six months after the first shot. So the window was four months.

For the Covid vaccine, the window opens three or four weeks after the first shot. When does it close? If it is four months after the window opens, that seems to me to be pretty significant in terms of the rollout issues. If that is the case, if you have vaccinated 1 million people on day one, you don’t need to have another 1 million doses ready on day 21 or 28. You may have nearly 5 months after the first dose is administered to have the second one ready to go.

Now extending the date on which you get your second shot out to the maximum timeframe certainly isn’t ideal, but it is a relevant factor in addressing the rollout issues, I think.

Also, what is the shelflife for each of the vaccines if they are stored properly? My daughter seems to think the vaccines will go bad at some point, but I haven’t seen anything that says that. Again, if properly stored.

[youthathletics]

looks like shortly after my post, google search and the hill teamed up to put something out:
https://thehill.com/policy/healthcare/5 ... culation=1

strange how a focus now on pushing shots through to as many as possible and a untried one dose regimen are being bandied about, but little to no discussion on cdc guides to have health and then frontline workers
included early. heard an entire health system getting vaxxed. including lab personnel who are backed by the right program (even if off-site) and undergrad nursing students who aren't patient facing.

and of congress will be able to vote safely.

Thanks for finding and sharing. Agree re little discussion of priorities...I'm still perplexed as to why they were working on vaccine distribution issues for many months yet seemed to not have clear recommendations about priorities, indeed no recommendations, until the very last moment...certainly doesn't engender confidence that either 1) the public health folks were in charge and/or 2) there wasn't political pressure from non-public health people.

It also disturbs me that, if the article is accurate, that for each vaccination distributed a second dose is being held back and not distributed. It's as if they have zero confidence that more doses are being produced and will be available. I understand some modeled reserve but 1:1 makes no sense to me absent a belief no more doses are being produced.

And am I correct that when they say the gov't is holding back the second doses, they mean the federal gov't is not shipping them to the states? Yet the federal gov't isn't tracking the individuals being vaccinated, the states are in charge of that...maybe? But the federal gov't isn't sending the states the second doses?

That sure sounds like a recipe for disaster.

tough to tell whether they had x scenarios already planned out, to be executed as results came in on trials and what was approved (i.e. if they weren't approved right away for elderly, some pre-existing conditions). or taking in as much info as possible to recommend knowing first batch could go nursing homes/health systems vs nursing home/over 75s.

anyway, i haven't seen whether they are shipping double doses at once and holding at the states or telling pfizer/moderna to hold in warehouse to ship 2nds. if it's the former especially or even the latter, there's an element of efficiency and resource management.

pushing that aside, the trade off here would seem to be 20+ million every other month (1/2 of potential recipients in months 1 and 3, for example) getting shots 3-4 weeks later vs. having a production issue that risks up to 40-50 million people not going on tested and approved protocol. science-wise, that could be a small issue or a potentially problematic one. so that might be a pretty large risk.

lipids were a problem getting out of the gate for pfizer. as well as other materials. so they had time to be ready relatively speaking and had trouble getting started. they just signed a lipid agreement in november. moderna has a similar process, has never coordinated a vaccine rollout. and each of these guys were needing it to be scaled and continuous. they don't have a supply chain history like coca-cola for this.
https://time.com/5917847/pfizer-cut-cov ... e-targets/
https://cen.acs.org/business/outsourcin ... nts/98/i44
https://www.forbes.com/sites/greatspecu ... cb6da15c77
the other thing is delivery isn't supposed to ramp higher every month, it's supposed to be a relatively consistent level for months.

i suspect if/when we can be assured disruption chances are lower, we should be able to convert at any time to getting as many as possible first doses and then get 2nds delivered weeks out.

The cynical side of me argues that they only want one dose, since this was fast tracked, more of a precautionary move. Maybe they are seeing varied results that were not seen in clinical trial that give them pause for dose two? Certainly hope 'warp-speed' does not evolve in to a catastrophe.

[wgdsr]

Chinese journalist who documented Wuhan coronavirus outbreak jailed for 4 years

Luckily we aren't there... yet. Just firing people for speaking out and sending SWAT to raid their homes.

