Where is the vaccine bottleneck (revisited)?

Have you read about vaccine manufacturing?

https://www.usatoday.com/in-depth/news/health/2021/02/07/how-covid-vaccine-made-step-step-journey-pfizer-dose/4371693001/

^ Thanks!

So, the actual process takes time (months). It sounds like no amount of money thrown at this would speed it up, and we’re just in a waiting game. So, there really wasn’t any validity to the criticism of the previous administration.

My 73-year-old mother is still not even eligible to get the vaccine. I’m so disgusted.

Anyway, it would be very easy to post the actual data on vaccination so people weren’t completely scratching their head trying to figure out why nothing appears to be happening.

Christ, a simple Wordpress blog would be better than nothing. Does the Biden administration realize that we’re experiencing a global pandemic.?

Initially, it seemed like there was some growing pains in each state figuring out how to get it into people’s arms.

Honestly, I think a slow start is not a bad thing. I know it’s very frustrating, but these vaccines need a lot of care in the logistics. The deep freeze means every part of the change of hands is delicate. We needed to know states could handle it before shipping tens of millions of doses, or vaccine might have expired on shelves.

Furthermore, seeing how people react to the vaccine is important. I know 20,000 people more or less were given the vaccine, but that’s only a few thousand in each age category, and only so many people who have certain underlying conditions or on particular medications. People in trials tend to be relatively healthy. What if we found out 20% of people taking the drug Prozac have severe reactions during the first month that it was being given to a broad part of the population? That would be important information possibly not observed during the phase 3 testing.

Now, the powers at be feel really good about Moderna and Pfizer, Biden has put in an order for more, and the distribution seems to be ramping up.

Also, keep in mind for Pfizer, the first three weeks were first doses. Starting the fourth week you need double the shots going into arms to have the same amount of first shots going into arms. Right around the 4–5 weeks in Governors became wary about shipments flowing, they were not getting what they expected. Some states stopped giving first shots, or slowed it down significantly. The story is the same for Moderna, but on a four week schedule.

My state there are several different ways to get a vaccination now, but you need to log into several different sites to try to make an appointment. Each supermarket has their own website. You can also do first come first serve in some counties, which initially was bad news, but now seems to be working well.

The biggest problem is everyone wants it now. Well, that’s impossible.

There should be some late night locations, I agree with you. I don’t know if 24 hours is realistic, but I do think people will go at all hours to get vaccinated.

Your 73 year old mother isn’t eligible because that’s what your state decided. In Florida it is 65 and up, but it was a massive amount of people trying to get the vaccine at once. I’m not sure which is better.

I created a covid Facebook group for my city and people are helping each other with tips. It’s been very successful. Some members who are good on the computer make appointments for other members and their neighbors. People at first come first serve locations post while they are on line to tell the group how long the wait is. You can join if you want and scan what people post. You can leave it whenever you want if you get bored. Maybe create one for where your mom lives.

@Cupcake Thanks for the excellent article!

The thing I don’t understand is why we aren’t building dozens/hundreds of new vaccine manufacturing facilities—or temporarily converting other facilities (Breweries? facilities for other pharma products) to pump this stuff out until we can get the shots into the arms of the global population. Why isn’t this being treated like a WW2-level existential threat? Every day this pandemic continues there is a greater chance of a mutation that could nullify the effectiveness of the vaccine.

@gorillapaws Sterile facilities are required and not every brew master is capable of mRNA production.

It is not like making Twinkies or Devil Dogs.

@Tropical_Willie I’m not advocating that brewers produce the vaccines, they would be run by experts. I’m saying breweries have huge, sterile vats, quality-control, refrigeration and distribution facilities and might be candidates for production. Maybe Breweries wouldn’t work, but surely they could be getting creative, repurposing facilities for other pharma production, etc.

I got my vaccination this week but it wasn’t easy. Each state is different and they seem to expect you to know where the information is. Also the web sites don’t work well (at least here in California).I still don’t know the rules on who can and who can’t get the shots. From my perspective, they simply don’t publish any information on how to get in line for these shots.

Tom, vaccine supply is increasing rapidly. I had lunch with my local county health officer today and he agrees with Fauci in that he thinks that everybody will be able to get at least their first vaccine by early April. I can’t remember what state you live in, but in California it’s going to be open up to high risk people by March.

