5 ms·

I suspect the title was abbreviated to fit HN length requirements, but it cut out perhaps the most important part. This data is for a single shot. There is an o

by Exmoor 6y ago

I suspect the title was abbreviated to fit HN length requirements, but it cut out perhaps the most important part. This data is for a single shot. There is an ongoing trial for boosting with a second shot down the line, but having a single shot that's known to be effective at eliminating the disease and extremely effective at reducing severe cases and hospitalizations is a game changer. We can vaccinate lower risk populations with this vaccine and do it twice as fast. Once everyone is vaccinated, we can invite people to come back for a second shot as a booster. From the phase 1/2 trial data I saw, I'd expect a second shot to boost the efficacy to numbers approaching the mRNA vaccines. Edit: It also only needs to be refrigerated so it eliminates a lot of coordination related to frozen transportation, scheduled appointments, etc. will be eliminated.

interestica 6y ago
What is the optimal vaccination strategy? So far, it just seems like we're following "vaccinate healthcare workers and the most vulnerable" and that, on the surface, seems intuitive. But is there some other sort of algorithm that can determine the best way to reduce overall transmission the fastest? Random vaccinations? Targeted groups in different regions? Double shots for vulnerable before single shots for others? Mobile vaccination services?
- bagacrap 6y ago
  well we definitely shouldn't be vaccinating people who've had and recovered from the virus before we vaccinate other who haven't, and we most likely shouldn't be giving out second shots before more people get a first shot. Of course individual risk and exposure plays a role, but the incremental protection conferred by the second shot in the arm of a person who's already recovered from covid is pretty low, even if they are a healthcare worker.
  - interestica 6y ago
    > we most likely shouldn't be giving out second shots before more people get a first shot. It's mostly thinking out loud because sometimes the most effective solution is a bit counter-intuitive. There may be some value in getting more people to a guaranteed 100% protection. Right now, in Canada, we seem to be following an intuitive route. But in BC, they've already administered ~4000 second doses. (Likely only in long term care facilities). https://www.cbc.ca/news/canada/british-columbia/covid-19-update-jan-29-1.5894208 https://www.cbc.ca/news/canada/british-columbia/covid-19-upd... So it seems like the strategy there may be to get those residents to 2 shots before others.
- matteotom 6y ago
  One strategy, which wouldn't be applicable to most places in the United States right now, is to target a couple levels of potential contacts of every case. So when a person tests positive, you vaccinate all their contacts, and then all those people's contacts, and you can be pretty sure to have broken that line of transmission.
  - interestica 6y ago
    This is what I was looking for. That seems to make a lot of sense. > which wouldn't be applicable to most places in the United States right now Which begs the question: how do you delineate regions for strategies in a pandemic? Political/provincial/municipal borders are useless when you're talking about disease transmission. Does it then make sense to have different strategies for different areas (and to divide areas up based on completely different concepts -- like proximity to major highways, for instance).
  - TylerE 6y ago
    That's far too late. It takes weeks for the vaccine to become effective.
- Exmoor 6y ago
  Since you asked, my layman's strategy would be to keep prioritizing the groups at most risk of negative consequences to get the mRNA vaccines and open a second "lane" with less stringent requirements to get a shot of the J&J vaccine. So right now where I live, healthcare workers and people 65+ can get the vaccine and it looks like it'll be another month before they add more eligibility. Perhaps you would open up another lane to say, frontline workers (retail, teachers, etc.) so they can get the J&J vaccine right now or wait until the eligibility for the mRNA vaccine gets relaxed to them. Upside is this gets the most at-risk individuals access to significant protection the quickest. Downside is that forego "really good" protection for "amazing" protection and get sick while they're waiting.
