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As state gets set to open vaccinations to everybody, some people who got their first shot still can't get their second

WBUR reports on people in vaccination limbo, who were able to get the first of their two Moderna or Pfizer shots but now can't find a place to get their second.

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Even one shot of Pfizer and Moderna confers a substantial amount of effectiveness. Many people were debating only giving one dose of Moderna in an effort to get more people vaccinated faster. Having 80% effectiveness against mild to moderate and 95% effectiveness against severe cases or hospitalization is a wonderful thing.

We need to get shots in arms, not hand wring about how we do it.

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Why's it misleading?

Two doses of these vaccines is the protocol. Just because in your opinion one dose is better than nothing doesn't negate the fact that the state screwed up making second appointments available to some people.

This should be an easy problem to solve. The state knows exactly how many people are in this situation, and where they got their first dose. Just reserve some slots for second doses, and set up a process for people to make their appointment.

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If we're mandating that teachers return to in person learning, we should prioritize vaccinating them fully before opening it up to those of us who don't have health issues and just want to get vaccinated.

Baker is being pretty disingenuous to declare schools need to open, make teachers eligible for shots and then increase competition for what is still a limited resource. He's just itching to declare it over and blame the feds for not supplying vax in time to meet his arbitrary schedule I think.

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I don't know the details of the website backend but it would be fairly easy to program it so that anyone who indicated they were a teacher on the sign up would be given priority over someone else.

Of course, everyone thinks their case makes them a higher priority.

Who is more important: a 70 year-old homebound immigrant? A 30-something teacher? A supermarket cashier? A 55 year old restaurant server who is the sole supporter of an injured husband and a disabled child?

If I was in charge I would make anyone under 70 with a WFH job the lowest priority and not eligible until there are ample supplies.

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All those people should be getting their shots before say, I do. I've signed up to get a shot when available but I hope I am not competing with those people.

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But teachers are not any more special than Starbucks baristas or grocery clerks or other public facing folks who have been working unvaccinated in person for a year. They already have special days at the big sites to work with. The state simply cannot support Special Vaccine Concierge Service to every little school due to strong technical limitations.

Vaccine supply is massively increasing, too. Seem's Biden's gnomes worked the whole damn supply chain to increase the supply massively, and also convinced competing pharma makers to play nice and weet more into the system.

The bottom line is that things have been very tight, but amping up existing capacity and bringing additional factories into play is having very strong results on supply now that everything is getting up and running.

This weeks supply is already about four to five times what it was a couple of months ago. That is massive, and that is what is leading the state to open up the floodgates.

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The state simply cannot support Special Vaccine Concierge Service to every little school due to strong technical limitations.

True - I tend to forget the storage and usage requirements for the Pfizer and Moderna vaccines, the size of the cartons and the restrictions on what can be done with leftover doses once a carton is opened. I think you have to use them all onsite, and the cartons are not small.

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For those I know who've already got their shot, they made their second appointment when they checked into the 15 minute waiting room. But they all went through CVS or clinic/hospital sites, so I suspect the problem is the state vax clusterf*ck.

According to my doc, I'll be eligible next week, but it's probably 2-3 weeks before I'll be able to get an appointment via our hospital. Which is FINE; I can hold out until June if I have to.

The biggest worry is my middle-schooler; WarriorTeen is too young for Pfizer, so the Moderna and Pfizer stage 2/3 trials for teens can't show results soon enough for me. Most of the summer camps have already been cancelled (sigh), but I'd really like to send her back full-time to school in September.

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Most of the cancelled second visits happened when we had delays in shipping due to the massive storms in mid-February.

Unfortunately, many places did not follow through to get makeup vaccine and reschedule, leaving people in a lurch. It seems to be worst with the federal direct places like CVS and Wallgreens. My dentist is having that problem with them not rescheduling her second dose.

The example in the article? Classic example of not paying attention to fundamental logistics. Vaccinators were advised to not give first doses if they didn't have a second dose clinic scheduled in follow up. They gave first doses at their third clinic. Why they thought that was a good idea is on them, not the state. Although as mentioned above, it is better than not having any at all.

