Covid-19 Vaccinations in the United States | Hacker News Reader

Covid-19 Vaccinations in the United States

covid.cdc.gov

39 pointsystad80 comments

Is anyone else totally unclear about how exactly you are supposed to sign up or be placed in a waiting line for the vaccine?

I'm not too concerned about myself, but say, my parents? Who is keeping the order of the queue or adding people to it in a way that you know when you're supposed to expect to get the vaccine?

Is it just up to your personal doctor? A local hospital? The county? Who is keeping the list? Who do you ask to be added?

Maybe I'm not a key/critical category person so I am not in the target group, but aside from the high level CDC guidance on who should get it, there seems to be a vast chasm of lack of information / authority connecting to the individual person to know how to take action to receive the vaccine.

But again, maybe I'm missing something. It seems like a total chaos fest, muddling / random walking our way through the crisis. I guess the same theme as the entire handling of the situation in the US. God forbid we have some centralized authoritative list of who is who, and who does what, to know when someone should get the vaccine.

But I guess when 0% are vaccinated, anything even half-assed is useful.

There’s pilots you can sign up for, eg for SF https://wecanbeatcovid.org/

Pre-screening questions and then they’ll call you if they’re interested. Roommate got a call within a week, but another three of us haven’t heard back. Probably depends somewhat on diversity. My guess is that your best shot is applying as soon as one of these studies open up registration. FIFO.

There is an extremely large difference between taking an approved (with emergency authorization) vaccine and joining a research study where you could be getting a different vaccine at earlier stages of approval or potentially a placebo.

Joining a research study is great and helps push the science forward with other vaccines or whatever the researchers are studying, but it is not at all the same thing as scheduling when you are going to be getting an approved vaccine.

At this point I believe it's just frontline health workers and elderly individuals in assisted living facilities. In those situations eligible people are being notified by their applicable institutions (employer, etc.) to schedule their first dose. I'm not sure what the process will look like once things get more broad (over 65, etc.), but I suspect it will be well publicized.

We will rapidly be past that group though as it's a very small percentage of the county. When each county is making their own rules it's going to get hectic quick.

My PCP is at a large local hospital chain, and I recently got an e-mail from them saying that they would notify people as soon as they met the eligibility criteria.

At least here, large multi-state hospital systems are expected to get shipments directly from the feds, and the state will be coordinating distribution to smaller providers.

https://www.doh.wa.gov/Emergencies/COVID19/Vaccine (See "How will vaccine distribution work?")

Thanks for that example info.

In every state/county website I have looked at, it has somewhat comprehensive information for the distributors of the vaccine. But nothing for the consumers. It is all from the logistics point of view -- down to the distribution point of "hospitals are going to get it". After that, nothing. Total absence of information.

Unanswered is the major (but simple) question of, "how do you apply/request to get the vaccine?"

No answers on that front. For 330M people waiting to find out how. It's kind of an embarrassment.

Edit: I acknowledge we're in an unprecedented time with a vaccine developed at unprecedented speed. But I have a feeling this is not going being managed well. We had months of warning that a vaccine was coming. And months more until the general population's turn is ready -- and I bet we still won't have good information.

Why does it need to be any more complicated than a flu shot? You can get those on demand at most pharmacies, urgent care clinics, even many employers set up dates/times for it on-site.

OK there's some special cold-storage needed, and you need two doses, so maybe it will be a little more complicated, but in practice I'm expecting that we'll get to a point where you just walk in to a local vaccination provider and get the shot.

That's like comparing a UN food drop in a war zone without any food and going grocery shopping.

I think you'll cover the people who are clamoring for it pretty quickly. Everyone else will just wait for it to become generally available. I've already had COVID, as has my household, so I'm not in any rush to get vaccinated. Neither are most of the people I know (sample size < 10).

I think you underestimate the demand. Your sample size is small and contains an abnormally large percentage of people that have already had covid so that will skew things.

I haven't had covid and would like to get vaccinated as soon as I can. Many, but not all, people I know feel the same way.

that's exactly what's planned. cvs already has a page up.

https://cvshealth.com/covid-19/vaccine-information

"In 2021, COVID-19 vaccines will be in all our stores

We’re following federal and state guidelines that prioritize vulnerable populations, including those at long-term care facilities, to be among the first to receive the COVID-19 vaccine.

