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Friday, February 5, 2021

Vaccine shell game, the question of one shot or two and the changing priority system: What gets a population protected best?

     The vaccine rollout has had many questionable techniques.  We now see the effort to provide more locations to get one of the hypothetical shots.  This approach with a large supply of vaccine might make sense in getting the vaccine to more people but with a very limited supply, it more resembles a shell game.  Moving the same number of shots to more locations requires people to register at more locations and making the system possibly more frustrating than a more centralized system.  Compounding the confusion is trying to determine how each sign-up system works. Most sign-ups right now led to a place where you learn that there are no appointments or lead to an error message.

     A call to our Howard County Health Department this week gave me this information.  The supply to the Health Department was reduced by 66% because more vaccine from the state was now going to pharmacies, more health providers and the state plan to open a hybrid school plan in March has placed a priority on vaccinating school personnel.  After the effort last week to get as many people in the 1B group vaccinated this week the supply has been directed to the school effort.  This effort will probably impact supply in a few weeks also as the school personnel comes back for their second shot.  The effort to get school personnel vaccinated will delay resuming vaccinating the remaining 1B group and will push back the beginning of the 1C group to an unknown date in the future.  The opening of mass vaccination sites next week in a couple of locations will only add a new element into the shell game.  Until there are new vaccines approved and other measures developed to increase the supply of existing approved vaccines the frustration with getting a shot will only increase.

      The United States has been slower to approve new vaccines than Great Britain.  The Astra Zenica vaccine was approved in Great Britain in December and has increased its ability to vaccinate 50% more of its population than the United States.  While other factors may be involved in this difference such as a national health insurance system the availability of more vaccines plays a role.  I would expect that the United States will eventually approve the Astra Zenica vaccine months after it has been used in Great Britain.

    Another difference with Great Britain is its priority in getting more people with one shot than the United States priority of getting a second shot to everyone who has received the first shot.  Since the approved vaccines all presently require two shots this limits the population that can be vaccinated with one shot.  The question is it better to get one shot into as many people as possible and be satisfied with the 60-70% immunity in more people or have half the number of people vaccinated with 90% immunity? Great Britain is looking at delaying the second shots out to 6 weeks to get more people the first shot.  There is some preliminary data that indicates that with just the first shot people are protected from any serious illness from COVID. Given the limited supply of vaccines and 3,000 Americans still dying every day an emphasis on getting as many first shots as possible is not an unreasonable question.

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