16 family members given vaccine

lucernarian

bucketybuck wrote: »

So they say.

No guidance.

It says a lot that the concept of a reserve list could not possibly occur to anybody without "guidance".

When you're already trying to manage a system at the local level and have secured 90% of leftover doses for others who fall into priority 2, and it's 9.30pm at night and you're responsible... I think not wasting the doses was the better alternative. But including your own in that scenario, that was a mistake.

I'm sure they were told in advance to be around just in case, but then again the Master of the Coombe was responsible for administering the vaccine to everyone possible, not consider complicated ethical issues and come up with the best plan on the spot. The HSE and department of Health are the responsible ones if anything - and securing 120 people to take doses at short notice at late evening was a damn sight better than binning 17 of them.

GreeBo

Deleted User wrote: »

Standby list of all healthcare workers within 30 minutes reach. Actually this would have taken effort in part of HSE to set up such a register but a couple of folk with tech knowledge and some hospital admin knowledge could have set this up very nicely. Those for vaccine 1, those for vaccine 2.

Great idea, but that didn't exist at the time, so again, who are your 16 people and how are you finding them?

astrofool

plodder wrote: »

5 days. I agree it's not feasible to move it after it arrives in any location. It'd be better to use up the remainder of the five days finding the right people to give it to, than what happened here.

The vaccine had already been made up, and could no longer be stored, mostly due to the skill of those administering the vaccine in being able to extract the extra doses, but there was a couple of hours, maybe minutes, on the clock to get 120 doses used, and they managed to find 104 workers to use them, for the remaining 16, family of staff were available to take them (noting that in the case of the master, both family members worked at the hospital, either full or part time), however, the master should have found another staff members family for the vaccine.

GreeBo

plodder wrote: »

The vaccines are stored at -70 here in Dublin somewhere. Presumably, the batch for the Coombe was taken out of the ultra cold storage and was brought straight to the Coombe where it was put in a fridge. It wasn't brought on a sightseeing tour of Ireland for three days first. So, the clock started ticking when it left the central cold store and it was used on day 1 ie within 24 hours. Unused vials could have been kept for a few more days and used when more people were found from the right categories. I'm not playing a blame game here. I'm just saying this situation where people have to be found with a couple of hours notice doesn't have to arise.

Ok, but how many days had they already been in the coombe do you know? Do you know for a fact that they had only been there 1 day?

bucketybuck

lucernarian wrote: »

I'm sure they were told in advance to be around just in case

Oh I have no doubt whatsoever that they were told to be around just in case.

There is absolutely nothing complicated about having a reserve list or an alternate list or whatever you want to call it, you don't need a ****ing memo from the lord above to know that you might have spare doses should one of those on your original list not show up for any reason.

Like I said before, this is only one of the most important vaccinations in the entirety of human history, is it really a lot to ask that we are doing the very basics correct?

Anyway, it is isn't about this one case, it was always about how this case illustrated what is likely happening on a wider scale, and with the further reports coming out it is pretty clear that it wasn't an isolated example.

steddyeddy

GreeBo wrote: »

Great idea, but that didn't exist at the time, so again, who are your 16 people and how are you finding them?

You're saying that but you can't believe the only available person was his son who doesn't work in the hospital.

plodder

astrofool wrote: »

The vaccine had already been made up, and could no longer be stored, mostly due to the skill of those administering the vaccine in being able to extract the extra doses, but there was a couple of hours, maybe minutes, on the clock to get 120 doses used, and they managed to find 104 workers to use them, for the remaining 16, family of staff were available to take them (noting that in the case of the master, both family members worked at the hospital, either full or part time), however, the master should have found another staff members family for the vaccine.

Yes, I know. They did a good job in the circumstances. But, the question is why were they all made-up? Each vial is diluted separately. Why would you make up the whole batch when it starts the 6 hour clock ticking on all of it, when you could leave some of it in the fridge for up to 5 days. I'm not really asking why they did it by the way. I'm just saying going forward, this doesn't need to happen if you only make up small quantities at a time.

GreeBo

polesheep wrote: »

It's not about the remaining doses, it's about cronyism, nepotism, cheating, corruption, I could go on. Today it's vaccines tomorrow it will be something else.

If those in positions of power are permitted to use that power to the benefit of their family or friends then we are no better than a banana republic.

Lol it's not about the remaining doses?

Really? Because I'm almost sure the whole point of a vaccine rollout is giving it the doses, but if you'd prefer it to be about optics then I'm glad you have zero involvement in any of this.

lucernarian

steddyeddy wrote: »

You're saying that but you can't believe the only available person was his son who doesn't work in the hospital.