And the new J&J vaccine is probably going to be approved next week which will increase supply more rapidly, and it has the advantage of being one shot, not two.

In terms of the Trump administration, yes, they can be criticized. Pfizer offered them a million extra doses but the Trump administration refused to pay for them, so it went to other countries. The Department of H&H services ended up reversing that and requesting it, but it was already taken by then, so we had to go to the back of the line.

And I’ll just add that the fact that we have a vaccine at all is just stunning. A year ago we were just starting to really talk about Covid. Now we are arguing about who will get a vaccine that is practically 100% effective. This is an absolute triumph of science, engineering, ingenuity, and infrastructure. Trump notwithstanding.

I don’t mind waiting my turn, but I just turned 78 and there’s still no appointment for me, yet they keep adding more and more people to the “eligible” list, without vaccinating those already on the list. I don’t understand that.

As a little aside, @hello321, it’s just kind of obnoxious to assume that “...people don’t really give a shit…” because they don’t flock to your question.

@Caravanfan – Thanks.

Yes, I’m well aware that this is all way faster than a vaccine has ever been developed. It’s amazing. However, I can’t help but feel that there is a lack of readily available info – at least here in Massachusetts. We’re apparently 46th in the country by vaccination rates.

I’d expect some kind of national approach to something that is a larger threat than any war that has ever been fought. And by “approach”, I mean some kind of strategy for communicating the actual data to the public about where the bottleneck is.

The answer to my question is apparently contained in the @Cupcake link. There is no amount of money that can be thrown at this problem that will speed up the process. So, I guess the question has been answered.

@canidmajor – We’re going this way again? Are you as frustrated and depressed as I am? If so, I’ll understand.

@Caravanfan Didn’t Trump get the offer to buy more vaccine before it was approved? That seems like a hard call. He had already put money towards several vaccines I think, banking on at least one to get approved. Even if Pfizer looked really good already we didn’t know for sure how well it would do once out in the greater population.

@ALL Here is an article about how a web designer helped combine all the various websites to one website for New York to make it easier. I think the federal government should put him on the payroll to make a single website for the country. https://www.nytimes.com/2021/02/09/nyregion/vaccine-website-appointment-nyc.html?smid=fb-nytimes&smtyp=cur&fbclid=IwAR1HzJNQM06l-k6mws4VXJ7ecCPQlYSwj3yC0NsWfOwG-9lP2-XbZ-6uzbU

@hello321 You’re correct. It’s a product of the system we live in. The Federal government obviously felt that the priority was to distribute the vaccine and then allow the more local governments decide who gets what when, feeling that it’s more efficient. Maybe it is, maybe it isn’t. My opinion is that once you mix politics with science things get screwed up. (For example, in Oregon, things are stalled because certain interest groups are rallying hard for their members to get vaccinated before others)

@JLeslie It was clear that Pfizer was going to be approved anyway—it was just a matter of when. They should have thought ahead.

We are not 1.5 months into the new administration. President Biden was inaugurated on January 20th. That was 24 days ago, 3½ weeks.

And according to what I read, Trump administration officials would not tell Biden’s incoming people what the covid vaccine distribution plan was. They were left to find out for themselves that there simply was no plan.

Ever been on a project team at work, with, say, eight or ten people working on some kind of “deliverable”? How far did you get in 3½ weeks? Typical teams that I was on had trouble even defining the problem in that amount of time.

@canidmajor, I emphatically agree.

^ Got it. Thanks.

@Jeruba I read the same. There was planning to be able to distribute to the states: the states knew they needed deep freeze freezers and to select central locations in the state. Fedex was ready to move the vaccine, including procedures at their hub for doing it at the temperatures and time necessary. It wasn’t that nothing was done (and my news wants to truly make it sound like NOTHING was done) but the planning seemed to stop there, which was inadequate and incomplete.

There seemed to be no one in charge of reordering vaccine if it went well in the first week. Even if people think more should have been ordered before the approval, which I think can be seen from two sides, once going well in the general population it should definitely have been ordered then.

The distribution within the states was left up to the states.

The states were practicing running vaccine centers before the vaccine arrived under advice from the fed. Maybe not all states did this.

The CDC while under the Trump administration gave recommendation on who should get the vaccine first.

