Interactive - Your Vax Priority

December 4, 2020 11:19 AM

Find Your Place in the Vaccine Line interactive NYT piece.

CDC advises people to wear masks indoors at all times, except at home

Obituary provides a scathing critique of those who choose not to wear masks

Vax distribution

This would be a fine thread to add Covid vaccine links, other Covid19-related links.

posted by theora55 (114 comments total)

61% of Americans want to take a vaccine. About 20% do not. (National Geographic poll)
posted by doctornemo at 11:39 AM on December 4, 2020 [1 favorite]

The last link seems to be same as the 3rd.
posted by anshuman at 11:41 AM on December 4, 2020 [1 favorite]

Neat! If we're strictly defining obesity by BMI, I move up an entire order of magnitude in line depending on if I've pooped or not!
posted by phunniemee at 11:43 AM on December 4, 2020 [29 favorites]

Mixed emotions about my place on line. Good news is that I come pretty much right after the essential workers. Bad news is that I have enough criteria to come right after the essential workers.
posted by AugustWest at 11:44 AM on December 4, 2020 [23 favorites]

Has there been any informed discussion as to whether/how much a vaccine might cost someone in the US? Will it be akin to the yearly flu vaccine, which is nominally free? Or, will we be on the hook to reimburse Pfizer’s development costs?
posted by Thorzdad at 11:45 AM on December 4, 2020

Based on your risk profile, we believe you’re in line behind 268.7 million people across the United States.

Guess I'd better bring a folding chair.
posted by The Tensor at 11:45 AM on December 4, 2020 [41 favorites]

I believe it is free. US government in op warp speed paid these companies during development and will pay or the vax.
posted by AugustWest at 11:46 AM on December 4, 2020

Man, I wish there was some way to put COVID deniers and mask refusers at the very back of this line....
posted by JoeZydeco at 11:48 AM on December 4, 2020 [17 favorites]

I wish there was some way to put COVID deniers and mask refusers at the very back of this line....

Nope, they need it first so they don't continue to infect the rest of us.
posted by uncleozzy at 11:50 AM on December 4, 2020 [43 favorites]

I suspect COVID deniers and mask refusers will put themselves at the back of the line.

But they should be at the front of the line, not for fairness, but for pure practicality -- they're the ones most spreading the fucking disease.
posted by jacquilynne at 11:51 AM on December 4, 2020 [25 favorites]

Any surveys on whether people will take the vaccine are not going to be meaningful or precise right now. There has been so much FUD being cultivated from the top, and the option to get vaccinated is still abstract at the moment. Once people start seeing their friends and loved ones starting to get it without incident, many of the skeptical ones will follow.
posted by PhineasGage at 11:52 AM on December 4, 2020 [6 favorites]

I'm approximately last in line, which is fine. I'm a reasonably-healthy middle-aged person who lives alone in a house with a yard, can work from home, and is enough of an introvert that not interacting with anyone doesn't hugely bother me. I would like to be vaccinated soon, but I'll live if I have to wait until August. But I suspect that I won't have to wait until August, because enough people will refuse it that there will be vaccines available for willing last-in-liners before then.
posted by ArbitraryAndCapricious at 11:52 AM on December 4, 2020 [17 favorites]

I'm near the end of the line, with only four folks behind me. Seems kind of suspect though and they didn't ask many questions. I don't have insurance and I'm not important so really I assume I get the vaccine... never, just like the normal flu vaccine.

Oh my and it's a double dose a vaccine that requires you to come back a month later??
posted by GoblinHoney at 11:58 AM on December 4, 2020 [2 favorites]

I feel like putting children and young adults ahead of older adults is one of those things you can't argue against without sounding like a monster, but at the same time I feel like it's dumb. And I feel like it's an extension of the god awful, criminal "we have to keep the schools and colleges open because *reasons*" mentality that has killed and injured thousands.

But I'd settle for keeping the queue the way it is and firing/permanently blacklisting from public service all administrators and politicians who decided to keep their schools open at the cost of actual lives.
posted by Skwirl at 12:01 PM on December 4, 2020 [11 favorites]

Word on the street has it that I'll be the last in line.
posted by NoMich at 12:02 PM on December 4, 2020 [2 favorites]

I wasn't that surprised to be at the back of the line for adults--I'm in reasonable shape in my late thirties. But I was surprised to be behind both young adults and children, and even more surprised that there were essential workers in line after the kids. I thought that the current vaccines hadn't been approved for use in people under 18 yet?

Maybe they are assuming that they will get that approval fairly quickly? Reducing transmission among kids goes a long way towards reducing R-naught (I remember more than a few articles that vaccinating only students against the flu would probably be more protective than vaccinating only the elderly and at-risk), so I'm in favor. But it was still a bit of a shock to see 90% of the population in front of me.
posted by thecaddy at 12:03 PM on December 4, 2020 [3 favorites]

I'm at the end of the line which is fine with me. I don't go out much and I can work from home just fine.
posted by octothorpe at 12:03 PM on December 4, 2020 [1 favorite]

How 700 Epidemiologists Are Living Now, and What They Think Is Next
Sorry about the NYT paywall.
posted by theora55 at 12:15 PM on December 4, 2020 [4 favorites]

There are always cutoffs, so if you’re near a dividing line just being a pound or two lighter or a year or two older can make a huge difference. It doesn’t make very much sense for the individual, but at a population level it is entirely rational. In my case, being only two years older would advance my place in line by 150 million — largely a matter of whether I come before or after children and young adults. I’d prefer not to wait too long, but I accept that having to wait a while makes sense as I’m not high risk and I don’t have to interact with very many people.
posted by Quinbus Flestrin at 12:18 PM on December 4, 2020

How much will it cost me?

The federal government has promised that any coronavirus vaccine will be provided free of charge to the American public. That would be very unlikely to change under a Biden administration. The federal government has paid $7.76 billion upfront to four companies alone for their vaccines; Pfizer, Moderna, AstraZeneca and Novavax, and tens of millions more upfront or in options to three other companies to guarantee they can develop coronavirus vaccines.

"We've paid for the vaccines, we paid for the shipping costs, and the administration costs ... will be covered by healthcare payers, private insurance, Medicare, Medicaid, and our program to cover Covid-19 expenses for the uninsured," Azar said December 3.

From When can I get a coronavirus vaccine? [CNN]
posted by glonous keming at 12:20 PM on December 4, 2020 [3 favorites]

I'm another person who lives alone, WFH, and is continuing to isolate (the article theora55 linked to is comforting in a way, it's good to see I'm living like the cautious epidemiologists). So I'm okay with being near the end of the vaccine line - especially because, while I'm no anti-vaxxer by any means, I'm sort of disquieted by the breakneck speed of COVID vaccine development and corresponding lack of thorough long-term testing. As things stand at the moment at least, I'd prefer to hold off on being a beta-tester.
posted by Greg_Ace at 12:29 PM on December 4, 2020 [6 favorites]

US government in op warp speed paid these companies during development

Moderna, yes. Pfizer, no.
posted by They sucked his brains out! at 12:30 PM on December 4, 2020 [7 favorites]

I put my info in - 42, my county, nonessential worker - and came out 5th from the end. I changed the age to 41 for Herr Duck (same other information) and he came out 13th from the end! So I put the age back to 42 and now I was 6th from the end. I'm not sure why my spot in line keeps moving. But I'm always close to the end of the line.

