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if they don’t get the 2nd jab in 12 weeks the vaccine isn’t effective
It might be a bit less effective, it might be a lot less effective... it's a gamble. The figures for number of people vaccinated look great though, don't they?
How are vaccinations given in care homes? Do the vaccinators have to change PPE completely between patients?
We have done our largest care home last week. Can stay in same ppe if staying in same room for each vaccination- like at a vaccine site.
Fresh ppe required if we have to go to patient’s room because they can’t be brought to us (ie bed bound)
There’s lots of reasons why the rollout is patchy.
vaccune supply isn’t fixed and you only get a few days notice, once this become more routine, I’d imagine it’ll make planning a bit easier.
Most vaccine sites are being manned by GP staff as volunteers, as a PM I still need to make sure my practice can still function, so I can only release staff when I’m sure that will happen. So while in theory a vaccine site may have the capacity to vaccinate 8 people at a time, it may only have enough staff for 5...
the IT we’re using is unfamiliar and not very stable, I don’t think it was designed with this in mind, so when we book in folk to be contacted, it often misses people, so we have to go through the list and call folk manually. Also it’s built around booking your appt online and lots of oldies don’t have phones that can do this.
As groups of practices are sharing vaccine and facilities we’ve had to make sure all pats get a go at the vaccine, so I can only invite small groups of the cohorts at a time, I cant send out an invite to all my <75’s, so as mentioned if you have a surname at the end of the alphabet, apologies.
it’s clear that the communications to pats has been sketchy, out pats are being invited to both our sites and the mass vaccine sites (the later is organised* centrally and has nothing to do with local GPs or PCN )
* in the loosest sense of the word.
it’ll settle down once we get into our stride. At the moment my only really worry is the housebound elderly, they’re vulnerable and we don’t have a good way of getting vaccine to them.
The figures for number of people vaccinated look great though, don’t they?
I'll be the first in line to criticize the govt, but in this case, I agree with their planning, it's clearly better for more people to have "some" protection than for a smaller group to have "full" protection.
East Devon is patchy as well. My 92 year old neighbour still too old while her friend 80 has been vaccinated. The friend phoned on spec and was told there was space at the end of the day so got vaccinated.
They have positioned the vaccination centre in Exmouth which is the bottom left hand corner of the area that runs up to Honiton. You have to make your own way to a carpark in Exmouth then get on a bus and be transported to the tennis courts acting as the vaccination centre.
All GP practices have sent staff over there so are now running a reduced service.
I’ll be the first in line to criticize the govt, but in this case, I agree with their planning, it’s clearly better for more people to have “some” protection than for a smaller group to have “full” protection.
Aye, it's easy too to look at ScotGov up here being slower cos they're doing all the care homes and get all morally righteous over the undoubted tactic from westminster for the numbers to look good, but I'm trying to keep a lid on it, mainly cos I don't think rattling through as many people as possible is a bad thing.
Unless we get proof that 1 jab doesn't do as much as was thought.
it’s clearly better for more people to have “some” protection than for a smaller group to have “full” protection
If you could quantify the difference between "some" and "full"... in the medium term... then I might agree. It feels like a hunch at the moment. One I hope we don't regret going into next winter.
Yeah it’s a hunch, but TBH, lots of stuff we do (in GP practices) is. Not everything can be nailed down as tightly with evidence as we’d probably like.
My mum hadn’t been done yet,some of her friends were done over the weekend – it’s being done alphabetically and we’ve got s late in the alphabet surname.
Balls, too late to change to Aaron A. Aaronson by deed poll? I'll be in October if not.
Thanks for the replies regarding the 2nd jab timescales.
Glad I don't have to make the call between greater coverage of lower strength vs lower coverage of higher strength. I'd like to think someone's looked at the figures and worked out which is best, but I'll don my dad's sceptic hat and say I suspect a bigger number of 1st jabs looks better in headlines so they've opted for that.
If we have a time lag of 12 weeks, then surely this puts other age groups back further in the queue, because everyone will have to have a first vaccination, but the first set of age groups will still be coming round for their second.
Will more people be trained to apply the vaccination and more centres open?
TJ - if I were you I would take the vaccination. I feel it's as important for NHS staff to get this as the elderly -imo.
TJ – if I were you I would take the vaccination. I feel it’s as important for NHS staff to get this as the elderly -imo.
