[mchusma]

First Dose First and approving more vaccines are the easiest answer to this question. The prioritization is not working well, for the reasons outlined in this article.

However, we can give approximately 4x the rate of people getting 100% protection from ICU/death.

First dose first gives you approximately 2x the throughput (all first doses from all vaccine candidates thus far are fully protective from death).

Approving Astrazeneca, J&J, and Novavax today would give you a group of vaccines that don't rely on cold storage, so can be run through different distribution channels.

At 4x the rate, these prioritization concerns are much less important.

The US is flatlining in its number of doses administered, which means that by prioritizing 2nd doses, we will start to vaccinate very few new people soon (choosing instead to administer 2nd doses). We can see a looming shutdown of any progress towards herd immunity, and urgent action is needed.

[SteveNuts]

How can technology help with this? What percentage of manufactured doses per week are being administered?

[SllX]

They already built a system in Washington to keep track of where every single dose anywhere in the country is and redistribute it as necessary.

I take the existence of this system at-all to be emblematic of the general failure of government vaccine distribution.

I’ll offer up my reasoning if asked, but I would like you to think about why I say this and what type of accounting we should actually be practicing.

[andrei_says_]

I’d love to hear your reasoning and alternatives.

[SllX]

Throw the computer system out the window onto the car of the guy who thought spending time and resources on this was a good idea.

All we care about is how many people were vaccinated, and how many doses are thrown out before use.

Obviously we care about how many are vaccinated. Why do we care how many are thrown out? To show where and how we failed. We didn’t get SARS. This is our SARS moment, but more importantly, we are in the process of proving out an entire new class of vaccines that were never used before, are easier to produce on a per virus basis than any vaccine before it, and more effective than what we did before using traditional methods. So where are we failing in the distribution, and why?

Three forms you can file electronically with less info than a birth certificate.

1. Patient ID. First dose or second dose, and the address of the Office they were vaccinated.

2. Vaccine disposal. Basically a summary of how many were thrown out and why these doses were wasted.

3. A reorder form.

At this point we have dumped trillions of dollars of relief into the economy with a promise from House Democrats to dump trillions more. Trying to keep a perfect record of where every single dose is in the country rather than just injecting them in anyone who wants a vaccine is expensive overhead and wasted effort.

[andrei_says_]

> Trying to keep a perfect record of where every single dose is in the country rather than just injecting them in anyone who wants a vaccine is expensive overhead and wasted effort.

I hear this and I also think there’s value in mechanisms preventing abuse at scale.

Also, bean counters gonna bean count and they happen to allocate resources so bean counting is always a priority. That’s a human / perspective issue built into the system of prioritizing bean counting.

[dcolkitt]

The FDA's continual foot dragging on approving AstraZeneca is criminal. The UK has already thoroughly reviewed it and decided it was safe for approval. Is there any reason to believe that British scientists are any less competent than their American counterparts?

If the trials were successful in the UK, it's a complete waste of time to insist that they be duplicated in the US. Especially when thousands die every day. It's not like biology works different in the Western Hemisphere. This is just another example of bureaucrats flexing their power to aggrandize their own importance.

[armada651]

The FDA's continual foot dragging on approving Thalidomide is criminal. West Germany has already thoroughly reviewed it and decided it was safe for approval. Is there any reason to believe that German scientists are any less competent than their American counterparts?

Frances Kelsey is just another example of bureaucrats flexing their power to aggrandize their own importance.

[andrei_says_]

You forgot the /s and that may be confusing to many.

Frances Kelsey refused to approve the drug despite immense pressure to do so, and thus prevented releasing a drug causing birth defects.

[dcolkitt]

Covid kills more people every day than the entire number of birth defects caused by thalidomide in its entire history. Maybe it's time to start living in the here and now, instead of worrying about a minor incident from more than half a century ago. It's easy to count type I errors, now actually make an effort to quantify that against the countless number of type II errors.

I'm willing to bet you any amount up to $10,000 that AstraZeneca vaccine does not result in more than ten thousand deaths worldwide within the next two years. You clearly believe otherwise, since you think it's prudent for the FDA not to approve it. If you're not willing to risk your money, why are you willing to risk people's lives? Do you accept?

[skadamou]

Here is a good article that explains how drug approval is different in the US from Europe/UK [1]. Basically, the FDA has a reputation for being more thorough and for not taking the drug companies at their word and instead looking at the raw data from their trials. IDK if that is the best approach for approving the AstraZeneca vaccine but as this article explains, the FDAs approach did prevent thalidomide from being used in the US which was later found to cause birth defects in Europe and Canada.

[1] https://www.theguardian.com/world/2020/dec/04/how-vaccine-ap...

[dcolkitt]

Thalidomide occurred more than fifty years ago. Do you think it's maybe possible that medical science has advanced a little bit since then?

Also the total number of birth defects that thalidomide ever caused over its entire lifecycle, is less than the number of Covid deaths per day. Relative to the number of lives that hang in the balance, thalidomide is a rounding error, and shouldn't be considered.

On net, there's absolutely zero evidence that European drug approval is dangerous vis-a-vis the US. European healthcare systems produce much better outcomes than the US. And they have for decades.

[the-dude]

Does it really matter? Does AZ have production locations in the US?

Because their production schedule is behind on their orders for the UK and the EU.