As an aside, does anyone have a good dashboard for vaccinations? Like daily stats or anything? I'm interested in following the rollout.

there's this:
https://covid.cdc.gov/covid-data-tracker/#vaccinations
top reps have bèen talking about reporting lag, but haven't defined it even with these "smaller" numbers.

there's also this for registering when the time is right?
https://www.cdc.gov/vaccines/covid-19/r ... index.html

[Typical Lax Dad]

looks like shortly after my post, google search and the hill teamed up to put something out:
https://thehill.com/policy/healthcare/5 ... culation=1

strange how a focus now on pushing shots through to as many as possible and a untried one dose regimen are being bandied about, but little to no discussion on cdc guides to have health and then frontline workers
included early. heard an entire health system getting vaxxed. including lab personnel who are backed by the right program (even if off-site) and undergrad nursing students who aren't patient facing.

and of congress will be able to vote safely.

Thanks for finding and sharing. Agree re little discussion of priorities...I'm still perplexed as to why they were working on vaccine distribution issues for many months yet seemed to not have clear recommendations about priorities, indeed no recommendations, until the very last moment...certainly doesn't engender confidence that either 1) the public health folks were in charge and/or 2) there wasn't political pressure from non-public health people.

It also disturbs me that, if the article is accurate, that for each vaccination distributed a second dose is being held back and not distributed. It's as if they have zero confidence that more doses are being produced and will be available. I understand some modeled reserve but 1:1 makes no sense to me absent a belief no more doses are being produced.

And am I correct that when they say the gov't is holding back the second doses, they mean the federal gov't is not shipping them to the states? Yet the federal gov't isn't tracking the individuals being vaccinated, the states are in charge of that...maybe? But the federal gov't isn't sending the states the second doses?

That sure sounds like a recipe for disaster.

tough to tell whether they had x scenarios already planned out, to be executed as results came in on trials and what was approved (i.e. if they weren't approved right away for elderly, some pre-existing conditions). or taking in as much info as possible to recommend knowing first batch could go nursing homes/health systems vs nursing home/over 75s.

anyway, i haven't seen whether they are shipping double doses at once and holding at the states or telling pfizer/moderna to hold in warehouse to ship 2nds. if it's the former especially or even the latter, there's an element of efficiency and resource management.

pushing that aside, the trade off here would seem to be 20+ million every other month (1/2 of potential recipients in months 1 and 3, for example) getting shots 3-4 weeks later vs. having a production issue that risks up to 40-50 million people not going on tested and approved protocol. science-wise, that could be a small issue or a potentially problematic one. so that might be a pretty large risk.

lipids were a problem getting out of the gate for pfizer. as well as other materials. so they had time to be ready relatively speaking and had trouble getting started. they just signed a lipid agreement in november. moderna has a similar process, has never coordinated a vaccine rollout. and each of these guys were needing it to be scaled and continuous. they don't have a supply chain history like coca-cola for this.
https://time.com/5917847/pfizer-cut-cov ... e-targets/
https://cen.acs.org/business/outsourcin ... nts/98/i44
https://www.forbes.com/sites/greatspecu ... cb6da15c77
the other thing is delivery isn't supposed to ramp higher every month, it's supposed to be a relatively consistent level for months.

i suspect if/when we can be assured disruption chances are lower, we should be able to convert at any time to getting as many as possible first doses and then get 2nds delivered weeks out.

The cynical side of me argues that they only want one dose, since this was fast tracked, more of a precautionary move. Maybe they are seeing varied results that were not seen in clinical trial that give them pause for dose two? Certainly hope 'warp-speed' does not evolve in to a catastrophe.

What is the precautionary move possibly against? What kind of varied results? It could be positive or negative? Not sure what you mean here.

[wgdsr]

What is the time window for the second shot? When I got my shingles shot a few years ago, I was supposed to get the second shot between two and six months after the first shot. So the window was four months.

For the Covid vaccine, the window opens three or four weeks after the first shot. When does it close? If it is four months after the window opens, that seems to me to be pretty significant in terms of the rollout issues. If that is the case, if you have vaccinated 1 million people on day one, you don’t need to have another 1 million doses ready on day 21 or 28. You may have nearly 5 months after the first dose is administered to have the second one ready to go.

