COVID-19: Vaccine and testing procedures Megathread Part 2 [Mod Warning - Post #1]

mirrorwall14

CIARAN_BOYLE wrote: »

Seeing other reports now

120 extra doses.

They contacted the hse during the day who contacted local gaps and community health workers.

Then when the hse told them they had sent who they could people started ringing around themselves.

Then they looked at family of staff.

I understand that theres a level of skill in getting 6/7 doses from a vial. Who ever was on charge in the coombe should be sent to teach a class. 120 extra doses in a day. Fair play to them.

If it’s the Coombe themselves administrating there are two particular phlebotomists in that hospital that are incredible. I’ve had three pregnancies through there and have terrible veins. No matter the dehydration, swelling, bad veins etc they got it first time every single time even when the wards and diabetes nurses failed. Never came across anything like it. I’ve had awful experiences through the years with blood draws but never with them

When I read the 120 doses extra the first thing I commented to my husband was I bet they were involved lol

Melanchthon

CIARAN_BOYLE wrote: »

Once the doses are made up you cant even bring them upstairs.

Never mind a taxi.

Really? That seems strange? CDC/FDA guidance seems to indicate stable for 6 hours at room temperature after dilution.

https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/index.html

Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for HCP ...
https://www.fda.gov/media/144413/download


Pfizer themselves say Pfizer themselves say it can be stored 5-8 days at 2-8 degrees. That's probably unopened

https://www.pfizer.com/news/hot-topics/covid_19_vaccine_u_s_distribution_fact_sheet

NHS states that
Whilst avoiding excursions is the best policy, managing minor excursions can be achieved in the limited circumstances described below.

https://www.sps.nhs.uk/articles/storing-the-pfizer-biontech-vaccine-in-the-fridge/

Is Ireland operating under different guidance or is this just HSE defence?

Melanchthon

Amirani wrote: »

The vaccination process would be one of the lower importance items going on in hospitals at the moment to be honest. Hospitals nationally are absolute swamped with tonnes of staff out sick, wards closing and some wards beyond capacity. There's a very real ongoing threat of not being able to provide care to people who need it. This is all of far more importance than whether there's <1% of vaccine doses left at the end of the day.

See that's an interesting defence, so it wouldn't be a priority for him but when there is spare doses going some of them just happen to go to his kids? That means he is either paying a lot of attention to it or directly intervening when staff told him there was an excess left over.

CIARAN_BOYLE

Melanchthon wrote: »

Really? That seems strange? CDC/FDA guidance seems to indicate stable for 6 hours at room temperature after dilution.

https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/index.html

Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for HCP ...
https://www.fda.gov/media/144413/download


Pfizer themselves say Pfizer themselves say it can be stored 5-8 days at 2-8 degrees. That's probably unopened

https://www.pfizer.com/news/hot-topics/covid_19_vaccine_u_s_distribution_fact_sheet

NHS states that
Whilst avoiding excursions is the best policy, managing minor excursions can be achieved in the limited circumstances described below.

https://www.sps.nhs.uk/articles/storing-the-pfizer-biontech-vaccine-in-the-fridge/

Is Ireland operating under different guidance or is this just HSE defence?

The germans had to throw out over a thousand doses after making them up downstairs and bringing them upstairs.

I've no idea.

6 hours at room temperature is after dilution. Theres no comment in those articles about how much movement you can do with it.

Irish Stones

dominatinMC wrote: »

A lot of hypotheticals there. Do you have a link to this story, or are you just here to spread your usual negative rhetoric?

I don't have a link because it was a news on TV, but even if I had a link, would you really bother? So far I linked lots of stuff, but nobody seemed to care much. So, it is not worth the effort, isn't it?

dominatinMC

Irish Stones wrote: »

I don't have a link because it was a news on TV, but even if I had a link, would you really bother? So far I linked lots of stuff, but nobody seemed to care much. So, it is not worth the effort, isn't it?

So you've no evidence then? Moving swiftly along..

lucernarian

[Deleted User] wrote: »

Someone who doesn't immediately assume the worst and jump to conclusions = shill?

