8 ms·

I work here and was in clinic this morning. We had three eligible patients. One consented to it and is having the vaccine now. The other two declined. Not m

by dm319 6y ago

I work here and was in clinic this morning. We had three eligible patients. One consented to it and is having the vaccine now. The other two declined. Not making a point, just a data point.

thisistheend123 6y ago
Hey thanks for your comment. Could you describe in more detail how the vaccines are currently being stored in your clinic? How long does the vaccine can remain in room temperature, once taken out of clod storage. How many doses have been allocated to your clinic and on an average how many patients do you foresee being vaccinated over a short period of time, let's say a month. Also, are health workers also planning to get vaccinated soon, as they are on the frontline and among most vulnerable to infection. Any other details you would like to share. Thanks again.
- dm319 6y ago
  I run a specialty clinic for a type of cancer, so it isn't specific for vaccination. However, patients >80 yrs who were attending in person were identified as eligible for the vaccine. They have attended elsewhere in the hospital to receive the vaccine, but my understanding is that it needs -80/70 for storage, and can be moved a total of 4 times before needing to be discarded. I'm afraid I do not know more. Maybe if I wasn't so busy in the clinic I would have read through the info sheets in more detail, but it's always a rush!
- bserge 6y ago
  I've stated this is my worry with the BioNTech/Fosun vaccine - transporting it safely to Eastern Europe. They can't seem to transport frozen fish properly, I really hope they keep that vaccine in proper conditions, otherwise it'll be rendered useless...
  - ceejayoz 6y ago
    It's likely the chain of custody for fish and critical medical supplies will be somewhat different.
    - bserge 6y ago
      I can only hope so. They could very well outsource it to the usual transportation companies, and there isn't much accountability tbh. Oh well, if this one doesn't work, perhaps we can try again with the Oxford vaccine heh
      - ceejayoz 6y ago
        It travels in purpose-built shipping containers, so it shouldn't really matter what the trucker does. https://www.cbsnews.com/news/covid-vaccine-pfizer-distribution-logistical-nightmare/ https://www.cbsnews.com/news/covid-vaccine-pfizer-distributi... > In order to get around that, Pfizer has developed specially built deep-freeze "suitcases" that can be tightly sealed and shipped even in non-refrigerated trucks. https://www.fiercepharma.com/manufacturing/pfizer-designed-new-container-and-plans-to-tap-shipping-companies-for-covid-19 https://www.fiercepharma.com/manufacturing/pfizer-designed-n... indicates they can hold temperature for ten days. They'll likely include seals and simple sensors to detect temperature excursions; for example, my daughter's growth hormone comes with a little piece of plastic that turns permanently pink if it's not stored at the right temperature for a few minutes.
        bserge 6y ago
        Oh, very interesting. I'm mostly worried about last mile distribution, but yeah, they're not stupid, they took all the necessary measures.
      - watwut 6y ago
        You know, thinking fish and vaccine are treated the same does not show smart understanding of region. Honestly, it shows not understanding it at all. Not that vaccines are about to be flawless. But failure will be different.
- dm319 6y ago
