Vaccination centres too far away.

(121 Posts)
Thingsthatgo Thu 06-May-21 20:07:14

I’m really sorry, because I am sure that this has been asked a billion times on here before. I’m 44, and I got my invitation to book my jab through the national vaccination service by text. All of the places are miles away in different cities and I do not drive.
Everyone is saying to wait, and that my GP will contact me, and I’ll get a closer appointment, but when I mentioned it to my GP they said that they would not be contacting me.
Also, not sure it’s relevant, but the booking service seems to think that I’ve missed an appointment or something. It keeps saying that I shall have to rebook rather than just book.
Anyone have any wise words for me?

OP’s posts: |
Thingsthatgo Sun 09-May-21 21:45:43

*without DH having to take time off too

OP’s posts: |
Thingsthatgo Sun 09-May-21 21:44:47

@choux I didn’t call the number but an appointment came up in Brighton, so I booked it. It’s still a pain to get to, But doable with DH having to take time off too. My second appointment is Portsmouth, nothing closer available, so I just going to keep trying to change it every day and keep my fingers crossed. I know that many people here think I’m being awkward but I have found it pretty stressful to be honest, and until I get a second appointment somewhere I can get to and back within a school day, so I can do the school run, I am going to be on edge about it.

OP’s posts: |
looptheloopinahulahoop Sun 09-May-21 20:52:26

Tealightsandd

Disability and mobility issues necessitating easier access is NOT about wanting everything on a plate. It's not about not wanting to travel. It's about not being able to travel.

There is a lower take up amongst disabled people because they are unable to get to far away centres. Because of disability.

I agree with this and I think the OP is being given a hard time.

However, I also agree that some people are being a pain in the neck. We have two centres in our town, one of which is right in the town centre and on bus routes; the other is on the outskirts but still very accessible and walkable for a lot of people, and an inexpensive taxi ride otherwise. Also affluent town so people can afford a taxi.

Oh the bleating. Taxis were giving rich 80 somethings free rides, it really annoyed me as the drivers probably had less money than their passengers did.

And this weekend the vaccination centre worked Saturday instead of Thursday because of the election and then there was bleating about would there be free parking (it costs a max of £1 for the time you are in there).

If a taxi is going to cost you £60 each way, twice, it's too expensive for a lot of people and having 8am slots on a Sunday is a nonsense - what public transport operates that early on a Sunday?

But moaning about £1 for parking angry

WombatChocolate Sun 09-May-21 11:49:00

It’s good to hear there is free transport too for those who need it.

I think there I support around to help people, but people often don’t know and often are reluctant to say they face barriers to getting jabbed, but if they do, they can be directed to either help with travel or access to the few closer appointments which are around.

Hope everyone struggling to book manages to find something that works for them.

WinterHoliday Sun 09-May-21 11:07:47

Thanks for that link about the unit in Brighton. I have a friend who lives nearby in Sussex who has mobility issues and she hasn't been able to find any appointments in places she can easily get to yet so I've let her know about it.

Choux Sun 09-May-21 10:00:44

@Thingsthatgo did you ever call the number that @mimipuss gave you?

Brighton and hove have a mobile vaccination unit. It's in Brighton today and you book appts by calling https://www.brighton-hove.gov.uk/news/2021/new-location-mobile-vaccination-service-weekend0_. It does say drop ins are accepted so they may not have huge take up. If you can't get it today the unit must be somewhere you can get to on a future weekend.

https://www.brighton-hove.gov.uk/coronavirus-covid-19/vaccinations

Free transport to regular vaccination appointments are also available if you need it. Full details of all the options available with phone numbers to call are and email addresses are here depending on where you are:

https://www.sussexcommunity.nhs.uk/services/covid-19-vaccinations.htm

0300 303 8060

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WombatChocolate Sun 09-May-21 09:04:48

Absolutely, 8 hrs isn't going to be reasonable and I don't think anyone would expect you to do it.

And at the moment when supply is restricted, which means that for some people the soonest appointments are that far away, those running the system know people won't book now but keep checking back until it is reasonable and manageable. Some people will be happy to book when it will take 2 hours each way and some when it's an hour.

And of course it varies geographically. Some people when they first looked found appointments within 2 hrs or 1 hr and when they looked again coukd see them 30 mins away.