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For those I know who've already got their shot, they made their second appointment when they checked into the 15 minute waiting room. But they all went through CVS or clinic/hospital sites, so I suspect the problem is the state vax clusterf*ck.

Yup when I went to East Boston Health Center to get mine, they booked the 2nd shot as I checked in.

Sad that people who went to the mass vax sites have to go thru this again to get the second shot.

Such poor planning.

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I went to Gillette, and after getting my shot was given a card with a link to schedule the second dose. I was able to schedule the second dose while waiting out my 15 minutes - plenty of time slots available on the appropriate day 4 weeks out. A few different people I know who went to Gillette and didn’t book while waiting were able to use the card once they got home to book the next appointment. (Or were elderly people who handed the card to their kids, who booked the appointment for them.) Now, if you didn’t book promptly and lost the card, you’d likely have problems... but overall anyone getting their first shot at a mass vax site should find it straightforward to book their second. You’re not just dumped back into the general competition for shots.

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So if its not the vax sites that have this issue nor CVS or a HealthCenter..

What is the issue?!?

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Article spends the most time discussing nursing home staffers who got shot #1 during clinic #3 of 3 that nursing homes held.

It does also mention people who went to mass vax sites and then failed to register promptly for second shots - but sounds like this is dozens of people out of the hundreds of thousands who’ve gone to the mass vax sites, and the state is trying to make it even simpler for people to register while still at the site. So it’s not a foolproof system, but it’s not a major systemic problem either.

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When we didn't get vaccine for almost two weeks due to the weather.

Large sites automatically gave rebooking priority for second shots and automatically rebooked people when there was the unexpected supply crunch.

CVS/Walgreens are federal direct supplied and many of those sites just dropped the ball on the rebooking.

Others are small volume sites like the one in the story that just decided to hand out first shots when they were advised to just not.

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People who were cancelled there were automatically rebooked.

This is mostly a CVS/Walgreens issue and a "small site didn't plan well" issue.

I have spent a lot of time this week shipping small amounts around to cover small shortfalls for senior housing and staff. Most of the nursing homes ordered more than enough and have been returning unused vials.

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this morning required me to schedule my second shot at the same time I scheduled my first shot, and for exactly four weeks later (so I must be getting Moderna).

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When some of the retail sites canceled second doses due to vaccine not arriving, they didn't automatically reschedule.

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My husband got his first shot at a Walgreens in Mattapan last week, and was booked for a second shot 4 weeks later, so we also assumed he must be getting Moderna. But he actually got Pfizer.

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It's supposed to be 3 weeks for Pfizer, 4 weeks for Moderna. It probably does not matter that much, but those were the intervals used in clinical trials for each vaccine, so they are the CDC recommendations.

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Apparently the Pfizer interval is wider than we were led to believe at first - 3 to 6 weeks. Per the CDC:

Interval between mRNA doses

The second dose of Pfizer-BioNTech and Moderna vaccines should be administered as close to the recommended interval as possible, but not earlier than recommended (i.e., 3 weeks [Pfizer-BioNTech] or 1 month [Moderna]). However, second doses administered within a grace period of 4 days earlier than the recommended date for the second dose are still considered valid. If it is not feasible to adhere to the recommended interval and a delay in vaccination is unavoidable, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be administered up to 6 weeks (42 days) after the first dose. Currently, only limited data are available on efficacy of mRNA COVID-19 vaccines administered beyond this window.

(Emphasis mine)

It looks to me as though the more important part of the interval is the shorter end - second dose should not be administered any sooner than 3 weeks for Pfizer and 4 weeks for Moderna (although per the excerpt above, even there up to 4 days early seems to be allowable.)

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so I suspect the problem is the state vax clusterf*c

So, I don't think it's the state vax setup. I got my first shot today at a MassVax site and set up my 2nd appt. during the 15 minute wait time, similar to what your acquaintances did at CVS/clinic/hospital sites.

Edit to Add: Just after I got my shot, I received a text and email with link to set up the 2nd appointment. It was incredibly easy.

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They made the initial basket.

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