Vaccination nation

[Kron3007]

Millions are skipping their second dose of vaccine. Doctors say they are worried. But they have no idea what the effects are of skipping the second dose, they say, just speculation. They don't know how long the vaccine will be effective for. In Europe, it has been standard policy to wait 3 months between doses, but why not 6 months? It's not exactly evidence-based practice.
https://www.nytimes.com/2021/04/25/business/covid-vaccines-second-doses.html

I am in Canada and they have decided to delay the second shot by up to four months.  This is based on data that shows immunity after the first shot lasts at least this long.  Based on this and the relative lack of vaccine, this approach provides better protection at the population level.  I think the reason it is set at four months instead of some other longer period was simply based on the data showing it was still effective at that point and lack of data for longer periods.

So, it is very much an evidence based decision.  Ideally there would be more evidence to make more informed decisions but it seems pretty reasonable.

What's a little more out there is that Quebec has decided to use use a different vaccine entirely for the second dose in some cases.  I assume this would work, but seems unorthodox:

https://www.cbc.ca/news/canada/montreal/quebec-second-dose-moderna-pfizer-1.5998847

[Puget]

Youngest got her first dose last week but was not scheduled for a second.  She called the DOH yesterday and was told to wait until the second dose was closer to coming due to schedule it.  I don't think that kind of rigamarole helps bring people back (though she will be pursuing it further, not giving up on the second dose).

That's a really bad practice. My state has almost no one skipping the second dose, probably in large part because they schedule both doses at the same time, or schedule the second dose during the 15 min. waiting period after the first, then send reminders. You need to make the process as frictionless as possible.

[Caracal]

This is just insane: https://www.nbcmiami.com/news/local/miami-school-says-it-wont-employ-vaccinated-teachers-citing-debunked-covid-myths/2437547/

Seems like that could easily get them sued, no?

For starters, doesn't that open them up to an ADA suit from an employee with a medical condition that makes them more vulnerable to COVID who gets a vaccine?

[apl68]

Our governor has announced today that the state will begin offering vaccination incentives in the form of state lottery tickets and hunting/fishing license gift certificates.  Apparently several other states have already started offering similar deals.  I guess we'll see if it helps any.

[Parasaurolophus]

I just got my first dose today. Only 16 weeks to go for the second!

[Puget]

I just got my first dose today. Only 16 weeks to go for the second!

Glad you got a dose. And wow-- I'm used to thinking of Canada as doing most things well, but they really have not done well with this, at least in terms of getting second doses on schedule. I don't have a a clear idea of what went wrong-- betting on the wrong vaccines? Just not procuring enough doses?

The world distribution of vaccines doesn't always track that much with what you might expect, e.g., EU not so great, Mongolia fantastic. Others make sense-- small, relatively wealthy countries have generally done well.
https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html

And then there's Bhutan, poor, mountainous, largely roadless, and more than 60% vaccinated in a week-long campaign-- fascinating story: https://www.nytimes.com/2021/04/18/world/asia/bhutan-vaccines-covid.html?searchResultPosition=2

[spork]

I just got my first dose today. Only 16 weeks to go for the second!

Glad you got a dose. And wow-- I'm used to thinking of Canada as doing most things well, but they really have not done well with this, at least in terms of getting second doses on schedule. I don't have a a clear idea of what went wrong-- betting on the wrong vaccines? Just not procuring enough doses?

The world distribution of vaccines doesn't always track that much with what you might expect, e.g., EU not so great, Mongolia fantastic. Others make sense-- small, relatively wealthy countries have generally done well.
https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html

And then there's Bhutan, poor, mountainous, largely roadless, and more than 60% vaccinated in a week-long campaign-- fascinating story: https://www.nytimes.com/2021/04/18/world/asia/bhutan-vaccines-covid.html?searchResultPosition=2

I heard a radio story about summer vacation airline travel from the USA to the EU, and the complications that have arisen due to the USA's lack of a comprehensive, efficient vaccination verification program. Bhutan (and probably Israel) and the USA demonstrate the difference in outcomes between countries that sufficiently invest in coordinated national public health systems and those that don't. 

[Parasaurolophus]

I just got my first dose today. Only 16 weeks to go for the second!

Glad you got a dose. And wow-- I'm used to thinking of Canada as doing most things well, but they really have not done well with this, at least in terms of getting second doses on schedule. I don't have a a clear idea of what went wrong-- betting on the wrong vaccines? Just not procuring enough doses?

The world distribution of vaccines doesn't always track that much with what you might expect, e.g., EU not so great, Mongolia fantastic. Others make sense-- small, relatively wealthy countries have generally done well.
https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html

And then there's Bhutan, poor, mountainous, largely roadless, and more than 60% vaccinated in a week-long campaign-- fascinating story: https://www.nytimes.com/2021/04/18/world/asia/bhutan-vaccines-covid.html?searchResultPosition=2

What went wrong is the US is not sending us the doses we purchased.

The federal government bought 400 million doses. But we have no domestic vaccine manufacturing because the Conservatives sold it off thirty years ago. So we're currently relying on doses from Europe, which have been delayed a bunch.

The federal government had an agreement in place early on the pandemic with China that would have restored a measure of domestic vaccine-making, but China scuppered it because Trump dragged us into the Huawei thing and kept us there.

