Great post. Longterm we also badly need a one-dose vaccine like the flu-shot already is, so more research/trials are also needed. Scheduling people for two shots and making sure they come for the second one is a big logistical headache. Especially if they have a bad reaction to that first shot. Ask anyone who's had to get two-dose vaccines for other diseases (or had to try and get them for their kids)--things happen that make that second shot not a sure thing.
The JNJ vaccine is a one-shot deal. The US Government has already bought 100 million doses for when it gets an FDA emergency use authorization - which should be coming later this month.
"We are currently building up a system like that, but we will not be able to afford to scale it down or dismantle it once the initial vaccination drive has been completed."
If you think a Republican Senate will approve funding for maintaining a vaccine infrastructure purely as a preventive measure, I've got a degree from Trump University to sell you. If the past 20+ years has taught us anything, it has taught us that Republicans are degenerate gamblers.
We have spent $625M/yr since 2005 to stock the Strategic National Stockpile with vaccines for influenza, anthrax, smallpox along with various antiviral drugs.
Since 2001, $20 billion has gone to state and local government purely for pandemic planning and infrastructure building (our current experience seems to show the money just vanished into thin air)
Then add another $300 million per year for annual influenza vaccine grants to the states for building out their immunization information systems, lab support, monitoring, etc.
We’re already spending bundles of dough and have been for the better part of two decades. The problem is that so far, we haven’t seen any results.
Do you think there is possibility state governments might jump in? I haven't seen any polling, but I could imagine this would be an opportunity for governors to levy some tax to get better funding for primary care and public health. Like, people really go out of their way thank health-care workers right now.
IIRC regulation of vaccines and other pharmaceuticals is almost exclusively the domain of the federal government. That leaves individual state governments with little scope for action.
There's a major public goods problem here: California preparing for a pandemic will by itself make the rest of the country far more prepared for a pandemic. That gives every other state a big incentive to shirk their responsibilities. There's also the issue that republicans in state government are just as radically right-wing, if not more so, than republicans in the federal government.
Ideally, this would all be administered federally, but absent that I'm not sure California preparation for a pandemic is simply California bearing all the burden and getting none of the gain. Like, if more Californians are vaccinated there's a less likely chance of a local outbreak, which is good specifically for California. Yes, it would also decrease the risk of other states too, but wouldn't it be too a lesser degree (i.e. the proportional benefits bend towards California)?
This is the first piece I've read that isn't just bitching and moaning or pointing fingers. It's a monstrous problem that will take a huge effort to overcome, but it is doable if we truly approach it as we did the war against fascism last century. It's ironic that, with all the failed "wars" on terrorism, drugs, crime, etc., we finally have something that justifies that kind of terminology. I just hope that our new leadership is up to the challenge and that it can sufficiently unify a deeply fractured nation.
Thank you Noah, great piece. Here in Alaska the public health crew in charge of vaccine distribution is doing a decent job so far. They've been able to adjust their rules as needed, first staying fairly strict with the priority tiers, then opening things up when the priority schemes were slowing things down. We're doing 65+ now. Soon the bottleneck will be lack of supply, which is as it should be.
They've had website issues that allowed non-prioritized people to get through, but so what? Getting doses in arms is good for everyone.
Contrast that to my other home state of Oregon which has a panel that has been arguing about the 'equity' issues around their prioritization scheme for weeks. Yes, there will be inequity, yes, there will be unfairness, but get those shots in arms! That's the most important thing.
Your friend Zoe comes across as a bit of a Karen. I’m guessing as a health care provider she is probably a little stressed.
I am solely on the side of vaccinate as fast as u can.
I think the slowness is a result of the medical community trying to be to accurate about priorities.
Speed is more important than accuracy. Better to do more people and have the odd person slip throughout the system and get vaccinated early.
I’m still hanging on here in Texas on this job. Why do people think it’s a good place to move too! Hopefully I can last another month being lucky.
Great post. Longterm we also badly need a one-dose vaccine like the flu-shot already is, so more research/trials are also needed. Scheduling people for two shots and making sure they come for the second one is a big logistical headache. Especially if they have a bad reaction to that first shot. Ask anyone who's had to get two-dose vaccines for other diseases (or had to try and get them for their kids)--things happen that make that second shot not a sure thing.
The JNJ vaccine is a one-shot deal. The US Government has already bought 100 million doses for when it gets an FDA emergency use authorization - which should be coming later this month.
Thanks for the update. I wasn't aware of that. Good news! 👍
Not much to add other than, this is a very sobering read.
"We are currently building up a system like that, but we will not be able to afford to scale it down or dismantle it once the initial vaccination drive has been completed."
If you think a Republican Senate will approve funding for maintaining a vaccine infrastructure purely as a preventive measure, I've got a degree from Trump University to sell you. If the past 20+ years has taught us anything, it has taught us that Republicans are degenerate gamblers.
We have spent $625M/yr since 2005 to stock the Strategic National Stockpile with vaccines for influenza, anthrax, smallpox along with various antiviral drugs.
Since 2001, $20 billion has gone to state and local government purely for pandemic planning and infrastructure building (our current experience seems to show the money just vanished into thin air)
Then add another $300 million per year for annual influenza vaccine grants to the states for building out their immunization information systems, lab support, monitoring, etc.
We’re already spending bundles of dough and have been for the better part of two decades. The problem is that so far, we haven’t seen any results.
Do you think there is possibility state governments might jump in? I haven't seen any polling, but I could imagine this would be an opportunity for governors to levy some tax to get better funding for primary care and public health. Like, people really go out of their way thank health-care workers right now.
IIRC regulation of vaccines and other pharmaceuticals is almost exclusively the domain of the federal government. That leaves individual state governments with little scope for action.
There's a major public goods problem here: California preparing for a pandemic will by itself make the rest of the country far more prepared for a pandemic. That gives every other state a big incentive to shirk their responsibilities. There's also the issue that republicans in state government are just as radically right-wing, if not more so, than republicans in the federal government.
Ideally, this would all be administered federally, but absent that I'm not sure California preparation for a pandemic is simply California bearing all the burden and getting none of the gain. Like, if more Californians are vaccinated there's a less likely chance of a local outbreak, which is good specifically for California. Yes, it would also decrease the risk of other states too, but wouldn't it be too a lesser degree (i.e. the proportional benefits bend towards California)?
Two things:
- Emphasizing using the defense production act. Here, here!
- Has anyone made a infographic showing both the dynamic of vaccine inoculation velocity and ordering of who gets vaccine?
This is the first piece I've read that isn't just bitching and moaning or pointing fingers. It's a monstrous problem that will take a huge effort to overcome, but it is doable if we truly approach it as we did the war against fascism last century. It's ironic that, with all the failed "wars" on terrorism, drugs, crime, etc., we finally have something that justifies that kind of terminology. I just hope that our new leadership is up to the challenge and that it can sufficiently unify a deeply fractured nation.
Don't forget the rest of the World. If the vaccine program only covers Americans, travel restrictions will have to remain in place forever.
Thank you Noah, great piece. Here in Alaska the public health crew in charge of vaccine distribution is doing a decent job so far. They've been able to adjust their rules as needed, first staying fairly strict with the priority tiers, then opening things up when the priority schemes were slowing things down. We're doing 65+ now. Soon the bottleneck will be lack of supply, which is as it should be.
They've had website issues that allowed non-prioritized people to get through, but so what? Getting doses in arms is good for everyone.
Contrast that to my other home state of Oregon which has a panel that has been arguing about the 'equity' issues around their prioritization scheme for weeks. Yes, there will be inequity, yes, there will be unfairness, but get those shots in arms! That's the most important thing.