  Some details: Vaccine storage and preparation The Pfizer/BioNTech coronavirus vaccine has the most difficult storage requirements of all the COVID-19 vaccine candidates currently undergoing trials. Currently, it needs to be stored between -80 to -60°C and has a six-month expiry. Over time and with more data being collected this may change.(4) The vaccine needs to be thawed (for approximately three hours in the fridge or 30 minutes at room temperature) before use and may be stored undiluted at 2–8°C for five days, or for two hours at 25°C prior to use.(4) To prepare the vaccine, it should be diluted using 0.8 mL of sodium chloride 0.9% solution for injection, marked with the date and time, and can then be stored between 2 to 25°C. It must be used within six hours or the remainder discarded.(4) To equalise the pressure in the prepared vial, 1.8 mL of air should be withdrawn using the same syringe for preparation, after which it can be mixed by gently inverting 10 times, producing an off-white solution that is ready to be administered. The vaccines are available in packs of 195. There are five 0.3 mL doses within each vial. In comparison, the Moderna vaccine can be stored at -20°C for up to six months, 30 days at 2 to 8°C and up to 12 hours at 25°C. Each vial contains 10 doses. The AstraZeneca/Oxford vaccine is much simpler than both options, with storage allowance of 2 to 8°C for up to six months. Once open, the vials should be used within six hours stored in a fridge or 48 hours if at room temperature. They are delivered in packs of 10 vials with each vial containing eight or 10 doses of vaccine.
mchusma 6y ago
Interesting. Thanks for sharing the anecdote. Seems odd to me you are asking people. Isn't there a line or something? My biggest concern with virus rollout is millions of doses sitting on shelves waiting for "high priority" people to get them (who refuse) while "low priority" people are still banned from getting.
- dtech 6y ago
  isn't there a priority list? If people refuse it should go to the next one
  - dm319 6y ago
    Yes the priorities are the over 80s, any spare slots are being given to the most-at-risk clinical groups (i.e. guessing ITU, A+E, resp and ENT). They reported internally that they administered 'dozens' today, so less than a hundred. There are some real logistical issues and it's not felt that other local centres will be able to provide it yet. It's clearly going to take a while to get this vaccine out.
- dm319 6y ago
  No there's not a line, in this weather I don't think that'd be a good idea, and it'd likely be chaotic. These patients are attending hospital anyway for follow-up, so since they are here they are being vaccinated.
- deleted 6y ago
  [deleted]
acqq 6y ago
The news report that both the first (Margaret Keenan, 90) and the second person (William Shakespeare, 81) were vaccinated at the same "University Hospital, Coventry." So it's not that only one person was vaccinated there? Are you reporting only about the people you're directly in charge of, three of which where eligible, and one accepted, but still there were more vaccinated today there?
- Throwaway1771 6y ago
  That's what I read from GP's comment.
- dm319 6y ago
  Yes, these were patients attending my clinic for other reasons. At any one time there are obviously several clinics running - I suspect the hospital will announce how many in total have been vaccinated at the end of the day.
adwww 6y ago
Interesting that you had three eligible patients - I wonder if that is repeated across the hospital, how many eligible inpatients are there likely to be out of each batch of vaccines? It sounds like it might be a struggle to find enough people to give it to once each container is opened.
- dm319 6y ago
  These were patients attending for another reason. It's a large teaching hospital (1250 beds) with many patients attending for outpatients every day, so I'm sure there will be plenty of eligible patients to give the vaccine to.
ulfw 6y ago
If they don't want it, I'm more than happy to fly to the UK to get it. Hong Kong doesn't seem to want to vaccinate most people before 2022 https://www.scmp.com/news/hong-kong/health-environment/article/3112750/coronavirus-hong-kong-infectious-disease-expert https://www.scmp.com/news/hong-kong/health-environment/artic...
- chosenbreed37 6y ago
  Wow.
- string 6y ago
  I suppose that's one way of keeping protesters off the streets.
- officialjunk 6y ago
