You'll have had yours tiers....

[WaxOnFeckOff]

Thread 946....

I read a report this morning about the difficulties in transporting the virus to places like care homes, with the implication that they might have to wait until they sort out the logistics. Unfortunate since this is the group who actually needs it not least because positive cases are still being discharged back into them

I actually can believe that it's very unstable as it's composed of mRNAs wrapped in lipid nanoparticles. Our RNAs were always transported in coolers on dry ice to keep them cold enough then thawed before use, which is a pain but very doable, so I'm a little confused about why the government are making such a meal of it. As an aside, I was reading up about the lipid nanoparticle technology yesterday and it sounds quite exciting - much closer to 'real' infection than the chemically adjuvanted vaccines often used now and because the cells take up and then express the antigens I would guess you get a stronger response to it to. Only time will tell I suppose.

Do they have enough of the Pfizer's vaccine to do all the care homes?
Or are they going to use the Pfizer one for hospital / nhs staff.

Given how long we've waited. The Oxford vaccine is in for approval, and probably only a week behind the Pfizer one they will probably just wait that extra week.

Our RNAs were always transported in coolers on dry ice to keep them cold enough then thawed before use, which is a pain but very doable, so I'm a little confused about why the government are making such a meal of it.

Interesting. I have scant inside knowledge but that was my initial take as well. Suspect there is a bit of expectation management going on atm to make sure we all follow the rules until the back end of the New Year at least.

Also just in terms of PR it works better to have people queuing round the block clamouring for the vaccine rather than the optics of pushing it onto care home residents with limited consent capacity.

Getting cynical enough to be a politician.

I think they have 20m pfizers, so enough for 10m people across the uk.

That should cover at least priority groups 1-3 (basically 75+, frontline health and social care, carehome staff), plus a good chunk of group 4 (70+ and CEV) but probably not all of 4. The 75+ population is roughly 6m, plus the health and care workers. 70-74 is about 3.4 million. CEV is a huge unknown as a large proportion will overlap with the older population.

But trying to distribute a deep frozen vaccine in 5 days, in batches of 1000, around care homes seems a challenge in all bar the most populous parts of Scotland

Do you think there has been a ploy to get the Pfizer vaccine approved before the Oxford one?

I can't decide if its just happened that way or is there has been some behind the scenes stuff going on.

No extension to school holidays. Apparently

I wish I was working on that logistics project though - quite exciting to find solutions to those challenges.

Possibly overly cheery due to painkillers for covid lurgy!

@Bikingbear

No extension to school holidays. Apparently

I just saw that. Interesting. I really thought they'd go for it!

I don't doubt it's logistically difficult but it is technically possible, and they have the British army on hand to help with that (who are apparently quite good/experienced with this kind of thing). Given the importance of elderly in care homes being protected immediately (whilst we're in the middle of a second wave) I would expect that anything and everything would be done to make it happen. A few weeks could make a lot of difference in terms of mortality.

It just feels a bit to me like it's a bit difficult, so they're managing expectations and getting their excuses in early.

So did I.
I'm still not 100% convinced they won't mess around with schools. Just to be different from Boris. I can hear it coming "the virus levels are still high in the teir 4 areas..........so we are going to have a week distance learning........just to help push the levels down......" maybe I'm far to cynical.

I might believe they aren't going to mess around once we are past next Tuesday and have announced a rip roaring success in Glasgow and the Shires suppressing covid and getting us all out of jail.

100 percent agree @Y0uCann0tBeSer10us

We have logistical expertise in the army and all the stops need to be pulled out not merely expectations lowering communications management.

This is going to sound terrible.
Could part of the reason for making the care homes wait be the Pfizer vaccine has a higher success rate, so they'd rather ensure the hospital staff (who we need to keep healthy) are given that extra protection?

The Oxford one is cheaper, lower success rate and the people in care homes are on their last legs anyway. Sorry for being so blunt.

That is one way of looking at it, we've all become very cynical this year.

I think that's part of the issue though @Bikingbear. It's hard enough to even talk at a societal level about life expectancy issues in relation to covid never mind when we start talking about individuals.

