COVID Vaccine !

[nickyboy]

I failed to mention anything the £10 extra is the only thing being reported this morning.
As it happens i willl seeing with a number of GP’s tomorrow on patient transport call out’s. So I can check if this is the case
My post still stands yet again you believe they are coining it. To believe any HCP is some how making money out of any of this Covid horror show is not worth anymore of my time on it. Neither is the person making it. The only ones coining it are Dido , Serco and the many others all of which have failed to do even the basics right.

https://www.england.nhs.uk/2020/12/...boost-to-support-care-home-vaccination-drive/

 

[midlife]

Mrs 73 still had to wait for 15 mins after her’s a few days ago.

Our mob probably read the pulse lol

https://www.pulsetoday.co.uk/news/c...es-after-oxfordastrazeneca-covid-vaccination/

 

[Ajax Bay]

Given that the recommendation is not to drive for 15 minutes, some passive delay seems entirely sensible, for the Oxford-AZ vaccine as well as for the Pfizer dose. A little time will be taken with post-vaccination info, second dose appointment arrangements/card stuff and immediate reactions will be during that time. And by the time a self-driver gets to their car it should be 15 minutes.
Are we being extra cautious compared to flu vaccination? Our local (seaside) car park was used and recipients did not need to leave their car. The same car park is set up in a similar fashion, but I am too young to have got a closer look besides riding by.

 

[Buck]

If you have recently had covid, is there a length of time you have to leave it before being vaccinated?

Julia. 28 days is the suggested timescale If it is a,positive COVID PCR test and not just suspected. We ask this question whenbokking and if “yes” then we note to follow up 28 days after the date of the result.

 

[Buck]

GP practices receive £12.58 per Covid vaccine administered and for Care Homes as an incentive to hit the government target there was a lot of money thrown around to get this done.
it is not cheap to do this as there has to be a GP on site to provide clinical governance of the vaccinations. With the Pfizer vaccine it is also quite a time consuming exercise as you have to reconstitute the vaccine and draw it up out of multi-dose vials so not as simple as say the single dose flu jabs each year.

For the housebound we had planned all of ours splitting our practices into two teams and we have over 500 patients who are HB and many are geographically spread I.e. 30 mins between visits. In addition, to get these done over and above the normal acute HVs we did this over the weekend which incurred additional cost (1.5 overtime) for those working. Thankfully there is no post vaccination 15 minute wait for the AZ vaccine which is the only vaccine able to be used for HVs.

Putting specifics to one side, the set up costs and running costs before any one patient is vaccinated are not insignificant and whilst these additional sums are welcome, they are not pure profit but they are a mechanism to incentivise some GP practices who shall we say are slow off the mark!

The above hopefully give some context and I’m not going to justify the costs or income or profit/loss but we believe at best we will be cost neutral on all of this. We decided we would support the vaccination programme (yes, it was optional) as this is our moral duty and if we lose some money as a result then so be it but current projections are that we will be neutral. As @nickyboy says It’s the meat with the bone. Taking either in isolation is a mistake.

 

[Pale Rider]

So you think a DN is any cheaper ?

I have no view on costs, which is why I didn't mention it.

Given that my details were passed on by the GP to a vaccination centre, it seems to me my GP practice might be doing very little with regards to administering vaccines.

The general point being that not everyone in the NHS is under enormous pressure due to the pandemic.

Which in one respect is a good thing, because if everyone was permanently working at 100mph they would blow up within weeks.

 

[roubaixtuesday]

Very informative thread on the SA variant and vaccine effectiveness against it.


View: https://mobile.twitter.com/DrZoeHyde/status/1358749325610737665

 

[Ajax Bay]

'Downing Street briefing' this pm offered these figures for vaccine completions (data to inform @mjr's preferred assessment of performance versus 15 Feb target model aiui).
Gp 1 - 'All' care homes visited. 93% of residents vaccinated. Percentage of staff not mentioned so I assume lower, because of hesitancy.
Gp 2a (O/80) - 91% vaccinated
Gp 2b (Health and Care workers 'frontline') - not mentioned - might we assume there's been ample offer/opportunity?
Gp 3 (75-80) - 95%
Gp 4a (70-75) - 73% (actually "just under three quarters" was phrase)
Gp 4b (CEV) - not mentioned
Now a plea for anyone in these priority groups (NB change of routine to get the last few 'done') to phone in if they have not been contacted or to use the communication they've received to book a jab, and if they've got two, to choose one and get on with it.