  the pfizer vaccine doesn't prevent infection, but does save lives by preventing severe symptoms, which is why at-risk groups are prioritized. the vaccines that actually prevent infection are still being developed. 2022 sounds realistic for that, if not a tad early.
  - n4r9 6y ago
    What do you mean it "doesn't prevent infection"? Trials showed vastly reduced infection rate amongst people who'd had the vaccine.
    - markburns 6y ago
      As a layperson I read “prevent” to mean a 100% reduction. Not sure if there’s a slightly different interpretation than that but I’d presume that’s what they mean?
      - officialjunk 6y ago
        Didn't have a link handy at the time. Read this https://www.forbes.com/sites/williamhaseltine/2020/09/23/covid-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed/ https://www.forbes.com/sites/williamhaseltine/2020/09/23/cov... "We all expect an effective vaccine to prevent serious illness if infected. Three of the vaccine protocols—Moderna, Pfizer, and AstraZeneca—do not require that their vaccine prevent serious disease only that they prevent moderate symptoms which may be as mild as cough, or headache." "Prevention of infection is not a criterion for success for any of these vaccines. In fact, their endpoints all require confirmed infections and all those they will include in the analysis for success, the only difference being the severity of symptoms between the vaccinated and unvaccinated."
defertoreptar 6y ago
I'd guess that people will be the most apprehensive at the very beginning but then will be more open to it as it goes along.
ryandrake 6y ago
Same thing happening on this side of the pond. It's been reported that approximately 50% of Americans say they definitely or probably would refuse a vaccine [1]. And the trend over time is more and more are planning to refuse. Seems fitting that in a place where we can't beat the virus because of people who refuse to distance and wear a piece of cloth over their face, it's possible we won't even be able to beat it with a vaccine... because of the same assholes. 1: https://www.pewresearch.org/science/2020/09/17/u-s-public-now-divided-over-whether-to-get-covid-19-vaccine/ https://www.pewresearch.org/science/2020/09/17/u-s-public-no...
- bstar77 6y ago
  Outright refusing the vaccine is absurd, but refusing at this phase of the distribution is not.
  - mcv 6y ago
    That is definitely true, but the link seems to be from September and talks about refusing a vaccine in general, not this particular at this time. 50% is insane. 5% I'd be able to understand, but not 50%.
    - harambae 6y ago
      It's a little hard to obtain accurate data now about what people will potentially do in the future when faced with more information.
    - rualca 6y ago
      > 50% is insane. 5% I'd be able to understand, but not 50%. I'm hardly anti-vaxxer, but I'm going to wait this one out until a lot of people went head-first into it. I take my vaccines like I take my software upgrades: no pre-releases of system-critical ones.
  - dm319 6y ago
    A lot of people are slightly skeptical/worried about the safety here in the UK. These aren't anti-vaxxers. More 'you first'.
fairity 6y ago
Color me surprised if there ends up being an actual problem with demand for this vaccine. As soon as vaccinated people start flaunting their freedom of movement, people will clamor to line up. The vaccine's scarcity will further magnify the desire to get vaccinated. It's natural for the initial reaction to be skepticism. Nobody wants to be first, but as soon as the first cohorts get vaccinated and the media publish their nonplussed reactions, the lines will explode and we'll have the opposite problem: me-first.
- tim333 6y ago
  >As soon as vaccinated people start flaunting their freedom of movement That could be a big factor. At the moment there's nothing - no vaccination certificate that lets you fly easier or something like that. But it could be a big motivator if there was.

