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How does one ration a COVID vaccine?

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How does one ration a COVID vaccine?

 
Old 12-02-20, 02:27 PM
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Old 12-02-20, 06:14 PM
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China has started shipping large quantities of vaccine to developing world countries, for phase III trials, most of these countries have been promised early acccess to the vaccine. China has still not released any efficacy data from their vaccine trials, although over a million Chinese people have been vaccinated.


Sinovac Biotech, a Nasdaq-listed drugmaker based in Beijing, has signed deals to provide 46 million doses of its Covid-19 vaccine to Brazil and 50 million doses to Turkey. It'll also supply 40 million doses of vaccine bulk -- the vaccine concentrate before it is divided into little vials -- to Indonesia for local production.

CanSino Biologics, which developed a coronavirus vaccine with a research unit of the Chinese military, will deliver 35 million doses of its vaccine to Mexico, one of the five host countries of its trials.

China National Biotec Group (CNBG), a unit of state-owned pharmaceutical giant China National Pharmaceutical Group (Sinopharm), has been less open about its deals. The company's two vaccine candidates are undergoing phase 3 trials in 10 countries, mostly in the Middle East and South America. In the United Arab Emirates, Dubai's ruler Sheikh Mohammed bin Rashid Al Maktoum volunteered to be vaccinated in trials and the vaccine was approved for emergency use. The Emirati company in partnership with Sinopharm hopes to produce between 75 and 100 million doses next year.
China's global vaccine campaign is in stark contrast to the Trump administration's "America first" approach, which focuses on vaccinating its own citizens before those elsewhere.

"So far we haven't heard the US saying or suggesting they're gonna earmark a percentage of their vaccine to support poor countries. So that puts China in an even better situation to use the vaccine to serve its foreign policy objective," Huang said.

In October, China joined a World Health Organization-backed global initiative to ensure the rapid and equitable distribution of Covid-19 vaccines to rich and poor countries alike.

The project, known as COVAX, is designed to discourage governments from hoarding coronavirus vaccines and instead focus on vaccinating high-risk groups in every country. But it was shunned by the United States, partly because President Donald Trump did not want to work with the WHO, leaving a global public health leadership vacuum for China to fill.
https://www.msn.com/en-us/news/world...em/ar-BB1bxJ6M
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Old 12-03-20, 12:22 AM
  #28  
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Originally Posted by skookum View Post
China has started shipping large quantities of vaccine to developing world countries, for phase III trials, most of these countries have been promised early acccess to the vaccine. China has still not released any efficacy data from their vaccine trials, although over a million Chinese people have been vaccinated.


https://www.msn.com/en-us/news/world...em/ar-BB1bxJ6M
Wow, so while American and European companies may still be treading water, the Chinese companies may be pumping out hundreds of millions of doses of the vaccine for people around the world.
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Old 12-03-20, 01:31 AM
  #29  
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Originally Posted by jack pot View Post
all you one man one voters out there have suddenly become AUTHORITARIAN now that there is a glimmer of survival ... if everyone was really EQUAL and this really was a DEMOCRACY the vaccine recipients would be ordered by randomly chosen social security numbers from a list of people residing in a specific area of distribution ......... NO EXCEPTIONS > everyone is finally equal in the USA .... no more BLM no more ANTIFA no more people being being better than you and no more me 1st ..................................... of course the simple fairness of this is also why no one would want it

The ultimate goal is to minimize total life years lost. All people are treated equally, you should be happy with that, judging by your strong sense of equality.

The effect of the vaccine in reaching the goal above is two fold: 1) it protects the person receiving the vaccine and 2) it stops the transmission, protecting others also.

In order to stop transmission there needs to be a large part of the population vaccinated, which takes a long time during which many people continue dying.

Therefore, model outcomes have shown optimal solutions for distributing the vaccine include focussing on the most vulnerable first, followed by people who necessarily need to be in contact with many people.

Solutions chosen are trying to save as many lives as possible, that is the simple reason why no thinking person would decide to randomly distribute the vaccine.
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Old 12-03-20, 04:51 AM
  #30  
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About half the population gets the influenza vaccine every year in September/October/November.