Do the last two count as Trump planning? I don’t know. When the CDC did things we didn’t like under Trump we held Trump responsible.

By the time Trump left office, we were vaccinating almost a million people a day, “a day Louie, a day” (I wonder how many will get that reference). Obviously there was some planning. If you expect a government run program to go flawlessly, you are naive. The distribution is extremely complex given the different storage and transportation requirements, the unknown certification of which would pass first, and the different dosages. I think they did a phenomenal job. Some States seem to be handling all this very well. Others, not so much. If the s States will just tell us the rules, it will go a long ways to reducing the tension.

@Jaxk: “If the s States will just tell us the rules, it will go a long ways to reducing the tension.”

Communication is the element missing from all of this. The atmosphere here in MA is approaching panic. Some communication would go a long way in calming this down. People are hurting.

@hello321 Even if we make it a given the fed could have done better, I’m just curious, do you hold your state responsible at all for not organizing and communicating well? The states had time to prepare.

^ Of course. People are furious with the governor.

@JLeslie: “The states had time to prepare.”

Yes. And it shouldn’t be up to the states.

Additionally, the more snarky answers here have confirmed what I suspected about privilege and apathy among a certain population. People don’t seem to give a shit that things are as bad as they are. They have other things to focus on, and feel that people shouldn’t even ask if something else can be done.

They have revealed how interaction should move forward on this site. I’m glad I now know. I’ll proceed accordingly.

@hello321 I’m just curious, how would you have designed it?

We do not have a socialized medical system. Not all available pharmacies or supermarkets with pharmacies are national chains.

Work still would have had to be done at local levels to make sure everything was thought through, and even so local actions would need to be taken to tweak distribution.

States likely would not have had flexibility to decide who who gets vaccine first, that might be good or bad. Mind you the CDC has already changed their parameters on that, maybe they would have anyway.

What big changes has Biden made that have improved things besides ordering more vaccine? I do think Trump screwed up not doing a follow up order of vaccine. I don’t think he cared once he lost the election.

Would you have put it all in the hands of DoD maybe?

@hello321, are you under the impression that the few users on this site are somehow representative of the general population and that they also have a civic obligation to answer any particular question?

Your question asks for factual information. Believe it or not, some people don’t answer those questions when they don’t know the answer. They don’t just pile on with opinions in place of facts. And they avoid nuisance answers like “I have no idea” because they aren’t helpful.

@hello321 I guess it hasn’t yet occurred to you that people may indeed give lots of shits, but don’t have helpful or pertinent information to give, and your Q is pretty specific about asking for data.

People have been pretty forthcoming on this thread, where is your data?

The shit I have given doesn’t include satisfying your curiosity. It includes contacting my representatives and stuff. If I though that I had information that anyone here would find useful I would post it.

I get your frustration, but bashing the people you are asking for help and information is counterproductive.

@JLeslie: “I’m just curious, how would you have designed it?”

I don’t know. I’m not a scientist and want to know where the bottleneck is.

But it seems that if a population is being bombed, we’d act as though we were. We’d have some expectations regarding communication so that there isn’t panic.

@canidmajor – I didn’t bash you. I repeat, I didn’t bash you. So, I was a bit confused at your response…until I realized that I had mentioned Biden and you likely took offense to that. I have been very consciously avoiding being critical of the current administration. But your response shows that it was for nothing.

I’m happy you’re not surrounded by death, depression, frustration, fear, and economic despair. Try to keep in mind that you’re probably in the minority.

Anyway, I’m glad you made it clear where you stand and how I should proceed. Kind of a bummer, but at least you were honest.

If you are on Facebook I encourage you to join my COVID page even just for a day, just scroll through the many posts. I won’t know who you are if anonymity is a concern. Half the people have their home town on Facebook as out of state because this is Florida, and a huge percentage of people live in two places. It has been very helpful and might help your local area creating something like it. The only people we reject are brand new Facebook pages that could be trolls. https://www.facebook.com/groups/295484614867730/

Because of my Facebook page I have a real handle on vaccines available in my area. I also was a buyer for a department store and an account executive in my career so I know what statistics are important to influence distribution. I don’t know if I actually affected anything, but we had zero vaccine in the Publix stores in one of the counties where I live, and a week after I wrote the supermarket chain, we finally have vaccines in our local stores. They did respond to me immediately when I wrote them. It was just a paragraph full of the relevant statistics. Also, my local commissioner is in the Facebook group and has been very helpful.