In any case, I'm fine with that. I don't have any ongoing medical issues that would be exacerbated by COVID-19, I'm working from home but not working much and could survive financially if my not-much-workingness continued on a bit longer, and I am not a caregiver for anybody right now. I'd happily let just about anyone I know budge in line ahead of me.
posted by Gray Duck at 12:33 PM on December 4, 2020 [1 favorite]

I'm really curious about how private companies will affect people's willingness to get vaccinated. I've read that some organizations - TicketMaster springs to mind, but MAYBE also Disney, and some airlines? - will require vaccination certificates. I can actually really imagine people who would not under any circumstance get a vaccine at the government's urging, but who would grudgingly go along with it if Disney made it a condition of a trip to DisneyWorld.

(Hm - looks like TicketMaster was only exploring that option and is not going to require vaccines ... but I can imagine it for cruise ships ... Hm.)
posted by kristi at 12:42 PM on December 4, 2020 [3 favorites]

I'm towards the back which is fair and not a problem for me, except that I haven't gone anywhere outside of my neighborhood (two dayhikes this summer were my only exception and those were still within 30 miles of my neighborhood) in almost a year and I'm suffering the worst case of wanderlust!
posted by WalkerWestridge at 12:43 PM on December 4, 2020 [1 favorite]

I'm close to the back of the line, and relieved to be there. I am so fiercely pro-vaccine (burying an immunocompromised child will do that to you) but also so scared of a novel vaccine without testing for any long term bad outcomes. I am so scared - of my son becoming sick or harmed, of the effect on him if I become sick or harmed. Yes, I realize that that sickness/harm could come from Covid without the vaccine. And yet I'm tears-in-my-eyes-about-to-vomit scared of the vaccine, even as someone who dutifully gets their flu shot every year and anything else the doctor suggests. I'm sure it's not wholly rational and certainly no small part of it is reaction to trauma, but I would sign up for another year of strict social distancing, stay-at-home, and mask wearing more readily than the vaccine right now, today. Of course, I recognize that the ability to take that approach represents a privilege that many of the people who are most at-risk from Covid do not have and that my behavior must consider the societal impact as well. But in this case, that behavior would be to forego a resource of limited availability while continuing to maintain procedures to avoid being a link in the chain of transmission, and allowing someone who might be more in need of protection to have it. On the other hand, I would ask those who are scared of the flu vaccine or DTAP or MMR and so forth to put their fears aside to protect children with cancer, those who cannot be vaccinated and so forth, so don't I by extension have to do the same here, now, with this vaccine. (The retort in my head: Those ones have the benefit of long term testing dammit, and this one does not and what if it kills me and little E loses another mother and no one can take care of him right and he suffers and on and on catastrophizing trauma meltdown.)

So, my proper place in the back of the line it is with plenty of time to work through these feelings and come to grips with it and learn more and talk to my docs and so on while continuing to do the best I can to avoid getting or spreading Covid.
posted by MustangMamaVE at 12:44 PM on December 4, 2020 [13 favorites]

I'm about sixth from the end. But my kid with a chronic lung condition is pretty close to the front. Which is great! There's part of my brain that won't stop screaming until that shot goes in her arm.

Except that the vaccine will have to be approved for children, and that probably won't happen in time for the start of the 2021-22 school year. So my kid's notional place near the front of the line is meaningless.

It seems inevitable that school will be in person, next year, but I don't know if I'll be able to send my kid there.
posted by gurple at 12:45 PM on December 4, 2020 [5 favorites]

Pfizer chairman: We're not sure if someone can transmit virus after vaccination I assume, and hope, that many questions will be answered.
posted by theora55 at 12:45 PM on December 4, 2020 [4 favorites]

If I put myself as a non-essential worker, I am at the end of the line. However, my job has been technically listed as essential (legal services), and if I use that; middle of the line.

So I will wait for HR to let me know how to classify myself, and if I need something from them.
posted by indianbadger1 at 12:52 PM on December 4, 2020

Note that your position within a group on the line appears to be random. Resubmit without changing anything and your position will move so don't read anything into it.

I'm in my late 50's and at the end as well. I understand why I'm behind young adults, I agree with it, but I can't say I'm entirely happy about it.
posted by cosmac at 12:54 PM on December 4, 2020 [4 favorites]

corresponding lack of thorough long-term testing

For what it's worth, even normal vaccines don't really go through "long term testing" before approval. My understanding is that the length of time a study goes is so they can collect enough data from infections of the control group to know that the vaccine is working, not to wait for side-effects to appear.

Pfizer chairman: We're not sure if someone can transmit virus after vaccination

This makes sense, because the studies were not designed to find this out. The endpoints of the current studies are all "did people get sick, and if they did get sick, did they get very sick, or die."
posted by BungaDunga at 12:56 PM on December 4, 2020 [11 favorites]

I find it slightly cruel that even though my job involves spending a lot of time getting breathed on by 18-year-olds, I'm pretty sure I'm not an essential worker for the purposes of getting vaccinated.

I've been sick with something all week that put me out of breath just going from the bed to the fridge, so I'm going to get an antibody test as soon as I'm likely to have any antibodies, and then hopefully I can be a little less anxious about getting vaccinated.

(No, I didn't see anybody for Thanksgiving.)
posted by Jeanne at 12:58 PM on December 4, 2020 [4 favorites]

Thanks to my crappy lungs I'm towards the front of the line and I'm ok with it. I trust the science behind these vaccines and I'm ready to have some of the fear lifted from me.
posted by drewbage1847 at 1:05 PM on December 4, 2020 [3 favorites]

non-paywalled link to the 700 epidemiologists survey posted above by Theora55
posted by HyperBlue at 1:07 PM on December 4, 2020 [6 favorites]

Why are young adults and children ahead of middle-aged people in many of these priority orders? Is it because they're more likely to be running around spreading any diseases they have?
posted by Harvey Kilobit at 1:09 PM on December 4, 2020

Apparently "Adults aged 18 to 30 should come earlier, NASEM recommended, because they may be responsible for more asymptomatic transmission."

The NASM report says:

there is increasing evidence that this group may be disproportionately fueling asymptomatic and/or presymptomatic transmission... In addition, this group includes college-aged individuals, who are more likely to be living in congregate settings—such as college dormitories, house shares, and other communal living facilities—and thus face increased risk of contracting SARS-CoV-2 infections. Numerous outbreaks of COVID-19 are already occurring in such settings in the United States. Furthermore, SARS-CoV-2 infections in college-aged adults can threaten the health of faculty and other university staff, many of whom are older or have underlying illnesses that put them at risk of severe COVID-19. Similarly, the 2019 U.S. Census data show that approximately one in two young adults currently live in parental homes, and thus are at higher risk of transmitting the infection to their family members, who may also be at increased risk of severe disease and death due to age or comorbidity

And if you look at their timeline, they are definitely putting everyone 31-65 who aren't essential workers and aren't at significantly higher risk due to comorbitities at the very end of the line.
posted by BungaDunga at 1:27 PM on December 4, 2020 [11 favorites]

Is it because they're more likely to be running around spreading any diseases they have?

