[chrisk]

Part of it is that it is a real logistical challenge to get the vaccines to all the right people at the right time.  There will be some people who will no-show for their appointment.  There will be others who might get sick at the last minute and will be turned away.  There will be some vials where you get an extra dose out of.  And you probably pad the vaccine doses just in case a vial breaks or has to be rejected for some reason, so you wind up scheduling fewer people than there are doses.  Normally, that's not a big deal; you just put the vial back in the fridge and pick up where you left off the next day.  But in this case, you have five days from when you thaw the vaccine to use it so that there is the very real possibility that if you don't give it to someone, anyone, you will lose it.  It is better to give the vaccine to a researcher with a Stanford ID who might not otherwise qualify than to have to waste the dose.

Up close, this will look messy and imperfect, and make some people mad about unfairness, but on the whole, most of the people who need to get vaccinated will, and this is definitely something where perfect is the enemy of good.

BC

It will look messy and imperfect because it will inevitably be messy and imperfect, but the main thing is to get vaccine into the "targeted groups" arms ASAP. The real issue here is that we are going agonizingly slowly. As many have pointed out it will take YEARS at the rate we are going. At some point the perfect is very much the enemy of good enough, but we are even real short of good enough.

I expected the State to be pretty messed up because they really didn't figure this out in advance at all. However, it boggles my mind that there seems to be no sense of urgency. I certainly don't want vaccine wasted because of "undue haste", but the idea it would take a month to immunize all the phase 1a people is just unsatisfactory IMHO.

Do you think the state has a working data base set up yet to keep track of the massive volumes of residents who will be vaccinated? Won’t they need all sorts of interfaces with lots of EMRs and provisions for manual tracking?

[chrisk]

Part of it is that it is a real logistical challenge to get the vaccines to all the right people at the right time.  There will be some people who will no-show for their appointment.  There will be others who might get sick at the last minute and will be turned away.  There will be some vials where you get an extra dose out of.  And you probably pad the vaccine doses just in case a vial breaks or has to be rejected for some reason, so you wind up scheduling fewer people than there are doses.  Normally, that's not a big deal; you just put the vial back in the fridge and pick up where you left off the next day.  But in this case, you have five days from when you thaw the vaccine to use it so that there is the very real possibility that if you don't give it to someone, anyone, you will lose it.  It is better to give the vaccine to a researcher with a Stanford ID who might not otherwise qualify than to have to waste the dose.

Up close, this will look messy and imperfect, and make some people mad about unfairness, but on the whole, most of the people who need to get vaccinated will, and this is definitely something where perfect is the enemy of good.

BC

It will look messy and imperfect because it will inevitably be messy and imperfect, but the main thing is to get vaccine into the "targeted groups" arms ASAP. The real issue here is that we are going agonizingly slowly. As many have pointed out it will take YEARS at the rate we are going. At some point the perfect is very much the enemy of good enough, but we are even real short of good enough.

I expected the State to be pretty messed up because they really didn't figure this out in advance at all. However, it boggles my mind that there seems to be no sense of urgency. I certainly don't want vaccine wasted because of "undue haste", but the idea it would take a month to immunize all the phase 1a people is just unsatisfactory IMHO.

Do you think the state has a working data base set up yet to keep track of the massive volumes of residents who will be vaccinated? Won’t they need all sorts of interfaces with lots of EMRs and provisions for manual tracking?