Once vaccines are available to the general public, anticipated to be in early 2021, we will begin offering them in our nearly 10,000 CVS Pharmacy locations nationwide. We expect to be able to administer as many as 20-25 million shots per month.

When that time comes, booking an appointment for your vaccination will be simple and seamless. The same digital experience that we created for COVID-19 testing and flu vaccinations will be available to schedule COVID-19 vaccinations, so that you can easily book an appointment and, depending on the vaccine type, the required booster dose as well."

I don’t think you can just proactively request one, but that providers will notify you as soon as you are eligible and they have it available.

My PCP and the hospital they’re at already knows my date of birth and my medical history. I haven’t been told I can get it yet because, well, I can’t get it yet.

I got an e-mail from a grocery chain saying they will be offering the COVID vaccine. No additional details on how to sign up or anything. The communication had a 'more info is coming' vibe to it.

Phase 1a, basically health care workers and nursing home patients, is some 24M people. At time of writing less than 10% have received even their first shot, so at current rates it's going to take quite some time to vaccinate them all.

Same questions here, Especially for those not well connected to a hospital or a part of a congregate living institution. How does an essential worker that works retail for example get their dose? Are the companies like Walmart going to coordinate it? How does a 70 year old that lives in their own home get theirs? Their gemeral provider?

It's up to each state. My state has their vaccination plan up on the state department of health website.

A general plan is one thing (categories of people, in what order, etc). We all know roughly what that order is, I think. Where is the list of actual people and names being kept? How do you know when it will be your turn? Where do you sign up?

My close friend is a firefighter/paramedic and was told by his chief "to call this number as quickly as possible" to get on the early vaccination list. He did and was given the first dose last week. It became a race for those even most eligible.

For the rest of us, it's a bit of crap shoot depending on where you live. Some counties in our state have created sites where you can enter in your information so that when you're eligible, you'll be notified. For those of us not in those counties, we're hoping similar systems, because the alternative is very messy and will almost certainly add to the body count.

Looking on from canada, /me jelly.

I know we'll get there too and i just have to be patient. I just really want covid to be over with already.

Is it my US-centric news, or are the vaccines really getting distributed to the US much faster than other countries. I know one was approved in the UK recently, and Germany hasn't been happy that a vaccine they helped develop hasn't gotten approval there, yet. There is the Russian vaccine, but I haven't seen any peer-reviewed results.

The Biontech vaccine has actually been approved and distributed in the EU a couple of days ago. But the EU seems to have done a bad job on procurement, and vaccination will take longer as a result, with general availability in the summer, if and only if the AZ vaccine is approved.

It's a disaster and I'm pretty sure unless they can conjure up a solution, there will be a public outcry. But the EU and its members are pretty good at disavowing responsibility to one another when something bad happens.

What exactly is the disaster? The only holdup was that the EU countries did not want to use emergency use approvals so there is only a single approval so far (Pfizer). The procurement seems okay. Austria where I am has orders from Pfizer until end of Q2 for 25% of the population alone.

I don't have an issue with the approval process itself. But Isreal, for example, expects delivery of enough doses to vaccinate 60% by the end of Q1. They just ordered more. We didn't.

https://www.tagesschau.de/ausland/israel-impfungen-coronavir...

Israel bet on two vaccines (Moderna and Pfizer), the EU bet on 4. In particular many EU countries (like Austria and others) were hoping for non mRNA vaccines to be approved faster because they would be significantly easier to handle.

We purposefully did not "order more" at the time it was offered since that was before approval. EU countries have been extending their orders after the approval went through to bridge the time until other vaccines become an option.

The EU in total ordered four times as much vaccines as we need.

Not sure who is downvoting you, that's how I understand things as well. I suppose whether that qualifies as a disaster is a matter of opinion.

Europe was really penny-wise/pound foolish. Instead of doubling down on all promising vaccine candidates, they ordered too little of the expensive vaccines (18 USD vs 5-7). Adding to this some more backdoor politics that led to buying just 300m Biontech doses because Biontech was perceived as the "German" vaccine and Sanofi (the "French" vaccine) also had only 300m orders on the book.