Some members are making 20 appointments a day for other people. Older citizens are having trouble maneuvering around the websites. Today an outside location was rained out. Immediately people helped share information about the new location it was moved to.

Because of my buying experience I know that no matter how efficient a centralized system is, things at local levels do get missed and overlooked. Like I think my state distributed vaccine by population size in a county, rather than eligible population size. That’s where my math came in.

Also, the volunteer medical care in your local area might be looking for people. We have a lot of retired medical professionals here, and they are helping with vaccinations. Here is the national link. https://mrc.hhs.gov/HomePage but where I live each county has their own page on the county department of health website.

I do think someone should be overseeing it all at the federal level, but have no doubt it would still be imperfect. I do agree communication is one of the biggest parts of the frustration for people.

^ Thanks!

Here in MA, we have people posting Craigslist ads offering $ to bring 75+ people to their covid appointments because if you accompany someone, you can get a shot. People at work are trying to find people who are 75+ just to have access to the vaccination. It’s the wild west here. Crazy shit is going down. People who are 75+ are getting multiple, competing offers ($$$).

I know a couple where the woman is 76 and her husband won’t be 75 until August. They made the mistake of having her daughter drive her to get the appointment, and now they’re trying to find a 75+ neighbor who he can drive.

Anyway, I’m sorry for being depressed and anxious right now. I’m on the phone with crying, desperate relatives and friends throughout the week, and I can hardly keep it together myself. It’s not a good scene. The general mood around here is one of the apocalyptic doom without any hope. It could be just hitting everyone all at the same time due to fatigue and lack of knowledge of timeframes and how this will proceed. But everyone I meet is asking the same question: “where is the bottleneck?”.

Take care all.

@hello321 Holy crap! That whole escort older citizens for dollars is crazy. You mean a 40 year old can get vaccinated if they bring an 80 year old?

I encourage you to write local leaders. That’s another thing several in my Facebook group were doing. Local leaders and the governor. Don’t be angry, be specific and possibly give alternate ideas if you have productive and realistic ones.

If you see something in my Facebook group that might be helpful you can relay that to your state and local leaders also.

People need to be more patient while being proactive. I hate to say that, because if God forbid a 75 year old catches COVID and dies while being patient then that’s obviously a tragedy; I realize the risks. I have no choice but to be patient because I’m not eligible yet.

Leaving the states to figure it out for themselves instead of coordinating nationally, while denying them funds to do it and encouraging mayhem around various governors’ actions, was typical Trump administration b.s.

What if Trump had put someone in charge who made bad decisions? Then the entire nation might be as bad as the worst state. We want the fed to be better when we had no confidence in the person in charge. There is some irony there. Think about USPS and how so many Democrats lost confidence when Trump put a new person in charge. Education. FEMA.

The states have no excuse in my opinion. The states know their population best, they have health departments, can hire logistics experts if they don’t have them, and can coordinate with neighboring states if they want to and coordinate with private business.

The states should have figured out their own plans. However, a coordinated national response would have required that states submit their plans. The federal government could have identified states with strong plans and shared them as potential best practices. The federal government could have also made minimum requirements, such as a need to address vulnerable populations (age 65+, political representatives, teachers, etc.) within each state-level plan. Irrespective of the vaccine timeline, the states should have each been required to plan, with means for sharing innovative storage, transportation and delivery strategies (facilitated by the federal government)... WELL before the first vaccine was approved.

This all should have been managed from the Trump administration. By the time Biden took over, the states were far past planning (well, should have been) and were in early implementation. I just don’t see how we can blame Biden for this.

Honestly, this is just a public health response. Have the CDC take charge and demand detailed plans from state departments of health, if you want. Those specifics don’t really matter – but someone with federal authority needed to put the wheels in motion, so to speak. And it needed to happen long ago.

MA sounds like a mess. I’m so sorry.

@Cupcake Good point about making states submit plans. I wonder if anything like that was done. That’s a really good exercise to get the wheels in motion.

One problem in Florida was the state didn’t require the counties to submit plans. That also would have been right in line with your idea. Seriously, that’s such a good exercise.