Yep. Just like we can't ever keep them from fucking each other, we can't keep them from going to bars and whatnot and breathing on each other.
posted by sideshow at 1:28 PM on December 4, 2020 [7 favorites]

I'm really curious about how private companies will affect people's willingness to get vaccinated.

I was discussing this with my wife yesterday. She’s an administrator for a home healthcare (unskilled) company. They haven’t yet looked into whether their caregivers will qualify to be the first in line for a vaccine. But, there’s also the question of whether the company should (or will be legally allowed to) require their people to get vaccinated once it’s available. They already have clients who require a caregiver to have tested negative before they allow them in their home, so it’s not hard to imagine clients requiring caregivers be vaccinated, too. Not sure how that works when the vaccine is a two-dose process.
posted by Thorzdad at 1:31 PM on December 4, 2020 [3 favorites]

How the rich and privileged can skip the line for Covid-19 vaccines IM SHOCKED!
posted by robbyrobs at 1:41 PM on December 4, 2020 [4 favorites]

They already have clients who require a caregiver to have tested negative before they allow them in their home, so it’s not hard to imagine clients requiring caregivers be vaccinated, too. Not sure how that works when the vaccine is a two-dose process.

I work in an adjacent industry, and I think it would work the same as any other credentialing. Many facilities already require proof of other current vaccinations, and I am very sure that COVID-19 will be no different. Home health has fewer regulations, but every home health scheduling system I've ever seen has the ability to track and require credentials.
posted by uncleozzy at 1:52 PM on December 4, 2020 [1 favorite]

Well, see, if you let me cut in front of you, and I let you cut in front of me...
posted by sexyrobot at 1:55 PM on December 4, 2020 [2 favorites]

The greatest benefit of this, to me, is discovering that Illinois and Kentucky also have counties named Gallatin! I wonder if there's any twinning relationships there. I'm just unreasonably curious about what our doppelgangers are like?
posted by traveler_ at 2:03 PM on December 4, 2020 [1 favorite]

Gov. Cuomo's press conference today was pretty interesting. He has an actual case of pfizer vaccine to demonstrate how it works...it's pretty high tech. The boxes are packed with dry ice, have a gps tracker that can report on the temperature inside, and hold about 5000 doses in a medium size cardboard box.
posted by sexyrobot at 2:04 PM on December 4, 2020 [7 favorites]

Yep. Just like we can't ever keep them from fucking each other, we can't keep them from going to bars and whatnot and breathing on each other.

This. In my PNW college city we locked down early enough to really not have any cases in the spring. We had a small "second" wave in mid-summer that was contained, but cases really started to spike (largely in the 10-19 and 20-29 age brackets) in mid-to-late September when the college kids came back to town. Even though most fall classes are remote, they still have leases they were unable to get out of, jobs, and generally want to have fun with other students rather than be stuck at home with their parents -- if that's even an option for them. The university's managed to keep dormitory cases relatively low post-move-in, but the vast majority of students live off campus.
posted by bassooner at 2:09 PM on December 4, 2020 [4 favorites]

Are all essential workers getting the vaccine earlier than the general population?

All the grocery workers, fast food workers, baristas, etc who were told they had to continue, there's no way in hell the America we live in will vaccinate them in a timely manner.
posted by Slackermagee at 2:18 PM on December 4, 2020 [10 favorites]

I admit, I am a little twitchy about taking a novel design of vaccine that has only had a few months to check for long term effects, but I'm over 50 and in a risk group, so I'll take it when my turn comes up (which is 10th in line for California, so presumably some time in early spring.) If for no other reason that I expect that vaccine uptake in the US will not be sufficient to achieve herd immunity, so I'm likely to catch it otherwise, and I figure that the risks of unknown effects are less than the 1 percent or so chance of dying if I get covid.

I do feel that it's a little wrong to conflate the "it's so that Gates can inject microchips" and the "new vaccine design that hasn't had a long time to shake out" groups of doubters. There's been a couple of vaccines previously that turned out to have problems down the line.
posted by tavella at 2:19 PM on December 4, 2020 [3 favorites]

Oh my god, that Washington Post article about pediatric vaccine approval just broke my spirit. I have a medically-complex child who hasn’t been in school since March. Last summer of working from home with a bored, frustrated kid was so, so hard. I can’t risk him getting COVID, and I can’t risk his immune system freaking out by getting an off-label vaccine (both could have the same catastrophic health impact for him). So while he’s theoretically way far ahead of me in line, I might get vaccinated before him and still have to scramble for child care and remote schooling options next summer and fall. I want to puke.
posted by Maarika at 2:28 PM on December 4, 2020 [13 favorites]

According to this I can get a vaccination just after I find a parking space at Trader Joe's.
posted by srboisvert at 2:29 PM on December 4, 2020 [29 favorites]

I'm 90th in line. I changed the age to my son's age, (26) and he is 45th in line. Maybe normally healthy, 21-60 is all one big block, and they are dropping us in randomly or something, because nothing else makes any sense for that result.
posted by COD at 2:36 PM on December 4, 2020 [1 favorite]

You guys it turns out you can make health care policy based on moral and public health principles instead of profit! Wild. Who knew?
posted by latkes at 2:42 PM on December 4, 2020 [4 favorites]

I've mentioned this before, but it bears mentioning again.

In 1976 there was a swine-flu scare. As a result they developed a vaccine and vaccinated one quarter of the US population within 6 months. I don't believe a word of this 'it will take a year or more before people are vaccinated'. How soon people forget history, or maybe there aren't enough people who were alive when this happened. We did this before!

Some of the first vaccines (mRNA) take special handling and might be more difficult to manufacture and distribute. But hard on their heels are vaccines from Johnson & Johnson and Novavax, among others, that are easy to manufacture and don't require special handling, and are being manufactured in the millions as we speak (because of the urgency, they are taking the risk of doing full-speed manufacturing even though these haven't been approved yet).

Unless this is all bungled (and with new management, this isn't as likely to happen now), I think everyone who wants to be vaccinated will be vaccinated by the middle of 2021.

I know I'm optimistic, but that's what I think will happen, based on past experience.
posted by eye of newt at 2:43 PM on December 4, 2020 [12 favorites]

I'm pretty far back, which surprised me because I'm 63 and thought I was higher risk. Turns out if I bump the age to 66, I move up almost 50%, so the age thing must be a hard ceiling rather than a sliding scale.
posted by CheeseDigestsAll at 2:47 PM on December 4, 2020 [1 favorite]

I'm in my thirties with only asthma as a pre-existing condition which puts me down the list, but my occupation seems to move me up somewhat.

I'm pretty optimistic about getting vaccines out quickly too. The only that makes me nervous is congressional inaction holding things up. I think we might see countries with more functional health systems and safety nets get this thing out faster, but we've also been setting up a distribution network ourselves (the U.S) for the past year, so we'll see.
posted by eagles123 at 2:51 PM on December 4, 2020 [1 favorite]

As a result they developed a vaccine and vaccinated one quarter of the US population within 6 months. I don't believe a word of this 'it will take a year or more before people are vaccinated'.