The tone of some of the posts border on the hysterical, with wild claims about this profession or that profession deserving the highest priority. This has swung in the reverse today, where as a last gasp measure it's revealed that children of staff be vaccinated to avoid waste and the staff in the rollout are to blame and to be held responsible etc.


9 of the 17 relations were over 70, we don't know what preexisting conditions the rest have.

I've tried to only ask specific questions about specific things I've observed that don't seem to be in keeping with best practices or the plan that isn't really a plan, and I appreciate not being casted as a doom monger or naysayer in the process

Irish Stones

dominatinMC wrote: »

So you've no evidence then? Moving swiftly along..

It seems you don't want to understand, it was a TV interview, how can I possibly have a link to a TV interview?
And should I have it, you would really watch it, or just for the fun to ask for a link?

Melanchthon

CIARAN_BOYLE wrote: »

The germans had to throw out over a thousand doses after making them up downstairs and bringing them upstairs.

I've no idea.

6 hours at room temperature is after dilution. Theres no comment in those articles about how much movement you can do with it.

Yeah I understand that, this BMA article does recommend against movement after dilution but the other documents (and I have looked at a few now don't state it). You could be right.
https://www.bma.org.uk/advice-and-support/covid-19/vaccines/covid-19-vaccination-programme

I just realized some thing though? So they vaccinated 16 people that, let's say this diplomatically weren't on the vaccination schedule, that means a minimum of two vials.

Did they dilute vials knowing that they had carried out all the scheduled vaccinations? The thawed but undiluted vials are stable for a few days? The workflows on those charts seems to point to dilution immediately before vaccination. Is anybody here actually involved in the vaccination process. As in how many teams operate within a hospital diluting vials?


CV-19 WS0055 Storage and Handling Pfizer COVID-19 Vaccine
https://www.saskhealthauthority.ca/news/service-alerts-emergency...

https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19/information-for-healthcare-professionals-on-pfizerbiontech-covid-19-vaccine

Edit: I don't know why the Germans binned that many doses? Was there a cold chain break, did they make an error in binning them?

Datacore

They could have a priority backup list that the spare vaccines go to, if people were identified to be “on call” to get it.

Say for example if there were a list of people willing to be there within 1 hour of being called.

Or a roving vaccinator on a motorbike who picks them up and delivers them eg to maybe vulnerable elderly people living at home.

The extremely short shelf life means you’d need someone literally on standby though.

I think if we go too extreme on this though, you’ll just end up with people deciding that it’s less controversial to just dump the spare doses than try to administer them in an ad hoc way to anyone who is near by.

Kivaro

Amirani wrote: »

Some people have clearly never worked in a hospital, or anything remotely related to healthcare. Do you actually think the Master of the hospital is down counting the vials of vaccine they have and number of doses they're getting throughout the day?

What will have happened would be the vaccination team get through their list of people and reach the end of the day with some left over. At this point, vaccination team contact management and the Master is informed that "there's 16 doses left over, what should we do with them?"

In this situation, the Master of the hospital confirmed that he was actually managing the process himself ...... according to the early news this morning.

Micky 32

Irish Stones wrote: »

It seems you don't want to understand, it was a TV interview, how can I possibly have a link to a TV interview?
And should I have it, you would really watch it, or just for the fun to ask for a link?

Thankfully going through my own research from actual experts and not from on the “tv” it’s unlikely what you’re claiming.

The vaccines will stop the Covid 19 pandemic but it possibly won’t eradicate the SARS COV 2 virus that cause it. However experts predict it will become endemic and people who get it in the future will mostly just have head colds etc.

Amirani

Datacore wrote: »

Or a roving vaccinator on a motorbike who picks them up and delivers them eg to maybe vulnerable elderly people living at home.

is_that_so

Datacore wrote: »

They could have a priority backup list that the spare vaccines go to, if people were identified to be “on call” to get it.

Say for example if there were a list of people willing to be there within 1 hour of being called.

Or a roving vaccinator on a motorbike who picks them up and delivers them eg to maybe vulnerable elderly people living at home.

The extremely short shelf life means you’d need someone literally on standby though.

I think if we go too extreme on this though, you’ll just end up with people deciding that it’s less controversial to just dump the spare doses than try to administer them in an ad hoc way to anyone who is near by.

