Here's what I am hearing from my friends in health care (not specific to CA, but more national in nature) - the trouble isn't necessarily that the people doing the injections are overwhelmed, it is a crisis of getting the right people at the right time to the administration location. As it turns out, there is no master list of who falls into the different priority groups, where they are, and how to contact them. And there is a moderate rate of no-shows or people who decline, leading to a chaotic footrace to get alternate recipients to a particular site before doses spoil. While I agree Newsom has spent too much time at the French Laundry, I do not think states and counties turned out to have the expertise or resources needed and the varied approaches have caused confusion, especially in border areas where people are hearing info from multiple jurisdictions. Since the chief executive was so intent on involving the military, it would have made sense to spend the last few months registering people with a federal selective service type system so they could be filtered into priority groups and then called by draft numbers to report as vaccine doses were available.

In all honesty, it's not entirely unexpected that from the top down, we really have no fool proof plan on how to issue out the vaccine efficiently. Heck, we run a tight-knit, fairly well oiled construction company here with +/- 75 employees full time, we get things wrong all the time, now multiply that by about 4 million, and that's the level of process. I think the election in November clouded priorities for everyone...it's unfortunate, and like I said politics corrode everything. As a movie Senator once said, "Half the things I do are for political survival."

I just hope there's an exponential learning curve, and things are tightened up as they go. Typically, that is the case. Revisit the scenarios later and take the lessons learned.

Now a question to everybody, I myself am an engineer, builder and a pseudo-scientist...do y'all trust the vaccines? They were developed rather quickly comparatively to most. (reports of people refusing...etc. etc.)

I was perhaps slightly hesitant in October when the vaccine seemed like a political football being launched as a hail mary. Since then I have become much more confident as I have learned about how an mRNA vaccine works. I am not a biologist or doctor, but since it cannot give you Covid and does not contain live or dead virus, it seems like the worst case is that it just doesn't work or fades over time. There are risk/benefit tradeoffs with any medical treatment, but given how deadly the virus is, I believe benefit outweighs risk, at least for me. I think acute treatment chemical drugs being used on an emergency basis without real control/variable testing are a larger risk that I would rather avoid relying on. There are also a few among us who cannot take vaccines (immune disease, organ transplant, etc.) and their safety relies on able-bodied people like me being vaccinated, a social responsibility I take seriously.

Totally agree with all your points. This mRNA technology, while understood for a long time, is real rocket science as it’s being applied to vaccines. I’m curious to see how the nanotech derived vaccines compare.

as of 3 days ago, only 1/3 of California’s received doses have been administered. That part seem like a more local problem to me. Plenty of mismanagement to point at on both sides of the political spectrum.

If we want to call it a local failure, then it is a local failure nearly everywhere. Most of the states have only administered 20-40% of their stock, and while CA is far from leading, it isn't last either. Also fair to point out CA has administered more individual doses than any other state. In general, New England, Appalachia, and Big Sky country are a little above the curve, while the west, south, and Great Lakes are below. West Virginia and North Dakota are outliers that lead the nation with >60% administered. Unless Dr. Strange has taken us to a parallel universe where WV leads the world in health, I would posit that with the resources at hand the rollout is bound to go better in states with small, homogenous populations centered in relatively few geographic locations.

Regarding the safety of the vaccines, I'm a analyst, not a doctor, but I happen to work with researchers who have been involved with vaccine research this past year. To a person, they endorse the current vaccines for the average adult. As one said to me, the chance of a negative reaction to the vaccine is a lot smaller than what might happen if you catch the virus. And because of the importance of the research they do, many have already received a shot (or will soon).

Los Angeles Times - Dec 29, 2020

Seven days, 29 killings: L.A. County’s deadliest week reveals pain, inequity and injustice

Crime up, homicides up over 20%

"...Law enforcement authorities, victims’ relatives, gang intervention workers and others attuned to the escalating violence say they believe the pandemic has contributed to the rise in killings, but the extent of its effect is unclear. Nerves are on edge. People are out of work. Institutions that might have stemmed the violence — schools, workplaces, community centers — are closed."

"...“I know there are a lot of factors, but there is a correlation with a lack of social engagement, job loss, isolation,” she said. “There’s a lot more to be understood about the impact of COVID on violence.” "

Gang intervention stopped.

"...“There’s anxiety gangbanging where folks just don’t care,” said Ben “Taco” Owens. “And they do things in broad daylight or randomly.” "

Star Tribune: OPINION EXCHANGE

What ails vaccine rollout is too much management, not too little

- Gov'ts requiring new certification to administer Covid vaccine?!
- Confusion over eligibility
- lack of capacity (normal channels cut out)

Related:
- Cuomo vs deBlasio turf war: ironically, deBlasio coming off rational
- Politico: "30 doses were flushed down the toilet in Albany when they went unused at a nursing home, the Times Union reports"
- Newsday: Cuomo's order: $1 million fines, licenses in peril for COVID-19 vaccine fraud in NY

Author's suggestions (partial):
- simple 65 years of age cut off
- allow broader channels
- community groups (Catholic church's might be perfect)

Reader comments claims the Dakotas & Iowa doing better than Minnesota.

https://m.startribune.com/what-ails-vaccine-rollout-is-too-much-management-not-too-little/600007536/

CDC says over 6.6M first doses have been administered already. In the last 24 hours, they've administered almost 750K. Keep that rate up (though it's been increasing) and it's 5.2M per week which is 1.5% of the population. For reference, about 250K people were infected today (official reporting).