Of course those of us with elderly and vulnerable relatives and friends absolutely want to protect them and it's really sad when they die. However, the vast majority of deaths have occurred in the population who already had a DNR or who were already at or over the normal life expectancy. Also being blunt in saying that we have fucked up the economy and the future of our youth in the main to protect people who may have died from flu or any other cause this year or might have made it another winter.

I really get that it's hard and it's really hard to lose anyone, neither DH or I have any parents and we've also lost 4 siblings between us. None of those from covid but really suspect that BiLs recent cancer death was as a result of late identification and lack of treatment.

You'll all think i am a really hard cow now, but as I say, if you look at a societal level rather than thinking about our lovely elderly relatives who we'd want to live forever, it becomes a different view to the choices we might be making.

There is also the point that many who we sought to protect would be happier enjoying the love and contact from their families in the final months that they may have, covid or no covid.

I agree @WaxOnFeckOff.

Sometimes I think it’s easier to look at it more pragmatically if you’ve suffered loss and also see difficult things at work

Waxon you really have had a tough time. Yip many in homes would much rather see family and friends than to be locked away for months.

I fully accept we couldn't allow covid to rip through society with people who need care not being able to get it and hospitals becoming overwhelmed but some of the 'rules' are ridiculous.

I agree there is a lot of expectation management going on re the vaccine - at UK and Scottish levels, to be fair. I'm really, really trying not to be cynical, but I do think that if they felt it was critical that care homes did get it NOW, rather than the Oxford or Moderna vaccines in a few weeks, there would be ways of doing it.

I'm not entirely convinced that the supposed differences in effectiveness is anything to worry about. Even given the huge number of people in the trials, the variables (age, sex, underlying conditions, ethnicity and so on) must make everything very difficult to compare, especially as relatively small numbers of people actually contracted the disease at all in either the vaccine or control group. So the difference between 70% and 90% effectiveness may only be 1 or 2 people. And I think the flu vaccine is only about 50-60% effective, and there are no arguments that that's not worth having, or we need to find a better one to give to the most vulnerable, or least expendable. As long as fewer people get ill enough to need to go to hospital than at present (and so, fewer people die), so leaving beds free for other stuff, I think we're winning.

They are, and devoid of any input from the grown up electorate.

I didn't realise the flu jag was so low. But I think the measles vaccine is only about 70% too.

And in the longer term the effectiveness of the vaccines won't matter as once you have a reasonable percentage vaccinated it stops the spread and by default protects the rest.

I see she’s now said might not be possible to get the vaccine to care homes...

Biking the measles element of the MMR is 95% effective after one dose and 96% after 2 doses. vk.ovg.ox.ac.uk/vk/mmr-vaccine#:~:text=Two%20doses%20of%20MMR%20vaccine%20is%20also%20around%2086%25%20effective,vaccine%20was%20introduced%20in%201968.
Even the mumps and rubella elements are above 85%.

Unlike flu you don't get measles more than once, which is why only children are vaccinated.

I had measles when I was 3, it was not fun. I can remember being in hospital. I also remember my mum discharging me and taking me home and she had to try to carry me on a long walk to the bus stop and then again on the other side. She was furious about something but I don't know what. I convalesced at home for quite a long time. I had to have hearing tests regularly right up until high school. I'd missed the vaccination for some reason I think.

@WaxOnFeckOff I actually agree with the sentiment that you have to look at the whole of society instead of the narrow focus on COVID deaths when thinking about things like lockdown, and I agree to a large extent with the scientists behind the 'focussed protection' idea. In the context of vaccination though - at this point we really only know that it protects the people taking it from severe disease and there isn't any real talk of sterilising immunity coming from it at this point, which is why the JCVI have quite clearly laid out their priority tiers in order of greatest clinical need. It may or may not stop an infected person passing it on, so it's probably premature to be thinking about herd immunity in that respect, but it is very likely to reduce the severity of disease in the person who has been vaccinated, reducing their chance of hospitalisation and/or death.

The Scottish government (and the UK government for that matter) agreed to the priority list as laid out by the JCVI, which involves prioritising care home residents first because they have the greatest clinical need. If they have decided to prioritise another group instead they should come clean about that and make their case, rather than poor excuses about the logistics being too hard when it could be done if there was the will.

Wax the vaccine wasn't routinely available when I was wee (I'm early 50s).