There are two doses of the COVID vaccine, but we have the infrastructure to distribute vaccines... as long as they can be properly handled.
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Old 12-03-20, 09:29 AM
  #31  
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Originally Posted by CliffordK View Post
Wow, so while American and European companies may still be treading water, the Chinese companies may be pumping out hundreds of millions of doses of the vaccine for people around the world.
I wouldn't say they are treading water, they are manufacturing vaccine while waiting for regulatory approval. I think the US and europe are going to hit the ground running and start vaccinating as soon as approval is granted, which looks like next week in the US and end of the month in Europe.
The Chinese are not as worried about their domestic market, as covid is not endemic there as it is in the rest of the world. I find it strange that they haven't released any numbers on efficacy or safety besides vague statmemnts in press releases. As far as I know all the vaccines being shipped out of China are intended for late stage trials, and not for general distribution. I dont think any jurisdiction out side of China has approved any of the Chinese vaccines yet. Even inside China they just have emergency approval which seems to have been granted without releasing any hard data.
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Old 12-03-20, 10:37 AM
  #32  
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Originally Posted by mr_pedro View Post
The ultimate goal is to minimize total life years lost. All people are treated equally, you should be happy with that, judging by your strong sense of equality.

The effect of the vaccine in reaching the goal above is two fold: 1) it protects the person receiving the vaccine and 2) it stops the transmission, protecting others also.

In order to stop transmission there needs to be a large part of the population vaccinated, which takes a long time during which many people continue dying.

Therefore, model outcomes have shown optimal solutions for distributing the vaccine include focussing on the most vulnerable first, followed by people who necessarily need to be in contact with many people.

Solutions chosen are trying to save as many lives as possible, that is the simple reason why no thinking person would decide to randomly distribute the vaccine.
not bad Ayn Rand would be proud of a plan focused on the minimizing of "work years" lost as opposed to lives lost .............. admittedly my egalitarian idea is doomed because no one ever wants to be equal if there is a chance that he can be better off
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Old 12-03-20, 01:36 PM
  #33  
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Originally Posted by skookum View Post
I wouldn't say they are treading water, they are manufacturing vaccine while waiting for regulatory approval. I think the US and europe are going to hit the ground running and start vaccinating as soon as approval is granted, which looks like next week in the US and end of the month in Europe.
The Chinese are not as worried about their domestic market, as covid is not endemic there as it is in the rest of the world. I find it strange that they haven't released any numbers on efficacy or safety besides vague statmemnts in press releases. As far as I know all the vaccines being shipped out of China are intended for late stage trials, and not for general distribution. I dont think any jurisdiction out side of China has approved any of the Chinese vaccines yet. Even inside China they just have emergency approval which seems to have been granted without releasing any hard data.
It is unclear how much has been made so far. Everything seems to point to about enough doses for 1% of the population in various markets.

They have started somewhat early, but one would have anticipated that as preliminary data started rolling in mid-summer, that the number of doses in production would have increased substantially.

From what I can see of the US Government Contract, it was written contingent on approval, whereas it should have been written so that if doses were made, and the vaccine wasn't approved, they would still get some compensation for unused doses (25%? 50%?) Thus enabling full-scale production to start earlier.
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Old 12-03-20, 01:44 PM
  #34  
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I haven't found the Pfizer clinical trial results yet.

Here is the protocol.

https://pfe-pfizercom-d8-prod.s3.ama...ol_Nov2020.pdf

One thing is that they've made an attempt to restrict the vaccine from pregnant women, as well as nursing women. There likely have been a couple of pregnancies in the group of subjects, but very little overall testing.

That generally won't make a lot of difference for al the super-young or super-old, or males getting vaccinated.

But, could leave a hole in the EUA for women from about 15 to 50.
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Old 12-03-20, 02:21 PM
  #35  
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Originally Posted by jack pot View Post
all you one man one voters out there have suddenly become AUTHORITARIAN now that there is a glimmer of survival ... if everyone was really EQUAL and this really was a DEMOCRACY the vaccine recipients would be ordered by randomly chosen social security numbers from a list of people residing in a specific area of distribution ......... NO EXCEPTIONS > everyone is finally equal in the USA .... no more BLM no more ANTIFA no more people being being better than you and no more me 1st ..................................... of course the simple fairness of this is also why no one would want it
That would make sense if one were distributing candy to children. But that isn't the issue at hand.
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Old 12-03-20, 02:31 PM
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Should we start by sending vaccines to all the states where Trump held rallies?
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Old 12-03-20, 02:32 PM
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Are strippers considered essential?

Asking for a friend.
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Old 12-03-20, 05:02 PM
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Some unsurprising but negative news..

Pfizer says they can only produce half of what they expected this year, 50 million doses, instead of 100 million. Enough for 25 million people.