> Instead of doubling down on all promising vaccine candidates

They did. But after the approval went through. The EU have orders on generally way too many vaccines than it needs.

> or are the vaccines really getting distributed to the US much faster than other countries.

This was the purpose of Trump's Operation Warp Speed, billions went into manufacturing and distribution. He's delivered on his promise.

In canada we have vaccinated 58,818 so far or 0.16% of the population https://covid19tracker.ca/vaccinationtracker.html . The politicians are implying that it should start to really ramp up as time goes on (goal of 125 thousand by end of month [month doesnt have that many days left...] and 3 million by march), but i guess we will have to wait and see.

"Based on current schedules, the Department of Health and Human Services estimates that there will be enough doses of COVID-19 vaccine available in the United States to vaccinate 20 million Americans by the end of 2020, 50 million by the end of January 2021 and 100 million by the end of the first quarter of 2021, HHS Secretary Alex Azar said in a press call on Dec. 9."

From:

https://www.pharmacypracticenews.com/Covid-19/Article/12-20/...

And yet here we are at the end of 2020 with 2 million vaccinations, not the promised 20M. And in the same period of time, 3M have caught the disease.

Yes. The pandemic has far from peaked and the plans and projections are overly optimistic.

Actually, the claim was that 20M doses would be available, not administered. And just over 11M have been distributed, with 2.5 days remaining in the year. That's pretty good considering that quote was from three weeks ago.

We can always do better, but I'm shocked at how well this has gone over the last month.

I’m not. At this rate it will take 8 years to fully vaccinate.

There’s no reason to expect it’ll continue at this rate.

20M is the number they switched to after failing to meet their estimate from 3 months ago. In October, HHS Secretary Azar said that Operation Warp Speed would deliver 100 million doses by the end of the year.

https://thehill.com/changing-america/well-being/prevention-c...

Wow. That's initial doses for 1/30 people already, a few weeks after approval. And there's still more vaccines yet to be approved and distributed.

If the Defence Production Act really ends up being used we could see the US hit herd immunity in 3 months.

Since we're distributing to old and vulnerable first, I speculate we'll see fataility rate plunge in as little as 3 weeks. Maybe enough to take the whole US out of lockdown

It'll be closer to 6-8 weeks since these early vaccines require two doses.

Substantial resistance is built up after 8 days from the stuff I've read. Yeah immunity level is not great, but look at mortality in the studies.

AFAIK nobody that got even a single dose ended up in the hospital. That's huge if true. That means hospitizations will plummet well before everyone is through their second dose.

It’s 12 days

https://www.nejm.org/doi/full/10.1056/NEJMoa2034577

Do you have a citation for this claim? I heard or read similar but then couldn’t find the source.

I dug deep for this lol... It looks like somebody ballparked it from a graph, I read it in a news story I can't find. It looks like COVID incidence among study participants comes to a screeching halt somewhere around 8-12 days after first dose

Page 30 of https://www.fda.gov/media/144245/download

See this graph > Cumulative Incidence Curves for the First COVID-19 Occurrence After Dose 1, Dose 1 All-Available Efficacy Population

Also keep in mind this graph is probably based on COVID diagnosis date. Since it's unrealistic to test positive the day you contract COVID, I think it's reasonable to say it might even be effective from day 3-5 on

Amazing! Thank you for digging!

This is the most common question that I am asked at work.

They allegedly have partial immunity after the first dose (how partial i have no idea, and it might fade really quickly if you don't get the second), but its possible its enough to have some effect if enough of the right populations have the first dose.

I wish I was this optimistic.

The production of those doses started long time before the approval. I've heard that we can count ourselves lucky, if we reach sufficient vaccination rate before winter.

One thing to keep in mind, obesity is a risk factor.

You should really put your normal account against interesting - and rather bold - predictions like this. Other than getting it wrong, I can't imagine what reason you might have to throwaway on this subject? HN is a largely good faith audience.

The risk of getting cancelled is too high, so it’s best to always use a throwaway.

