Here’s the federal government’s plan for vaccine prioritization, which was approved 13-1 this week. States have some authority to alter it, but most are expected to more or less go along with it.
Presumably, the vertical axis is Number Vaccinated:
Proposed groups for Phase 1a vaccination Health care
Personnel (HCP) (~21 million)
Wow, America has 21 million health care workers. Health care is a huge fraction of the national GDP, so I guess that makes sense, but, still, wow. I’m wondering how many of them, however, are back room data clerks and the like who have zero need to interact with patients?
Vaccinating doctors, nurses, orderlies, etc. up front will serve as a vast Phase IV trial to see what turns up.
Having doctors go first is good propaganda. Most people trust their own personal doctor, so him saying, “I got my vaccination back on New Year’s Eve. My wife, who is also a doctor, and I are going out for dinner and dancing on Valentine’s Day because we are now virtually immune. So you’ll be getting vaccinated ASAP, right?”
Long-Term Care Facility (LTCF) Residents (~3M)
• Skilled nursing facilities (~1.3 M beds)
• Assisted living facilities (~0.8 M beds)
• Other residential care (~0.9 M beds)Summary of Work Group considerations supporting
vaccinating health care personnel in Phase 1a
As of Nov 30, at least 243,000 confirmed COVID-19 cases among HCP, with 858
deaths
So, the Case Fatality Rate for health care personnel has been about 0.4%. The Infection Fatality Rate would be lower, but probably not all that much lower because health care personnel get tested a lot. Health care workers probably average, what, in their early to mid-40s in age, and tend to be skinnier and healthier than the public average.
LTCF modeling demonstrates more cases and death averted at the facility by
vaccinating staff compared to vaccinating residents2
COVID-19 exposure (inside and outside the healthcare setting) results in
absenteeism due to quarantine, infection and illness. Vaccination has the potential
to reduce HCP absenteeism
If you get a case of COVID at the peak of a wave in your area and have to go to the hospital due to not being able to breathe, you don’t want to find when you arrive that a huge percentage of the workers at the hospital aren’t there because they are sick or quarantining.
Long-Term Care Facility (LTCF) residents and staff accounted for 6% of cases
and 40% of deaths in the U.S.1 (Nov 24, 2020)
– Skilled Nursing Facilities (~1.3M)
• ~496,000 confirmed + probable cases (as of Nov 15, 2020)2
• >69,000 deaths
So, that’s a Case Fatality Rate of about 14% in Long-Term Care Facilities.
Another presentation on the Monday meeting:
By the end of December, the number of doses available will be about 40 million,
enough to vaccinate 20 million people
– Anticipate 5-10 million doses per week post-authorization
If they could be confident of getting a steady 10 million extra doses per week in January, then they could inoculate 40 million in late December and have enough to re-inoculate on schedule in January. If not, then they have to keep some of the doses in the deep freeze for the second round.
How severe are the reactions to the vaccine? Not inconsiderable.