I'm Sure We'll Be Seeing This Become Common In The Coming Weeks

[BoSoxGal]

You’re an idiot on this Joe. Period.

[Joe Guy]

You’re an idiot on this Joe. Period.

Thank you for not turning our disagreement into a personal attack. That would be immature and hurt my feelings.

[Scooter]

It seems odd and a bit suspicious that no one else within the hospital, or attending as an outpatient, could have been found to whom this dose of vaccine could have been administered, that it ended up going to someone outside of the hospital who happened to have a connection on the inside. That being said, it is almost certain moving forward that some vaccine doses, for whatever reason, are going to go to people outside of the priority populations being targeted for vaccination at the time. It is completely unworkable and probably unethical to be saying to those people, "we'll allow you to jump the queue for the first dose, but you're S-O-O-L on getting a second dose."

[Joe Guy]

It is completely unworkable and probably unethical to be saying to those people, "we'll allow you to jump the queue for the first dose, but you're S-O-O-L on getting a second dose."

Not unethical in my opinion. If they were following my idea, they would be jumping the queue with the knowledge there are no guarantees unless there are enough leftovers the next time. They aren't losing anything if they don't get the second one.

[Scooter]

Are you going to do that for everyone who receives vaccine outside of the then targeted populations? Because that is going to be a logistical nightmare to administer, and no health care facility is going to want to take that on, and few people are going to want to take up that offer, so there is going to be a fair amount of vaccine flushed down the toilet.

[Joe Guy]

Are you going to do that for everyone who receives vaccine outside of the then targeted populations?

Do what? Give unscheduled people the option I described?

Because that is going to be a logistical nightmare to administer, and no health care facility is going to want to take that on, and few people are going to want to take up that offer, so there is going to be a fair amount of vaccine flushed down the toilet.

I don't see the logistical nightmare aspect that you describe. People would either take a chance to get ahead in line or they would get it when they are the targeted population.

[Long Run]

Which, of course, gets back to the main point that there should be a sensible backup for leftover dosages, i.e., you vaccinate another near the top of the list person who is readily available, rather than a friend of someone in the know. If a bottom of the list person (like a healthy 33-year old in a non-vital job) is not guaranteed a second dose, that will remove the incentive to ever ask such a person if they'd like to jump ahead of 80% of the population.

[BoSoxGal]

Sorry Joe but saying you are being an idiot on this point is not personal attack, it’s simple fact. What you are proposing is a violation of medical ethics. You’re being idiotic to try to win a point but your assertions are entirely out of keeping with the standard of practice in medicine and you are wholly unqualified to propose them. Ludicrous. Idiotic. Fact, not attack.

[BoSoxGal]

I just have to add that I’m shocked you can’t seem to grasp the very obvious argument against your idiotic proposal, which is that such an unethical scheme as you would propose would undermine decades of efforts historically and the present ongoing effort of the public health community to instill confidence of the public in the efficacy of vaccines and the soundness of the science behind them. To have said for decades that many vaccinations require boosters i.e., more than one shot for full efficacy and to have drumbeat this over and over and over with ignorant members of the public and now you’re proposing that doctors and pharmacists and public health workers should suddenly say it really doesn’t matter if you get the second shot, you’re good to take your chances?

I mean that is completely idiotic. Dangerous, too.

[Joe Guy]

.......What you are proposing is a violation of medical ethics. You’re being idiotic to try to win a point but your assertions are entirely out of keeping with the standard of practice in medicine and you are wholly unqualified to propose them....

Is it standard practice and medically ethical to give vaccines to people based on their connections to people in authority instead of administering the vaccines to the people who need them the most?

.....and now you’re proposing that doctors and pharmacists and public health workers should suddenly say it really doesn’t matter if you get the second shot, you’re good to take your chances?

I didn't propose anything like that. I said that if people who are NOT in the target group choose to be vaccinated with a leftover vaccine, they should be told upfront that they may or may not be able to get the second vaccine - and they may end up having to get the two vaccines later when they qualify for them.

