Shanghai Disneyland will close in effort to contain coronavirus

I'm not sure how well (or not) Michigan is doing overall, but U-M is planning to vaccinate all staff and students who want it. In mid-December they published a survey where we can sign up to get in line, voluntarily disclosing any potential health issues that might change our placement in the queue. Then we wait for someone to contact us to schedule the shot. Hopefully, we don't replicate Stanford's f-up where they ended up scheduling physicians and senior administrative staff with no in-person care duties ahead of the residents actually working in the hospital.

I don't know how anyone plans a vaccination rollout without doing something similar---at least, not until there is sufficient stock to just vaccinate everyone who wants it.

Then of course there is this.

https://nypost.com/2021/01/01/alarming-number-of-us-health-care-wor...accine/amp

Including other similar cases around the country. What message does this send to the remainder of the population? I have quite a few people at work who are willing to get a vaccine, but are not in any hurry because they want to see if people grow an extra limb or anything from it.

I'm only about 10-15% into this, but it is excellent. The New Yorker has a small allocation of free articles for non-subscribers, and is also available through News+.

https://www.newyorker.com/magazine/2021/01/04/the-plague-year

I think instead of worrying about what message health care workers refusing the vaccine sends we should just move the allocated doses for those that say no thanks on to the next tier of people in line and give them to those that want them. There's a lot of talk in the media about there not being enough doses for everybody but then all this concern over people who don't want the vaccine. If there isn't enough of something to go around why be concerned about the people who don't want it? Give it to the people that do want it first.

There is some percentage of people who need to be vaccinated to achieve herd immunity. 60-70% has been the range often cited. Fauci recently has been pushing that range up. Recently saying 75-80+ percent. At some point, enough people refuse the vaccine and herd immunity is mathematically eliminated as an outcome. And we are starting with the populations must vulnerable to the virus. Seems to me higher percentages of those most at risk for exposure to the virus/serious illness would be willing to get vaccinated. So if 60% of the most vulnerable people say no to vaccines, just going to the next group isn't going to work in terms of the larger goal. There are also logistical issues in terms of getting people in for vaccines on a timely basis which become more challenging if variable percentages of various vaccine groups refuse the vaccine.

For OhioStater or Professor Noble (or anyone else that works somewhere with access to vaccines), have there been talks about what happens if people refuse the vaccine? For most employers (mine included) there is no access to vaccines so someone who refuses can effectively hide behind "I cannot find one" as an out. At least for a period of time (likely I would think about a year or more). But if the employer has access and a priority plan for distribution, someone who is up for a vaccine which is available will not have that excuse. Will people who refuse an offered vaccine lose jobs? Students not be permitted on campus?

From what I have seen, Phase 3 trials typically last 1 to 4 years.

https://www.fda.gov/patients/drug-development-process/step-3-clinical-research

When I have seen health care officials discuss the vaccine and safety of it, they note that purpose of Phase 3 trials is to prove/show effectiveness and safety. And they are careful to note that the Phase 3 trials to date have established effectiveness and short term safety. By definition, long term safety isn't established in a couple months. Its emergency use that is authorized. Given the severity of the situation, we are essentially saying we will determine long term safety issues by vaccinating millions of people and seeing what long term issues (if any) develop.

The employer doesn't matter in the long run... the feds are paying for the vaccine for everyone. Eventually, there will be a point where everyone can have it. And I'm pretty confident that a great many employers and locations will not allow people without a vaccine.

And yes, normally phase 3 drug trials are a lot longer because it's the only way they can reach any kind of statistical significance. When it's for a vaccine that globally has a half-million new cases per day, it doesn't take long to get a valid sample.

GoBucks89 said:

For OhioStater or Professor Noble (or anyone else that works somewhere with access to vaccines), have there been talks about what happens if people refuse the vaccine?

As far as I know, it is voluntary for all U-M staff and students. From what my son is telling me about who he knows who's had the first round, U-M is starting to schedule staff and students who are in Phase 1B.

That's the frustrating part of this whole thing. I'm in group 1B (teacher) and chomping at the bit to get the vaccine. But here in Illinois we won't get through group 1A until mid-February. There is a county in Indiana where teachers have already received the vaccine. Based on Brian's post above it sounds like Michigan is preparing to move to the next phase as well. Meanwhile my county, DuPage, hasn't even set up a page for vaccine registration.

