They don’t know if the vaccinated person can still pass virus to others, so vaccinated people can’t just drop all other preventative measures like masks and distancing.
And people want to visit their relatives. It’s not just staff going in/out.
1 Like
My 89 year old father in assisted living is heading back to the hospital today - low oxygen levels. He was in the hospital with covid for over 6 weeks in the spring, back in the fall with what they said was a lung infection, and now again today (don’t know if they will admit him or not). My feeling is that his lungs are damaged and they will never be the same (one of the doctors last hospital trip said he has “lung disease”). Probably a combination of having covid and decades of smoking.
1 Like
All the more reason to vaccinate the vulnerable people ahead of the younger super spreaders.
5 Likes
Are they going to be screening out people who have had the virus and presumably have the antibodies from being vaccinated?
Dup
@twoandandone of course…I didn’t forget that vaccinated folks can pass it on so write it off as wishful thinking. My mother’s facility is doing a test for staff who live with relatives who are positive and that isn’t sufficient either.
It is completely human nature to get upset about the priority list and have questions, maybe especially based on personal situations (“Why should convicted murderers get the vaccine before my sweet elderly mother?” “Why should that partying 20something go before X?” “Should the 28 year old healthy bus driver go before the elderly non-working person?” “Shouldn’t the grocery store worker who has put themself on the line this whole time to feed us go before a retiree who can easily stay at home?” Etc. There are many different “fair” ways to look at things).
However, I really do hope people don’t get TOO, too wrapped up in those details. I feel strongly that we should be awash in awestruck gratitude that an exceptionally effective vaccine is actually beginning to be distributed in well under 12 months, when so many had predicted it would take a minimum of 18 months. I feel like these early vaccinations are all bonus, and we all benefit by having any one get vaccinated, even if it isn’t us or our loved ones. Especially since the experts seem to think there will be sufficient supplies to reach all willing American adults by probably April or May, I hate to think a lot of resentment will occur. I mean, scarcity is an issue and if it was going to take like 4 years to get it to everyone, that would be one thing. But in most cases, we are probably talking about an extra month or two or maybe 3, but still we will get a fantastic vaccine before we could have ever legitimately expected it. So after the healthcare workers and nursing home patients, I don’t really care what the order is, even if they did a draft-like lottery—I feel like everyone is so lucky to get it in the first half of 2021. I pray that people focus on gratitude more than resentment about priority order. Although I totally understand it is human nature. 
I can’t quite imagine the meeting where the CDC developed their priority list—there are so many fascinating ethical considerations!!!
One of the more interesting ones I heard was an issue with nursing homes going early. I believe that they will, but a concern raised is that there are often non-covid-related and non-vaccine reasons for death. So it’s possible that some elderly nursing home patients may pass away soon after getting vaccinated, having nothing whatsoever to do with the vaccine. But that could lead to terrible misinformation and scare people (“My granny got the vaccine and 4 weeks later she died; I’m not taking that vaccine”). There is definitely a risk there, but I’m sure it seems that the benefit of going early to nursing home outweighs that risk. Very tricky decision-making required!!
9 Likes
Would that be practical, since it would involve giving every person an antibody test and waiting days for the results before giving the vaccine? The extra visit and extra days waiting would just slow down the administration of the vaccine for everyone to deprioritize the minority who have had COVID-19 (under 10% as of September, presumably more now, but unlikely to be a majority except in a few hot spots) and who are not voluntarily waiting until others have gotten the vaccine before getting it themselves.
Around my area, according to a news report I saw a couple of days ago, the healthy 18-30 somethings are rarely interested in getting the vaccine so that might free up some spots.
I don’t know if my area is similar to the rest of the nation.
According to DH, Pfizer is doing testing of the vaccine in people who have had Covid. The word so far is that the vaccine works for them, too. It triggers the body to produce the ideal neutralizing antibodies, and it doesn’t trigger the dysfunctional immune cascades that can happen with the real virus. Also, they think the vaccine antibodies are going to last longer
4 Likes
A lot of that is due to just plain numbers as you know. The unacceptable side effects may not show up until millions of doses have been consumed. (pharmacist for 41 years). Like you, I saw a lot of wonder drugs come and go. I personally prefer to take an old drug if I can rather than falling for the “new is better” blitz.
2 Likes
The vaccine trials have included/will include sample sizes of 40,000-60,000 which is uncommonly large for drug or vaccine studies. Certainly side effects could still come to light. If we don’t get a high proportion of adults to take the vaccine, we have no chance at herd immunity, because 70 million or so kids are not going to be getting vaccinated for quite awhile.
I certainly hope neither one of you are sharing your personal concerns about the vaccines with your patients. The concept of preferring an ‘old drug’ to ‘new is better’ is completely irrelevant for this vaccine.
2 Likes
I am retired. I never said I had concerns about the vaccine. I am over 65 and absolutely plan to get it as soon as I can.
1 Like
At the same time, I think it’s maybe a good thing that there are some slower-to-adopt people, since we are dealing with a scarce product for the next several months. The latest poll I saw indicated approximately 60% of American adults are ready to take the vaccine. Since there won’t be enough in the first few months for all the people who want it, then those other 40% can step out of the line and wait for all of the eager people to take it. By then, I hope and pray a lot of the “waiters” will be ready. Many of those ~100,000 trial participants will be closing in on a year post-vac by then, which certainly doesn’t make it an “old drug” but might give more confidence to the reluctant if the trial participants haven’t grown two heads or had other medium-term side effects. So having some portion of people prefer to wait a bit may help get the vaccine quicker to those who really want it (me, me, me! 
), and everyone may wind up being happier in the end this way. Of course, I sure hope that the communication plan does get us ultimately to over 70%+ adoption (with the kiddos eventually worked in!!).
The problem is that very few jails and prisons have the facilities onsite to treat seriously ill patients. So when prisoners get sick, they need to be transported outside the facility to be treated in local hospitals – which puts a strain on the local hospital and also increases exposure to the local community. This can also create issues tied to security which are not really compatible with many quarantine protocols.
I saw this locally when there was an outbreak at San Quentin – and for awhile at least half of the Covid beds in my county’s hospitals were occupied by prisoners. If that happened again… well, this time around we don’t really have many beds to spare.
Given limitations on vaccine availability, some hard choices need to be made. There may very important distinctions to be made depending on the type of the facility. Your local county jail has a lot of people coming in and out – so it actually provides a good opportunity to vaccinate many people in the local community who tend to be lower socio-economic status. A state prison super-max facility is more likely to be located away from an urban center, and houses a lot of prisoners in isolation units where contact with others is quite restricted – so that might be a population where vaccination can be deferred.
1 Like
No, they still need to be vaccinated.
Unfortunately, with all of the “quarantine fatigue”, so many people have basically given up on behavioral modification to avoid getting or giving COVID-19, so they may see even the smallest delay in getting the vaccine because an “undeserving” (to them) person or group is ahead of them as a reason to be resentful, rather than grateful that a more-effective-than-expected vaccine will be available sooner (even for those who will be last to get it) than previously expected.
good news is that my father did not get taken to the hospital, they were able to get his oxygen level up enough. Spoke to him last night and he sounded good.
18 Likes
Regarding the possible long wait to get the vaccine…it took me 8 months to work my way to the top of the waiting list for the Shingrix vaccine. I’d like to think that by August (8 months from now), we’ll be able to accommodate all who want it.