Perhaps it would help if a message went out saying that because supply for 1st jabs is low, people might need to expect to wait longer to find appointments that work for them. I think they want to limit the messaging though as the more message snet out the more confused people get.

I guess one thing that does happen, is that if people look and see the kind of journey you saw Dances, that although they aren't prepared to book it, it increases their awareness that a journey is likely to be needed and when the venue that will take 90 mins each way comes up, they are perhaps more willing to book it and indeed keen to get get it.

Supply for 1st jabs is so limited, it really does become a case of rationing by distance or time doesn't it. Essentially there isn't enough supply for everyone who wants the jab at the moment. It just isn't practical to offer it locally to everyone when supply is so low, so you either rollout much more slowly (and that reduces the pool of people who can travel to the centres and make it less efficient again) or offer it to a wide group of ages and offer what's available and let them decide if they want to go and get it. And before a cohort can be signed off and the next moved onto, the gov will need reassurances that efforts have been made to follow up those who didn't book, and one way to do that will be to offer those who haven't the few more local appointments and to use the drop in centres and buses etc. But lots of people are now travelling distances of an hour or two, because that's the way to get the jab and they want it.

In an ideal world supply would be sufficient to enable everyone to have the jab within half an hour of 45 mins.

So I agree what's available to you isn't realistic and no-one would imagine hardly anyone would book those slots, but others from other directions will be nearer those venues than you are, and they will. But there's a gap in lots of people's minds between the reality of journeys required and what might have been needed 2 months ago. 2 months ago. Lots of 1st jab people could walk 5 mins or drive to the centre in their town for an appointment and lots of phase 2 people imagine that's still the case. They think if they wait, everyone can have that local appointment but don't realise the supply just isn't there now and lots of local centres have stopped doing 1st jabs, so most people are having to go 30 mins or an hour or a bit longer, if they aren't to wait for the mop up which could be weeks off. I can see why people are rather surprised and a bit cross to see an 8 hr journey offered, and then to need to look multiple times before they find a resonable journey, which is still an hour away, when in their mind they'd be going to a centre in their town. Expectations and supply aren't quite in line.

Hope you find somewhere suitable soon.

DancesWithDaffodils Sun 09-May-21 07:56:36

So, we are in agreement that an 8 hr journey on public transport (16 hr day, plus appointment time, plus things not quite lining up), as my "nearest" appointment is not appropriate. And me refusing to accept that as an appointment isnt me being difficult or unreasonable?

And that a charity is unlikely to drive me that journey - a much shorter 2 hour drive each way, so at least a 4.5 hour commitment.

And that £15 uber credit wouldnt cover it?

This was a weeks worth of checking several times a day.

Some people arent just being difficult about appointment availability. They are being realistic about the journey (I live in a major cluster of big towns and cities - I wasnt expecting something in walking distance, I was wanting something that wouldnt take the whole day)

MercyBooth Sun 09-May-21 00:13:11

she was worried she might pick up a different variant as it was in a different town

Its almost as if scary media campaigns have consequences isnt it.

WombatChocolate Sat 08-May-21 23:21:21

Dances, it's difficult to say what's a reasonable length of time or mileage to travel. Journeys can vary and the longest in time aren't always difficult journeys and sometimes short mileage can take ages of be more tricky for some people.

Charities will vary with how far they will take people but they want to help so I think they will go a distance. Some of it will be down to individual volunteers. Someone upthread mentioned Uber will pay £15 each way or first £15 each way as a gift to help people get to vaccinations.

An earlier poster made the very valid point that the reason centres a long way off are shown, is that limited appointments (due to limited supply) mean they can either show no availability in a close radius or show it further away. People then choose if they wish to book sooner and travel further, or wait and look again and expect closer will come up as popularity from a new rollout age group drops a bit. Essentially, the further people will travel, the sooner they can have it. Would it be better to not rollout to new age groups until the distance could all be within 15 miles or similar? I don't know. They've decided to rollout and I gues with limited supply, the distance themselves act as the rationing function and those who will travel get it first. If they didn't rollout to so many, the process overall would be slower, but no one would be travelling quite so far...tricky balancing issues again.