Based on what I've read and heard on the subject, if someone gets only one of the current vaccines when two are required, they could be as much as 50% protected from the virus.

[Guinevere]

No operation this size is going to go off with perfect efficiency, and as I think everyone else has already said, if there is any oversupply of vaccine I'd rather see it go to people who want it and can get to the site promptly to receive it. As long as it's not slowing distribution or being hustled on the black market. A few people get it early? I don't care. Like BSG, to me it's not even remotely as irksome as the politicians who denigrated masks and shut-downs, and who assisted in Trump's downplaying the seriousness of the pandemic, now jumping in to get vaccinated first.

Let’s just call them out by name — little marco Rubio and Lindsay graham, at the top of the list.

As for the vaccine, if you’re going to give so on the first dose, then they should get the second dose as well. To do otherwise, is almost the same as just throwing it out. We need as many people vaccinated as possible. I’m sure there will be line jumpers; so long as the vast majority goes to those you should be getting it first, I’ll deal with it.

I have a bunch of friends who are nurses, most at big Boston hospitals. For the past week I’ve seen photographs of or reports of them getting their shots. I’m so happy about that - beyond well deserved and needed.

[Gob]

You’re an idiot on this Joe. Period.

Thank you for not turning our disagreement into a personal attack. That would be immature and hurt my feelings.

[ex-khobar Andy]

Curiously, and against all intuition, the Astra Zeneca vaccine seemed to be more effective if the second dose was at half strength. In one sense, and I haven't seen this reported, this gives me confidence that one dose is very effective.

One of the 'nice' features of COVID, from a vaccine development point of view, is that it's so prevalent. It makes running the statistics easier.

Think about it. If you are running a trial with 10,000 patients in the control (placebo) group and 10,000 in the vaccine group with a rare condition, you might get 10 positives in the placebo group and only 2 in the vaccine group. That would lead you to believe that the vaccine is 80% effective but there is a lot of uncertainty in that estimate and the results could well be random.

But if it's a relatively common condition, you might get 500 positives in the placebo group and 100 in the vaccinated group. It's the same 80% effectiveness but with much more confidence - or, to put it another way, a much tighter confidence interval.

So with the odd results from Astra Zeneca, the explanation is either that the dose-response relationship we have all relied on since the days of Paracelsus ("Sola dosis facit venenum") (for the benefit of non-lawyers and non-priests and sundry colonials, I'll translate that for you as "The dose makes the poison") is wrong or there is something haywire with the stats. I'm not inclined to toss out the response baby with the dosage bathwater, and I'm more likely to believe that the first dose is very effective by itself, and the numbers shown by the mal-administered second dose are due to the fact that there are just far fewer cases after one dose and hence much greater statistical uncertainty.

[BoSoxGal]

I’m stunned by the stupid arrogance on display in this thread.

[Gob]

No you're not, you're just milking your own feigned sense of moral outrage, and assumed vastly superior virtue. Milking it so badly the tits are bleeding, as per norm.

[BoSoxGal]

You’re right, I’m not really stunned. I’ve sadly grown far too accustomed to the arrogance and hostile sexism from you, Joe, dales and Meade when he’s in the mood.

As I mentioned in another thread, the best of this place died this year. New year upon us and new leaves to be turned.

[MajGenl.Meade]

Well I agree in part.

[dales]

You’re right, I’m not really stunned. I’ve sadly grown far too accustomed to the arrogance and hostile sexism from you, Joe, dales and Meade when he’s in the mood.

I'll try to be better for 2021.

This I find amusing (and sad) coming from someone who wishes the death of AW.

[Joe Guy]

I’m stunned by the stupid arrogance on display in this thread.

I haven't received the 120 years of education and experience that you have somehow managed to accumulate, but I am able to perceive the hysterical humor in your above statement.

[Gob]

That's professor BSG you're talking about!

In my personal experience as a student and professor, a lot of students avoid poetry because they are intimidated by it