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23rd November 2020, 06:33 AM | #1 | ||
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Covid vaccines - supply, distribution and rollout / Beginning of the end
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“If only it were all so simple! If only there were evil people somewhere insidiously committing evil deeds, and it were necessary only to separate them from the rest of us and destroy them. But the line dividing good and evil cuts through the heart of every human being. And who is willing to destroy a piece of his own heart?” Aleksandr Solzhenitsyn, The Gulag Archipelago |
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23rd November 2020, 08:26 AM | #2 |
Penultimate Amazing
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Looks like the Pfizer one will need to be kept on dry ice, -70. Moderna, a freezer will suffice, -20.
Last numbers I read were 22M doses in January, but no mention of minthly production after that. Maybe they make 22M in the first week, 200M/month after that? (I exaggerate) Meantime, Jan is two more months of data in their studies. |
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23rd November 2020, 08:56 PM | #3 |
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23rd November 2020, 08:59 PM | #4 |
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Australia are saying they'll be able to vaccinate the At Risk population by March 2021 using a combination of 4 different vaccines.
"Different COVID-19 vaccines in 'different circumstances' as Government outlines March rollout plan" http://www.abc.net.au/news/2020-11-2...y-out/12914340 |
23rd November 2020, 09:09 PM | #5 |
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I see two contradictory goals here:
- make vaccination as widespread as possible, especially making sure to reach fringe populations like migrants and houseless and - finding ways to monitor the effectiveness and health impact of the vaccine for a month or two in as many people as possible, from as many demographics as possible I don't expect this rollout to be smooth at all. |
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23rd November 2020, 09:27 PM | #6 |
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You'll be interested in the COVAX Facility.
https://www.gavi.org/covax-facility "COVAX is the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator The ACT Accelerator is a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. "COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO. Its aim is to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world. https://www.gavi.org/news/media-room...gagement-group "The ACT-Accelerator is not a decision-making body or a new organisation, but works to speed up collaborative efforts among existing organisations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organisations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it. "The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation." |
23rd November 2020, 09:28 PM | #7 |
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I'm 2/3 of the way through Bottle of Lies - The Inside Story of the Generic Drug Boom, by Katherine Eban.
The book so far focuses on one company, Ranbaxy, and the gutless FDA. But it still frightens me when I think of any drug manufacturing in India. And Oxford-AstraZeneca is manufacturing one vaccine in India. I do hope the vaccine lots are tested and not just by the companies themselves. |
23rd November 2020, 09:31 PM | #8 |
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24th November 2020, 12:02 AM | #9 |
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24th November 2020, 01:59 AM | #10 |
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For Europe there is OCABR https://www.edqm.eu/en/human-ocabr-guidelines
I have dealt with the Serum Institute of India directly and they are first class. |
24th November 2020, 03:18 AM | #11 |
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Many ifs buts and maybes there, though given the results so far, the regulators would have great difficulty refusing the use of the vaccines.
I'd have thought the manufacturers should be well into bulk production already - and governments should be guaranteeing payment for the bulk production - simply to get a head start. as to distribution - the RNA vaccines sound just fine for use in cities and especially in major institutions such as health care and so on, where the infrastructure is available for storing the vaccines. The AZ vaccine is far better for more far flung locations. As an aside - the Imperial College vaccine is a type of RNA vaccine, but the developers are looking to produce a type of RNA vaccine that is also stable at fridge temperatures - with some expectation of success. |
24th November 2020, 03:45 AM | #12 |
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24th November 2020, 04:19 AM | #13 |
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24th November 2020, 11:27 PM | #14 |
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24th November 2020, 11:28 PM | #15 |
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And you know some bastard to going to try to hijack or steal some of the vaccine to sell on the black market.
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25th November 2020, 12:02 AM | #16 |
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Why?
Millions of doses of flu vaccine have been distributed annually for decades now. It’s not as though this is anything new. OK, maybe more people will be interested in just how fast COVID vaccines can be manufactured and distributed than they’ve been in flu vaccines, but scaling up an already existing distribution network shouldn’t be that difficult. |
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25th November 2020, 12:32 AM | #17 |
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It's paywalled because it's from the current issue, but New Scientist has a pretty good overview of the logistical challenge that distributing a COVID vaccine to the world presents.
https://www.newscientist.com/article...-to-the-world/ It'll come out from behind the paywall next week, or you can check it out in paper form at your local library. |
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25th November 2020, 03:14 AM | #18 |
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It seems only 2,700 vaccine volunteers had the Oxford/Astrazeneca initial half-dose - followed by a full dose - (in the UK) 'by accident' where the efficiacy rate is said to be '90%'. In Brazil, where the other candidates were given a full initial dose, it only had 62% effectiveness against Covid19. In other words, the result is purely 'accidental' and not by design, eschewing normal 'scientific method'. Other criticism is that we only have Astrazeneca press release but not the protocols of the vaccine trials design, as we do for the other two major vaccines recently released - Pfizer and Moderna, each citing circa 95% effectiveness.