And I agree too, that some people who aren't booking because of distance, coukd often do a bit more to get the jab if their circumstances are tricky. If someone speaks to the GP and explains genuine issues of difficulty travelling for medical reasons or cost reasons, GPs will (becaus they have been instructed to help those who will find it hard to access the jab to get it) find ways to help which might include a more local jab. But people need to speak to the GP and not expect osmosis and that GPs will automatically know that someone will struggle to afford the cost or has a new issue which makes travel impossible.

Sometimes someone calls the GP to basically say they don't want to travel and would prefer local. As came up earlier on the thread, some GPs are saying I that situation, quite honestly that there just aren't any local 1st jab clinics run by GPs at the moment, so the best thing is to keep looking at the national site and book as soon as something a bit closer comes up, even if it's still further than the person would like. They can't arrange local jabs when supply is so tight for everyone who would just prefer not to travel, but who can.

So the message remains the same....the fastest way to get the jab is to be prepared to book whatever is available as soon as you can and travel. If appointments seem really far away, waiting a day or two and keeping checking can mean things become available much closer even if not really local. And everyone will be offered the jab in a form that works for them over time, even if they never book...it could be several weeks later but local jabs, drop in centres and vaccine buses will all operate as phase 2 moves on through the cohorts,mot ensure everyone gets the jab...but we are only 2 weeks into this phase and these mop-up services might take a while and not be offered until it's clear there are groups who haven't booked....only being 2 weeks in it's hard to know that yet. It might just be lots of peop,e haven't got round to booking. Not everyone is desperate to be done quickly. Lots of people are pretty relaxed about it.

OurSiteMap Sat 08-May-21 20:24:27

We had a local woman posting all over Facebook about how disgusting it was that her 65 year old mother couldn’t get her jab when they were doing the 50 year olds. Ranted about how her GP had refused and nothing was showing on the booking site.

I know the 65 year old mother quite well so knew the full story. She had been able to book on the national site but decided that it was too far to drive (coincidentally this was Brighton too) and she was worried she might pick up a different variant as it was in a different town. She does drive and has her own car. I told her to phone her GP and explain but she said the GP wouldn’t help. When I dug further, it turns out that when she phoned the GP it said that there was a queue and she would have to wait approximately 5 minutes for someone to answer. She didn’t try again!

Several weeks later her daughter was still ranting on Facebook so I urged her to phone the GP again. And lo and behold they gave her an appointment at the local GP hub.

I do appreciate that it is difficult for some people to travel but some people really don’t make an effort

DancesWithDaffodils Sat 08-May-21 19:41:26

Wombat what do you think would be a reasonable time for people to travel to a hub?
And how far will the charities that have been mentioned take people?

WombatChocolate Sat 08-May-21 19:25:37

Iwant, it’s likely that the centre offering jabs close to home is offering only 2nd doses. Most GP services are doing that now. Many haven’t registered to do the 2nd phase of 1st jabs and they didn’t have to, because in this phase it’s not so key to have local centres absolutely everywhere. They will be involved in the follow-up of those who don’t book. Some of that follow-up is likely to be encouraging people to book at the national centres rather than immediately offering local jabs...simply because they don’t have the supplies or won’t be running specific clinics for 1st doses. It’s likely some will use spares from their 2nd dose clinics for anyone who really cannot travel.

I guess it’s all part if the overall planning and picture. Whilst on one hand it’s really important that people keep being offered the jab as eventually get it locally, if that really is the only way, at the same time, with people being younger, if they have to wait a bit longer for it to reach them locally, it’s not as desperate as it would have been in terms of 80 year olds having the longer wait. And of course 2nd jabs simply cannot wait beyond 12 weeks and must be prioritised.

Again, it’s all about balancing all the competing demands for speed, efficiency, 1st and 2nd jabs both needing to be offered, the fact some age groups can only have certain jabs, and supply not being as high as they would like. No one demand can be allowed to derail other elements of the programme. And the difficulty is that the overall plan I g is very complex and people cannot know the full picture precisely because it’s so complex. So some people just look at their own situation or those of a group of their friends or contacts and feel annoyed that the age rollout is too slow, or that too long is being spent following up the hesitant/deprived at the expense of faster rollout, or too little time is being spent following up the hesitant or deprived and it’s moving forward too fast, or that some nearby areas are jabbing younger people or using up spare doses in a different way that always seems to favour others and not themselves, or there aren’t enough local centres, or they don’t like the centralised booking system, or they live in Scotland which doesn’t have a centralised booking system, or it’s not right who has been included in group 6, or it’s not right where the cut off age for AZ is, or they want to be able to choose which jab they have, or it’s not fair some people got the jab locally and others had to travel, or that some got it quicker and some had to wait etc etc.