Agree with this. My partner gets her first jab today it's a comfort for the both of us to know she will have some sort of protection when shes meeting people from the community.
TJ – if I were you I would take the vaccination. I feel it’s as important for NHS staff to get this as the elderly -imo.
So say we all.
Sandwich Jr had his first jab last Thursday. Lateral Flow and PCR positive over the weekend! Now isolating again along with the rest of his household.
Just call him "Lucky".
just got back from a ride, and happened to pass a funeral, mourners might as well been holding hands they were so huddle together and not one mask between them.
My folks are having their first jabs Wednesday, and booked in for second jabs in April. In-laws in Sussex heard nothing yet.
I'm not personally too surprised or concerned at the delivery being patchy - it's a numbers game while supply and delivery are being worked through. Expecting the whole country to be done neatly in the same age groups at the same time seems unlikely.
Seem to be hitting the biggest population centres first and figuring out how to do the more rural areas after. Assuming that the rural areas probably have lower infection rates/risk, I'm not too surprised.
Anyone in pharma development able to explain how they determine the appropriate dosing interval. From what I've seen Pfizer have been at 21 days since the start, so how do they know that's the optimal time before the trial starts - or do they just pick a value and stick with it to make the whole trial more streamlined? Oxford on the other hand seem to have had all sorts of intervals in their trial, but relatively small samples at each interval which again makes robust analysis more challenging but the BMJ's view seemed to be that >6w interval was more effective than <6w, yet I think it was still proposed at 21d before the policy change?
Impressed with the chap who got his request for the Organist to play Jesu, Joy of Man's desiring while being jabbed in Salisbury Cathedral. Personally, as there was no choir, I would have gone for Organ Sonata No.4.
Ok I have booked my jab . Fretting already - i am a bit needle phobic 🙂
do they just pick a value and stick with it to make the whole trial more streamlined
I'm not in Pharma, I'm a doctor, but I have some experience with this. When they are designing clinical trials, they need to make these sorts of decisions up front. They will have preliminary information from phase 0-3 trials about vaccine response times, but often it'll be a consensus of experts. I.e. they will know from previous experience what timing is likely to work. It's the same for drug storage, dosing, dose scheduling etc. They'll do their homework and estimate the best set of parameters for the trial.
Then, in general, doctors will use the medication as it was tested in the trial. Almost without exception we will use medication (especially new medication) in the same populations at the same doses/frequencies etc. That's what why it's so weird that some people are talking about giving single doses (only). Not because it doesn't make scientific sense (maybe it does, I am not an immunologist) but because it's outwith the clinical trial data.
The Oxford trial is interesting because, as you say, they've clearly designed the trial to allow more flexible use of the drug in terms of storage and dose intervals. This is tremendously useful when it comes to prescribing, since we can use the medication more broadly. However, the downfall with this type of design is when people try and infer conclusions from non prespecified subgroups, which is what some did with the (erroneous) dosing regime thing.
i am a bit needle phobic
The irony !!!
Apparently my Covid secure workplace is having close for a week. Maybe it wasn't quite so Covid secure!
happened to pass a funeral, mourners might as well been holding hands they were so huddle together and not one mask between them.
God forbid people might need some comforting whilst burying a loved one.
Covid secure
Is the worst ever phrase, even worse than "social distancing" in this whole pandemic.
It lends a security and strength to something that is so weak, un-obtainable and transient.
do they just pick a value and stick with it to make the whole trial more streamlined
Decisions are made very early about a dose range to be tested (I do this all the time). What you do in the first in human trials will fix the path ahead. For drugs, it's relatively simple because the body handles these foreign chemicals and proteins in predictable ways. medicines will typically be dosed every half-life to give a little accumulation that allows some robustness (e.g. you miss one dose). Short half-life means frequent dosing (paracetamol). Long half-life, or a long-lasting effect (proton pump inhibitors) means daily or occasionally less. Antibodies are weekly to monthly as they have a half-life of three weeks normally.
Vaccines are different. Here one has to look at the immunogenicity - what did the immune system produce after dosing? How long did it take? What happens if I hit it again too soon? Some of this is done in animal toxicology experiments. Then you do the trial. You escalate the dose and test different intervals. And make a clinical judgement. Then it is into Phase 3, 30k trials at a single dosing regimen (that's dose and frequency).
For the mRNA vaccines, they probably work about the same - it's the same material packaged in about the same lipids and PEG nanoparticles, the interval difference is just that clinical judgement. Perhaps someone at Moderna decided that the adverse events at higher doses were worth a little longer before a second dose.