- mjevans 6y ago
  Pure armchair speculation, but I'd at least like public heath officials to explain their logic. Tier 0: High risk daily exposure. (Medical, Rescue, Law Enforcement) Tier 1: Frequent contact with Tier 0 (elderly in care) and/or high risk of complications (anyone in a hospital setting for an extended duration). +++ My tier 2 seems to differ from public health models, at least that I've seen. My logical basis is to break transmission vectors. +++ Tier 2: Those who can't social distance well; essential workers with contact. This group should include anyone in unavoidable public service positions of any sort. E.G. (but not exhaustive): Teachers, grocery store workers, restaurant workers, chefs, warehouse and delivery workers. Tier 3: High risk but CAN social distance and isolate. Tier 4: Everyone else; possibly stratified by some score of age, prior medical conditions / risk factors, etc.
  - maxerickson 6y ago
    Teachers and such in many states have approximately the priority you've outlined (with over 65 overlapping).
  - jakear 6y ago
    The most annoying thing for me is how easily people can game the “healthcare worker” definition. I know folks who are on the board of healthcare facilities, zero interaction with patients of course, and they get first priority and have already completed both rounds. Similarly, folks who stay at home all of the time to take care of disabled family get first priority, despite no external contact. Meanwhile, teachers who are forced to stay in a confined space with dozens of little rugrats who despise wearing masks, especially when coughing/sneezing, still haven’t gotten anything.
- bluGill 6y ago
  Nobody knows. The experts have their ideas, but there is no way to be sure. One problem is optimal needs to consider the real world, not the ideal world. West Virgina (typically the butt of backwards people jokes) has done more vaccinations per capita than any other state even though their allocation per capita is the same as other states. This is because that state has decided that the optimal strategy is getting vaccines in arms, not ensuring it is the ideal arms: by not having the overhead of checking eligibility they can give their doses faster which is better than a slower pace of only getting the vaccine into the right people. Note, I simplified West Virgina's strategy, it is more complex. Just less complex than other states.
- schrodinger 6y ago
  Controversial, but what if we instead gave them to those that wanted it the most? In other words, let the 20–30 yr olds that are itching to socialize & travel get it; it may not seem fair, but as a "harm reduction" strategy could still make sense. If they're going to be going out to dinner, meeting friends, and traveling anyway, might as well inoculate them…
  - burlesona 6y ago
    I believe this is what Indonesia is doing.
- burlesona 6y ago
  One idea I haven’t seen discussed, which I think is interesting although politically intractable: What if we allocated doses geographically, with a goal of (1) getting some regions fully reopened and back to work immediately, but also (2) establishing a sort of inverse quarantine zone where we’ve stamped out COVID and keep it to zero. Again I think in the real world this won’t work because we already have shown the western world largely won’t obey quarantines / lockdowns etc. But if our primary goal was to eliminate the disease - which seems worthwhile if we could pull it off - then a geographic approach might be more effective than a distributed approach. Specifically, I think you’d have a better chance of getting vaccination rates into the 90% range and subsequently via travel restriction keep these green zones clean so that even those who refuse the vaccination aren’t acting as a reservoir for it.