Now extending the date on which you get your second shot out to the maximum timeframe certainly isn’t ideal, but it is a relevant factor in addressing the rollout issues, I think.

Also, what is the shelflife for each of the vaccines if they are stored properly? My daughter seems to think the vaccines will go bad at some point, but I haven’t seen anything that says that. Again, if properly stored.

they have only been tested and approved for 21 days and 28 days. i haven't seen anything regarding a "window" and think the expectation is that each stay on that timeline.

no doctor here, but one possible issue is that immune response at least possibly reacts either more poorly or even detrimentally in some (cytokine or other bad response) for other timelines. haven't been studied.

here is what pfizer has put out on storage:
https://www.pfizer.com/news/hot-topics/ ... conditions.

edit: some other storage from moderna
https://investors.modernatx.com/news-re ... 19-vaccine
6 months at freezing, and once started to be thawed and refrigerated, diff timelines:
https://www.cdc.gov/vaccines/covid-19/i ... index.html

look at preparation and administration summary.

[youthathletics]

looks like shortly after my post, google search and the hill teamed up to put something out:
https://thehill.com/policy/healthcare/5 ... culation=1

strange how a focus now on pushing shots through to as many as possible and a untried one dose regimen are being bandied about, but little to no discussion on cdc guides to have health and then frontline workers
included early. heard an entire health system getting vaxxed. including lab personnel who are backed by the right program (even if off-site) and undergrad nursing students who aren't patient facing.

and of congress will be able to vote safely.

Thanks for finding and sharing. Agree re little discussion of priorities...I'm still perplexed as to why they were working on vaccine distribution issues for many months yet seemed to not have clear recommendations about priorities, indeed no recommendations, until the very last moment...certainly doesn't engender confidence that either 1) the public health folks were in charge and/or 2) there wasn't political pressure from non-public health people.

It also disturbs me that, if the article is accurate, that for each vaccination distributed a second dose is being held back and not distributed. It's as if they have zero confidence that more doses are being produced and will be available. I understand some modeled reserve but 1:1 makes no sense to me absent a belief no more doses are being produced.

And am I correct that when they say the gov't is holding back the second doses, they mean the federal gov't is not shipping them to the states? Yet the federal gov't isn't tracking the individuals being vaccinated, the states are in charge of that...maybe? But the federal gov't isn't sending the states the second doses?

That sure sounds like a recipe for disaster.

tough to tell whether they had x scenarios already planned out, to be executed as results came in on trials and what was approved (i.e. if they weren't approved right away for elderly, some pre-existing conditions). or taking in as much info as possible to recommend knowing first batch could go nursing homes/health systems vs nursing home/over 75s.

anyway, i haven't seen whether they are shipping double doses at once and holding at the states or telling pfizer/moderna to hold in warehouse to ship 2nds. if it's the former especially or even the latter, there's an element of efficiency and resource management.

pushing that aside, the trade off here would seem to be 20+ million every other month (1/2 of potential recipients in months 1 and 3, for example) getting shots 3-4 weeks later vs. having a production issue that risks up to 40-50 million people not going on tested and approved protocol. science-wise, that could be a small issue or a potentially problematic one. so that might be a pretty large risk.

lipids were a problem getting out of the gate for pfizer. as well as other materials. so they had time to be ready relatively speaking and had trouble getting started. they just signed a lipid agreement in november. moderna has a similar process, has never coordinated a vaccine rollout. and each of these guys were needing it to be scaled and continuous. they don't have a supply chain history like coca-cola for this.
https://time.com/5917847/pfizer-cut-cov ... e-targets/
https://cen.acs.org/business/outsourcin ... nts/98/i44
https://www.forbes.com/sites/greatspecu ... cb6da15c77
the other thing is delivery isn't supposed to ramp higher every month, it's supposed to be a relatively consistent level for months.

i suspect if/when we can be assured disruption chances are lower, we should be able to convert at any time to getting as many as possible first doses and then get 2nds delivered weeks out.