And thus the problem. This requires a national plan...not a haphazard approach which is what we have right now.

When it's for a vaccine that globally has a half-million new cases per day, it doesn't take long to get a valid sample.

In terms of effectiveness, that is true. But there is still a lot we do not know about the effectiveness. How long does the protection last? Do they prevent transmission or just getting sick?

In terms of safety of the vaccines on a long term basis, the number of new cases of Covid each day is not relevant. That takes time and several billion vaccinations won't change that (other than it will likely take years to get several billion vaccinations which in and of itself will mean we know more about any long term effects).

The number of daily new cases of Covid is relevant to the cost-benefit analysis the world is undergoing right now in terms of vaccinations. Risk of long term issues is worth avoiding the human toll the virus is extracting. Right result. However, leads to significant potential of free rider issues. US doesn't need me to get vaccinated to reach herd immunity. But if more than 15-40% of the population takes that approach, we don't reach herd immunity.

Sounds like University of Michigan is taking the approach that, from what I have read/heard, is expecting to be taken by a large number of employers: encourage vaccinations but do not mandate them.

Mulfinator said:

Based on Brian's post above it sounds like Michigan is preparing to move to the next phase as well.

The *University* is, but not the state in general. My partner is in health care, has an appointment with a county health office, but doing all work remotely, so presumably in Phase 1B (I think). She isn't even sure if she'll get it through her primary care physician or through the county office, and no one has said anything. The University health system is not yet providing vaccination to people who might otherwise be in Phase 1B but are neither U. staff nor students. So, if I weren't an employee, I'd be in the dark still too.

In contrast, my daughter is a grad student at U. Wisconsin. They are only talking about vaccinating people affiliated with the University health system, not other staff/students. That may change, but we don't know yet. So, it's entirely possible that her brother (who is still a student at U-M) will get it well before she does.

wahoo skipper said:

And thus the problem. This requires a national plan...not a haphazard approach which is what we have right now.

Effectively what I was trying to say but didn't quite get there. Instead we get variation between states, counties, and even employers. There's so much uncertainty that it's inexcusable. It's not like we didn't have tons of lead time. We have been hearing about vaccine candidates since May.

I don't remember this amount of confusion back in 2009 with the H1N1 vaccine. Somehow I knew to show up at the local high school to wait in line for the vaccine. I do remember being eligible to receive the vaccine only because my son was under a year old at the time.

There was a vaccine for H1N1?

—Dave Althoff, Jr.

There was, but it was just part of the regular seasonal flu vaccine.

There was and the one used in much of Europe was found to have side effects not known until large portions of the population had been vaccinated with it. It was made slightly different than the other brands and was causing narcolepsy in some people. It was statistically considered a "rare" side effect but for those affected, especially those that were in a group pushed into taking it by employers, rare doesn't mean anything. The damage is done.

RideMan said:

There was a vaccine for H1N1?

bigboy said:
There was, but it was just part of the regular seasonal flu vaccine.

I did a bunch of reading on the H1N1 pandemic earlier this year. There was a separate vaccine developed for H1N1 in 2009.

It's now just part of the annual flu shot.

Vaccines "might not" work as well against South African strain of virus.

https://www.cbsnews.com/news/covid-vaccine-new-strain-south-africa/

That's a horrible scare headline. The story is mostly about how it will likely be fine.

Paisley said:

There was and the one used in much of Europe was found to have side effects not known until large portions of the population had been vaccinated with it. It was made slightly different than the other brands and was causing narcolepsy in some people. It was statistically considered a "rare" side effect but for those affected, especially those that were in a group pushed into taking it by employers, rare doesn't mean anything. The damage is done.

I believe you are referring to Guillan-Barre syndrome. I do remember that being a concern with the vaccine. However, from what I can find there were only 411 cases out of 45 million monitored individuals. So it was significantly less prevalent than the H1N1 vaccine of 1976.

Fun fact: H1N1 is the same virus responsible for the 1918 pandemic.

It was specifically narcolepsy, only with the Pandemrix brand vaccination. They have theories now for why it likely happened and why it was not an issue with the other brands.

https://www.news-medical.net/health/Narcolepsy-and-swine-flu-vaccine.aspx