by Exmoor 6y ago

interestica 6y ago

What is the optimal vaccination strategy? So far, it just seems like we're following "vaccinate healthcare workers and the most vulnerable" and that, on the surface, seems intuitive. But is there some other sort of algorithm that can determine the best way to reduce overall transmission the fastest? Random vaccinations? Targeted groups in different regions? Double shots for vulnerable before single shots for others? Mobile vaccination services?

bagacrap 6y ago
well we definitely shouldn't be vaccinating people who've had and recovered from the virus before we vaccinate other who haven't, and we most likely shouldn't be giving out second shots before more people get a first shot. Of course individual risk and exposure plays a role, but the incremental protection conferred by the second shot in the arm of a person who's already recovered from covid is pretty low, even if they are a healthcare worker.
- interestica 6y ago
  > we most likely shouldn't be giving out second shots before more people get a first shot. It's mostly thinking out loud because sometimes the most effective solution is a bit counter-intuitive. There may be some value in getting more people to a guaranteed 100% protection. Right now, in Canada, we seem to be following an intuitive route. But in BC, they've already administered ~4000 second doses. (Likely only in long term care facilities). https://www.cbc.ca/news/canada/british-columbia/covid-19-update-jan-29-1.5894208 https://www.cbc.ca/news/canada/british-columbia/covid-19-upd... So it seems like the strategy there may be to get those residents to 2 shots before others.
matteotom 6y ago
One strategy, which wouldn't be applicable to most places in the United States right now, is to target a couple levels of potential contacts of every case. So when a person tests positive, you vaccinate all their contacts, and then all those people's contacts, and you can be pretty sure to have broken that line of transmission.
- interestica 6y ago
  This is what I was looking for. That seems to make a lot of sense. > which wouldn't be applicable to most places in the United States right now Which begs the question: how do you delineate regions for strategies in a pandemic? Political/provincial/municipal borders are useless when you're talking about disease transmission. Does it then make sense to have different strategies for different areas (and to divide areas up based on completely different concepts -- like proximity to major highways, for instance).
- TylerE 6y ago
  That's far too late. It takes weeks for the vaccine to become effective.
Exmoor 6y ago
Since you asked, my layman's strategy would be to keep prioritizing the groups at most risk of negative consequences to get the mRNA vaccines and open a second "lane" with less stringent requirements to get a shot of the J&J vaccine. So right now where I live, healthcare workers and people 65+ can get the vaccine and it looks like it'll be another month before they add more eligibility. Perhaps you would open up another lane to say, frontline workers (retail, teachers, etc.) so they can get the J&J vaccine right now or wait until the eligibility for the mRNA vaccine gets relaxed to them. Upside is this gets the most at-risk individuals access to significant protection the quickest. Downside is that forego "really good" protection for "amazing" protection and get sick while they're waiting.
mjevans 6y ago
Pure armchair speculation, but I'd at least like public heath officials to explain their logic. Tier 0: High risk daily exposure. (Medical, Rescue, Law Enforcement) Tier 1: Frequent contact with Tier 0 (elderly in care) and/or high risk of complications (anyone in a hospital setting for an extended duration). +++ My tier 2 seems to differ from public health models, at least that I've seen. My logical basis is to break transmission vectors. +++ Tier 2: Those who can't social distance well; essential workers with contact. This group should include anyone in unavoidable public service positions of any sort. E.G. (but not exhaustive): Teachers, grocery store workers, restaurant workers, chefs, warehouse and delivery workers. Tier 3: High risk but CAN social distance and isolate. Tier 4: Everyone else; possibly stratified by some score of age, prior medical conditions / risk factors, etc.
- maxerickson 6y ago
  Teachers and such in many states have approximately the priority you've outlined (with over 65 overlapping).
- jakear 6y ago
  The most annoying thing for me is how easily people can game the “healthcare worker” definition. I know folks who are on the board of healthcare facilities, zero interaction with patients of course, and they get first priority and have already completed both rounds. Similarly, folks who stay at home all of the time to take care of disabled family get first priority, despite no external contact. Meanwhile, teachers who are forced to stay in a confined space with dozens of little rugrats who despise wearing masks, especially when coughing/sneezing, still haven’t gotten anything.
bluGill 6y ago
Nobody knows. The experts have their ideas, but there is no way to be sure. One problem is optimal needs to consider the real world, not the ideal world. West Virgina (typically the butt of backwards people jokes) has done more vaccinations per capita than any other state even though their allocation per capita is the same as other states. This is because that state has decided that the optimal strategy is getting vaccines in arms, not ensuring it is the ideal arms: by not having the overhead of checking eligibility they can give their doses faster which is better than a slower pace of only getting the vaccine into the right people. Note, I simplified West Virgina's strategy, it is more complex. Just less complex than other states.
schrodinger 6y ago
Controversial, but what if we instead gave them to those that wanted it the most? In other words, let the 20–30 yr olds that are itching to socialize & travel get it; it may not seem fair, but as a "harm reduction" strategy could still make sense. If they're going to be going out to dinner, meeting friends, and traveling anyway, might as well inoculate them…
- burlesona 6y ago
  I believe this is what Indonesia is doing.
burlesona 6y ago
One idea I haven’t seen discussed, which I think is interesting although politically intractable: What if we allocated doses geographically, with a goal of (1) getting some regions fully reopened and back to work immediately, but also (2) establishing a sort of inverse quarantine zone where we’ve stamped out COVID and keep it to zero. Again I think in the real world this won’t work because we already have shown the western world largely won’t obey quarantines / lockdowns etc. But if our primary goal was to eliminate the disease - which seems worthwhile if we could pull it off - then a geographic approach might be more effective than a distributed approach. Specifically, I think you’d have a better chance of getting vaccination rates into the 90% range and subsequently via travel restriction keep these green zones clean so that even those who refuse the vaccination aren’t acting as a reservoir for it.