Available at 9.30pm, with not even an hour left to get there. I'm not saying that was the right outcome, but expecting literal individuals responsible for this to make the right call without prior guidance in such a high-stakes decision, to make the perfect judgement call is just too much. No one person should have had that influence or responsibility in the first place, and that's why HSE and NIAC should be the ones explaining how and why this happened.

The good news is that with more vaccines available going forward, this will be less and less relevant.

astrofool

plodder wrote: »

Yes, I know. They did a good job in the circumstances. But, the question is why were they all made-up? Each vial is diluted separately. Why would you make up the whole batch when it starts the 6 hour clock ticking on all of it, when you could leave some of it in the fridge for up to 5 days. I'm not really asking why they did it by the way. I'm just saying going forward, this doesn't need to happen if you only make up small quantities at a time.

Speed and efficiency, the whole batch would have been designated for use, and the people making up the batch would be able to do all of them simultaneously, it's not a case of "1 vial, done, I'll be back in 15 minutes to do vial 2".

Of course a lot of people don't understand this.

GreeBo

steddyeddy wrote: »

You're saying that but you can't believe the only available person was his son who doesn't work in the hospital.

Fantastic point, but again avoiding the question asked.
Tell me your explicit steps for funding 16 more people at 9:30pm on a Friday night able to get to the Coombe within 45 mins.

steddyeddy

plodder wrote: »

Yes, I know. They did a good job in the circumstances. But, the question is why were they all made-up? Each vial is diluted separately. Why would you make up the whole batch when it starts the 6 hour clock ticking on all of it, when you could leave some of it in the fridge for up to 5 days. I'm not really asking why they did it by the way. I'm just saying going forward, this doesn't need to happen if you only make up small quantities at a time.

They come in trays usually. There's definitely a lot of incompetence involved correct protocols here.

They would have "discovered" they had extra at the start of the 8th when the announcement was made. It wasn't a case of making dilutions and then panicking.

astrofool

lucernarian wrote: »

Available at 9.30pm, with not even an hour left to get there. I'm not saying that was the right outcome, but expecting literal individuals responsible for this to make the right call without prior guidance in such a high-stakes decision, to make the perfect judgement call is just too much. No one person should have had that influence or responsibility in the first place, and that's why HSE and NIAC should be the ones explaining how and why this happened.

The good news is that with more vaccines available going forward, this will be less and less relevant.

It's also unlikely, that even with a list, that you could have 120 people extra planned to be there, I mean, where do they wait in a maternity hospital? do they have nothing else to do? Those making up the vaccine did a great job in formulating the extra doses, and now people are complaining about it.

GreeBo

plodder wrote: »

Yes, I know. They did a good job in the circumstances. But, the question is why were they all made-up? Each vial is diluted separately. Why would you make up the whole batch when it starts the 6 hour clock ticking on all of it, when you could leave some of it in the fridge for up to 5 days. I'm not really asking why they did it by the way. I'm just saying going forward, this doesn't need to happen if you only make up small quantities at a time.

Again, how do you know these visits weren't already out of cold storage 4 days?
Made up or not they had to be used presumably.

steddyeddy

GreeBo wrote: »

Fantastic point, but again avoiding the question asked.
Tell me your explicit steps for funding 16 more people at 9:30pm on a Friday night able to get to the Coombe within 45 mins.

Well it's 8 hours not 45 minutes so literally anywhere in the country. Why 45 minutes?

steddyeddy

GreeBo wrote: »

Again, how do you know these visits weren't already out of cold storage 4 days?
Made up or not they had to be used presumably.

I know because there's very clear instructions. They have to be diluted ~ 2 hours following removal from the -80, then you have 6 hours to inject.

plodder

astrofool wrote: »

Speed and efficiency, the whole batch would have been designated for use, and the people making up the batch would be able to do all of them simultaneously, it's not a case of "1 vial, done, I'll be back in 15 minutes to do vial 2".

Of course a lot of people don't understand this.

What do you mean simultaneously? The Pfizer instructions describe it as a manual process that is done separately for each vial. One person can only make-up one vial at a time presumably?

steddyeddy

astrofool wrote: »

Speed and efficiency, the whole batch would have been designated for use, and the people making up the batch would be able to do all of them simultaneously, it's not a case of "1 vial, done, I'll be back in 15 minutes to do vial 2".

Of course a lot of people don't understand this.

You would never do up a whole batch with something mRNA based. You would certainly do a few but not the whole lot.

astrofool

steddyeddy wrote: »

Well it's 8 hours not 45 minutes so literally anywhere in the country. Why 45 minutes?