It’s not perfect. It has to be broad brush to reach 53m people twice using uncertain supply and changing rules about who can be given which jab. But it’s constantly being tweaked and improved and adjusted to ensure supply is used more effectively, rollout is as fast as possible and that take up is as high as possible. Some of those goals are directly in conflict with each other and mean not everyone can have the jab immediately and locally. More people can have it sooner if more people travel. But the system hasn’t written those who can’t travel off. It will get to them...but it will take longer. For most people, the fastest way to be jabbed is to book on the national system and travel. And most people will do that. Some go to considerable efforts to make it happen because they think it’s really important to have it ASAP for themselves and for others too. Others don’t travel and wait however long it takes...and at the moment it could well be several weeks, some because they simply can’t travel, and others because rather choose not to. But they will all be reached in the end if they want the jab.

Iwantacookie Sat 08-May-21 18:42:26

OP it frustrating when I know theres a centre offering vaccines 2 minutes away from my house but it keeps wanting to send me to a local village 10 miles away (rather than our much bigger town)
I'm just waiting theyll offer it me eventually.

Tealightsandd Sat 08-May-21 17:47:57

The efforts sound very encouraging @WombatChocolate
There's a very long way to go outside of Covid issues, but definitely it sounds like good work is being done to improve access to vaccines. It's progress, which is positive smile

I particularly think the pop ups are helpful. Hopefully we're moving in the right direction.

WingBingo Sat 08-May-21 17:44:21

This is down to availability of appointments.

Rather than say none available you are offered a site further away. Just keep trying and as slots are available nearer, you can book it.

I can’t see why that’s an issue.

WombatChocolate Sat 08-May-21 17:37:12

Teaslight, in my mind, there has been an enormous effort to get to grips with the issue should out mention. Absolutely, the issues you mention prevent lots of people accessing healthcare and the issues are hugely complex and not easily solved quickly. But huge efforts are being made and people are working on both the communication side and also the location of jabs.

For example, I saw an NHS England message to GPs talking about where drop-ins are advertised and focus groups looking at how the message needs to be delivered and that traditional messages might not get across. One area has been trailing offering multi-generational households the chance to all go together, even when some are younger than the current age cohort, because it has been thought by going together, some groups will be more likely to attend, especially when the location is in the heart of their community as a pop-up. Vaccine buses have gone to the car parks of the shops that people in deprived areas are most likely to shop in. They have parked near the schools or community centres to make it easier for people. They haven't had to book but could just go. It's not perfect but real efforts are being made and vast resources put into it. And it's a vast job to reach 53m adults. And it might not be perfect but I think amazing progress has been made in terms of reducing hesitancy and also helping those less likely to get jabbed for other reasons done.

We will have to look at the figures in August and see then how successful the scheme has been inreaching people, but within it all you have to facto in supply. We all know supply for 1st doses has been low through April and still has. That has made it difficult. In fact, rather than push on and rollout to the under 50s, instead the doses available were devoted to reaching the over 50s who hadn't got jabbed...the hesitant and those with barriers that had stopped them coming forward. And big progress was made to reach 95% wouldn't you say?

The same will continue to happen as they look at what younger people with barriers need. It's different for 40s and will be different for 30s and 20s. We will keep seeing adjustments to the campaigns and mop-up operations to reach people where they are, when they don't come forward and use the national booking site. But there's not enough jab at the moment for al GPs to offer it locally, plus younger cohorts who can mostly travel aren't best served with an efficient rollout by lots of tiny services and lots of Gps have reasonably said they need to revert to their usual work. It is balancing all this stuff. I think those who could be left behind have had a lot of effor put into reaching them with the jab and continue to have that, but the whole system cannot be designed just around them.

Tealightsandd Sat 08-May-21 17:33:23

We cross posted @WombatChocolate
I think there's clearly some good effort being put in, but unfortunately it seems to be area and GP dependant. Some areas and GPs are doing everything they can, making sure they're helping those who need it, reaching out. Others are less well managed.

One of the best ways to improve access is to ask people affected, what would help. We have people on this thread explaining some of the difficulties. The prohibitive cost of public transport for travel is one issue.

