Vaccine roll-out: the logistics

[teuchter]

We are in a semi-unprecedented situation where almost everyone in the country is quite highly motivated to make something fairly specific happen: get the vaccine to as many people as possible as quickly as possible.

I'm quite interested to know what it is that determines the speed at which the vaccine can be rolled out - is it at the manufacturing end, the injection end, or points inbetween?

No doubt the answer to that will be complicated and will change over time.

This thread is for people who are interested in the details of how the process actually works.

 

[elbows]

Fill & finish bottlenecks are what the likes of JVT have been most prepared to draw attention to of late.

Professor Van-Tam said: “The only thing that is going to slow us down is batches of vaccines becoming available. Many of you know already that it’s not just about vaccine manufacture. It’s about fill and finish, which is a critically short resource across the globe.”

PM's pledge of 'normality' by Easter to be hit by vial supply issues delaying vaccine roll-out

There is enough of the Oxford/AstraZeneca vaccine already produced for four million jabs, but there's a lack of critical materials for 'fill and finish'

inews.co.uk

 

[teuchter]

Are vials re-usable, or do they just get junked after use?

 

[iona]

Are vials re-usable, or do they just get junked after use?

Disposed of in sharps

 

[LDC]

Are vials re-usable, or do they just get junked after use?

Junked generally. No suggestion that might be different with this vaccine.

It's early days for the program, highly likely and expected to be some delays and problems, mostly at the production end currently. I do worry that the inflexibility and top-down approach loved by the government and NHS will stifle some of the efforts to get it out there.

 

[Pickman's model]

Are vials re-usable, or do they just get junked after use?

that's a poorly thought out question, which should be simply 'are vials reused?' - many things which are reusable are chucked away.

 

[ska invita]

Isn't that cold temperature delivery an issue too?

 

[mwgdrwg]

I suggest we get a venture capitalist wife of a tory minister to organise it all, it's what makes the most sense.

 

[StoneRoad]

Think the main bottleneck is production of the glass vials. [sorry, no pun intended]

If it has to be a special grade of virgin glass I'm not sure how extra recycling can help ...

 

[mwgdrwg]

Think the main bottleneck is production of the glass vials. [sorry, no pun intended]

If it has to be a special grade of virgin glass I'm not sure how extra recycling can help ...

I suggest we get the neighbour of a tory minister to produce them, even though they have zero experience of manufacturing them, it's what makes the most sense.

 

[mwgdrwg]

Sort it all on Whatsapp, like the kids.

 

[LDC]

Are vials re-usable, or do they just get junked after use?

There wouldn't be the ability to clean, sterilize, and refill them anyway, it'd be building another process from scratch that would probably take longer than the alternatives.

 

[quimcunx]

Sort it all on Whatsapp, like the kids.

Or snapshoot or discard.

 

[mwgdrwg]

Or snapshoot or discard.

Not joking. It actually was WhatsApp - Hancock's former neighbour won Covid test kit work after WhatsApp message | World news | The Guardian

 

[8ball]

I'm a bit on the fence about this 12-week business.

 

[Athos]

Why not have big bottles from which individual doses are drawn into individual sterile syringes?

 

[8ball]

Why not have big bottles from which individual doses are drawn into individual sterile syringes?

I thought there were multiple doses in some vials at least (though I just gauged this from that report of someone destroying vaccines in the US - it seemed the number of doses lost was a lot higher than the number of vials).

 

[teuchter]

I'm a bit on the fence about this 12-week business.

I was hoping we could keep this thread focused on roll-out logistics rather than the parallel questions about medical ethics, efficacy and so on.

 

[mwgdrwg]

Why not have big bottles from which individual doses are drawn into individual sterile syringes?

It would then be impossible to keep the required medical separation of 5g chips.

 

[teuchter]

I thought there were multiple doses in some vials at least (though I just gauged this from that report of someone destroying vaccines in the US - it seemed the number of doses lost was a lot higher than the number of vials).

According to Newsnight last night ... they come in vials of 6 doses, but the paperwork says 5 doses and that's what they are administering because computer says no, so 1 in 6 doses is going to waste.

 

[Athos]

It would then be impossible to keep the required medical separation of 5g chips.

With all his money, you'd have thought Bill Gates could figure a way around that.

 

[8ball]

I was hoping we could keep this thread focused on roll-out logistics rather than the parallel questions about medical ethics, efficacy and so on.

Fair point, but the 12-week thing is justified in terms of logistics. Seemed to fit here.

 

[8ball]

According to Newsnight last night ... they come in vials of 6 doses, but the paperwork says 5 doses and that's what they are administering because computer says no, so 1 in 6 doses is going to waste.

Having worked in the area for over 20 years, this is exactly what I'd expect.