The cynical side of me argues that they only want one dose, since this was fast tracked, more of a precautionary move. Maybe they are seeing varied results that were not seen in clinical trial that give them pause for dose two? Certainly hope 'warp-speed' does not evolve in to a catastrophe.

What is the precautionary move possibly against? What kind of varied results? It could be positive or negative? Not sure what you mean here.

Spit-balling .... negative side effects unforeseen or even positive side effects not requiring dose 2. I suppose having a family member that worked at Ft. Detrick in the 50's and 60's always makes me skeptical.

[Typical Lax Dad]

looks like shortly after my post, google search and the hill teamed up to put something out:
https://thehill.com/policy/healthcare/5 ... culation=1

strange how a focus now on pushing shots through to as many as possible and a untried one dose regimen are being bandied about, but little to no discussion on cdc guides to have health and then frontline workers
included early. heard an entire health system getting vaxxed. including lab personnel who are backed by the right program (even if off-site) and undergrad nursing students who aren't patient facing.

and of congress will be able to vote safely.

Thanks for finding and sharing. Agree re little discussion of priorities...I'm still perplexed as to why they were working on vaccine distribution issues for many months yet seemed to not have clear recommendations about priorities, indeed no recommendations, until the very last moment...certainly doesn't engender confidence that either 1) the public health folks were in charge and/or 2) there wasn't political pressure from non-public health people.

It also disturbs me that, if the article is accurate, that for each vaccination distributed a second dose is being held back and not distributed. It's as if they have zero confidence that more doses are being produced and will be available. I understand some modeled reserve but 1:1 makes no sense to me absent a belief no more doses are being produced.

And am I correct that when they say the gov't is holding back the second doses, they mean the federal gov't is not shipping them to the states? Yet the federal gov't isn't tracking the individuals being vaccinated, the states are in charge of that...maybe? But the federal gov't isn't sending the states the second doses?

That sure sounds like a recipe for disaster.

tough to tell whether they had x scenarios already planned out, to be executed as results came in on trials and what was approved (i.e. if they weren't approved right away for elderly, some pre-existing conditions). or taking in as much info as possible to recommend knowing first batch could go nursing homes/health systems vs nursing home/over 75s.

anyway, i haven't seen whether they are shipping double doses at once and holding at the states or telling pfizer/moderna to hold in warehouse to ship 2nds. if it's the former especially or even the latter, there's an element of efficiency and resource management.

pushing that aside, the trade off here would seem to be 20+ million every other month (1/2 of potential recipients in months 1 and 3, for example) getting shots 3-4 weeks later vs. having a production issue that risks up to 40-50 million people not going on tested and approved protocol. science-wise, that could be a small issue or a potentially problematic one. so that might be a pretty large risk.

lipids were a problem getting out of the gate for pfizer. as well as other materials. so they had time to be ready relatively speaking and had trouble getting started. they just signed a lipid agreement in november. moderna has a similar process, has never coordinated a vaccine rollout. and each of these guys were needing it to be scaled and continuous. they don't have a supply chain history like coca-cola for this.
https://time.com/5917847/pfizer-cut-cov ... e-targets/
https://cen.acs.org/business/outsourcin ... nts/98/i44
https://www.forbes.com/sites/greatspecu ... cb6da15c77
the other thing is delivery isn't supposed to ramp higher every month, it's supposed to be a relatively consistent level for months.

i suspect if/when we can be assured disruption chances are lower, we should be able to convert at any time to getting as many as possible first doses and then get 2nds delivered weeks out.

The cynical side of me argues that they only want one dose, since this was fast tracked, more of a precautionary move. Maybe they are seeing varied results that were not seen in clinical trial that give them pause for dose two? Certainly hope 'warp-speed' does not evolve in to a catastrophe.

What is the precautionary move possibly against? What kind of varied results? It could be positive or negative? Not sure what you mean here.

Spit-balling .... negative side effects unforeseen or even positive side effects not requiring dose 2. I suppose having a family member that worked at Ft. Detrick in the 50's and 60's always makes me skeptical.

Thanks. Got it. (One aspect is skeptical, the other is optimistic).