Hopefully with some more work and tweaking - across all areas - access can improve. I think the pop ups are definitely one of the most helpful iniatives. Let's get more of them out there.

WombatChocolate Sat 08-May-21 17:22:30

I think this thread throws up too, so that some people simply don't want to have the jab or engage with the system. Some people have issues with government generally, or the governments handling of Covid, or probably a range of other issues. They aren't actually interested in whether the system is well designed or works, or even in actually discussing the pros and cons of it, but making random statements which don't really relate to the issue of location of centres, or to anything anyone else has said, or answering any questions about their situation that have been asked multiple times, but just being contrary with whatever the general view is. Same old.

Tealightsandd Sat 08-May-21 17:22:14

It's not about not recognising the good job done so far. It's about using data to make much needed improvements.

We have data showing us where take up is low. Some of it is due to hesitancy, but we also have low take up amongst groups who might be struggling to access the vaccines. The disabled, and people living in deprived areas.

The problem stems from before the pandemic. It's the wider lack of understanding about everyday life for people in deprived areas, and for the disabled. What it is like to be unable to access facilities or perform activities other people take for granted.

Now that we have the data in front of us, plans and arrangements need to be tweaked so that, for once, the excluded are included.

Increased supplies to local pharmacies. More pop ups (like some areas are already doing) in local community centres, churches, mosques. Make sure these pop ups are well advertised.

WombatChocolate Sat 08-May-21 17:16:39

Tealight, big efforts are going into helping those in less well-off areas get the jab and overcome the difficulties that might stop them such as cost of travel. In areas where take-up is low, the issue is carefully noted. Take up is being charted all the time. Extra clinics are put on as pop-up clinics or the vaccine bus goes. They are well publicised and locations are chosen to try and make it easier for people to go and which might be culturally relevant if that's helpful.

For people with agrophobia, GPs would arrange home visits. For the housebound they will do this. It is absolutely happening , but of courses these cases aren't already identified it all takes a while.

Much of April was given to catch-up of over 50s who hadn't got the jab. GPs worked really hard to make several contacts with individuals and find ways to get the jab to them. Constant messages went to GPs and other vaccine providers about the need to reach people on low incomes, with disabilities, living in deprived areas and anyone who might not find it easy to access the jab. Huge huge amounts of resources went into it.

And it will happen again. We are still in fairly early stages of phase 2.... Just a couple of weeks in and it's too soon to know who isn't going to book on the national system yet. But already, those who haven't will be in the follow-up system and getting texts and social media will be calling on people to contact their GP if they haven't booked. SUpply quite simply is limited and GPs haven't had supply for 1st jabs for a month now, but are expecting more Pfizer especially soon. People will be followed up and barriers overcome.

I find it really interesting that some people have a perception that those with barriers to getting jabs are seeing the barriers built up higher and obstacles out in their way, rather than than seeing all the huge efforts being made to bring those barriers down and actually the great success that is being achieved. Hesitancy has dropped significantly and lots of those who didn't book or respond to texts and letters for a variety of reasons have now been jabbed. It's an astonishing success. And NHS England continues to call on GPs to be creative and find ways to reach those who haven't been jabbed by thinking about how they communicate and where they offer jabs and break down the barriers. They are not resting and saying 'we tried and people didn't respond' but there is HUGE determination to reach people.

So this idea that the disabled and those in low incomes have been abandoned without the jab, just isn't right. Remember we are only 2 weeks into phase 2. It all takes time and of course not all under 50s are yet eligible or jabbed. But they will all be reached.

Tea light, do you feel people have been ignored? Have you not seen the significant efforts to reach those for whom the standard channels which work for most, don't work? Can you still think of lots of over 50s who haven't accessed the jab and who want it but haven't been able to book or get to somewhere that works for them, or are you thinking of under 50s, in this phase 2 which we are only 2 weeks into, and will all just have to be a bit patient for, because with the best will in the world, it's not possible to have done all under 50s in 2 weeks.

MrsFezziwig Sat 08-May-21 17:05:37

MercyBooth

*It's not a user friendly system*

Which is why i wont be using it.

So if it was user-friendly, you would be using it?