The system is now up and running so there is less likelihood of that but this does highlight weaknesses within the overall process.

Bubbaclaus

Has anyone suggested we get DPD to deliver the spare doses yet? Great entertainment reading some of the suggestions on here.

Gael23

A friend of mine who is a physiotherapist in Beaumont Hospital is getting to today

Sconsey

Datacore wrote: »

They could have a priority backup list that the spare vaccines go to, if people were identified to be “on call” to get it.

Say for example if there were a list of people willing to be there within 1 hour of being called.

Or a roving vaccinator on a motorbike who picks them up and delivers them eg to maybe vulnerable elderly people living at home.

The extremely short shelf life means you’d need someone literally on standby though.

I think if we go too extreme on this though, you’ll just end up with people deciding that it’s less controversial to just dump the spare doses than try to administer them in an ad hoc way to anyone who is near by.

Yeah that sounds like a sensible approach. Hopefully they will learn or already have learned that each hospital should draw up a list of 'backup' candidates prior to starting delivery. I know there are plenty of people in the higher groups that could be in hospital within an hours notice if called. Build up a big list of people that can fill any gaps...as you say the last thing we want is doses being dumped for fear of accusations of favouritism.

GreeBo

Datacore wrote: »

They could have a priority backup list that the spare vaccines go to, if people were identified to be “on call” to get it.

Say for example if there were a list of people willing to be there within 1 hour of being called.

Or a roving vaccinator on a motorbike who picks them up and delivers them eg to maybe vulnerable elderly people living at home.

The extremely short shelf life means you’d need someone literally on standby though.

I think if we go too extreme on this though, you’ll just end up with people deciding that it’s less controversial to just dump the spare doses than try to administer them in an ad hoc way to anyone who is near by.

Even with an on call list you are going to have situations where you either bin them or give them to someone who is already there.

Say the vial is expiring in 30 mins and the on call person is still making their way in...do you wait? start trying another on-call person?

Anything that gets it into someones arm rather than a bin is ok with me.

TBH, the two people that all this uproar is about arent going to be impacted be getting the vaccine, its not like they are now down the pub living it up.

CIARAN_BOYLE

Melanchthon wrote: »

Yeah I understand that, this BMA article does recommend against movement after dilution but the other documents (and I have looked at a few now don't state it). You could be right.
https://www.bma.org.uk/advice-and-support/covid-19/vaccines/covid-19-vaccination-programme

I just realized some thing though? So they vaccinated 16 people that, let's say this diplomatically weren't on the vaccination schedule, that means a minimum of two vials.

Did they dilute vials knowing that they had carried out all the scheduled vaccinations? The thawed but undiluted vials are stable for a few days? The workflows on those charts seems to point to dilution immediately before vaccination. Is anybody here actually involved in the vaccination process. As in how many teams operate within a hospital diluting vials?


CV-19 WS0055 Storage and Handling Pfizer COVID-19 Vaccine
https://www.saskhealthauthority.ca/news/service-alerts-emergency...

https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19/information-for-healthcare-professionals-on-pfizerbiontech-covid-19-vaccine

Edit: I don't know why the Germans binned that many doses? Was there a cold chain break, did they make an error in binning them?

From the HSE document they seem to be working on a max 12 hours from delivery to dilution. Maybe there's a policy problem on the HSE side.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.hse.ie/eng/health/immunisation/hcpinfo/covid19vaccineinfo4hps/clinicalguidance.pdf&ved=2ahUKEwjFjZLeyKXuAhVxaRUIHdlTAkYQFjADegQIEBAB&usg=AOvVaw32Yt42F4PfN6BlOfQ-ZLlT&cshid=1610977947534

Melanchthon wrote: »

Edit: I don't know why the Germans binned that many doses? Was there a cold chain break, did they make an error in binning them?

Read in German at the time so there could be errors in my translation. I'm not a professional translator.

They made it up downstairs. Transported it upstairs to a mass vaccination centre with hundreds queuing and they were discoloured.

JimmyVik

GreeBo wrote: »

Even with an on call list you are going to have situations where you either bin them or give them to someone who is already there.