by dm319 6y ago

I work here and was in clinic this morning. We had three eligible patients. One consented to it and is having the vaccine now. The other two declined. Not making a point, just a data point.

thisistheend123 6y ago

Hey thanks for your comment. Could you describe in more detail how the vaccines are currently being stored in your clinic? How long does the vaccine can remain in room temperature, once taken out of clod storage. How many doses have been allocated to your clinic and on an average how many patients do you foresee being vaccinated over a short period of time, let's say a month. Also, are health workers also planning to get vaccinated soon, as they are on the frontline and among most vulnerable to infection. Any other details you would like to share. Thanks again.

dm319 6y ago
I run a specialty clinic for a type of cancer, so it isn't specific for vaccination. However, patients >80 yrs who were attending in person were identified as eligible for the vaccine. They have attended elsewhere in the hospital to receive the vaccine, but my understanding is that it needs -80/70 for storage, and can be moved a total of 4 times before needing to be discarded. I'm afraid I do not know more. Maybe if I wasn't so busy in the clinic I would have read through the info sheets in more detail, but it's always a rush!
bserge 6y ago
I've stated this is my worry with the BioNTech/Fosun vaccine - transporting it safely to Eastern Europe. They can't seem to transport frozen fish properly, I really hope they keep that vaccine in proper conditions, otherwise it'll be rendered useless...
- ceejayoz 6y ago
  It's likely the chain of custody for fish and critical medical supplies will be somewhat different.
  - bserge 6y ago
    I can only hope so. They could very well outsource it to the usual transportation companies, and there isn't much accountability tbh. Oh well, if this one doesn't work, perhaps we can try again with the Oxford vaccine heh
    - ceejayoz 6y ago
      It travels in purpose-built shipping containers, so it shouldn't really matter what the trucker does. https://www.cbsnews.com/news/covid-vaccine-pfizer-distribution-logistical-nightmare/ https://www.cbsnews.com/news/covid-vaccine-pfizer-distributi... > In order to get around that, Pfizer has developed specially built deep-freeze "suitcases" that can be tightly sealed and shipped even in non-refrigerated trucks. https://www.fiercepharma.com/manufacturing/pfizer-designed-new-container-and-plans-to-tap-shipping-companies-for-covid-19 https://www.fiercepharma.com/manufacturing/pfizer-designed-n... indicates they can hold temperature for ten days. They'll likely include seals and simple sensors to detect temperature excursions; for example, my daughter's growth hormone comes with a little piece of plastic that turns permanently pink if it's not stored at the right temperature for a few minutes.
      - bserge 6y ago
        Oh, very interesting. I'm mostly worried about last mile distribution, but yeah, they're not stupid, they took all the necessary measures.
    - watwut 6y ago
      You know, thinking fish and vaccine are treated the same does not show smart understanding of region. Honestly, it shows not understanding it at all. Not that vaccines are about to be flawless. But failure will be different.
dm319 6y ago
Some details: Vaccine storage and preparation The Pfizer/BioNTech coronavirus vaccine has the most difficult storage requirements of all the COVID-19 vaccine candidates currently undergoing trials. Currently, it needs to be stored between -80 to -60°C and has a six-month expiry. Over time and with more data being collected this may change.(4) The vaccine needs to be thawed (for approximately three hours in the fridge or 30 minutes at room temperature) before use and may be stored undiluted at 2–8°C for five days, or for two hours at 25°C prior to use.(4) To prepare the vaccine, it should be diluted using 0.8 mL of sodium chloride 0.9% solution for injection, marked with the date and time, and can then be stored between 2 to 25°C. It must be used within six hours or the remainder discarded.(4) To equalise the pressure in the prepared vial, 1.8 mL of air should be withdrawn using the same syringe for preparation, after which it can be mixed by gently inverting 10 times, producing an off-white solution that is ready to be administered. The vaccines are available in packs of 195. There are five 0.3 mL doses within each vial. In comparison, the Moderna vaccine can be stored at -20°C for up to six months, 30 days at 2 to 8°C and up to 12 hours at 25°C. Each vial contains 10 doses. The AstraZeneca/Oxford vaccine is much simpler than both options, with storage allowance of 2 to 8°C for up to six months. Once open, the vials should be used within six hours stored in a fridge or 48 hours if at room temperature. They are delivered in packs of 10 vials with each vial containing eight or 10 doses of vaccine.

mchusma 6y ago

Interesting. Thanks for sharing the anecdote. Seems odd to me you are asking people. Isn't there a line or something? My biggest concern with virus rollout is millions of doses sitting on shelves waiting for "high priority" people to get them (who refuse) while "low priority" people are still banned from getting.

dtech 6y ago
isn't there a priority list? If people refuse it should go to the next one
- dm319 6y ago
  Yes the priorities are the over 80s, any spare slots are being given to the most-at-risk clinical groups (i.e. guessing ITU, A+E, resp and ENT). They reported internally that they administered 'dozens' today, so less than a hundred. There are some real logistical issues and it's not felt that other local centres will be able to provide it yet. It's clearly going to take a while to get this vaccine out.
dm319 6y ago
No there's not a line, in this weather I don't think that'd be a good idea, and it'd likely be chaotic. These patients are attending hospital anyway for follow-up, so since they are here they are being vaccinated.
deleted 6y ago
[deleted]

acqq 6y ago

The news report that both the first (Margaret Keenan, 90) and the second person (William Shakespeare, 81) were vaccinated at the same "University Hospital, Coventry." So it's not that only one person was vaccinated there? Are you reporting only about the people you're directly in charge of, three of which where eligible, and one accepted, but still there were more vaccinated today there?