I'll admit I'm unsure why the fact that we managed to vaccinate one quarter of a much smaller population in 6 months makes you confident we'll be able to vaccinate several times that many people in less than 6 months, particularly given where we are starting from government-wise?
posted by Justinian at 2:53 PM on December 4, 2020 [9 favorites]

I'll admit I'm unsure why the fact that we managed to vaccinate one quarter of a much smaller population in 6 months makes you confident we'll be able to vaccinate several times that many people in less than 6 months, particularly given where we are starting from government-wise?

While I'll grant you that things are royally messed up at the Federal level, I am optimistic for two reasons:
1. We already do this. In fact. we just did it. About 1/2 of the US gets Flu shots every year--usually within a few month period. The infrastructure to quickly vaccinate everyone already exists and was just tested. I sometimes wonder if the reason doctors and hospitals were pushing so hard this year for everyone to get a flu shot was just so they could practice for what is coming next.
2. These new vaccines aren't grown in eggs--several of them can be manufactured much faster than the 1976 vaccine. (Note I'm not an expert in this area, so take this point with a grain of salt).
posted by eye of newt at 3:03 PM on December 4, 2020 [2 favorites]

I'm right in the middle with... other elderly?

::sigh::
posted by Splunge at 3:19 PM on December 4, 2020 [8 favorites]

> 1. We already do this. In fact. we just did it. About 1/2 of the US gets Flu shots every year--usually within a few month period. The infrastructure to quickly vaccinate everyone already exists and was just tested. I sometimes wonder if the reason doctors and hospitals were pushing so hard this year for everyone to get a flu shot was just so they could practice for what is coming next.

Vaccine storage temperatures:

Seasonal flu: 2-8ºC
Pfizer 2019-nCOV: -70ºC
Moderna 2019-nCOV: -20ºC

Your local CVS or Rite-Aid offering flu shots probably doesn't have a freezer that can go tens of degrees below freezing right now.

And yeah, the AstraZeneca vaccine can be stored in a normal freezer, but won't be ready for emergency use for a while, and hasn't looked nearly as effective in early testing.

Also, all of these require two doses, while the seasonal flu vaccine requires one.

So yeah, not a great comparison.
posted by tonycpsu at 3:20 PM on December 4, 2020 [8 favorites]

I'm right about in the middle of the line. I live in a county with a pretty big high-risk population, too, so it will be interesting to see how long a wait I'm in for...
posted by Annabelle74 at 3:23 PM on December 4, 2020

I'm very close to the back of the line, being a person of no remarkable physical traits, and I'm behind 22,000 people who are homeless. The other day I was reading the help wanted ads for people to work on the campaign to get vaccines to homeless people; it sounds so very, very daunting. I hope it goes well.
posted by The corpse in the library at 3:32 PM on December 4, 2020 [3 favorites]

Not really buying the order, particularly as "at risk" is so vague. It also has very big steps on age as 31-64 all goes in one bin if not "at risk' (whatever that means) and not an essential worker. And at risk vs. not at risk moves me by more than 100 million steps.

The young adult and children bias is interesting. I think that the model is assuming they are responsible for most spread even though they are at much less risk of death (and presumably other severe complications of COVID-19).

This is interesting, but without exposing their method and data, the NYT has made a pretty but not very useful tool.
posted by jclarkin at 3:36 PM on December 4, 2020

Well as of this week me and my kid have been exposed (she's tested positive, I didn't but I am having the same mild symptoms). But apparently you should get the vaccine all the same.
posted by emjaybee at 3:39 PM on December 4, 2020 [4 favorites]

Vaccine storage temperatures:
Seasonal flu: 2-8ºC
Pfizer 2019-nCOV: -70ºC
Moderna 2019-nCOV: -20ºC

As I mentioned:
Johnson and Johnson: normal refrigerator temperatures
Novavax: normal refrigerator temperatures

Source

Yes, they are behind in testing, but not that far behind. The first few vaccines likely to be approved are getting all the press, but the vaccines coming soon afterwards seem likely to have fewer issues.
posted by eye of newt at 3:41 PM on December 4, 2020 [4 favorites]

My boyfriend and I are both essential workers, mid 40s. Which puts us in the middle of the pack. If I change the health risks question to yes (I am pretty healthy, but in the obese category. Boyfriend has high blood pressure), only 20 million people would be ahead of us nationwide. I am honestly okay with waiting til mid pack.

The children thing is confusing. Our 3 year old is not far behind the mid pack point. I wonder if it has more to do with keeping or getting daycare/schools open rather than any large risks to that population group.
posted by weathergal at 3:46 PM on December 4, 2020

H1N1 was not novel. It was a variety of influenza. Every year we tune ours vaccines to account for different varieties of influenza. So it’s not very surprising that we could roll out a vaccine tuned for H1N1 in a short time. The coronavirus was novel. Developing a vaccine in the time we did is surprising.
posted by rdr at 3:51 PM on December 4, 2020 [1 favorite]

> Yes, they are behind in testing, but not that far behind. The first few vaccines likely to be approved are getting all the press, but the vaccines coming soon afterwards seem likely to have fewer issues.

The first vaccines got all the press because they were shown to be very effective, and were approved for EUA. The ones you mentioned haven't, and there's no telling whether they will or not. About half of drugs that make it to Phase 3 fail.

I understand the urge to push back against pessimism, but you need to do so with a credible argument. Pessimism is warranted here given the many hurdles yet to overcome.
posted by tonycpsu at 3:52 PM on December 4, 2020 [1 favorite]

All of this is from choosing Travis County Tx and "None of these" for profession.

No to Health risks question:
1-17: 185.6 M
18-30: 144.1 M
31-64 268.7 M
65 and up: 118.5 M

Yes to Health risks:
1-infinity: 23 M

I didn't walk through all the professions, but this seems oversimplified. There is only very small interactions between categories if any. It seems that the lowest number of any of the catagories are what you get. So an older teacher gets no "bonus" for fitting into multiple catagories.
posted by jclarkin at 3:55 PM on December 4, 2020

I wouldn't say that expecting it to take most of 2021 to get everyone vaccinated is necessarily pessimism even if it turns out not to be the case. Getting the most vulnerable vaccinated by midyear would be lightning fast vaccine development and distribution by historical standards. It's only been like 10 months!
posted by Justinian at 3:57 PM on December 4, 2020 [6 favorites]

Sounds cool - wish it wasn't paywalled. -- tiny frying pan
First link is working, for me; most NYT COVID-19-related material isn't paywalled. Maybe it's a browser issue on your end?
And at the CDC advises people... second link: "The Washington Post is providing this important information about the coronavirus for free."

Solid, non-paywalled primer at What We Know About the U.S. COVID-19 Vaccine Distribution Plan, NY Mag Explainer Dec. 2, 2020.