It was decided to stagger doses by 16 weeks a while ago so that we could maximize the number of first doses administered, given our supply shortages.

[kaysixteen]

Canada bought vax doses from the US that were not sent?

[downer]

So about 18 states have passed laws that forbid businesses from discriminating against the unvaccinated.

It's an interesting position, and I can see some justification for the position. I'm mainly struck that this is from the side who defended the rights of businesses to discriminate against gay people. What a vile group they are.

[Parasaurolophus]

Canada bought vax doses from the US that were not sent?

The US has been using the Defense Poduction Act to compel its vaccine manufacturers to fulfill all US demand for vaccines and vaccine components before they export them to fulfill their other purchase contracts. Practically-speaking, that's amounted to a soft ban on exports, and means that purchase agreements have yet to be honoured.

Excessive reliance on the US has always been a problem for us. I'm not particularly bent out of shape by the decision on the US's part; it just means that the slow vaccination rates are not really our government's fault, except in the broad sense that we have to stop relying on the US. And, actually, things are speeding up here--we've now pulled far ahead of the US in doses administered, we're just way behind on fully vaccinated people. Whether we should all be getting vaccinated before vulnerable populations elsewhere in the world is another matter.)

[Kron3007]

I just got my first dose today. Only 16 weeks to go for the second!

Glad you got a dose. And wow-- I'm used to thinking of Canada as doing most things well, but they really have not done well with this, at least in terms of getting second doses on schedule. I don't have a a clear idea of what went wrong-- betting on the wrong vaccines? Just not procuring enough doses?

The world distribution of vaccines doesn't always track that much with what you might expect, e.g., EU not so great, Mongolia fantastic. Others make sense-- small, relatively wealthy countries have generally done well.
https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html

And then there's Bhutan, poor, mountainous, largely roadless, and more than 60% vaccinated in a week-long campaign-- fascinating story: https://www.nytimes.com/2021/04/18/world/asia/bhutan-vaccines-covid.html?searchResultPosition=2

What went wrong is the US is not sending us the doses we purchased.

The federal government bought 400 million doses. But we have no domestic vaccine manufacturing because the Conservatives sold it off thirty years ago. So we're currently relying on doses from Europe, which have been delayed a bunch.

The federal government had an agreement in place early on the pandemic with China that would have restored a measure of domestic vaccine-making, but China scuppered it because Trump dragged us into the Huawei thing and kept us there.

It was decided to stagger doses by 16 weeks a while ago so that we could maximize the number of first doses administered, given our supply shortages.

Yes, our overall vaccination rate (total injections/capita) is about the same as Germany (which is relatively decent), we have just made a conscious decision to prioritize the first dose and delay the second shot (a smart choice IMO).  So, it is not that we are "doing poorly" getting the second dose out, we just made this decision based on the availability.  On this front, we are doing very well and are now ahead of the USA.  Ultimately, it looks like our vaccination rate will be substantially higher than the US (Especially red states...).

As for our overall success (or lack thereof) in getting vaccines quickly, as you mention this is really our own fault and the lack of domestic manufacturing capacity as a result of both major parties and their lack of vision/diligence (likewise with our flawed PPE stockpiles).  I hear a lot of people blaming the government for our lack of access, but this is a decades old problem and the fact that we are on par with Germany for doses/person when we have no manufacturing capacity and they do seems to suggest the government has actually done well on that front given the cards they were dealt.  I do question why we still dont have capacity given that we are over a year into the pandemic, but that is a slightly different thing.

As for the US not releasing doses, I also understand this policy but am surprised how slow they are to release them now given their current situation.  Especially the millions of astrazenica doses since they have not even approved it....

I am also surprised to see China, Russia, India, and the EU sending doses around the world before they are vaccinated themselves.  The US seems to be the outlier on this front despite the general love of full on capitalism.

 

[Hegemony]

It now appears that the decision to delay the second shot has the unintentional side effect of actually producing a better immune response than the classic 3- or 4-week wait. Being a bit immune-deficient myself, I have a little bit of envy for the people who have an added boost to their immunity.

[Stockmann]

I am also surprised to see China, Russia, India, and the EU sending doses around the world before they are vaccinated themselves.  The US seems to be the outlier on this front despite the general love of full on capitalism.

Russians seem to be very wary of the Russian vaccine - given the legacy of Chernobyl, Lysenkoism, etc, it's misguided but understandable. I know, anecdotally, through the grapevine, that some clearly high-risk Russians would rather wait for as long as it takes for foreign vaccines to become available rather than take Sputnik V. So exporting it when your own population doesn't want it makes sense.

Here in Shitty Location, I've finally gotten a jab - but it's not available to my wife and may not be for a long time. Since there are no appointments for US visas available here until 2022, getting immunized in the US is not an option. I know Russia immunizes foreigners for a very modest fee, and I in fact know someone here who will get vaccinated in Russia, but there are various logistical problems with that for me. Reportedly Cuba will offer its vaccinations to tourists, that might also be an option as and if more is known about the Cuban vaccines, and if we become desperate enough.

[ergative]

I finally got Pfizer #1 yesterday. Arm is pretty sore, but otherwise fine. Except I took two very satisfying couch-naps, and even for me on a Sunday that's an unusually large number of couch-naps.