It's science. But science is not certain.
What is certain is how pharma can promote the medicine. ONLY as it was tested against the label. @superficial can do whatever he/she wants, but assumes liability. Pharma can only promote based on what was tested. So it's 21 and 28 days. No if's and no buts!
Personally, as there was no choir, I would have gone for Organ Sonata No.4.
The Shining version of Dies Irae would be my personal choice, or maybe this, if the organist was up for it.
Covid secure
Is the worst ever phrase, even worse than “social distancing” in this whole pandemic.
It lends a security and strength to something that is so weak, un-obtainable and transient.
Very well put!
Ok I have booked my jab . Fretting already – i am a bit needle phobic 🙂
It’s ok, you’ll just feel a bit of a prick...
I’ll get my coat.
Ok I have booked my jab
Fake Scotsman strikes again. It's a jaG
Lol! Agreed!
Is the worst ever phrase, even worse than “social distancing” in this whole pandemic.
"World-beating" has to be the worst, surely? Everything that has been tarnished by this phrase has demonstrably not been. When they start rolling out for vaccine delivery, then we are sunk.
At least everyone sees straight through "world beating" and "moonshot".
Things like "Covid secure" and "social distancing" have pervaded everywhere and set an expectation that's just inapropriate.
I would prefer "physical distancing" and "Covid careful".
So a moral (and arguably fact gathering question).....(to check my moral compass)
What is your understanding of the reason that staff as well as residents are included in group 1 ( Residents in a care home for older adults and staff working in care homes for older adults) of the vaccine roll out?
1. To help prevent them bringing covid into the home?
2. To give them an additional layer of personal protection?
3. to reduce sickness in a key sector?
And bonus question - how far from a direct resident facing role should the vaccine be offered for someone working in the 'industry' in your opinion?
ta
No facts but my opinions are:
a) for all three reasons
b) resident-facing only except at the end of the day if there's some going spare in which case it should be given to anyone who can roll their sleeve up.
except at the end of the day if there’s some going spare in which case it should be given to anyone who can roll their sleeve up.
I think it is fair to say there has been some mission creep.
The Shining version of Dies Irae would be my personal choice, or maybe this, if the organist was up for it.
Hmm, I thought something uplifting would be better than something to remind those queuing of their mortality.
What is your understanding of the reason that staff as well as residents are included in group 1
A reasonable expectation of a reduction in transmission. Especially if they are bank staff who move between homes. A PHE study found that homes with such bank staff were six times more likely to have a COVID outbreak than those without.
That's a massive effect, so worth the vaccination of a relatively small number of people.
Plus the personal protection from severity of infection, should they become infected.
A reasonable expectation of a reduction in transmission. Especially if they are bank staff who move between homes. A PHE study found that homes with such bank staff were six times more likely to have a COVID outbreak than those without.
That’s a massive effect, so worth the vaccination of a relatively small number of people.
Plus the personal protection from severity of infection, should they become infected.
So not the accounts department of a chain of care homes who normally work in head office 20 miles from the nearest resident currently working from home then? Just checking 😉
Company reason in this case - because 3
This is a scary statistic.
https://www.independent.co.uk/news/health/uk-covid-death-rate-coronavirus-b1788817.html
I fully expect plenty of finger pointing headlines over the next couple of weeks about people/companies considered to have ‘jumped the queue’.
All care home staff should be vaccinated, to keep them running… to say it’s been a hard year for all those in the sector, trying to keep people cared for and as safe as possible, is an understatement. Yes, that includes administrators. Same goes for hospitals.
tjagain
Full Member
Ok I have booked my jab . Fretting already – i am a bit needle phobic
Can you video it?😁
I had to thread my way through a funeral party who were blocking the road last week. I did feel slightly awkward - I was wearing this 
All care home staff should be vaccinated, to keep them running… to say it’s been a hard year for all those in the sector, trying to keep people cared for and as safe as possible, is an understatement. Yes, that includes administrators. Same goes for hospitals.
The lad is a care-home nurse, they are vaccinating everyone as everyone on the management side can be required to fill-in if the nursing staff are laid low (many are promoted nurses). As the management move in admin circles it makes sense to ensure none of those staff can be a vector in either direction.
Just checkin
A caveat is that any dose left over should go into the nearest unvaccinated arm. No quibbles.