Quote:
Astrazeneca has announced it will be issued at cost price to third world countries - implying a small profit from others - but could this be because they have been gazumped by Pfizer/BionTech and Moderna, of which the EU via Ursula von Leyen, the President of the EU Commission, has ordered the Moderna version - costing twelve times as much per dose. Could Astrazeneca be just offloading its vaccines, of which millions have already been produced in readiness, to the poorer countries of the world - plus the UK, where there is talk of it being mandatory - whilst the first world EU and the USA get the Pfizer and Moderna ones?
Quote:
Whilst, of course, penicillin, too, was 'discovered by accident' by Sir Alexander Fleming, it wasn't till at least over fifteen years later or more that penicillin was released to the public as a generic antibiotic, one of the greatest medical triumphs of the 20th century. |
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25th November 2020, 04:15 AM | #19 |
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The price point was announced some time ago - well before the results of the MRNA vaccines were produced.
I'd like to know what happened to the tests in the USA. There were supposed to be 30,000 involved, though the test was "stopped" after someone fell ill and not restarted for a long time after the test resumed elsewhere, because the american authorities held it up. If we're going for conspiracy theories one might ask if the tests were held up deliberately? |
25th November 2020, 04:18 AM | #20 |
Penultimate Amazing
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The trials were stopped in July or September for some reason with full speed ahead, not 'a long time'. These are scientific and economical facts, not conspiracy theory.
The Astrazeneca trials are based on a UK cohort and a Brazilian one. I didn't know about the US one. Question: if the FDA refuses to pass it, should the UK be concerned, even if its own body gives it the green light? |
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25th November 2020, 04:32 AM | #21 |
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The trials were stopped briefly in the UK , Brazil and I believe South Africa. The USA trials were stopped at the same time but for much longer.
As to the approvals, If the UK authorities give the green light then that's fine by me. Far more important than the percentages is the fact that none of the vaccinated people who showed symptoms suffered sever symptoms. I object to the hospitalisation part - just getting a bad cold is a win. |
25th November 2020, 05:15 AM | #22 |
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To me, that sounds akin to, 'I know nothing about art but I know what I like'.
As only 50% effectiveness is needed to get the green light, that won't be a problem. The problem might be in the design of the trials. You can't change your hypothesis half way through without redesigning your paradigms, scope and parameters and starting again. Yes, it's an emergency, but then there are now other vaccines available which will likely have no problem getting past the regulators. |
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25th November 2020, 05:22 AM | #23 |
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25th November 2020, 03:31 PM | #24 |
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25th November 2020, 04:49 PM | #25 |
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25th November 2020, 07:14 PM | #26 |
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I wonder how long it would take for everyone who wants one to get one? And what % of the population will say no?
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26th November 2020, 04:11 AM | #27 |
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It would be kinda cool if it turns out that an accident leads to a new scientific discovery. Progress often is made in directions that weren't anticipated. I didn't realize that the initial half dose was only an accident. Interesting how they're spinning it.
Even if it turns out to be only 60-70% effective, the lower cost and the fact that it doesn't need to be kept in special freezers is a point in its favor. Even if it ultimately doesn't turn out to be the most effective vaccine candidate available, I think it will have its niche. And the contribution to science is important too. So many different approaches are being tried that I think even the failed attempts (if there are any) and those that turn out to be less effective will be good reference information in the future. |
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28th November 2020, 11:42 AM | #28 |
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How long will these vaccines, each of these three, be good for? (A year? Six months? Do they even know? I mean, given that apparently it's unclear how long, and even whether, actual Covid survivors stay immune.)
That's something I haven't seen mentioned. (Maybe it's just that I haven't noticed. I only glanced through the press releases and articles. But that's the kind of thing that kind of leaps out, so to say, and it hasn't here, so I was wondering ... ) |
28th November 2020, 12:14 PM | #29 |
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Covid vaccines - supply, distribution and rollout
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28th November 2020, 12:36 PM | #30 |
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28th November 2020, 05:21 PM | #31 |
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Right. I thought as much, but I was wondering if they might've found some way to estimate that (like they do sometimes, elsewhere, for instance estimating lifespan effects of some things using genetic markers/proxies, well before a life span has elapsed) -- although absolutely, common sense does say that you need as long a trial, that is, X months actually elapsed, to know what might happen in X months. Clearly not, then. This pandemic is unprecedented in terms of the super prompt vaccination development -- a truly wonderful achievement, the one aspect of this where we as a species shone, stood out! -- but it's a bit unsettling, not knowing if your vaccine will run out of steam in four months' time! Well, I guess they'll spell all of this out, clearly and officially, once it's actually rollout time. |
28th November 2020, 07:09 PM | #32 |
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The development of a COVID vaccine isn’t really super prompt compared to others, such as MERS, SARS, Ebola and even mumps in the ‘60s.
