Octopus Overlords

“We know that for the Moderna vaccine, giving half of the dose to people between the ages of 18 and 55, two doses, half the dose, which means exactly achieving the objective of immunizing double the number of people with the doses we have,” Slaoui said.

“We know it induces identical immune response” to the full dose, he added.

I'm confused. Are they halving the dose so that they can give people two doses where each dose is half sized? I guess that's one way of giving two "doses".

So because the Federal government only concerned itself with getting a vaccine but didn't lay the groundwork for efficient distribution by the states we're now considering having the dosage cut in half. Ok...

It would be nice to see the clinical data since to be honest, with this colossal fuck up of a vaccination program I don't really trust the competency or motives of anyone with Operation Warpspeed.

Hmmm... Who to believe... The Trump appointee that says it's safe to go with half-dose vaccinations or Fauci, who says to stick with what was actually tested in the clinical trials...

Feds may cut Moderna vaccine doses in half so more people get shots, Warp Speed adviser says

Earlier Sunday, top federal infectious disease expert Anthony Fauci cautioned that the government shouldn't deviate from the doses and schedules used in clinical trials on the vaccines, adding that distribution efforts need to be more efficient.

"We know what the science tells us," Fauci said on NBC's "Meet the Press," without directly addressing Slaoui's suggestion. "So my feeling ... is let's do it the way the clinical trials have instructed us to do it. But let's get more efficient into getting it into people's arms."

It's a coin toss, I guess. ¯\_ (ツ)_/¯

There actually is a bit of legitimate debate about doing this. For example, the UK is going this route. However, some of the people who proposed this wanted there to be expedited trials instead of just throwing the switch.

Oh this is different than one dose and done like the UK is proposing. It is interesting they claim they *know* that half-dose is identical. FWIW the guy making the claim in the Reuter's article ran GSK's Vaccine Division. In pure Trump administration fashion though he was on the board of Moderna and reportedly has $10M or so in stock options with them. A wee bit of a conflict there.

I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

Ralph-Wiggum wrote: Mon Jan 04, 2021 9:52 am I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

That happened in the Oxford/AstraZeneca trial, not Moderna.

My question has finally been answered. My PCP will contact me when a vaccine is available and my number comes up. I'm not sure how they identify essential workers etc... from the list but as long as there is a list and vaccines will eventually match that list, all is well.

Ralph-Wiggum wrote: Mon Jan 04, 2021 9:52 am I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

The overwhelming sentiment I'm seeing in my public health community is that people are focusing on the wrong thing here. While everyone is arguing over the scientific basis for half-doses, no one is addressing the actual problem - delivery. Cutting doses in half isn't going to speed up anything because it's a "last mile" issue right now. Cutting dose volume or considering one shot vs two isn't going to get millions of people vaccinated faster.

Smoove_B wrote: Mon Jan 04, 2021 11:57 am

Ralph-Wiggum wrote: Mon Jan 04, 2021 9:52 am I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

The overwhelming sentiment I'm seeing in my public health community is that people are focusing on the wrong thing here. While everyone is arguing over the scientific basis for half-doses, no one is addressing the actual problem - delivery. Cutting doses in half isn't going to speed up anything because it's a "last mile" issue right now. Cutting dose volume or considering one shot vs two isn't going to get millions of people vaccinated faster.

Yeah, seems to line up with how we as a nation have focused on each aspect of the pandemic. For example, restaurants are hurting --> open restaurants for indoor dining rather than the actual fix, which is to compensate restaurant owners/staff until it's safe to open for indoor dining.

Zaxxon wrote: Mon Jan 04, 2021 12:23 pmYeah, seems to line up with how we as a nation have focused on each aspect of the pandemic. For example, restaurants are hurting --> open restaurants for indoor dining rather than the actual fix, which is to compensate restaurant owners/staff until it's safe to open for indoor dining.

Excellent observation. It's also been pointed out that we just did all the science and made the case that a two shot vaccination is the answer. A month later, the idea that we'd be discussing options that are different than what the science just told us to do completely undermines trust in the very science we had been pleading with the general public to trust.