Sorry, but you piqued my interest. What does “getting canceled” mean here? You made some projections which may or may not be correct... but do you think people would remember who you are and hold it against you in the future if you made that comment with your main account? I apologize if that isn’t what you meant, I’m just trying to understand your thinking.

I'm guessing they mean in general. HN crowd doesn't cancel people, but HN is also a public board with a somewhat peculiar fan following on Twitter...

What's an example of a person being "canceled" by leaving a good faith Hacker News comment?

Canceling can be something that hasn't happened yet. All that we write online is forever.

Exactly

Social media searches are common on candidate screening nowadays. Say you left a conservative-sounding comment (like noting that the fast vaccine deployment is due in part to Trump's Warp Speed program) here on HN.

This would be a huge red flag against you when seeking a job at Silicon Valley companies - which are notoriously liberal leaning. "Cultural fit" is what they are looking for, not diversity (of opinions).

Care to elaborate? I haven't encountered cancel culture at HN nor do I understand which risk you see should it occur.

If they're like me it's more a long-term risk of having all your social media accounts tied together into some creepy profile. By somebody buying ISP DNS data (already happens), marketing data (same), or ML writing analysis.

Until there's privacy laws preventing such things it's better to be anonymous

The issue is not cancel culture on HN itself, but out in the real world, where saying anything that can be interpreted as "wrong" under your real name can have real consequences.

I've seen junior programmers advised on Twitter by seniors to take care what (and whose) tweets they "heart", or those tweets could weigh heavily against them at future job interviews.

Don't see why that wouldn't hold here on HN as well.

Expressing political opinions these days is a dangerous game. And more and more things are becoming politicized. Remember Coinbase? They were crucified for declaring that they just want to work.

Really? Who is doing this kind of research into candidates? When I interview people I don't have time to check out their entire social media history. There are also plenty of people that complain that their interviewers don't take the time to check out relevant things like github so I don't think I'm alone in this. If your interviewer has the time to waste checking out your entire Twitter feed then that sounds like a possible sign of a dysfunctional workplace.

There's automated platforms to find candidates social media profiles. It's pretty standard these days.

Finding social media profiles is easy. Reading the content takes time. I'd guess places that go through your social media are probably just doing quick searches for terms like the company name or the n word. I also doubt its standard practice at most companies I'd be interested in working for to go through social media for roles that aren't public facing.

There's danger in speaking your mind on the internet when it's tied to your name. I dont want my employer and whoever to know my opinions on everything. I don't see why anyone would want that.

I'm not worried about HN, it's who else finds my HN account. It may be possible to identify you through your writing soon enough. And there's not so many software engineers in the US. Not worth the risk.

I don't see why making wild predictions is a problem?

I don't have any static social media accounts besides placeholders I use for work related stuff. Every 3 months or so I clear my history and start fresh. Paranoid? Probably. But I don't like the idea of leaving a digital record of so much of my life

> If the Defence Production Act really ends up being used we could see the US hit herd immunity in 3 months.

We've had so much time to ramp up production that using the defense production act would just confuse things. We were actually producing vaccines before they were approved in order to rush this out.

Vaccines are traditionally not very profitable. Companies don't have an incentive to ramp up production ASAP because they know as soon as everybody is vaccinated demand will tank. There's plenty more profitable things to spend their time and resources on.

However, for everyone besides the drug companies it's advantageous to manufacture doses as quickly as possible.

It's the same reason DPA is used in wars. It would be vastly more profitable to produce scarce luxury items but not in the best interest of society.

The interests of drug companies and society are not completely aligned here and DPA would force them to apply all their resources to the problem, rather than maximum profitability.

> Since we're distributing to old and vulnerable first, I speculate we'll see fataility rate plunge in as little as 3 weeks.

As others have said, there's more lag than you think, so it'll be more like 6-9 weeks, especially with a Christmas surge. The other thing to remember is that we have a poor understanding of how it spreads. I don't mean that it's airborne, but that there isn't much evidence to suggest vaccinating the elderly and first responders is the best way to stop the spread. It's not an unreasonable choice, but there's a lot we failed to understand going into the winter.