NYT: "Even when there is enough vaccine to reach all Americans, the particulars are murky. Healthy adults working from home have lower risk, so they may get vaccinated after people who commute, according to a recommendation by the National Academies of Sciences, Engineering and Medicine. If quantities are limited for longer than a few months, a lottery might be necessary, the group warned. [...] It’s hard to grasp how complicated the rollout will be. For every 100 doses, providers will need 105 needles and syringes of varying sizes, 210 alcohol prep pads, 4 surgical masks, 2 face shields and 100 vaccine report cards to track patients’ vaccine histories, according to the C.D.C. That equipment must be manufactured, packaged and shipped to coincide with vaccine deliveries."

We've had these equipment shortages for most of the year. Months ago, the CDC released approx. $200 million in funding to state and local governments for vaccine planning; state health officials estimate $8 billion is needed.
(Also, I miss katra.)
posted by Iris Gambol at 4:14 PM on December 4, 2020 [3 favorites]

My place in line likely depends entirely on how/whether a perfect stranger chooses to define/measure my relative obesity. I suspect whatever mode will be arbitrary, hectoring, simplistic and disinterested in my actual health at the time, and thus unpleasant for me no matter how it goes (Either “Ugh, gross you’re too fat” or “ugh gross you’re too fat, but not fat enough”). Whatever. I was a WFH person pre pandemic and i have no kids and a large deck. Extravert, but not going to shows and parties isn’t going to kill me yet.
posted by thivaia at 4:20 PM on December 4, 2020 [1 favorite]

I wish they were a little more clear about what a "covid related health risk" meant. They list "obesity," but what exactly does that mean? Is it just measured by BMI, and how high does someone's BMI have to be to put them in that category? I'm definitely overweight by medical standards, but I'm not sure whether to say yes or not to that question. (It appears to make a big difference; if I say yes, I'm 26th in line; if I say no, I'm sixth from the back.)
posted by holborne at 4:24 PM on December 4, 2020 [1 favorite]

holborne, the CDC's COVID-19 "People with Certain Medical Conditions" section updated on Dec. 1 and has that info.
posted by Iris Gambol at 4:32 PM on December 4, 2020 [2 favorites]

In 1976 there was a swine-flu scare. As a result they developed a vaccine and vaccinated one quarter of the US population within 6 months.

It didn't go well: "The real victims of this pandemic were likely the 450-odd people who came down with Guillain-Barre syndrome, a rare neurological disorder, after getting the 1976 flu shot. On its website, the CDC notes that people who got the vaccination did have an increased risk of “approximately one additional case of GBS for every 100,000 people who got the swine flu vaccine.”"

(I'm a vaccine believer and will get it mine when my number comes up but the 1976 swine flu was... a bit of a debacle)
posted by BungaDunga at 4:37 PM on December 4, 2020 [4 favorites]

37, firefighter/Advanced EMT, no compromising health risks. 8th/9th in line. NGL, I have been offered a vaccine for sometime this month; whether or not that materializes...well, we’ll find out. I emphatically agreed to be vaccinated and am waiting on the phone call to tell me exactly where I need to be. I know a few folks who are wavering; I’m hoping my willingness to do it will help them decide that it would be a good idea to follow suit.
posted by sara is disenchanted at 4:42 PM on December 4, 2020 [16 favorites]

I'm pretty far back, which surprised me because I'm 63 and thought I was higher risk. Turns out if I bump the age to 66, I move up almost 50%, so the age thing must be a hard ceiling rather than a sliding scale.

I suspect the key variable is, at 66, you’re on Medicare.
posted by Thorzdad at 4:45 PM on December 4, 2020 [1 favorite]

My big question for myself is, do they vaccinate everybody who works at a hospital as though they're a healthcare provider (so we don't make the healthcare providers sick) or no? I suspect that decision will be made either by my hospital or by the state of Tennessee and that the lack of nuance in the NYT questions is because they don't know either.
posted by joannemerriam at 5:06 PM on December 4, 2020 [3 favorites]

I'm way toward the back of the line. Which on the one hand is perfectly fair, though I find it pretty depressing to know that I will still be locked inside through the end of the summer while most of the rest of the world is running around free again. :(

I would seriously sell a kidney to get a vaccine because of how bad this virus is. I can't imagine passing it up because so far the virus is so much worse than any possible side effects. But for those of you who are worried about that, I presume that by late summer (if I can get it by then) they'll certainly know more about if there's anything to worry about.
posted by jenfullmoon at 5:19 PM on December 4, 2020

Thanks BungaDunga for linking to the NASM report. I read the chapter on allocation, and wow, this NYT thing is a gross oversimplification. For example, you need 2 underlying conditions to get in the earlier group, not just 1.

So if you're feeling confused by the results or thinking, I recommend reading that chapter.
posted by joeyh at 5:27 PM on December 4, 2020 [1 favorite]

jenfullmoon, if it helps, everyone i know will still be taking all these precautions until a decent amount of the population is vaccinated.
posted by cooker girl at 5:28 PM on December 4, 2020 [4 favorites]

A lot of my risk tolerance is linked to positivity rate and case counts. If we were below 1% positivity here and there was a lot of hospital space and that antibody cocktail was readily available, I'd feel a lot less anxious about seeing friends on a socially distanced basis, getting take-out, getting a haircut, etc, none of which I am doing right now.

My assumption is that after the winter wave of cases and some vaccine roll-out, positivity rates will drop and there will be less stress on the hospitals. That alone is going to make things a lot better - not that we should all rush out and be reckless, but something like going to the beach is pretty safe if the positivity rate is low and you don't rush up to people and breathe on them.

The main thing I want to know is when it will be safe to see my dad. I guess I could drive to my brother's, quarantine in his basement for two weeks and then my dad could drive in (much shorter drive, he could quarantine at home) If all three of us were vaccinated and case counts were low and we sort of light-quarantined (minimal errands and only with masks) at home, then drove in, I think that would probably be all right, right?
posted by Frowner at 5:33 PM on December 4, 2020 [3 favorites]

These are cool and kind of like the future. So far in my life the greatest advancement I've seen has been two day mail order shipping. Now lets do something else cool with science.
posted by geoff. at 5:42 PM on December 4, 2020 [2 favorites]

The tool in the Times seems too blunt for what is actually going to be pretty fluid and complex. I'm also curious who, in the end, will be defined by state vaccination plans as "essential," since so many people are in that broad category that there will need to be further prioritization within that.

For example, I hope that the people at my local grocery store who have been doing amazing work every day get prioritized above investment bankers despite both being "essential."
posted by Dip Flash at 5:43 PM on December 4, 2020 [6 favorites]

I am healthy, 48, and WFH. The article says there will be 268.7 million people in front of me. This makes total sense.

So who's behind me? 25-year olds in perfect health?
posted by wenestvedt at 5:44 PM on December 4, 2020 [2 favorites]

It looks like they just report the lowest number from the groups you are a part of.

