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COVID-19: Vaccine and testing procedures Megathread Part 3 - Read OP

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  • Registered Users, Registered Users 2 Posts: 2,014 ✭✭✭Miike


    Of course France went down this route but I wouldn't see us following. There's no firm data on this course of action and it's not something either WHO or EMA are in a position to recommend. It's a risk to be honest.

    Would need more trial data.

    At the end of the day with AZ we're looking at a very very rare side effect, for the majority we should continue with the use of AZ is my opinion.

    The research proposal from France was only submitted last week. We're a long while out before we have good trial data for their course of action and in the absence of that data as you say the EMA or WHO are not in a position to make that recommendation and quite frankly neither are the NIAC.

    I'll take my chances with AZ and evidence based practice please and thank you :pac:


  • Registered Users, Registered Users 2 Posts: 68,173 ✭✭✭✭seamus


    Why? And in what sense?
    Firstly why wouldn't we expect to follow the Israelis? Apart from anything else they're even more densely populated so a lower threshold would make sense for us if anything.
    And what's this "foot to the floor" mean? Make every keep their lives on hold for even longer?
    Sorry, jumping back a bit. We wouldn't follow the Israelis because they're purely using Pfizer. We have a mix with different efficacies, so we can't assume that infection spread will hit the floor at 56% vaccinated.

    "Foot to the floor" means we don't ease up on our vaccination programme like Israel have done.


  • Registered Users, Registered Users 2 Posts: 15,468 ✭✭✭✭stephenjmcd


    The examiner article below for anyone thats interested regarding J&J & choice of vaccine or lack of.

    https://twitter.com/irishexaminer/status/1381512436906389504?s=20


  • Registered Users, Registered Users 2 Posts: 7,206 ✭✭✭Lucas Hood


    Would I right in assuming that you can now go to any walk in test center within your county now the 5km limit is gone.?


  • Registered Users, Registered Users 2 Posts: 68,173 ✭✭✭✭seamus


    We'll probably be a bit like the UK though. People find out through various means, what vaccine is in use in which MVCs and book themselves into the MVC which is using the vaccine they want.

    It's probably address-based, but people give relatives' addresses to get around it.


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  • Registered Users, Registered Users 2 Posts: 2,466 ✭✭✭landofthetree




  • Registered Users, Registered Users 2 Posts: 32,132 ✭✭✭✭is_that_so


    Lucas Hood wrote: »
    Would I right in assuming that you can now go to any walk in test center within your county now the 5km limit is gone.?
    Think that will remain, in terms of managing numbers it makes sense and it is focusing on local transmissions. That said, they probably couldn't stop you rolling up to one.


  • Registered Users, Registered Users 2 Posts: 11,729 ✭✭✭✭salmocab


    Lucas Hood wrote: »
    Would I right in assuming that you can now go to any walk in test center within your county now the 5km limit is gone.?

    They are for targeted localities so I doubt you’d be entitled to a test


  • Registered Users, Registered Users 2 Posts: 14,666 ✭✭✭✭josip


    AZ is roughly 20% of supply in Q2, whatever about their delivery schedule and the schedule of others its a large number and would have an impact whatever way you look at it. The higher the cut off (if there is one - not going to second guess NIAC) the more severe the impact & it would impact rollout to the vulnerable, the lower the cut off the less impact. It's a very very rare side effect, lots to weigh up for NIAC.

    Pfizer is the workhorse here but it needs all the others to chip in & AZ is a big part of that.

    As for the rest of the post I think we've exchanged views on this in the AZ thread a good bit so not going to bring it back up, we'll agree to disagree on a bit of it.

    If an over 45 only for AZ was chosen, then there would be c.10% reduction in Q2 first doses.
    They would be more than covered by the July supply from the other manufacturers.
    Plus they would be fully vaccinated sooner than if they had gotten AZ.