[Farfromgeneva]

Playing devils advocate is a younger persons game. I still do it too much but I’ve learned through my 30s that it’s not worth debating just to debate these days. We all go through that process I think.

And not sure, Joe, if you’ll get into the Acq or Finance side but feel free to ping me offline if I can be helpful. Spent a number of years in CRE finance in the CMBS business and then for a CRE CDO/HY Debt fun’s (controlled by a public REIT called Winthrop Realty Trust whos management was out in Greet Neck even though the business was HQ in Boston which they acquired via a reverse merger w pass the hat money). I was doing national work but still have contacts up there in CRE as well as cap Mkts finance and some local bank execs like Bridgehampton Bank (merging now w Dime) and a few others out that way.

Thanks, good to know. I appreciate it!

Joe

Know it’s a big town and they’re all around 10yrs older than you but any chance you’ve crossed paths with either the Murtha brothers (James was a friend who played goalie at Bart and his brother Nick played at Hop I think, or Duke, forgot) or Pete and his sister Brooke Gordon? Think they mostly all reside around that area now along with having grown up there.

The Murtha's are legendary around these parts. A few times at one of the local watering holes. My sister's HS Coach, Danielle Gallagher in the US Lacrosse Hall of Fame and was still paying for the national team at over 35 years old.

Joe

James, myself and one or two of his fraternity brothers created a pregame, game called MillCrateHead. We’d start off w a game of A-hole to get a buzz first, then we’d play MCH where one person puts an old school milk create on their head and the rest of us would fire empty beer bottles at him from a couch in the room. One at a time and the winner, who got 2 shots bought for them at the bar later, was the person who could take the most shots before bleeding (either a cut from those hard plastic crates or a bloody nose from a good middle shot).

I only met Nick a couple of times but James was an animal. We had some good times destroying Hobarts reputation with the local community back in the day!

Great story, that's amazing!

Will see if any of my friends are up for that game...

Joe

I’m not saying it was intelligent but there’s a lot we would do for a free drink. Ladies night dressing up, gallon of milk in 5 minute challenge, etc.

[njbill]

Thanks. So up to six months to store the Pfizer vac in the super duper freezers. That certainly is a significant factor in terms of manufacturing and roll out.

I’m no scientist, but if memory serves, when I have been administered a two shot vaccination, I have been told what the waiting period and window are for the second shot. Two month wait then four month window for shingles, as mentioned above. One year wait, I think, for pneumonia. (Wasn’t told what the window was.) I am not sure whether it was hepatitis A or B, but for one of them, I had never gone back to get my second shot. Three or four years later my doctor told me there was either no deadline or that I was still within the window. So I was able to get the second shot after a several year delay.

Makes sense to me that there would be a window for the second COVID-19 shot. Would be curious to know what it is. Maybe they don’t know yet.

[wgdsr]

giroir now saying in interview 20 million doses distributed by 1st week of january. he also said 30 million in january (in addition?) and 50 million in february. pfizer and moderna were talking in december that 50 million between them would be avail for the u.s. by year end.
so... either 100 million will happen in march with pfizer and moderna alone or we will already be late. vs the 100 million total each for pfizer and moderna by end of q1.
https://www.businessinsider.com/vaccine ... ys-2020-12
this article also says everyone can get one from just pfizer and moderna by the end of june, but it's not directly quoting anyone. the total number contracted for those 2 co's is 370 million doses by q2 as of this writing, which is 185 million people, so a disconnect somewhere.

again, we need jnj and azn to come riding in and flood the market. my guess is until that happens, distribution and production will be problematic and spotty from just these 2. it will be anyway.

[holmes435]

My family is in the last group of the first wave of doses with my wife being in the medical field. Here in Virginia they have split it up the first wave of vaccines into 4 different groups depending on your exposure level and who your patients are. We don't have any specific date yet, but it's looking like February or March maybe. Virginia has the Pfizer and Moderna vaccines.