Say the vial is expiring in 30 mins and the on call person is still making their way in...do you wait? start trying another on-call person?

Anything that gets it into someones arm rather than a bin is ok with me.

TBH, the two people that all this uproar is about arent going to be impacted be getting the vaccine, its not like they are now down the pub living it up.

Agree 100%.

Datacore

Amirani wrote: »

Quite doable if you’ve nimble administration and a list of people near by. Deliveroo for vaccines ...

The downside is the HSE is as nimble as an elephant that’s recovering from 4 hip replacements.

I suspect though this controversy will just result in a lot of people terrified to administer spare vaccines, so they’ll just be dumped to avoid ending up on the front page of some paper.

You’ll likely only be able to deal with this fairly in a mass vaccination centre context where you’ve a queue, but it won’t stop the criticism and ranting and raving.

B.A._Baracus

This is a silly question I am sure, I just don't know the answer to it.

But how are you informed you are eligible for the covid vaccine? Your doctor informs you?

Melanchthon

CIARAN_BOYLE wrote: »

They made it up downstairs. Transported it upstairs to a mass vaccination centre with hundreds queuing and they were discoloured.

If they had discoloration after being diluted they would have to be binned anyway regardless of transport or storage.

4.3.14. The diluted vaccine should present as an off white solution with no particulates visible. Discard the diluted vaccine if particulates or discolouration are present.

https://www.sps.nhs.uk/wp-content/uploads/2020/12/VH8-Preparation-of-Pfizer-BioNTech-COVID-19-Vaccine-Syringes-for-Administration-Issue-1.2-03.12.20.docx

CIARAN_BOYLE

Melanchthon wrote: »

If they had discoloration after being diluted they would have to be binned anyway regardless of transport or storage.



https://www.sps.nhs.uk/wp-content/uploads/2020/12/VH8-Preparation-of-Pfizer-BioNTech-COVID-19-Vaccine-Syringes-for-Administration-Issue-1.2-03.12.20.docx

My understanding was that the discolouration only came on after transporting although I could have misunderstood.

Datacore

I’ve been wondering about this myself.

I assume GPs are identifying patients within their practices who meet the criteria?

I’ve a relative in their mid 80s who’s been wondering if she should contact her GP or wait to be contacted. She’s not the pushiest.

choccymousse

Just wondering folks if you think GPs will charge for the vaccine . I know the vaccine is free but will they charge a nurses visit consultation fee etc . I get the flu vaccine for free but pay a €20 nurses charge . Probably thinking aloud more than anything but could these types of negotiations delay the vaccine roll out when the GPS are about to start administering it

is_that_so

Datacore wrote: »

I’ve been wondering about this myself.

I assume GPs are identifying patients within their practices who meet the criteria?

I’ve a relative in their mid 80s who’s been wondering if she should contact her GP or wait to be contacted. She’s not the pushiest.

This seems to be the plan when the GPs are on the system. As someone said on another thread it'll probably be mid February onwards.

seamus

choccymousse wrote: »

Just wondering folks if you think GPs will charge for the vaccine . I know the vaccine is free but will they charge a nurses visit consultation fee etc . I get the flu vaccine for free but pay a €20 nurses charge . Probably thinking aloud more than anything but could these types of negotiations delay the vaccine roll out when the GPS are about to start administering it

It will be free, free, absolutely free.

Even a €20 administration charge is a barrier to uptake.

The guidance will be very strict that GPs must not charge any fees for distributing the vaccine.

It might even be insisted that GPs require patients to book a separate appointment if they want something besides the vaccination.

JimmyVik

choccymousse wrote: »

Just wondering folks if you think GPs will charge for the vaccine . I know the vaccine is free but will they charge a nurses visit consultation fee etc . I get the flu vaccine for free but pay a €20 nurses charge . Probably thinking aloud more than anything but could these types of negotiations delay the vaccine roll out when the GPS are about to start administering it

I would pay €1000 for the vaccine

choccymousse

JimmyVik wrote: »

I would pay €1000 for the vaccine

Ha ha , I’ll outbid you to €2k ;-)

I was more thinking will GPs hold it up looking for additional payment, I believe for COVID referrals they eventually settled on €30 per referral