Another complication is people voluntarily refusing the vaccine. Let’s say you’ve got a nursing home with 200 residents. How many doses do you send over? Not 200, because some will refuse. How many, and how do you know? If you ask people to sign up, some will forget to, and then when the folks with the needles show up, they’ll just get in line with everyone else. If you assume everyone will by default, and let them opt out, some won’t opt out until they see the needles. You can try to estimate how many of the non-responders will get it, but if you get that estimate wrong (which you will, to at least some degree), you’ll still have either people not getting the vaccine who want it, or extra doses. And with the refrigeration etc. requirements on the current vaccines, you can’t just take extra doses back to the hospital and use them for the next drive. The only way to get an accurate count is to go around and individually directly ask every patient, and that’s a big logistical deal itself. And it gets even harder if, instead of a nursing home where the patients mostly stay put, it’s a school with 200 employees, who all go home at the end of the day and are busy and with other people present (who raise privacy issues) most of the time when they are at work.
When I received my first Pfizer vaccination last week, the nurse who administered my injection made sure I signed my CDC vaccination card. She warned me that there may be issues with people trying to steal the cards so they can fraudulently claim they were vaccinated. I do not know if a fear of anti-vaxxers stealing your card is realistic, but it may be another factor in why some of the documentation seems cumbersome.
Another cause for cumbersome documentation or evasiveness in letting you help someone else get their vaccination might be HIPAA-phobia. My wife works for a hospital in a non-patient-care capacity, and there is often paranoia-level concern about being caught in a HIPAA violation. They are told that if you slip up and mention anything about someone’s medical care or health issues, the HIPAA cops don’t just fine the hospital, they go after individual employees, too. You can be fined personally, the hospital terminates you, and the hospital gets fined. To try to prevent this, the hospital puts procedures in place that are even more cumbersome than the HIPAA regulations require.
For multiple reasons. Some people won’t use the net for religious reasons. They’re risking freedom-of-religion lawsuits.
My husband went through the online appointment scheduling procedure for our county, but never got an email confirmation that the appointment is actually scheduled. So he’s going to take a half day off and wait in the line, but it might be all for naught if they don’t show him as signed up. And there’s no way of checking to find out.
I tried to schedule him for another slightly later date as backup, but now the website is so jammed that it won’t let me do so. Maybe it’s the website’s way of saying he’s already signed up, but there’s no way of knowing.
What I don’t get is why vaccine production is so slow. Is it because it’s such a complex process? I’m sure that not every pharmaceutical factory in the world is operating at full capacity right now. Why don’t Pfizer et al just license their vaccines to any outfit that can make them?
The world needs a WW2-style production effort right now, and I don’t see anyone even trying.
If 10,000 people were doing the vaccinations and they did 100 each day per person it would still take two years. Sheer numbers are what is slowing it down primarily.
Sure and if 1,000,000 people were doing the US vaccinations and they did 350 each day per person we’d finish tomorrow.
In the US, we have plenty of people who can administer the shots. What we need is more shots to administer and I see no reason to believe that production won’t continue to ramp up. At our current rate of 1.46 million doses per day administered, we’ll get 75% of the population fully vaccinated within 10 months, and there is no reason to believe that we won’t exceed our current rate.
Yes, it’s very complex and requires expensive custom built machines. Someone elsewhere linked to a good article.
And Moderna, at least, has specifically suspended its patent on the vaccine for now.
It seems incredible to me that the category of people who need the vaccine most are also the least likely to be online. What a system! Where I am, appointments are coordinated by the NHS through GPs - who call (and text and email) people when they’re due for an appointment. My 90+ parents have had both Pfizer shots now, both times the GP called their landline. Worth noting we don’t book appointments ourselves, as GPs are organising the bookings.
The fact that the vaccines have specific low-temp storage requirements also complicates matters significantly. They can’t just crank out vials and toss them in cardboard boxes to be shipped all over the world.