WombatChocolate Sat 08-May-21 16:59:32

There is a balance between ensuring everyone can get the jab (they are doing that by following up anyone who doesn't book via national site when eligible, once enough time has passed to suggest they won't) and running a service which offers the limited supply of 1st doses efficiently. To run all the pharmacies and the GP led services and other local places to give local services for all immediately would mean each running a clinic with tiny supply because only around 120,000 doses are available each day.

The numbers having difficulties travelling will still exist but are smaller than when jabbing over 70s and CEV groups. Additionally, the supply for 1st jabs is much smaller. It isn't efficient to run thousands of tiny sites so everyone can go very locally.

The service is being adjusted all the time to meet the differing needs of different age groups and the varying supply. When you look at how it's adjusted, it's an amazing reactive system which is allowing us to respond to the evolving vaccine picture.

When offering 53m jabs x2 it will never be able to offer the perfect option at the quickest speed to all. The system of first offering each group the national system allows them to offer to large numbers and get through lots with the limited supply. This is really important and does enable most to get the jab fast.....and don't forget this is a key requirement of the whole process.

And then within that efficient, speedy process it's also vital to cater for those who won't fit the standard process too isn't it. Some won't be able to travel and some won't be organised enough to go online and book and some will book and then not turn up. All of those need following up and a tailor-made approach made to get each of them jabbed. That is happening too which is impressive. People might get a text reminding them to book on the national site and some will then book. Some will book after they get a letter and find more sites are now available. If people still haven't booked or contacted their GP, the GP might send them a link to book at a local clinic which has a few jabs available for 1st doses which is mopping up those who didn't get jabbed. If they don't respond, they might be sent the information about a local drop in centre which doesn't need booking. If nothing still happens they might ring them and have a chat about what will help them get the jab. It all takes a lot of resources and energy, but it is happening. It's really important that those who can travel, rather than just would rather not are encouraged to get on and book, because local supply is so small and needs to be used for those such as anyone who really cannot. And those disabled or without the means to access the voluntary services which will take people for their jab, will get a local appointment or even a home visit if they are housebound.

People with genuine issues which mean they cannot travel can always speak up and tell their GP....they don't have to wait and wait. But GPs cannot offer jabs they simply don't have, which is why where people can travel, they need to be encouraged to do so. With supply so limited, a GP local first jab might be several weeks off and will be further off if those who could have travelled insist on waiting for it too.

But remember the vast majority are getting done at the mass centres.the system is working well with many days if over 500,000 being done. We should focus on recognising that too....the whole system cannot be designed in phase 2 of under 50s to deliver in a local way to suit a small number of people who either prefer or need local jabs, when that would be inefficient and slow the whole rollout. Instead, we have a system which is designed to deliver efficiently and quickly when supply is limited AND to ensure no-one is left out either.

Where there are still those over 50 who haven't been jabbed (those 5%) continued follow-up is happening to still try and reach them. I find that pretty impressive.

It's interesting that some people can't see the huge successes of the programme, and instead only seem to see that it's not absolutely perfect for each individual in terms of time and location, when even then, the jab is there for everyone and local is absolutley there for anyone who cannot travel.

By the end of July, those who haven't had the jab, will have been offered it and often offered it several times, including locally. It really won't be that barriers were allowed to prevent them taking up the jab.

candycane222 Sat 08-May-21 16:48:57

Where I am there are also some pharmacies operating as part of the national system. Problem being they had limited capacity. I found where they were via a map somewhere in that booking website. It was only possible to book first jab at a few centres, but I had much more choice in the second jab part of the process

Tealightsandd Sat 08-May-21 16:43:17

Few people under 40 and who didn't qualify for the jab as CEV or in group 6 with various other conditions will be housebound though.

Lots of under 40s are not in group 6 or CEV but can experience difficulty travelling long distances. People with visual impairments, mobility issues, chronic pain, agoraphobia, and various other conditions.

Remember too that many conditions included in group 6 were at GP discretion.

The problem of affordable travel is a separate issue. There's a reason why deprived areas have lower take up. It's not so easy or simple for people on zero hours minimum wage to go on expensive 3-4 hour round trips.

We should have easy access to vaccines. Particularly for groups who have disproportionately suffered in this pandemic, including the disabled and deprived.

Even if people don't care about the poor and disabled, let's not forget we need majority vaccinated to prevent the development of mutated strains. In this situation, altruism and self interest have a shared goal.

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