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  • Registered Users, Registered Users 2 Posts: 14,666 ✭✭✭✭josip


    This doesn't come as a surprise based on the reported efficacy and anecdotally from what I'm hearing from countries where Sinopharm is doing the majority of vaccinations.

    https://www.theguardian.com/world/2021/apr/11/china-considers-mixing-covid-vaccines-to-give-greater-protection

    Hopefully they can work out a booster that will increase the efficacy.


  • Registered Users, Registered Users 2 Posts: 5,995 ✭✭✭Russman


    josip wrote: »
    If an over 45 only for AZ was chosen, then there would be c.10% reduction in Q2 first doses.
    They would be more than covered by the July supply from the other manufacturers.
    Plus they would be fully vaccinated sooner than if they had gotten AZ.

    That wouldn't be too bad considering. But would there be a reduction at all in the absolute number of first doses ? I haven't really gone through it in detail, but would it not just be a rebalancing of who gets jabbed and when ? If the cut off was over 45 or 50 or whatever, is there enough people in those cohorts for us to use our full AZ allocation on ?
    Not arguing with you at all, just hypothetically playing it out really.

    Tricky one for NIAC. I know the numbers and the odds don't extrapolate out directly, but if its a 1 in 200k chance of these events, and AZ are doing 800k-1m of our population, we could be seeing 5 cases. If the Norwegian rates came to pass we could be looking at 40-50 cases.


  • Registered Users, Registered Users 2 Posts: 14,666 ✭✭✭✭josip


    Russman wrote: »
    That wouldn't be too bad considering. But would there be a reduction at all in the absolute number of first doses ? I haven't really gone through it in detail, but would it not just be a rebalancing of who gets jabbed and when ? If the cut off was over 45 or 50 or whatever, is there enough people in those cohorts for us to use our full AZ allocation on ?
    Not arguing with you at all, just hypothetically playing it out really.


    I'd been thinking about that too and the downside I can see is that you'd have to delay vaccinating some of the older, more at risk, AZ-eligible cohort until May, June when AZ doses for those months were delivered.
    How much of a downside that would be, versus delaying some of the younger cohort to July would be for NIAC to calculate.


  • Posts: 1,178 ✭✭✭ [Deleted User]


    A reporter from The Examiner was just on RTE Radio saying that from speaking to his medical sources, there's no major concern about how any change in NIAC advice would affect the rollout. It's primarily a scheduling issue, and while it would have some impact, it's not as big a deal as is being made out. This is because Astrazeneca makes up only a fifth of our supply this quarter.


  • Registered Users, Registered Users 2 Posts: 12,059 ✭✭✭✭titan18


    It might not even be an issue. If you go over 50s atm lets say, all you do until probably end of May is disrupt AZ to people under 50 in groups 4 and 7. By the end of May, there might be more information on who exactly is prone to the clotting issue.


  • Registered Users, Registered Users 2 Posts: 68 ✭✭sd1999


    Flying Fox wrote: »
    A reporter from The Examiner was just on RTE Radio saying that from speaking to his medical sources, there's no major concern about how any change in NIAC advice would affect the rollout. It's primarily a scheduling issue, and while it would have some impact, it's not as big a deal as is being made out. This is because Astrazeneca makes up only a fifth of our supply this quarter.

    AZ was always planned for the 65-69s too so they've got as long it'll take to give them their first doses to iron things out.


  • Registered Users, Registered Users 2 Posts: 883 ✭✭✭eoinbn


    sd1999 wrote: »
    AZ was always planned for the 65-69s too so they've got as long it'll take to give them their first doses to iron things out.

    Once there is a restriction then that doubt could cascade to other groups. I can see a lot of people in the 50's/60's age groups turning AZ down. Hopefully I am wrong.


  • Registered Users, Registered Users 2 Posts: 451 ✭✭Gile_na_gile


    Perhaps the MDs can chime in, but it seems the rare clotting issue is more related to the adenovirus platform than the AZ vaccine specifically, since we are seeing similar results from the Janssen vaccine. Given their importance and similar efficacy (J&J seems better against variants), it would indicate it was best to plough on as the UK have done. Let other cohorts start and register their interest if the stock is building up and prioritise vaccination by any means rather than wondering what to do with AZ. The clotting risk is probably common to all groups anyway, since existing data favours the fact that many vaccinated people were female HCWs or social care workers.