Right, I think parent isn’t talking about slowing the spread, but fatality rate in isolation. Since the deaths are highly concentrated in older people, once they’re all vaccinated then COVID will, on average, be much less lethal and there will be much less pressure on ICU beds.

Yes I was probably too handwavey about it but that's exactly what I meant.

Once the vulnerable are vaccinated, hospitalization and fatality rates will plummet rapidly. Even if infection rates get far worse hardly anyone (relatively) will die. It will be COVID lite, more like a bad flu season

> > I speculate we'll see fataility rate plunge in as little as 3 weeks.

> The other thing to remember is that we have a poor understanding of how it spreads. I don't mean that it's airborne, but that there isn't much evidence to suggest vaccinating the elderly and first responders is the best way to stop the spread.

Fatalities, not infections. Average age of death is in the high 70s or 80s, so vaccinating the elderly is definitely the best way to drop that particular metric.

That's true, it's just a prediction. The first doses are going to care homes which have a wildly disproportionate number of COVID cases that end up in hospitalization. I think it's around 30%. And these people can also stay in the hospital longer, trying up beds.

Vaccinating these retirement homes, even with a single dose, should rapidly decrease the load on hospitals.

That's why I think people aren't being optimistic enough about recovery times. When 40% of the hospitalized cases are gone we can handle even a huge surge without overloading health systems. Since most lockdown metrics are based on hospital load, this means taking the country out of lockdown

I’ve always thought that vaccinating elderly and first responders was less about stopping spread and more about reducing fatalities among the most vulnerable. After all it is the least vulnerable who are most likely to be the main spreaders, and until a reasonable portion of <65 year olds are vaccinated, the spread is likely to continue and probably even flatten before that point.

However since most countries in the world are in the middle of a 2nd/3rd wave, it makes absolute sense to vaccinate the vulnerable first rather than try race against the curve with a vaccination programme. Especially when the vaccination lag is longer than the spread.

> less about stopping spread and more about reducing fatalities among the most vulnerable

This is a reasonable strategy, but I disagree with it.

> the least vulnerable who are most likely to be the main spreaders

[citation needed]. To my main point, we just don't understand how it spreads well enough to really say.

The people going out, being social and contributing to case counts are mostly younger healthy people. Which are among the last to get vaccinated. There was a fascinating article here a while ago claiming that if we vaccinated those people first, we actually would stop the spread far quicker.

Young people have far lower fatality and hospitalization rates though. If COVID only infected people under 40 it would be equivalent to a bad flu season.

A lot of reason for mask wearing and social distancing is to protect the vulnerable

yeah, i mean that’s why we are vaccinating the most vulnerable first and i agree that’s the ethically right thing to do. but doing it the other way around would probably stop it quicker.

Has the vaccine been shown to prevent transmission?

FWIW, here's the Canadian plan,[1] since there seem to be a good number of us Canucks on HN and it's natural to wonder/follow/compare with our close neighbours.

Some key points from the Canadian plan: (page 11)

* Canada has access to 7 vaccine candidates and regulatory authorization for 4 of them (Pfizer, Moderna, Janssen, AstraZeneca)

* 6 million doses (out of 38 million Canadians) to be delivered by March 2021

* "Pending regulatory authorization, Canada is well-positioned to immunize 100% of the population in 2021."

* general population vaccinations begin in April 2021 [2]

[1] https://www.canada.ca/content/dam/phac-aspc/documents/servic...

[2] https://www.theglobeandmail.com/canada/article-covid-19-vacc...

I'm not sure I buy the wisdom of warehousing the second dose rather than giving more first doses. An eager allocation strategy seems like it would result in higher vaccine throughput, and it's unlikely to result in an out-of-vaccine situation for the people who received the first dose given the production rate...

2Mi is a great number. But it is less than 1% of the US pop

These things take time. And those are the more complicated shots, waiting for other cheaper/easier to store vaccines ends up being a necessity

I'd be VERY interested to see vaccination rates among healthcare workers. I've heard some anecdotes that nurses and even doctors are refusing the vaccine at this point in time. This article says from a survey only a third of nurses would voluntarily take a vaccine, which is a lot lower than I expected.

https://www.pewtrusts.org/en/research-and-analysis/blogs/sta...

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