The rates of infection are still going to be high for the next few weeks and the deaths will be high for a couple weeks after that (due to lag). I wouldn't be surprised if deaths drop off quicker since they're prioritizing getting the vaccine to the elderly and who are most at risk of dying. But we're rounding the corner on this thing.

Josh Caplan@joshdcaplan

NYT: 66% of New York City’s vaccine doses sit unused

Here is a good tracker on vaccine distribution for anyone interested. Distribution started accelerating a few days ago, but the acceleration is not consistent across states - CA has a more consistent trendline than some states that achieved big jumps.

Consider this for context, the CDC says about 52% of Americans take the flu shot every year. And it is usually a drama-free experience without much wait at a pharmacy, doctors office, or workplace event. This proves we have the injection capacity for a mass vaccination over a couple months time, because we literally do it every year. To some degree there are handling challenges with the temperature of this vaccine. But it seems the biggest challenge is managing the patient side of the scarcity equation in a supply/demand mismatch. Fundamentally, do you give the vaccine to those who want it most or need it most? Much faster to give it all out to the wants because they will jump railings to cut to the front of the line. The same people do it at Six Flags and the grocery store deli. In this case, the most urgent needs tend to be harder people to reach in society and trying to get to them is only made harder by the din of the wants pounding on the doors, so to speak. It is a very valid question as to how much time you invest chasing the hard to reach people in the name of "health equity" before moving on. In FL and TX, they weren't done with healthcare workers yet but the governors were dissatisfied with the percentage optics so they opened it to everyone 65+, without telling the counties prior to going going live to the press. It's pandemonium with limited doses available at fragmented hospitals, health departments, and pharmacies and seniors racing all over town to chase them. At the end of the day, the seniors being successful are those who are plugged in to social media and spry enough to hop in the DeVille and peel out on a moment's notice. The seniors who aren't online, don't drive much, and can't stand for long periods are left behind. And then at the events, ineligible cops and politicians' spouses are showing up and getting it because exasperated health workers say it takes too much time to send them packing when they know these are people who will make a scene.

There there is the 48% problem. The flu shot is low/no cost, widely available, and well proven -- and 48% don't bother. For example sake, let's assume the 52% of people who take the flu shot are relatively easy to convince to take the COVID vaccine, but we really need 70-90% participation. We need a massive communication campaign now to convince the balance. And probably other motivations like threatening to deny school entry or delay tax refunds to anti-vaxxers.

Good points. But for a 'pandemic' / 'emergency', they had 6+ months to prepare, and many aren't impressed. Common sense rare.

What happens if we someday have a virus w a 5% mortality?

My understanding is that the African American & Latino communities are getting hammered (probably partly due to higher obesity rates), so that should have been a HIGH & EARLY PRIORITY to provide multiple pathways.

Last summer I would have brought in black and Catholic churches (Latinos), and Costco (sharp organization), and strategized this for mass roll out. "Outreach" with bilingual members of the community, in advance, to prime the pump.

(Gov. Ron DeSantis of Florida did fast track about 50 highway projects during the early shutdown, taking advantage of limited traffic. Just like we did 30 years ago on the collapsed Bay Bridge.)

No one said it was "easy", but it ain't an Apollo mission. Simple steps as stated above - advance "outreach", education, PRIORITIZE black and Latino communities. Priority for bilingual staffers.

I'm not going to ignore blatant, repeated blunders like our New York Gov who seeks media attention while tens of thousands of senior citizens die, alone.

Cuomo:
1. Didn't order Ventilators (POTUS bailed him out)
2. Didn't have adequate hospital beds (" ")
3. Didn't use USS Comfort while sending infected seniors back into nursing homes
4. Didn't use Javits Center
5. Not prepared for vaccine rollout for critical Fall season

MUST READ - New York Post

"In a single day, Israel immunizes more people against COVID-19 than New York City has in total since receiving its first vaccine shipment on Dec. 14. The two have similar populations, but 1.6 million Israelis have gotten jabbed and just 168,000 Gothamites have."

https://nypost.com/2021/01/08/heres-how-new-york-can-get-its-shot-together-and-beat-covid-19/amp/?__twitter_impression=true

When looking at vaccines administered as a percentage, the US is 4th in the world, nationally at about 2.3 doses per 100 people. Israel leads by far at 19 per 100 with UAE and Bahrain running up. Worth looking at what they are doing, though they are more culturally homogenous countries with more centrally administered governments. Curious if Israel has seen differences in health outcomes with the Palestinian minority like we have with some minority groups here. The suggestion of having appointments for the priority groups with an unrestricted "standby line" for leftover doses seems workable. I think NY has strict penalties for out-of-order administration because initially the rich and powerful were managing to sneak into nursing homes to cut the line. That said, age is like the easiest criteria to filter people by because it is an easily verifiable number. For the following groups of essential workers, eligibility will be very difficult to ascertain unless the shots are given in the workplace.