Just Look at all the catagories you match and pick the lowest:
Age 1-17: 185.6 M
Age 18-30: 144.1 M
Age 31-64 268.7 M
Age 65 and up: 118.5 M

Health care worker: "very few"
Essential worker: 126.5 M
First responder: 20.7 M
Teacher: 137.5 M

Yes to Health risks: 23 M

It's barely a model at all.
posted by jclarkin at 5:54 PM on December 4, 2020 [4 favorites]

So far in my life the greatest advancement I've seen has been two day mail order shipping

I think for most of us, that list also includes AIDS becoming survivable, Hepatitis C bring curable, a vaccine for chicken pox that will eventually render shingles a thing of the past, and the HPV vaccine which will prevent millions of censer cases, and multiple sclerosis is also manageable these days. (Sadly, just a few years too late for my mom) I'd call all of those pretty fucking transformative for late swaths of the population and that is just a non-exhaustive list off the top of my head, limited entirely to medicine.

No doubt we have our problems; our political system has been nearly all downhill since I was born, but there has also been a lot of frankly amazing progress that easily rivals what was done in prior generations. It's easy to forget, though, because these aren't things that really get talked about much.
posted by wierdo at 6:19 PM on December 4, 2020 [17 favorites]

Jeez, Gboard is getting worse. It's not that I can't write properly, pinky swear. :p
posted by wierdo at 8:26 PM on December 4, 2020

It's barely a model at all.

Shh!
posted by Greg_Ace at 8:37 PM on December 4, 2020 [3 favorites]

We did this before! (wrt swine flu vaccinations)

Earlier today, I read this article on Maine's vaccine plans. They're building off existing plans from previous epidemics, but COVID has introduced some additional complications:

For example, back during H1N1, there were these mass vaccination clinics with people lined up, and you don’t do that with COVID. The last thing you want to do is to create a situation that could become a superspreader event.

posted by cheshyre at 8:45 PM on December 4, 2020 [2 favorites]

Listen, strange newspapers delivered from websites distributing vaccines is no basis for a system of triage. Scarce resource prioritization derives from medical necessity and ethics, not some farcical interactive javascript.
posted by jclarkin at 8:47 PM on December 4, 2020 [19 favorites]

Do we know yet if we’re going to have to do this every year?
posted by Selena777 at 9:58 PM on December 4, 2020

No, we have to wait and see how quickly it mutates and how long the immunity lasts. I suspect we won't but that's not proven.
posted by Justinian at 10:04 PM on December 4, 2020 [2 favorites]

If we did I suspect we'd have to use one of the upcoming adenovirus based vaccines even if they are somewhat less effective, I don't know how viable a new yearly mRNA vaccine which needs deep freezing would be though I suppose we'd figure out the logistics if it came to that. Ideally you'd be getting it with your yearly flu vaccine so you wouldn't notice a difference.

You are getting a yearly flu vaccine right.
posted by Justinian at 10:11 PM on December 4, 2020 [1 favorite]

Interesting to see young adults are actually in the middle. But it makes sense it's difficult to get them to stay home and stop moving around. I was talking to a friend who was talking to an older friend, and the older friend had pointed out, with sympathy, that the younger you are, the more that can happen in a year, and so the more impatient you'll feel about the loss of a year. Someone my age could have met their future spouse this year and be married by the next, but an older person who's settled down might have had a year that didn't look too different from the last.
posted by airmail at 10:33 PM on December 4, 2020 [4 favorites]

Someone my age could have met their future spouse this year and be married by the next, but an older person who's settled down might have had a year that didn't look too different from the last.

I'm not sure how old you are, but while I think this sentiment does capture the mindset of the "young" (late teens /twentysomethings), the older I get the less true I think it is. I'm in my mid 30s and have had a year like no other. There was a Hidden Brain episode a while ago about how we think getting older makes us more settled, but when we get to that older age, we find life just as dynamic as before.

A younger person might be missing out on meeting a hypothetical future spouse, but millions of older people have had to grieve the death of a spouse, friend, or child. That in itself makes this a year like no other. And to have had to grieve alone, knowing that the person you loved most died surrounded not by friends and family but by faceless staff dressed "in frightening and confusing ways" (from the obit in the FPP).... Millions of others have lost their jobs, or are learning what it means to be a young stroke survivor, or have been attacked for asking others to put on a piece of cloth.

I don't think anyone, aside from maybe a hermit in a cave in the woods, has had a year untouched by this goddamn plague.
posted by basalganglia at 2:50 AM on December 5, 2020 [12 favorites]

In 1976 there was a swine-flu scare. As a result they developed a vaccine and vaccinated one quarter of the US population within 6 months. I don't believe a word of this 'it will take a year or more before people are vaccinated'. How soon people forget history, or maybe there aren't enough people who were alive when this happened. We did this before!

In '76, we didn't have anti-vaxxers. And, we didn't have the "Mah Freedumz" cohort which believes being told to wear a mask in the grocery store is brutal tyranny run amok. And, we didn't have the internet to boil their collective paranoia into overload. These are far different times.
posted by Thorzdad at 5:37 AM on December 5, 2020 [2 favorites]

Oh we've always had anti-vaxxers. It is worse than ever now, of course.
posted by tiny frying pan at 6:18 AM on December 5, 2020 [2 favorites]

So, I like this discussion and I even like the article and data representation. But it's hard not to be critical when things are so flawed. The flaws are huge. It's interesting as an attempt at prioritization, as data representation and it's especially interesting because it's based on some completely unrealistic assumptions.

BTW -- I know nothing and this is speculation so probably best to just stop reading.

I think the biggest and falsest assumption is that we have a working federal government. We should be spending billions at the federal level and more at the state level to create the infrastructure for vaccinating people in an humane order. This is not being done and is why the article/model is a fantasy. The end effect is likely to be chaotic and be based on much lower principles than the article implies.

To express this in a way that NYTimes readers can understand, if we want to control the order that people get vaccinated, everyone needs a boarding pass. Something(s) needs to determine the criteria for and to send out these passes. The federal government is not capable of that task. So it devolves to the states. Most or all of them are not capable of that task.

Healthcare workers are likely to be first. They are part of organizations that are capable of the physical task of getting and vaccinating and the record keeping needed.

Similar for related jobs or jobs that interact with healthcare like first responders.

Old age homes are a place likely to be ahead of the NYT's projections. The infrastructure for delivering healthcare is already there. This of course will also be affected by the state and municipal infrastructure and money but it's still a place where infrastructure, money, and desire intersect to make it possible for something to be done. Not everywhere though. Some states won't order this or provide money. Some care places are so poorly funded and dysfunctional that it won't be possible.

Teachers will not be a homogeneous group. This will be handled by states and school districts and individual schools. This is going to be all over the place dependent on how rich the district is and on the capability, money and beliefs of the individual state health departments. Vaccination of children in primary and secondary schools will likely be based on how their schools handle it.

Essential workers are fucked. It's not a class. Essential workers at a nuclear power plant will be treated differently than essential workers slaughtering and preparing meat and even that is different than the essential workers in a supermarket. Most of these will be dependent on their state/city and probably even more, what company they work for. This is IMO going to be the biggest place where things will be a chaotic mess due to money.

I suspect that people like me will be undeservedly bumped way up in priority. I'm a tech worker at a top company in my field. Even though I can work 100% remotely, the money in my field is going to completely distort things. Most years I get on site flu shots, multiple opportunities for mini health screenings, etc. Is Walmart going to be pulling for an associate shelving produce the way companies like mine are likely to be providing for it's workers? Walmart is the largest private employer in the US. Based on history, it will offload this effort entirely on it's local community/city/state/federal government. Of course, there's tons of big money industries that will also be spending money and influence to help their workers cut the lines. And tons of other companies and industries that will follow the Walmart model of socializing losses.