What is super prompt, is the accelerated (or more accurately compressed) clinical testing regime. Also unusually large, and also diverse, test groups are being used to help garner as much data on a populations response in as short a time as possible. Here is a ‘Warp Speed’ COVID-19 Vaccine Efforts Aim for Diverse Volunteers and Long-Lasting Protection, in an Scientific American article from September that discusses the manner in which Operation Warp Speed was to be performed. |
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29th November 2020, 03:24 AM | #33 |
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There's a new BBC podcast on this very topic, How to Vaccinate the World
Two episodes so far, it's a weekly discussion of the latest developments in vaccines and how to roll them out. |
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30th November 2020, 03:06 PM | #34 |
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Moderna submitted their request for emergency approval to the FDA today. They expect approval will take a couple weeks.
This vaccine is stable at normal refrigerated temperatures. Here is the notice I sent my EMS clients: They announced today the Moderna vaccine has been submitted for FDA approval. That is the one which only requires refrigerator storage. So I sent in my request to provide the vaccine. That is the first step. They will call and the next step is to sign an agreement and provide some other details. The vaccine approval won't happen for a couple more weeks. But this means the health department should be getting twice as much vaccine as they thought**. I'm not sure how they will designate the first to get vaccinated. We do know that health care workers with medical risks are first. Then the rest of heath care workers and high risk patients. That might mean I can go ahead with all EMS providers or they might need to prioritize nursing homes first (as they should). It depends on supply. The vaccine is not approved for children yet if anyone asks. This is the mRNA vaccine but it appears to be safe with 30,000 doses already given. One thing is some people are getting 1-2 days of fever and body aches. It's not a live vaccine and cannot give a person COVID, nor would they be contagious. But the side effects might mean you need to consider how you will staff around that. The vaccine is very effective protecting almost everyone from serious disease and most people from infection altogether. But it means people need to take the same precautions working with patients and the same quarantine time if exposed. **There is already a number for Pfizer's vaccine allotments. That is the one that has to be kept frozen. I didn't want to undertake that mess so I hadn't yet applied for any. |
30th November 2020, 03:20 PM | #35 |
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30th November 2020, 03:31 PM | #36 |
Nasty Woman
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IM injection.
I didn't look up the Pfizer procedure since I don't plan to give that vaccine. You don't have to warm up the Moderna vaccine as it is not frozen. You aren't supposed to have it out of the fridge longer that 8 or so hours. Here's a Moderna announcement And this is a generic discussion from last year: Optimization of Lipid Nanoparticles for Intramuscular Administration of mRNA Vaccines It is not an IV drug like some of these COVID treatments are. |
1st December 2020, 02:34 AM | #37 |
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Something concrete:
California to receive 327,000 doses of Pfizer coronavirus vaccine in December
Quote:
For reference the population of California is 39.5 million. |
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1st December 2020, 05:55 AM | #38 |
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Thanks for the link. While the politicians, most places -- with a few, a very few, honorable exceptions! -- have been conducting themselves and their policies disgracefully or, at best, muddling along somehow, it is how the scientists, specifically those charged with research into vaccines, have performed, that is, to me, the one bright thing in this whole Covid business. Sure, accelerated testing, actually trying this out on healthy individuals, the huge size and number of volunteers, all that: so that what we end up with are three almost-theres, and literally hundreds of others in the pipeline. In less than a year since the first cases. How do we not applaud that? ---- But of course, such accelerated release -- while entirely necessary -- does throw up questions. For one, how long will each of this vaccines hold for, keep you safe? For another, are they entirely safe, long term, from side effects? We simply don't know that, do we? Given this, and given the fact that I'm not in a high-risk category and that I am well able to work almost entirely from home, and don't see this changing over the next few months, normally I'd give the vaccines a miss until the first few months are out. But then my parents are, if not quite old, nearing there, and I visit them often, so yeah, my doubts notwithstanding, I'll queue up to get vaccinated just as soon as physically possible. I do wish, though, that in their press releases etc, these people would very clearly spell out these risks, these unknowns. (Although I can see why they might not. As it is there are enough people who keep saying they won't take it, and it may not make very good sense to increase those numbers.) |
1st December 2020, 03:31 PM | #39 |
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You can have it good, fast or cheap. Choose two |
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1st December 2020, 11:48 PM | #40 |
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My big question is that should most people in Australia receive the vaccine? There are hardly any cases. If they require everyone who enters the country to already have the vaccine then there is little risk of many people getting it in Australia.
More than 90% of the people diagnosed in the last 10 days in Australia acquired the virus overseas, yet the number of people entering the country is only a tiny fraction of those that normally do so. |
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