Pfizer Inc. expects to ship half of the Covid-19 vaccines it originally planned for this year because of supply-chain problems, but still expects to roll out more than a billion doses in 2021.

“Scaling up the raw material supply chain took longer than expected,” a company spokeswoman said. “And it’s important to highlight that the outcome of the clinical trial was somewhat later than the initial projection.”
The U.S. government has placed an initial order for 100 million doses of the Pfizer vaccine, with the option to purchase 500 million additional doses.

The EU ordered 200 million doses with an option for another 100 million. Japan ordered 120 million doses, and countries in South America and in the Asia-Pacific region also have placed significant orders.
WSJ
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Old 12-04-20, 09:37 PM
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Good article in The Economist (paywalled) on US vaccine roll out.
ASKED WHAT keeps her up at night as Texas prepares for the arrival of the first covid-19 vaccines, Imelda Garcia from the state’s health department singles out two opposite scenarios: either a serious shortage of vaccine, or lots of it sitting around unused because nobody wants to take it. These two worries are on the minds of many other public-health experts as 6.4m doses of vaccine stand ready to be dispatched across America, on a nod by the Food and Drug Administration (FDA), the federal drug regulator.
Organising America’s supplies of covid-19 vaccines is the task of Operation Warp Speed, a programme set up by the current administration in May. It pre-purchased 100m doses of both Pfizer’s and Moderna’s vaccines this summer, and large quantities have already been made. Each firm expects to have about 20m doses ready to distribute in America by the end of this year. This amount is roughly what would be needed to inoculate all America’s health-care workers, who are a priority group for the first vaccine supplies.
Next will come groups particularly vulnerable to the disease, including essential workers at high risk of infection (such as police officers, teachers and bus drivers), care-home residents, people with high-risk medical conditions and those over 65. The order of priority between these groups, which are suggested by the Centres for Disease Control and Prevention (CDC) and other national health agencies, may vary somewhat from state to state. The current plan is that vaccine supplies, as they become available, will be divvied up among states and six big metropolitan areas proportionately to their population. Each state will decide how to distribute them. At the current pace of vaccine production, widespread vaccination of the elderly is not on the cards until February.
People handling the Pfizer vaccine will need extensive training, says Ms Hannan. “This isn’t something where you can watch the video and then you are ready to go.” She worries that these new procedures will come at a time when hospitals and their staff are overwhelmed and exhausted by the flood of patients (see article). Because of all the intricacies involved, a fair amount of the first supplies of Pfizer’s vaccine may end up being spoilt.
This sort of groundwork, training and campaigning is expensive. The Association of Immunisation Managers estimates that, all told, state and local authorities will need $8.4bn. The CDC has put the total at around $6bn. So far, however, states have received only $200m for vaccination preparation, and a promise of another $140m this year. Approval of a big federal pot of money for this has been caught up in the political wrangling in Washington. The Moderna vaccine, developed with America’s National Institutes of Health, is a triumph of American science. Failing to vaccinate enough people to stop the virus would be a failure of American politics.■
The Economist
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Old 12-04-20, 10:06 PM
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The USA may have asked for 100 million doses. But, we're getting 50 million, and perhaps even less in the near future. And, divide that by two doses, and we can treat about 25 million people in the next couple of months... or a little less than 1 in 10 people.

That is assuming perfect handling and distribution, which may not be the case as above.

Also, if the vaccine gets degraded, the efficacy could drop significantly.
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Old 12-04-20, 11:36 PM
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Originally Posted by CliffordK View Post
The USA may have asked for 100 million doses. But, we're getting 50 million, and perhaps even less in the near future. And, divide that by two doses, and we can treat about 25 million people in the next couple of months... or a little less than 1 in 10 people.

That is assuming perfect handling and distribution, which may not be the case as above.

Also, if the vaccine gets degraded, the efficacy could drop significantly.
Well, not quite. The US ordered 100 million doses from Pfizer, with options for 500 million more.
The portion expected in 2020 wil be reduced by 50%, I'm not sure what that figure will be. I dont know what the response from Moderna is.

Estimating from the Economist article, it looks like about 15 million doses, enough to innoculate 7.5 million people. In 2020.

A decent start, if they can do it.

In Canada we will have precisely zero doses in 2020.
Just trying to keep things in perspective.
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Old 12-05-20, 01:26 AM
  #42  
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Also, 2020 is almost ending. A delay of only 1 month can already give rise to accurate but sensationalist headlines like delivery of only 50% in 2020.
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