[wgdsr]

My family is in the last group of the first wave of doses with my wife being in the medical field. Here in Virginia they have split it up the first wave of vaccines into 4 different groups depending on your exposure level and who your patients are. We don't have any specific date yet, but it's looking like February or March maybe. Virginia has the Pfizer and Moderna vaccines.

there are semi-officially 18 million in the healthcare field (remarkably 80% women) and 1.5 million nursing home residents. plus nh staff maybe 20 million +.
if she's in the first wave and doesn't get it until march, we're all looking at year end.

know a secondary healthcare affiliate worker who was given a date of feb 1 for shot 1. a los angeles rep was on today saying her entire healthcare system had been vaccinated. guess we'll see.

[njbill]

Delays likely due to supplies being diverted to take care of Wall Streeters, Hollywood movie stars, and pro athletes.

[wgdsr]

Delays likely due to supplies being diverted to take care of Wall Streeters, Hollywood movie stars, and pro athletes.

i see lawyers might? be tabbed in the next essential worker group, too. good on ya and renew your bar license.

[CU88]

The virus infecting thousands of Americans a day is also attacking the country's social fabric. The coronavirus has exposed a weakness in many rural communities, where divisive pandemic politics is alienating some of their most critical residents — health care workers.

A wave of departing medical professionals would leave gaping holes in the rural health care system, and small-town economies, triggering a death spiral in some of these areas that may be hard to stop.

https://www.npr.org/2020/12/28/95086197 ... -small-tow


We can all see where this is going, these r states will demand federal money to cure the problem they created...

[njbill]

Delays likely due to supplies being diverted to take care of Wall Streeters, Hollywood movie stars, and pro athletes.

i see lawyers might? be tabbed in the next essential worker group, too. good on ya and renew your bar license.

That would be ridiculous.

I’m hoping that when Joe gets into office, he will get things moving. I fear, however, that much of the actual, on the ground, implementation is going to be up to the states.

Haven’t been very impressed with NJ so far. For starters, our governor blew a deadline for getting nursing home workers and residents vaccinated. The mistake (only) resulted in a one-week delay, but every day is important, I think.

[wgdsr]

Delays likely due to supplies being diverted to take care of Wall Streeters, Hollywood movie stars, and pro athletes.

i see lawyers might? be tabbed in the next essential worker group, too. good on ya and renew your bar license.

That would be ridiculous.

I’m hoping that when Joe gets into office, he will get things moving. I fear, however, that much of the actual, on the ground, implementation is going to be up to the states.

Haven’t been very impressed with NJ so far. For starters, our governor blew a deadline for getting nursing home workers and residents vaccinated. The mistake (only) resulted in a one-week delay, but every day is important, I think.

as i don't see the feds being able to get from a to c so far, i hesitate to believe that means getting them to do a to z makes any sense.

i will submit that also stems from my lack of faith in most things govt getting done efficiently or with any real high end competence.

steep learning curve. we can hope some or most are on it?

[njbill]

Once they get outside the confines of the “easy” vaccinations in hospitals and nursing homes (easy in the sense that the recipients are right in the building), I fear it is going to be the Wild Wild West.

Using New Jersey as an example again, from what I have seen, it doesn’t appear that they have released any type of detailed plans for how large groups will get their vaccinations. They have identified some “mega centers,” but haven’t provided any details beyond that.

My understanding is that the feds determine how much each state gets and when, but after that it is pretty much entirely up to the states.

And, of course, critically, the next group to get vaccinated hasn’t been formally identified in New Jersey (or elsewhere?) unless they are going by the plan put on the website in October (which I doubt).

[a fan]

i will submit that also stems from my lack of faith in most things govt getting done efficiently or with any real high end competence.

Landing on the moon changed my opinion as to what the US government can do. Then they topped that by inventing the internet.

As for high end competence, I seem to remember the last NCAA D1 Championship going to a team owned and operated by the government. Pretty good for a bunch of no-good government workers, no? I understand that UVa is better than many (most?) private Universities when it comes to educating their customers!

[a fan]

The mistake (only) resulted in a one-week delay, but every day is important, I think.

This is why I questioned our infrastructure spend on both testing and vaccination way back in the summer....every week lost costs us Billions.

The vaccine rollout has been a *hitshow, and this, for once, is entirely on Trump. One last bit of proof that Trump couldn't manage a McDonald's with any proficiency, let alone the manufacture and distribution of a vaccine.