Vaccination rollout is going great, btw

https://twitter.com/MedicalBrunette/sta ... 2328649728

CANNOT SAY THIS LOUD ENOUGH!! If you LIVE IN DC, go to your nearest Safeway Pharmacy or Giant @ the end of day (~1 hr b4 close) & ask if they have leftover vaccines!! They MUST be used & will be discarded if not! You do not need to be a HCW or priority!! This is a walk-in!!

Max Peck wrote: Mon Jan 04, 2021 11:27 am

Ralph-Wiggum wrote: Mon Jan 04, 2021 9:52 am I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

That happened in the Oxford/AstraZeneca trial, not Moderna.

Whoops! I wonder then what the scientific justification is for giving a half dose of the Moderna vaccine.

Ralph-Wiggum wrote: Mon Jan 04, 2021 2:26 pm

Max Peck wrote: Mon Jan 04, 2021 11:27 am

Ralph-Wiggum wrote: Mon Jan 04, 2021 9:52 am I was under the impression that the effectiveness of the "half dose" mistake that occurred in the Moderna trials didn't actually hold up, statistically, under more intense scrutiny.

That happened in the Oxford/AstraZeneca trial, not Moderna.

Whoops! I wonder then what the scientific justification is for giving a half dose of the Moderna vaccine.

My probably-wrong-or-misunderstanding-it 5-sec explanation from my biochemist spouse is that the Moderna and Pfizer vaccines are extremely similar, and the Moderna has a multiple of the amount of active jiggly-bits in it compared to Pfizer's. (Something like 100 μg vs 30 μg.) And therefore the theory is that it's likely that a smaller dose would be similarly effective.

Note that she was definitely not endorsing this plan, just trying to give me the high-level rationale as to why it'd be considered. I almost certainly have the details wrong.

So it's just based on an assumption of how we think the vaccine should work rather than any clinical data? Cool cool.

Ralph-Wiggum wrote: Mon Jan 04, 2021 2:56 pm So it's just based on an assumption of how we think the vaccine should work rather than any clinical data? Cool cool.

I believe that is accurate, yes.

Zaxxon wrote: Mon Jan 04, 2021 3:00 pm

Ralph-Wiggum wrote: Mon Jan 04, 2021 2:56 pm So it's just based on an assumption of how we think the vaccine should work rather than any clinical data? Cool cool.

I believe that is accurate, yes.

Maybe we should just have congress vote on how much vaccine each person should get.

FWIW, I posted about an informative article from The Atlantic in the EBG thread, which discusses the subject of the newer, more rapidly-spread mutation of COVID-19 and how it's likely to make prompt vaccination rollouts an even more urgent priority.

It's definitely worth reading in its entirety, because I get the distinct impression that coverage of the newer, more rapidly-spread variant of COVID-19 has thus far been dangerously anaemic for the most part.

Jaymon wrote: Mon Jan 04, 2021 3:09 pm

Zaxxon wrote: Mon Jan 04, 2021 3:00 pm

Ralph-Wiggum wrote: Mon Jan 04, 2021 2:56 pm So it's just based on an assumption of how we think the vaccine should work rather than any clinical data? Cool cool.

I believe that is accurate, yes.

Maybe we should just have congress vote on how much vaccine each person should get.

I believe it (and then the rest of us) would simply die in the Senate.

My dad got the Moderna vaccine in TN today, mom goes on Wednesday.

Seems that uptake in that state is low.

My 100 year old grandmother in a NC assisted living facility got her first dose yesterday. Hopefully once everyone there has gotten their second dose, they can slowly start opening up things a bit. She has been practically isolated to her room for the last nine months.

Ralph-Wiggum wrote: Tue Jan 05, 2021 9:36 am My 100 year old grandmother in a NC assisted living facility got her first dose yesterday. Hopefully once everyone there has gotten their second dose, they can slowly start opening up things a bit. She has been practically isolated to her room for the last nine months.