I assume that the very rich and well connected will get vaccinated when they choose regardless of public health concerns. That likely matters only at the margins because this is likely to be a low million kind of figure. Since we ideally want to vaccinate 300+ million people in the US, this inequity is likely not very consequential.

Age isn't going to factor in to much at all except at the edge cases. Risks from getting COVID-19 will be at the edges (old age homes, Medicaid at least provided the financial infrastructure without new laws, maybe).

Health risk determination is mostly done at too low a level to have much effect. What HMO or insurance group you are part of will be much more important than your asthma or BMI.

Biden can't fix this. His pandemic response can (and I think will!) be 100 times better than Trumps. But this problem requires time and money. We wasted all the time and now (magically!) money will be scarce (as of Jan 20th when the deficit becomes super important guys!!). Things might be better if the Democrats win the Senate (but maybe not). The type of divided government we are likely to have can't respond to this type of crisis easily. And (IMO) Republicans at the federal government will sabotage any federal response as they have done for decades in order to dis-empower non-Republicans.

Sorry if you read this. It isn't worth the photons I used to send across it fiber. I still think my (non-)predictions are at least as accurate as the NYT's. But really, I liked the article and thought the data presentation was good but not perfect. And exposing the thinking of scientists and medical professionals on what should be the prioritization is good journalism.
posted by jclarkin at 6:53 AM on December 5, 2020 [7 favorites]

I really like my friend Marc's take on this article

I really dislike this framing and visualization and it strikes me as particularly American to emphasize your personal place in line. The goal is a healthy society.

Of course it's natural for we, as individuals, to be curious about our own individual place. Everyone here on MeFi is quick to share their place. But it strikes me as a particularly American (or maybe Western) discussion. That same self-centeredness has served us very poorly in this pandemic and is behind garbage like "you can't make me wear a mask". Even now the main discussion is about "who will choose to get this vaccine?" as if the entire ethical question were personal.
posted by Nelson at 6:54 AM on December 5, 2020 [10 favorites]

Eh, I skew very much toward the collectivist end of the spectrum, but I don't think it's all that problematic to acknowledge the reality of needing to prioritize who gets it first and understand where one is in the crowd. I don't think this article does a great job of doing that, for reasons people here have mentioned, but it's a natural human instinct and a not uniquely American one to want to get a sense of when one can expect to get something that could save one's life and the lives of those around them.

My hope is that a .gov version of this pops up when the adults take over that does a better job communicating the progress on vaccinating the public and giving individuals a sense of when they can expect it.
posted by tonycpsu at 7:08 AM on December 5, 2020 [4 favorites]

> I suspect that people like me will be undeservedly bumped way up in priority.

I have really good medical insurance, and it's interesting to ponder if that will make a difference. If in the US we're all getting it for free, does that mean people like me won't have the advantage we're used to? (I'm not complaining, if so; it's a terrible system.)
posted by The corpse in the library at 8:16 AM on December 5, 2020 [1 favorite]

basalganglia, you misunderstood my comment. Everyone of every age has been been affected by the pandemic - older people even more so in many ways, as they often have more obligations, like children and older parents, and they know more people with, or are more likely to have, compounding health conditions. I mean that it's difficult to tell younger people to stop going out and socializing because every social encounter has a higher probability of precipitating some kind of major change, and they itch for change. In that vein, it's even worse for children, who need to socialize for literal brain development. I've been fortunate to be able to stay home comfortably and I don't envy older people's more complicated situations, but when I see my same-aged friends running around against public health guidelines, I see where their FOMO comes from.
posted by airmail at 8:51 AM on December 5, 2020 [1 favorite]

For what it's worth, the UK has given up on the idea of doing care homes first, because they haven't fully worked out the kinks- care homes don't have -70 degree freezers. So they're doing over-80s in hospital first, because hospitals have deep freezers. This may rapidly change in the next few weeks, but this sort of messiness is probably going to happen in the US too, multiplied by 50 different states and multiplied again by municipality.

(the UK was also going to do NHS workers in the first batch, but took an abrupt U-turn on that too. it's a mess, and that's in a country with a nominally unified single healthcare provider)
posted by BungaDunga at 9:58 AM on December 5, 2020

I agree with you, airmail. I think it's really hard to tell young people to do anything because (1) underdeveloped prefrontal cortex = poor risk assessment and (2) general rebellious/wanting to strike out against authority means that curfews etc often backfire. The inability of younger people to stop socializing drives literally every infectious outbreak, from the Black Death to the yearly flu to Disneyland measles to covid-19. Public health officials are extremely aware of this, which is why healthy college students are so high on the vaccine triage list.

But the desire -- the need -- for social interaction with people outside your household doesn't evaporate once a person gets married/has kids/buys a house. If anything, the older you are, and the more obligations or health problems you have, the more likely you are to realize that your remaining time on earth is limited and precious -- young people have FOMO, old people have bucket lists.

What's more, loneliness and isolation are a massive problem among the elderly -- I spend a good portion of my professional life dealing with this (not just because of covid, though covid has heightened it for sure). I admit I was not aware of how dynamic retirement and aging is, until I entered my line of work. But it's a fallacy to assume that just because someone is middle-aged or older, they don't experience the same sense of urgency and loss as younger folks.
posted by basalganglia at 10:01 AM on December 5, 2020 [5 favorites]

In Texas - we are still really waiting to figure this out. I am a physician, and while I am primarily in the outpatient setting, I am typically rounding in at least one (and up to 5) hospitals on a near-daily basis (all but about 6 days per month). The company that manages my office has been approved to be a vaccination site (and we have the appropriate freezers for the RNA-based vaccines). But it's also possible that one of the hospital systems that I round at will allow for physicians who have privileges to get vaccinated there.

So... I will either be one of the first to get vaccinated, or I'll be in line behind hospital physicians/nurses/ancillary staff, skilled nursing workers and patients, front-line workers (EMTs -- who should arguably be at the top of the list, firefighters, police, and whomever else is included in the increasingly arbitrary "first-line worker" designation), and then me.

I'm fine with either outcome - very little changes in my life if there is vaccination. My husband is a math professor teaching remotely, so it's not like getting vaccinated means that I'm going to be able to go to the movies or eat in a restaurant. I'm not going to go into a room of a patient with COVID-19 without a mask and a face shield, or walk around a Target unmasked after work.

I will say that I think that if we are going to vaccinate police officers, we should also be offering vaccines to school teachers. I can't tell you how many patients I've had of late who have been infected by their kids, who sure didn't get sick with COVID, but sure as shit infected their parents with it. No other obvious sources, because most of my patients are pretty conservative with their activities, and actually are staying home, but their kids are back at school. If we are going to force school teachers to put their lives on the line so that they can teach our kids, the least we can do is make sure that they have the tools that they need to do their job safely... and if we won't do that, at the very least, prioritize them in line to get the vaccine.
posted by honeybee413 at 12:59 PM on December 5, 2020 [7 favorites]

Video Covering Vaccine Distribution

This is a good overview of the issues regarding vaccine distribution.