Throwaway1771 6y ago
That's what I read from GP's comment.
dm319 6y ago
Yes, these were patients attending my clinic for other reasons. At any one time there are obviously several clinics running - I suspect the hospital will announce how many in total have been vaccinated at the end of the day.

adwww 6y ago

Interesting that you had three eligible patients - I wonder if that is repeated across the hospital, how many eligible inpatients are there likely to be out of each batch of vaccines? It sounds like it might be a struggle to find enough people to give it to once each container is opened.

dm319 6y ago
These were patients attending for another reason. It's a large teaching hospital (1250 beds) with many patients attending for outpatients every day, so I'm sure there will be plenty of eligible patients to give the vaccine to.

ulfw 6y ago

If they don't want it, I'm more than happy to fly to the UK to get it. Hong Kong doesn't seem to want to vaccinate most people before 2022 https://www.scmp.com/news/hong-kong/health-environment/article/3112750/coronavirus-hong-kong-infectious-disease-expert https://www.scmp.com/news/hong-kong/health-environment/artic...

chosenbreed37 6y ago
Wow.
string 6y ago
I suppose that's one way of keeping protesters off the streets.
officialjunk 6y ago
the pfizer vaccine doesn't prevent infection, but does save lives by preventing severe symptoms, which is why at-risk groups are prioritized. the vaccines that actually prevent infection are still being developed. 2022 sounds realistic for that, if not a tad early.
- n4r9 6y ago
  What do you mean it "doesn't prevent infection"? Trials showed vastly reduced infection rate amongst people who'd had the vaccine.
  - markburns 6y ago
    As a layperson I read “prevent” to mean a 100% reduction. Not sure if there’s a slightly different interpretation than that but I’d presume that’s what they mean?
    - officialjunk 6y ago
      Didn't have a link handy at the time. Read this https://www.forbes.com/sites/williamhaseltine/2020/09/23/covid-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed/ https://www.forbes.com/sites/williamhaseltine/2020/09/23/cov... "We all expect an effective vaccine to prevent serious illness if infected. Three of the vaccine protocols—Moderna, Pfizer, and AstraZeneca—do not require that their vaccine prevent serious disease only that they prevent moderate symptoms which may be as mild as cough, or headache." "Prevention of infection is not a criterion for success for any of these vaccines. In fact, their endpoints all require confirmed infections and all those they will include in the analysis for success, the only difference being the severity of symptoms between the vaccinated and unvaccinated."

defertoreptar 6y ago

I'd guess that people will be the most apprehensive at the very beginning but then will be more open to it as it goes along.

ryandrake 6y ago

Same thing happening on this side of the pond. It's been reported that approximately 50% of Americans say they definitely or probably would refuse a vaccine [1]. And the trend over time is more and more are planning to refuse. Seems fitting that in a place where we can't beat the virus because of people who refuse to distance and wear a piece of cloth over their face, it's possible we won't even be able to beat it with a vaccine... because of the same assholes. 1: https://www.pewresearch.org/science/2020/09/17/u-s-public-now-divided-over-whether-to-get-covid-19-vaccine/ https://www.pewresearch.org/science/2020/09/17/u-s-public-no...

bstar77 6y ago
Outright refusing the vaccine is absurd, but refusing at this phase of the distribution is not.
- mcv 6y ago
  That is definitely true, but the link seems to be from September and talks about refusing a vaccine in general, not this particular at this time. 50% is insane. 5% I'd be able to understand, but not 50%.
  - harambae 6y ago
    It's a little hard to obtain accurate data now about what people will potentially do in the future when faced with more information.
  - rualca 6y ago
    > 50% is insane. 5% I'd be able to understand, but not 50%. I'm hardly anti-vaxxer, but I'm going to wait this one out until a lot of people went head-first into it. I take my vaccines like I take my software upgrades: no pre-releases of system-critical ones.
- dm319 6y ago
  A lot of people are slightly skeptical/worried about the safety here in the UK. These aren't anti-vaxxers. More 'you first'.

fairity 6y ago

Color me surprised if there ends up being an actual problem with demand for this vaccine. As soon as vaccinated people start flaunting their freedom of movement, people will clamor to line up. The vaccine's scarcity will further magnify the desire to get vaccinated. It's natural for the initial reaction to be skepticism. Nobody wants to be first, but as soon as the first cohorts get vaccinated and the media publish their nonplussed reactions, the lines will explode and we'll have the opposite problem: me-first.

tim333 6y ago
>As soon as vaccinated people start flaunting their freedom of movement That could be a big factor. At the moment there's nothing - no vaccination certificate that lets you fly easier or something like that. But it could be a big motivator if there was.