I wouldn't count on it if the report of a nursing home in Ohio is a common scenario. They said 60% of staff are refusing to get the vaccine, and that's going to mean perpetual lockdown.

Can you imagine a year ago telling someone that a global pandemic was on its way that would kill 300,000 Americans, nearly half the population would refuse to take any precautions against it, and when a vaccine did finally give hope to end months of lockdown and isolation, many people would refuse to take it?

It's like what I always say about my MIL who lives for drama. WHY? Why do you want to live in this chaos?

YellowKing wrote: Tue Jan 05, 2021 12:06 pm Can you imagine a year ago telling someone that a global pandemic was on its way that would kill 300,000 Americans, nearly half the population would refuse to take any precautions against it, and when a vaccine did finally give hope to end months of lockdown and isolation, many people would refuse to take it?

Yes.

If someone told me 5 or 6 years ago, no.

YellowKing wrote: Tue Jan 05, 2021 12:06 pm It's like what I always say about my MIL who lives for drama. WHY? Why do you want to live in this chaos?

May you live in interesting times.

The NJ online portal for vaccination registration was launched this morning. I'm not sure if it lasted 10 minutes before crashing. It's like the old days of the STEAM holiday sales, but now for vaccination.

Not sure what the epidemiological implications might be, but wouldn't one way of overcoming resistance to getting the vaccine be to reward those who do get it? Incentivize good behavior with carrots - vaccinated individuals could: stop wearing masks, start gathering again, attend sporting and other entertainment events, go to school in person, eat out at restaurants and bars etc. In other words, you don't want to get vaccinated, fine. But the rest of us who do are going to get to go back to our more or less regular lives after we get vaccinated.

I think one of the problems I've seen is a ton of reporting in the media that "things will never go back to normal, even post-vaccine." It doesn't really give people a great incentive to go out and get it. I mean, yes, it's possible that someone who has been vaccinated could still contract COVID-19, but from what I've read, it's really, really unlikely. And if you do get it, the vaccine should mitigate its symptoms and result in a very mild case.

At some point, we need to accept some small amount of risk in order to get public buy in for measures that will do incalculable good.

Right now it's more of a supply (and distribution) issue with the vaccine than a demand issue, right? I think the focus now is on how to best distribute it to the many (most) people that are eager to have it. I think incentives (which I think the main one is likely to be stadiums / concert venues requiring proof of vaccination to attend sporting events and concerts) will then go a long way to getting people who are reluctant but ultimately willing.

Smoove_B wrote: Tue Jan 05, 2021 12:30 pm The NJ online portal for vaccination registration was launched this morning. I'm not sure if it lasted 10 minutes before crashing. It's like the old days of the STEAM holiday sales, but now for vaccination.

I was reading the website and learned (if I understand correctly) that I'm in the 1A category as I work as an IT consultant for the Christiana Care health network just across the river in DE. I bounce between a couple hospitals and associated office buildings but am always behind the scenes besides using common entrances and such.

The website kept giving me errors but I finally got through. It asked for name and address, insurance info if you have it (stressed it's not needed), what kind of work you do, and some basic medical questions. When it was all done it said I'd get an email with more info.

Hoping teachers will be in the 1B category for my wife.

Not sure what the epidemiological implications might be,

There's no realistic way to give people with a fully vaccinated status a "pass" that would allow them to engage in activities or ignore public health orders (like wearing masks). Again, remember that we're still not entirely sure if the vaccination actually stops transmission (lowers/reduces) or is only effective against reducing the potential health impacts (lowering risk of complications) for the person vaccinated. This is why we're all going to be wearing masks (and should be) through at least the Fall of 2021 - we need to stop the spread.

This is also why 2021 should ideally look and feel better (as more people are vaccinated, deaths and hospitalizations should drop) but if it's still spreading in communities throughout the US (because local population resists vaccination, mask orders and social distancing recommendations) that means we're still all at risk for outbreaks.

There was talk of paying people to get vaccinated, but considering we won't pay people to stay home this seems unlikely. But I'm guessing if a corporation could get vaccinated, we'd pay it to do so.

