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With the J&J vaccine and most states having >15% of the population with at least one dose, we really should just be distributing to anyone and everyone as fast as possible.

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At least in my state the sorts of gross inefficiencies believe to be caused by the binning just aren’t true. There were some early wrinkles but were now rate limited by the total number of doses. So while frustrating for folks such as myself it still makes sense to prioritize based on need

I would argue that most states aren't prioritizing based on need. They're prioritizing based on risk if covid is caught, where they ought to be prioritizing primarily on risk of catching covid (with perhaps some secondary prioritization for risk if caught).

Under such a scheme, we'd have vaccinated anyone who has a hard time isolating, e.g. grocery store workers, nursing home residents and staff, prisoners. Instead most states are first vaccinating retirees who can easily avoid infection.

Sure, depends on how one chooses to define need as you point out.

I don’t disagree, there are a lot of factors going into prioritization and I don’t agree with all of the decisions but at the end of the day, and at least in my state, the notion that this is slowing things down is simply untrue

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