It's likely they couldn't start getting people for the extra doses until those scheduled had their shot, as the extra doses would also be to cover any accidents or mishaps occur while giving the shot (e.g. a tray being dropped, a fridge breaking), so it's "batch made" at the beginning of the day, "scheduled people vaccinated" however many hours later, then they can start getting in people for the extra (which could probably happen simultaneously when the last 10% of people are getting doses), but still logistically hard to do with a highly perishable item.

plodder

GreeBo wrote: »

Again, how do you know these visits weren't already out of cold storage 4 days?
Made up or not they had to be used presumably.

I wasn't there so I don't know obviously. If they were made up they had to be used, if they weren't then they didn't.

steddyeddy

plodder wrote: »

What do you mean simultaneously? The Pfizer instructions describe it as a manual process that is done separately for each vial. One person can only make-up one vial at a time presumably?

I think they mean the biochemist, nurse or pharmacist would quickly resuspend the contents of each vial in quick succession.

steddyeddy

astrofool wrote: »

It's likely they couldn't start getting people for the extra doses until those scheduled had their shot, as the extra doses would also be to cover any accidents or mishaps occur while giving the shot (e.g. a tray being dropped, a fridge breaking), so it's "batch made" at the beginning of the day, "scheduled people vaccinated" however many hours later, then they can start getting in people for the extra (which could probably happen simultaneously when the last 10% of people are getting doses), but still logistically hard to do with a highly perishable item.

They would have known they had extra from the very first vial dosing.

lucernarian

astrofool wrote: »

Speed and efficiency, the whole batch would have been designated for use, and the people making up the batch would be able to do all of them simultaneously, it's not a case of "1 vial, done, I'll be back in 15 minutes to do vial 2".

Of course a lot of people don't understand this.

Maybe make an effort to explain? Would that be too much to ask?

lucernarian

astrofool wrote: »

It's likely they couldn't start getting people for the extra doses until those scheduled had their shot, as the extra doses would also be to cover any accidents or mishaps occur while giving the shot (e.g. a tray being dropped, a fridge breaking), so it's "batch made" at the beginning of the day, "scheduled people vaccinated" however many hours later, then they can start getting in people for the extra (which could probably happen simultaneously when the last 10% of people are getting doses), but still logistically hard to do with a highly perishable item.

Yes, this is how it works from personal experience at least.

studdlymurphy

GreeBo wrote:

Fantastic point, but again avoiding the question asked. Tell me your explicit steps for funding 16 more people at 9:30pm on a Friday night able to get to the Coombe within 45 mins.

Local garda Station as they need them, local fire station also. I'm sure there are more than that also in the hospital, surely all patient were not vaccinated.

astrofool

steddyeddy wrote: »

You would never do up a whole batch with something mRNA based. You would certainly do a few but not the whole lot.

if you have to vaccinate 500 people over 6 hours, and you have 100 vials, 5 shots per vial, how many vials do you make up?

The answer is anywhere between 75 and 100, even if you pick a mid point of 90, you can end up with 105 extra doses, what do you do with them?

astrofool

studdlymurphy wrote: »

Local garda Station as they need them, local fire station also. I'm sure there are more than that also in the hospital, surely all patient were not vaccinated.

The patients were pregnant women, and are not advised to be vaccinated yet, pending EMA approval.

steddyeddy

astrofool wrote: »

if you have to vaccinate 500 people over 6 hours, and you have 100 vials, 5 shots per vial, how many vials do you make up?

The answer is anywhere between 75 and 100, even if you pick a mid point of 90, you can end up with 105 extra doses, what do you do with them?

It depends how long it takes to add the dilutions. You're not going to waste too long making up a batch of dilutions prior to dispensing.

astrofool

steddyeddy wrote: »

It depends how long it takes to add the dilutions. You're not going to waste too long making up a batch of dilutions prior to dispensing.

So the person with the skills to create the doses just hangs around all day, waiting for a vial to be used before moving onto the next one? for thousands of doses?

The important thing is that there is now a process to handle the extra doses, however, it will likely arise again that people in later groups get vaccinated due to extra vaccines being made available, even when all best efforts have been made to get people in an earlier group on site in time.

plodder

steddyeddy wrote: »

I think they mean the biochemist, nurse or pharmacist would quickly resuspend the contents of each vial in quick succession.

Sure. I guess they do groups of vials together. They could do 5, 10, 20 whatever.

But, when you get close to the end of the number of expected people, would you not make up smaller batches, so they don't go to waste. You don't want to be left with 20 vials made up and nobody to give them to?