Smoove_B wrote: Tue Jan 05, 2021 12:38 pm
There was talk of paying people to get vaccinated, but considering we won't pay people to stay home this seems unlikely. But I'm guessing if a corporation could get vaccinated, we'd pay it to do so.

Couldn't we pay companies for making sure that their employees get vaccinated?

Silly ignorant question.

Background: I keep hearing the rollout isn't science problem or politics problem, it's delivery/logistics problem.

Question: Why haven't we gone straight to American Red Cross? If they can do dozens of targeted blood drive in a neighborhood a year, why can't they be leveraged to deliver vaccines? They have the expertise in everything we we need but keeping things cold.

El Guapo wrote: Tue Jan 05, 2021 12:33 pm Right now it's more of a supply (and distribution) issue with the vaccine than a demand issue, right? I think the focus now is on how to best distribute it to the many (most) people that are eager to have it. I think incentives (which I think the main one is likely to be stadiums / concert venues requiring proof of vaccination to attend sporting events and concerts) will then go a long way to getting people who are reluctant but ultimately willing.

Yes, distribution is the issue. It's just very frustrating because given the limited supply we really want to make sure it's going to the people that need it the most. However, people that should be vaccinated (risk/status/employment) that are current refusing definitely need to be shuffled out and someone else in need should be taking that shot.

Based on what I've seen so far this last year, I think any type of proof of vaccination is going to backfire. I genuinely believe now our only hope is that we see more people engage in behavior that protects and promotes public health than those that do not. But there's likely going to be communities and populations where this is a never-ending cycle of insanity. Where it will sting is in the groups that cannot be vaccinated - like kids for example.

Is there any idea as to when we'll know if the vaccines prevent transmission?

LordMortis wrote: Tue Jan 05, 2021 1:00 pm Silly ignorant question.

Background: I keep hearing the rollout isn't science problem or politics problem, it's delivery/logistics problem.

Question: Why haven't we gone straight to American Red Cross? If they can do dozens of targeted blood drive in a neighborhood a year, why can't they be leveraged to deliver vaccines? They have the expertise in everything we we need but keeping things cold.

The Red Cross does a lot of good work, but I'm not sure they're a model of efficiency. Maybe I'm wrong on that, though.

El Guapo wrote: Tue Jan 05, 2021 12:47 pmCouldn't we pay companies for making sure that their employees get vaccinated?

Maybe. I think the legal arguments have yet to be tested on this. It's worked in hospitals, but I'm not sure what would happen if John from Accounting refuses to get a COVID-19 vaccination. I just found out this morning that a family friend (in early childhood education) refuses to get vaccinated for anything (she doesn't believe in them) and will not be getting the COVID-19 vaccination. She's a teacher so I don't know what will happen, but I've just added another person to the list.

LordMortis wrote: Tue Jan 05, 2021 1:00 pm Question: Why haven't we gone straight to American Red Cross? If they can do dozens of targeted blood drive in a neighborhood a year, why can't they be leveraged to deliver vaccines? They have the expertise in everything we we need but keeping things cold.

The Red Cross would be great partners in being able to set up community clinics - they have the knowledge, skill and experience in not only regular collection events, but also emergencies.

The issue is still the staff needed to offer the vaccinations and the support staff for them (and the field sites). Like so many other public health organizations, they have the ability to mobilize in a specific area to help with a discrete event (like a hurricane or other localized emergency). When the entire nation is burning, they don't have the capability to offer wide spread coverage. So then we're left with deciding where to send them. Do they go to NYC or LA where things are really bad or do we have them targeting smaller communities with a complete lack of resources? There's no good answer.

Defiant wrote: Tue Jan 05, 2021 1:03 pm Is there any idea as to when we'll know if the vaccines prevent transmission?

I'm not sure about studies being done, but the epidemiology following spread across the U.S. will look different (eventually) as more and more people are vaccinated.