 

[iona]

I thought there were multiple doses in some vials at least (though I just gauged this from that report of someone destroying vaccines in the US - it seemed the number of doses lost was a lot higher than the number of vials).

There are:

Each pack of the Pfizer BioNTech COVID-19 mRNA Vaccine BNT162b2 contains 195 vials with a minimum of 5 doses per vial (975 doses per pack). It is supplied with 0.9% sodium chloride diluent for injection in plastic ampoules. After dilution, the vaccine should be kept at 2°C to 25°C and used within 6 hours. Any unused vaccine should be discarded.

The AstraZeneca vaccine is supplied in packs of 10 vials. Each vial contains 8 or 10 doses of vaccine, and is a colourless to slightly brown, clear to slightly opaque liquid

(from here)

 

[platinumsage]

According to Newsnight last night ... they come in vials of 6 doses, but the paperwork says 5 doses and that's what they are administering because computer says no, so 1 in 6 doses is going to waste.

Some stories like this:

"The Brighton and Sussex University Hospitals NHS Trust offered vaccines to ambulance staff on December 27. But anger arose when South East Coast Ambulance Service (SECAMB) allegedly forbid staff from getting the jab, despite the vaccine potentially going to waste if not used up."

"...it is believed the vaccines supply was 'surplus for the day' and staff had been asked if they wanted the jab to 'prevent wasting a number of doses'. To the horror of ambulance staff, some who had travelled almost 100 miles to access this treatment, they were met by a SECAMB manager who had been instructed to turn the staff away at the door."

"The union shared a Facebook post from the South East Coast Ambulance Service (SECAMB) which say they have 'protocols to follow'. The post read: 'We've been made aware of an offer of staff to drop in for their covid-19 vaccine at a hospital site in our region. 'We appreciate the offer was made in good faith but we have protocols to follow in this regard. We would ask that staff do not do this. The trust has been given strict instructions on how our staff can access the vaccine and we will keep staff informed on when and how they can do this as the vaccine programme continues to be rolled out."

Union accuses ambulance chiefs of telling staff not to have covid vaccine at Brighton hospital

A union has accused ambulance bosses of telling their staff not to take up an offer of having the coronavirus

www.brightonandhovenews.org

 

[LDC]

Why not have big bottles from which individual doses are drawn into individual sterile syringes?

What size bottles were you imagining? It's a slightly fiddly process drawing out liquid with a syringe from a small bottle anyway. And again not sure they'd be manufacturing capacity for such a thing as large vaccine bottles as it's never been needed before.

 

[LDC]

Some stories like this:

"The Brighton and Sussex University Hospitals NHS Trust offered vaccines to ambulance staff on December 27. But anger arose when South East Coast Ambulance Service (SECAMB) allegedly forbid staff from getting the jab, despite the vaccine potentially going to waste if not used up."

"...it is believed the vaccines supply was 'surplus for the day' and staff had been asked if they wanted the jab to 'prevent wasting a number of doses. To the horror of ambulance staff, some who had travelled almost 100 miles to access this treatment, they were met by a SECAMB manager who had been instructed to turn the staff away at the door."

"The union shared a Facebook post from the South East Coast Ambulance Service (SECAMB) which say they have 'protocols to follow'. The post read: 'We've been made aware of an offer of staff to drop in for their covid-19 vaccine at a hospital site in our region. 'We appreciate the offer was made in good faith but we have protocols to follow in this regard. We would ask that staff do not do this. The trust has been given strict instructions on how our staff can access the vaccine and we will keep staff informed on when and how they can do this as the vaccine programme continues to be rolled out."

Union accuses ambulance chiefs of telling staff not to have covid vaccine at Brighton hospital

A union has accused ambulance bosses of telling their staff not to take up an offer of having the coronavirus

www.brightonandhovenews.org

FFS, manager cunts. That sort of thing is a bit typical of the slow moving rigid protocol thinking that I worry might slow the vaccine rollout.

 

[quimcunx]

According to Newsnight last night ... they come in vials of 6 doses, but the paperwork says 5 doses and that's what they are administering because computer says no, so 1 in 6 doses is going to waste.

I think Crispy shared a good video that explained a lot about logistics on another thread.

 

[Indeliblelink]

Why not have big bottles from which individual doses are drawn into individual sterile syringes?

Even using a sterile syringe you're risking contamination every time you stick something in the vial. At least only 5 people potentially get something unwanted if a vial gets contaminated.

 

[Athos]

Even using a sterile syringe you're risking contamination every time you stick something in the vial. At least only 5 people potentially get something unwanted if a vial gets contaminated.

I 'spose. Wonder how significant a risk that is, though, when weighed against delays to the programme.