    Anyone concerned about efficacy might get an mRNA top-up later in the year anyway, probably including protection against new VOCs, but would be good to have some data already on vaccine mixing.


  • Registered Users, Registered Users 2 Posts: 68 ✭✭sd1999


    eoinbn wrote: »
    Once there is a restriction then that doubt could cascade to other groups. I can see a lot of people in the 50's/60's age groups turning AZ down. Hopefully I am wrong.

    If that’s their choice they just end up at the back of the queue. There’s no evidence to suggest it’s not safe for them. There’s only so much that can be done.


  • Registered Users, Registered Users 2 Posts: 15,706 ✭✭✭✭charlie14


    Polar101 wrote: »
    That's a pretty common sight at business parks during the weekend. Did someone ask them if they were there for the vaccine, or are we assuming it just because of the Pfizer sign?

    I was not assuming it was the Pfizer carpark, or if it is, that they are there demanding vaccination. I just found it comical with the behaviour of many of that particular cohort during this pandemic should it be the case. Also that it would be the wrong company car park.


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  • Registered Users, Registered Users 2 Posts: 2,065 ✭✭✭funnydoggy


    Mammy got her call, being jabbed tomorrow in Parc Uí Chaoimh :)


  • Registered Users, Registered Users 2 Posts: 20,792 ✭✭✭✭Strazdas


    eoinbn wrote: »
    Once there is a restriction then that doubt could cascade to other groups. I can see a lot of people in the 50's/60's age groups turning AZ down. Hopefully I am wrong.

    I think vaccine hesitancy is hugely overstated. From what we are hearing, take up is very high and large numbers of people received AZ last week, even with the vaccine in the headlines.

    Problem with turning AZ down would be that you could be left waiting months to be vaccinated and I think most people are well aware of this - you don't get to turn down your AZ dose and get offered another vaccine two days later.


  • Registered Users, Registered Users 2 Posts: 68 ✭✭sd1999


    Strazdas wrote: »
    I think vaccine hesitancy is hugely overstated. From what we are hearing, take up is very high and large numbers of people received AZ last week, even with the vaccine in the headlines.

    Problem with turning AZ down would be that you could be left waiting months to be vaccinated and I think most people are well aware of this - you don't get to turn down your AZ dose and get offered another vaccine two days later.

    That's certainly the case with older cohorts wAhere they would have to wait until most of the country is done to get offered another vaccine but younger cohorts are already at the back of the queue and wouldn't have to wait as long for a new offer of they turn down their first one. For example a 65 year old is offered AZ at the start of May. If they turn it down, they would have to wait until maybe the end of July to get a new offer. A 23 year old is offered AZ at the end of June and would have to wait until the end of July to get a new offer. The cost for older cohorts of refusing a vaccine is higher than it is for younger cohorts.


  • Registered Users, Registered Users 2 Posts: 1,305 ✭✭✭nibtrix


    titan18 wrote: »
    It might not even be an issue. If you go over 50s atm lets say, all you do until probably end of May is disrupt AZ to people under 50 in groups 4 and 7. By the end of May, there might be more information on who exactly is prone to the clotting issue.

    I think even if they generally restrict AZ for younger age groups they will still recommend that cohort 4 & 7 go ahead, as their risk from Covid is higher than the risk of the side effects? That's been my understanding so far anyway.


  • Registered Users, Registered Users 2 Posts: 5,995 ✭✭✭Russman


    Strazdas wrote: »
    I think vaccine hesitancy is hugely overstated. From what we are hearing, take up is very high and large numbers of people received AZ last week, even with the vaccine in the headlines.

    Problem with turning AZ down would be that you could be left waiting months to be vaccinated and I think most people are well aware of this - you don't get to turn down your AZ dose and get offered another vaccine two days later.

    I tend to agree with this tbh.