Kurth wrote: Tue Jan 05, 2021 12:31 pm Not sure what the epidemiological implications might be, but wouldn't one way of overcoming resistance to getting the vaccine be to reward those who do get it? Incentivize good behavior with carrots - vaccinated individuals could: stop wearing masks, start gathering again, attend sporting and other entertainment events, go to school in person, eat out at restaurants and bars etc.

You say that like people aren't already doing those things.

Smoove_B wrote: Tue Jan 05, 2021 1:07 pm

El Guapo wrote: Tue Jan 05, 2021 12:47 pmCouldn't we pay companies for making sure that their employees get vaccinated?

Maybe. I think the legal arguments have yet to be tested on this. It's worked in hospitals, but I'm not sure what would happen if John from Accounting refuses to get a COVID-19 vaccination. I just found out this morning that a family friend (in early childhood education) refuses to get vaccinated for anything (she doesn't believe in them) and will not be getting the COVID-19 vaccination. She's a teacher so I don't know what will happen, but I've just added another person to the list.

In general companies could fire people for refusing to get vaccinated, and the legal arguments to the contrary don't seem super compelling. "People who don't want to be vaccinated" isn't a protected class, and short of that companies are generally able to fire people for whatever reason they want.

The main complication is likely to be people claiming religious exemptions, but my understanding is that the trend is against allowing that type of exemption.

Smoove_B wrote: Tue Jan 05, 2021 1:07 pm

El Guapo wrote: Tue Jan 05, 2021 12:47 pmCouldn't we pay companies for making sure that their employees get vaccinated?

Maybe. I think the legal arguments have yet to be tested on this. It's worked in hospitals, but I'm not sure what would happen if John from Accounting refuses to get a COVID-19 vaccination.

I would think for most at will employees this wouldn't be problematic from a legal perspective. If you make it a job requirement and the person refuses to get vaccinated, they can be fired. There would surely be some considerations for people who legitimately can't get vaccinated for either medical reasons (might run afoul of the ADA on that) or religious reasons (1st Amendment), but that's probably a bigger issue in theory than in practice. The former is a relatively small group and the latter may make a lot of noise, but how many people are going to be willing to get fired to file a claim if they're outside of the relatively small number of religions that actually have such restrictions? It's trickier for union or contracted employees.

Smoove_B wrote: Tue Jan 05, 2021 1:07 pm

LordMortis wrote: Tue Jan 05, 2021 1:00 pm Question: Why haven't we gone straight to American Red Cross? If they can do dozens of targeted blood drive in a neighborhood a year, why can't they be leveraged to deliver vaccines? They have the expertise in everything we we need but keeping things cold.

The Red Cross would be great partners in being able to set up community clinics - they have the knowledge, skill and experience in not only regular collection events, but also emergencies.

The issue is still the staff needed to offer the vaccinations and the support staff for them (and the field sites). Like so many other public health organizations, they have the ability to mobilize in a specific area to help with a discrete event (like a hurricane or other localized emergency). When the entire nation is burning, they don't have the capability to offer wide spread coverage. So then we're left with deciding where to send them. Do they go to NYC or LA where things are really bad or do we have them targeting smaller communities with a complete lack of resources? There's no good answer.

My question isn't about the emergency response teams but the opposite, the regular community based phlebotomy collection teams. They are ubiquitous, mobile, and have a lot of cross over experience/skill sets.

stessier wrote: Tue Jan 05, 2021 1:10 pm

Kurth wrote: Tue Jan 05, 2021 12:31 pm Not sure what the epidemiological implications might be, but wouldn't one way of overcoming resistance to getting the vaccine be to reward those who do get it? Incentivize good behavior with carrots - vaccinated individuals could: stop wearing masks, start gathering again, attend sporting and other entertainment events, go to school in person, eat out at restaurants and bars etc.

You say that like people aren't already doing those things.

Like so many other things, I guess it's all local. Where I live, no one is doing anything. Masks are mandatory everywhere. Bars and restaurants are closed except for outdoor dining (which is a joke in the Pacific NW in January). Schools are all remote. Sporting and entertainment venues are shuttered. Downtown Portland is like a freaking post-apocalyptic ghost town.