 

[Ajax Bay]

A point Van-Tam made in the 'Downing Street briefing' this pm was interesting (enough to share on here), wrt the SA variant (B.1.351) - see @roubaixtuesday 's link above for detail on reduced efficacy, small numbers in trial but likely 'an issue'.
He observed that the numbers of infections and geographic spread of Variant B.1.351 was still limited in UK and the vast majority of virus in the wild was the B.1.1.7 strain (aka UK/Kent discovered by genomics). (Worth pointing up the UK's superb genomics capability, quoted elsewhere as doing more than half the assays in the world, allows a better insight than anywhere to this. Is this effort government funded? (I don't know.)
Van-Tam also assessed that the B.1.351 did not seem to be more transmissible than the B.1.1.7 variant.
It was the substantially higher (Edit: 1.4) transmissibility of the the B.1.1.7 variant compared to the 'basic' (Jan-Sep 2020) which meant it 'out-competed' its predecessor and is now the dominant strain across the country. It also is one which resulted in the surge in cases and consequences from December onwards (along with other factors affecting 'R').
He deduced (on current evidence) that the B.1.351 variant would not out-compete the B.1.1.7 variant in UK so the effectiveness of the UK vaccination programme would be maintained.
Aiui

 

[roubaixtuesday]

A point Van-Tam made in the 'Downing Street briefing' this pm was interesting (enough to share on here), wrt the SA variant (B.1.351) - see @roubaixtuesday 's link above for detail on reduced efficacy, small numbers in trial but likely 'an issue'.
He observed that the numbers of infections and geographic spread of Variant B.1.351 was still limited in UK and the vast majority of virus in the wild was the B.1.1.7 strain (aka UK/Kent discovered by genomics). (Worth pointing up the UK's superb genomics capability, quoted elsewhere as doing more than half the assays in the world, allows a better insight than anywhere to this. Is this effort government funded? (I don't know.)
Van-Tam also assessed that the B.1.351 did not seem to be more transmissible than the B.1.1.7 variant.
It was the substantially higher (1.5 (CI 1.3 to 1.7)) transmissibility of the the B.1.1.7 variant compared to the 'basic' (Jan-Sep 2020) which meant it 'out-competed' its predecessor and is now the dominant strain across the country. It also is one which resulted in the surge in cases and consequences from December onwards (along with other factors affecting 'R').
He deduced (on current evidence) that the B.1.351 variant would not out-compete the B.1.1.7 variant in UK so the effectiveness of the UK vaccination programme would be maintained.
Aiui

There is what seems to be an obvious fatal flaw in VT's reasoning:

If the SA variant is vaccine resistant, and the other is not, then as soon as many people are vaccinated, it will have a huge advantage, and promptly out- compete the other and become dominant.

I presume I've missed something here as VT has far more expertise than me, but it seems an obvious conclusion.

 

[IaninSheffield]

If the SA variant is vaccine resistant, and the other is not, then as soon as many people are vaccinated, it will have a huge advantage, and promptly out- compete the other and become dominant.

I presume I've missed something here as VT has far more expertise than me, but it seems an obvious conclusion.

Isn't it the case though, that we don't know yet whether the vaccines reduce transmission, only that they reduce severity of symptoms? So the UK variant will continue to remain dominant as it continues to be transmitted?

But appreciate my reasoning may be flawed?

 

[roubaixtuesday]

Isn't it the case though, that we don't know yet whether the vaccines reduce transmission, only that they reduce severity of symptoms? So the UK variant will continue to remain dominant as it continues to be transmitted?

But appreciate my reasoning may be flawed?

Maybe that's the logic. But I think there was data published just this week suggesting the AZ vaccine does reduce if not eliminate transmission. And I think everyone expects at least some degree of reduction in transmission for all these vaccines - and it would be very odd if the variant that the vaccine was least effective against was not also the variant whose transmission was affected the least?

 

[lane]

Makes no sense to me. Having normal or Kent Covid does not protect against SA variant so why can't it spread alongside the other two. The current vaccines appear to offer an increasingly temporary solution.

 

[Ajax Bay]

I guess time will tell. Don't think there's merit in slowing down the vaccination programme, giving it gives evidence-based protection from serious illness and death, and putative reduction in transmission: and therefore overall numbers infected. In South Africa the proportion of variants is substantially different to UK so their decision to pause the use of the Oxford-AZ vaccine because of this small cohort inefficacy result is based on different circumstances. I note that the Pfizer vaccine has not been tested (clinical trial) against the B.1.351 variant, sfaik. Maybe it will do better.
Recommend two snips of media to people: Oxford Uni's Prof Sarah Gilbert's interview on the 'Andrew Marr show' on Sat am (about 0940 - 32:50 - 46:00) and a set of Q&A with two experts (one ex-RCGP Head, one JCVI) on BBC's 'Today' programme this Tue am (0842-0855 2:41:50 - 2:55:00). One of the questions in the latter makes exactly @roubaixtuesday 's point (above, about the effect of the vaccine suppressing the B.1.1.7 variant and therefore giving benefit to the B.1.351 variant). Answer (my best): "There'll be lots of variants; think the focus is too much on the SA variant; yes, vaccination will have effect on relative variant success but it's still the way out of high levels of serious illness and deaths; it's a paradox."

 

[mjr]

The UK signed a deal with CureVac last week. The EU signed theirs months ago. How different things could have been if the vaccines had developed at different rates.