    I wonder how it would work though if someone in one of the older cohorts simply doesn't register on the portal when that group is invited to, and leaves it 2/3 weeks to register ? They'd hardly be told "sorry you had your chance" would they ? You would imagine there would be an almost ongoing "mopping up" operation for people that were missed for whatever reason.


  • Registered Users, Registered Users 2 Posts: 11,202 ✭✭✭✭hmmm


    Strazdas wrote: »
    I think vaccine hesitancy is hugely overstated. From what we are hearing, take up is very high and large numbers of people received AZ last week, even with the vaccine in the headlines.
    It's hard to say "no" when you get a call from your GP with an appointment date and time.

    I think vaccine laziness might be a bigger issue when they issue a general call-up for age cohorts. "Ah sure I'll get to it at some stage, no rush".


  • Registered Users, Registered Users 2 Posts: 15,468 ✭✭✭✭stephenjmcd


    sd1999 wrote: »
    That's certainly the case with older cohorts wAhere they would have to wait until most of the country is done to get offered another vaccine but younger cohorts are already at the back of the queue and wouldn't have to wait as long for a new offer of they turn down their first one. For example a 65 year old is offered AZ at the start of May. If they turn it down, they would have to wait until maybe the end of July to get a new offer. A 23 year old is offered AZ at the end of June and would have to wait until the end of July to get a new offer. The cost for older cohorts of refusing a vaccine is higher than it is for younger cohorts.

    On this, there will be no "offer" per say

    Speaking to my GP this morning she say's you'll register online, validation of details, appointment to issue then. So whenever you register when your cohort is allowed, appointment follows. If the over 65 opened tomorrow for example they can register tomorrow or register in say 3 weeks time, doesn't matter when they register, it'll be open for them as long as vaccination is on going but she would expect most to jump at the chance straight away. That's her understanding of the process that's been explained to them.

    After that the only choice you have is when the appointment is issued, Yes I want the vaccine appointment or No I don't want the appointment. After that it's pure luck as to whatever vaccine you get, she say's it'll be whatever is in use in the vaccination centre you go to & in line with NIAC adivse. So say if NIAC give for example AZ cut off at 40. Someone who's 41 will turn up and it could be any of the vaccines, someone who's 39 turns up and it's one of Pfizer, Moderna or J&J for example. Which one you get is whatever one is assigned to the MVC.

    There'll be no choice, someone might have a preference but they won't be able to express said preference either.


    Just aside from this, she's finished the over 70s dose 1 and is planning on doing a small number of cohort 4 next week, in particular she said in practice she is focusing on patients in cohort 4 that would need more personal attention and be familiar with her & might not be comfortable with a change of setting or change of doctor etc for which it might be upsetting.

    She's got an excellent set up over there


  • Registered Users, Registered Users 2 Posts: 2,065 ✭✭✭funnydoggy


    stephenjmcd you have a fantasic GP it sounds like. Always a good thing :)


  • Registered Users, Registered Users 2 Posts: 15,468 ✭✭✭✭stephenjmcd


    funnydoggy wrote: »
    stephenjmcd you have a fantasic GP it sounds like. Always a good thing :)

    She's fantastic.

    Having read some stories on here of GPs being very short with people and not that welcoming I do feel lucky to have a GP that's very approachable. You don't feel like a thick going down for something that you think is minor and might be a waste of her time.


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  • Registered Users, Registered Users 2 Posts: 20,792 ✭✭✭✭Strazdas


    Russman wrote: »
    I tend to agree with this tbh.

    I wonder how it would work though if someone in one of the older cohorts simply doesn't register on the portal when that group is invited to, and leaves it 2/3 weeks to register ? They'd hardly be told "sorry you had your chance" would they ? You would imagine there would be an almost ongoing "mopping up" operation for people that were missed for whatever reason.

    I assume people are being contacted by their GPs anyway with an appointment? Some older people wouldn't even be online or have access to the internet. The portal is probably just an added way of making sure you get an appointment.


This discussion has been closed.
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