There were reports of counties in FL having no idea they had to plan anything. Sumter county here where I live was woefully inadequate initially. They did nothing for weeks. Everyone living in Sumter was going to neighboring counties to get vaccinated. Sumter! 58% of the population over 65 — 70,000 people over 65 —- and initially given 2,000 vaccines. It was a huge oversight and that’s why DeSantis has been here twice trying smooth things over. I wonder if the fed would have caught that mistake? Possibly, if the person in charge was really good. Sumter County currently has 1 in every 616 residents who have died from covid.

Regarding 65 and older, the federal government initially did not make them a priority. Worse, when TX and FL did the Democrats went crazy talk insane criticizing it on TV and even articles on respected periodicals and jellies went right along lockstep in hating on our governor. People don’t seem to be able to escape the messages that are propagated along political lines. https://www.fluther.com/224595/what-do-you-think-about-florida-gov-desantis-going-against-the/ When some more moderate news stations actually interviewed the experts they were more split on who should get vaccinated first and many experts basically said it’s a hard decision and people should not be so judgmental.

I like your idea, because it still allows for state autonomy, but also a second pair of eyes and the possibility of coordinating best practices across the states.

From what I understand the governors do meet once a week, I wonder if it’s hard for them to reverse course in states now that things are already in motion.

Conclusion: nothing would have been perfect.

I just saw on Solidad O’Brien’s Sunday show that Massachusetts is creating a website to centralize where appointments are available.

My sister won’t be able to get the vaccine until after every able-bodied, healthy person gets it (sometime next fall?). She has had reactions to vaccines and experienced anaphylaxis during vaccines. That and everything else she’s dealing with had her immunologist set to give her the vaccine in her office. Now that all vaccines in MA will go through mass vaccination sites, anyone with disabilities or that can’t go to the mall to get vaccinated will not be able to get vaccinated.

Tom, I’m sure you’ve gone through this?
https://www.mass.gov/covid-19-vaccine

^ Yep. My sister’s immunologist and team of doctors have been scrambling to try to find a solution, but are warning her that it might be months before vaccines are allowed into hospitals and doctors offices (where she needs to get it administered). The governor declared that all vaccines will be now be administered at mass sites (like a football stadium, a mall, etc). They had a plan, and now it’s gone.

The site was down much of the morning, and the availability once it came up is very limited. The closest available vaccine right now is 2+ hours away at a mall.

I’m done. Seriously. I guess I was just updating the thread, but I can’t keep talking about it. I’m emotionally spent and don’t know how I’m supposed to proceed. I’m surrounded my misery and I am struggling to keep it together myself. Kids (not mine) are going on all kinds of meds, they’re suicidal, my small extended family is isolated and have lost all hope of getting vaccinated. My friends have lost their jobs.

Local psychologists are still raising flags about the effects on children, and we’re still not vaccinating teachers. I don’t understand any of this. Whatever I could have expected the response to be – nationally and from the state – this is not it. People are just acting as though everything’s fine.

Oh well. I need to go watch something extremely silly to get my mind off this shit. There’s nothing I can do.

^^My bet is it will change again.

@hello321 I’m so sorry Tom that you’re going through this. I don’t understand why it’s so hard.

Did your mom get at least a first dose yet? Most of my friends in your state have been lamenting that it is not doing a great job rolling it out, but I hope by now they are sorting it out. I hope your sister is eligible as well.
I know this doesn’t have the specific data that will help you determine delays, but I have found it somewhat comforting to see that stuff is actually happening. I am fortunate to live in a place where they are handling it more efficiently, but I realize that it is hard for so many to have reasonable access.
https://usafacts.org/visualizations/covid-vaccine-tracker-states/?utm_source=Facebook&utm_medium=Paid&utm_campaign=COVID&utm_content=Vaccinations&fbclid=IwAR3heNOBArn8nYTxVaml4ovZel5e9La6cVHYChl1iNeaJUUIsHp2LdPJx0c_aem_AczZmiZQBI33r3odJmM7HspsQWoD6uIIKQbFXu4SsamKfXIxnBzCMokk7qjjjrADFMRvEn8WvxBBEqvZe2poXBJTReM5oMH_wzjzC6gAZncQrg#CT

I hope this gets better for your family.