Yep, that’s a really good article that @Wesley_Clark found. Just to add a point, the author says:
Even though I’m not a pharma manufacturing person…
Well I was (kinda - one time technical support to sterile manufacturing; retired), and there is one further point that should have been highlighted in the article. Vaccines are sterile - no surprise there - but you can’t sterilise them, at least the mRNA nanoparticle ones (I’m less certain about A-Z type). They have to be aseptically manufactured - in simple terms, you have to sterilise all your starting materials and then work sterile from that point onwards - through all of the complex steps that the article describes. I assume this is done using isolation technology within a sterile area - difficult to do, difficult to monitor for sterility at every step.
Nothing about this is simple - and still they are chucking out millions of doses per week.
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I was just speaking to somebody who does consulting for drug companies to get FDA approval. She was saying that the current process makes the vaccine in large vats lined with plastic. Between batches the sterile plastic liner is disposed of and replaced, which greatly speeds up the process. Cleaning and sterilizing an unlined stainless steal vat would increase the downtime between batches.
Articles have started coming out in the last few days about Pfizer’s “lightspeed” plans. So far they’ve reduced the batch production time from 110 days to 60 days, and the key step of creating the DNA from 16 days to 10 days.
Nobody has ever made an mRNA vaccine in anything close to these quantities, so it’s not like other factories have lines they can just switch over. Perhaps when one of the more traditional style viral vector or protein vaccines gains approval, then there will be third parties equipped to start producing it.
Here is the first article that came up in a search. It says the same thing as the one I read yesterday.
Yes.
Slow is because it is genuinely difficult to ramp up production.
Complicated (and inequitable) is because of living in a country that wasted the many months it had to plan an organized rollout. See:
As for GP’s, they have no vaccine role here in the U.S. because of fears some not having a family doctor would lead to modest inequity – and despite the Affordable Care Act having reduced the concern.
So instead we have the greater inequity of a scrum in which the most internet savvy and/or socially connected have a massive advantage.
.
I’m hearing of seniors who are in their 70’s and 80’s just giving up because they don’t have online access or are computer illiterate. The phone lines (if you can find a number) are overwhelmed and the volunteers at the vaccine sites cannot schedule first shots.
It really shouldn’t be this complicated. But I really expected nothing better.
Vaccine manufacturing is slow, though speeding up. But the biggest issue is the sheer number of people that need to be vaccinated. Los Angeles County, all by itself, has a larger population than Israel.
My mom will be 78 in a week and a half, and she is online and has a smartphone. But apparently her local public health authority created a system in which appointment confirmations are sent only via text message, but without mentioning it at signup! So Mom registered on the website but had no idea that her landline wasn’t actually going to do her any good. For chrissakes, if you’re trying to vaccinate elderly people, why on Earth would you assume that even if they have mobile phones, that a) they use them for text messaging on any kind of regular basis, or b) that the 75+ crowd is going to provide their mobile numbers as a default???
Hey, I do both. Not that it has done me a damn bit of good.
So does my (80-year-old) dad. But it shouldn’t be the default assumption for anyone, let alone for the 75+ crowd.
My dad retired from the government, so both he and my mom have good insurance, in addition to medicare.
When the vaccine became available, they went to their insurance website, logged in, and got their appoinments for later that week. Others, who had the same benefit, logged in one or two days later, and got appoinments a month later.
A friend of theirs only has medicare. She’s the same age. She hasn’t been able to get an appointment.
So it’s not just which group is priority. It’s where the person lives, which insurance they have, what smartphone/computer/etc. they have, how many other people want it, if they can drive, etc.
My own opinion is that they should be using the schools more. For those living near a stadium, great. But for rural areas (yes, I know even in rural areas, it can be more than 30 minutes to get to a school), I think a school is the best bet. Or a church.
The vaccines need to get to the people. Some sort of mobile truck which has all the equipment, along with an ambulance or two. Plus the people doing the work.
Roll up, get your pin cushions lined up, and go.
Wish it was so easy.
Absolutely agree.