1) It looks like states and cities are being asked to devise their own plans. Unfortunately, it seems like they haven't received the money from the federal government yet to create the required infrastructure.

2) Pfizer is creating its own supply chain to handle the unique storage requirements of its vaccine.

3) The other vaccines can be shipped and stored within existing pharmaceutical supply chains.

Not in the video, but I'm wondering if part of the prioritization criteria is being created based on the number of social contacts a person has. In theory, if you vaccinate people most likely to spread the disease because they interact with a lot of people, you can halt the epidemic faster than if you vaccinate people with fewer social interactions.

Also, it looks like Britain will be the first to start distributing the vaccine starting next week: British Distribution

The quick approval and subsequent chest thumping seems to have degenerated into arguments over Brexit and "vaccine nationalism" Fauci verus UK row
posted by eagles123 at 1:46 PM on December 5, 2020

The Covid-19 vaccines are a marvel of science. Here’s how we can make the best use of them

The Association of Immunization Managers and ASTHO — the Association of State and Territorial Health Officers — have been pleading with Congress for money to do the work on the ground to get people vaccinated. They argue states need $8.4 billion to recruit and train extra workers, to run local advertising, to beef up software programs that are not currently up to the task. So far, they’ve received $340 million...

While health care workers are going to be at the front of the line for vaccines in the United States, three-quarters of them are women, and most them are of childbearing age. A significant number of them — roughly 330,000 — are either pregnant or are breastfeeding a baby, the CDC estimates.

Are Covid vaccines, and especially these first two vaccines, safe for this subset of health workers? There are no data upon which to answer that question. There aren’t even data that could be extrapolated from previous experience. The Pfizer and Moderna products will be the first mRNA vaccines to be authorized for use...

This fall Pfizer expanded its trial to enroll volunteers as young as 12. But there may not be enough data on 12- to 18-year-olds to make a recommendation for vaccine use when the FDA considers issuing an emergency use authorization. And no studies have been conducted in preteens to date.

posted by BungaDunga at 4:36 PM on December 5, 2020 [2 favorites]

These comments saying that young adults are being prioritized because they can't stop partying and older adults would never be that foolish kinda rub me the wrong way. Sure, to an extent, but the fact that young people are less likely to become symptomatic means that even a well-meaning person can spread COVID during an essential trip to the grocery store, for example. I think it also devalues the fact that this young generation is really struggling with economic security. On the whole, they're more likely than older adults to be under-insured, under-employed, or stuck in a group housing situation... all of which put them more at risk. I'm in my thirties and fine being behind them in line.
posted by Emily's Fist at 6:22 PM on December 5, 2020 [8 favorites]

When they talk about healthcare workers I hope they are prioritizing not the frontline doctors and nurses but the unskilled nursing assistants and facility workers who receive minimum wage and work two or three jobs in different nursing homes. They may work three days in one nursing home, two days in another and a day in a third.

Studies using cell phone tracing in New York have shown that every nursing home is connected to seven other nursing homes by movement of part time unskilled workers. This is how pandemics spread through nursing homes among the most vulnerable. If they want to prevent deaths, they need to vaccinate these workers first.
posted by JackFlash at 6:58 PM on December 5, 2020 [5 favorites]

JackFlash - based on what I know about the vaccination hierarchy in Texas, the plan is to vaccinate long-term care facility employees and patients. Most of the places that I work have said pretty clearly that they are encouraging vaccination, but not requiring it, which seems more problematic to me.
posted by honeybee413 at 9:12 PM on December 5, 2020 [1 favorite]

Yesterday I interviewed the president of a hospital about whether the vaccination will prevent spread to others and not just save the person vaccinated, and he thinks it would but was not definite in that belief.

I think that is at the heart of the question of who to vaccinate first: Should it be those most likely to get seriously, even terminally, ill--the elderly, those with serious health conditions, for example, or those who are out in the public and likely to expose more people by carrying the disease.

It seems to me that the plan is, consciously or otherwise, set up to prioritize saving first those who receive the vaccine because of who they are--healthcare workers, e.g., --and not the broader public, who will gradually become safer as fewer and fewer people carry the virus. Otherwise, store clerks would be higher on the list.
posted by etaoin at 9:20 PM on December 5, 2020

Most of the places that I work have said pretty clearly that they are encouraging vaccination, but not requiring it, which seems more problematic to me.

Yeah, that's a real problem. Patients in nursing homes aren't spreading the disease because they aren't going anywhere. It's the employees that are spreading the disease, from patient to patient and nursing home to nursing home. They need to be vaccinated as a top priority, both for the patients' safety and the employees and their own family's safety.

40% of all covid deaths are nursing home patients. If you want to cut the death rate, you have to start there, including mandatory vaccination for all employees.
posted by JackFlash at 9:23 PM on December 5, 2020

even a well-meaning person can spread COVID during an essential trip to the grocery store, for example

If that were how this disease is being spread, masks alone would cut transmission to very low levels and keep it there. Can happen is not the same thing as frequently happens, and it's frequency that turns out into a pandemic.

A surgical mask (or cloth mask made of appropriate materials) reduces the number of exhaled droplets by around 60%. They also reduce droplets inhaled from the environment by about 40%. N95s do even more good. This pandemic is not being driven by well meaning asymptomatic carriers, is being driven by people who assume that they don't need to follow the rules because they "aren't sick" or because it's inconvenient to them and people who are rejecting science for political reasons. That and kids mostly too young to keep a mask on their face even if they are given one. We've been incredibly lucky that those kids rarely get severely ill. Or maybe not lucky, since kids dying in droves would probably change people's mindset
posted by wierdo at 10:22 PM on December 5, 2020

The way the companion article in the Times explained it, there are two possible approaches being debated: prioritize reducing deaths (ie, prioritize vaccines to the people most at risk of dying if they catch covid), or prioritize reducing infections (ie, prioritize vaccines to the people most at risk of catching and spreading covid, even if they are low risk for dying).

There are ethical arguments for both approaches and the way that we have devolved all responsibility onto states will probably mean we can watch the different approaches in action simultaneously. Under either scenario I am near the back of the line, unless the "essential worker" category is interpreted broadly, in which case I might jump towards the front. I'm ok with where my prioritization sits, but it's going to be disgusting watching the rich and well-connected get access before critical workers and at-risk people.
posted by Dip Flash at 8:38 AM on December 6, 2020

Bloomberg: Tracking the Coronavirus Vaccines That Will End the Pandemic
posted by tonycpsu at 2:45 PM on December 6, 2020 [1 favorite]

Or maybe not lucky, since kids dying in droves would probably change people's mindset

My hot take: I've felt (and said) since about April that covid-19 hits the very unfortunate sweet spot where it is bad enough to kill a whole lot of people but not quite bad enough to terrify everyone into taking it as a deadly serious threat. If the CFR were a bit higher we might, counterintuitively, have ended up with fewer deaths.
posted by Justinian at 8:04 PM on December 6, 2020 [6 favorites]