As to previous comments, I'm not sure any governors are going to get passing grades. Some mistakes were made in the fog of war, others are far less excusable. Seemingly the planning and communication for vaccine distribution is unacceptably incomplete. My guess is that states were distracted managing disease prevention efforts in open conflict with local interests after the emergency economic backstops were allowed to expire. In NY it was the nursing home lobby, in FL it was the restaurant lobby, and in CA it was the open rebellion from Orange, San Diego and parts of LA County.

I think we can all agree there won’t be many politicians that come out of this looking good. Heck, I read an op/ed piece in the Mercury news from a Philadelphia Inquirer writer saying that Reagan was the reason for the slow rollout (cuts he made 40 years ago to Health and Welfare that led to health center and some hospital closures).

Scary that the politician that looks the smartest here might be Arnold!

Andrew Cuomo@NYGovCuomo

"We simply cannot stay closed until the vaccine hits critical mass. The cost is too high. We will have nothing left to open. We must reopen the economy, but we must do it smartly and safely."

https://twitter.com/VictorJoecks/status/1348694929476734976?s=20

San Jose Mercury News

Lagging behind most of the US, California in mad dash to distribute COVID-19 vaccines

California ranks 43rd nationwide for its vaccine rollout.

No big deal on the vaccine rollout. The virus pretty much disappeared in April or May last year just like Trump said it would!

Blame slow rollout on the software. (2 systems)

https://www.google.com/amp/s/ktla.com/news/local-news/software-snag-partially-blamed-for-californias-slow-covid-19-vaccine-rollout/amp/

ABC 10 News - Jan 6th

"The state began receiving the Pfizer vaccine in mid December. So far, more than 454,000 doses have made it to arms, but counties are sitting on roughly 1.29 million doses, with another 911,000 doses on the way."

"A lead member of the state’s coronavirus vaccine advisory committee has growing concerns that a majority of the vaccines could be wasted.

"...There are literally hundreds of thousands of doses out there sitting in warehouses while you have nursing home residents and staff…who are waiting to be vaccinated,” Mike Wasserman told ABC 7 in the Bay Area."

https://www.google.com/amp/s/www.abc10.com/amp/article/news/health/coronavirus/vaccine/why-california-has-been-slow-on-the-vaccine-rollout/103-5a49c6f3-af0f-4fb4-970f-f2ca3363a00f

SRC is a former 22-year Federal prosecutor.

shipwreckedcrew@shipwreckedcrew

"So, its okay now to dine indoors in NY.
Who could have guessed that in the middle of the cold and flu season in NY, but right at the end of the Trump Administration, that Cuomo and DeBlasio would find health conditions improved so much? Amazing the curative effects of Georgia"

My understanding is that NY has a red/orange/yellow system with indoor dining only allowed in yellow counties (but now expanded to orange). Upstate bar owners in “orange” counties sued and won a temporary injunction allowing reopening. But the state seems likely to appeal. Dining rooms in NYC remain closed under a separate order. I don’t really see a huge connection to senate elections.

7 day rolling average for new cases has dropped for about 10 days straight. Total hospitalizations have dropped each day over the last 10 days also. Almost 5% of the population (16.2M people) have gotten their first dose and we’re up to almost 1M vaccinations per day (so over 2% each week at that pace). I think that’s going to increase as we start allowing younger people to get vaccinated.

I don’t think it will be completely normal by then but I think we’re going to be relatively normal by June. There won’t be 20K people in an indoor basketball arena by then. But we’re rounding the corner on this thing.

One note, I’ve read that even if you get the vaccine, you probably won’t get sick but you could still get the virus and transmit it to others. So even if you get your vaccine, still wear a mask for a while until more of the population gets their shots.

Yes, everyone needs to remain steadfast on precautions, vaccine or no vaccine. I saw in the literature that there is a difference in risk of shedding between the two vaccines. I just received my second dose of the Moderna. Vaccines never bother me. But in this case the first one made me a little lightheaded, and of course the injection site was sore. But the second dose knocked me down for about 24 hours. Chills, fluish, and lightheaded. My colleague pre-treated herself with tylenol and then took it every 6 hours for 24 hours. She had very mild symptoms. What i experienced was expected. Dont let vaccine side effects stop anyone from getting vaccinated. They are safe.

isn’t there some concern that premeditating with Tylenol may reduce the effectiveness of the vaccine?

https://www.som.uci.edu/docs/COVID%20Vaccine%20FAQ%2012.17.2020%20v2.pdf

Thanks for referencing that. I did not pre-treat myself, but a colleague of mine did. I took tylenol once the evening after the injection.

What would cause the difference in the reactions between the two shots? Does getting the second just amplify the reaction (for lack of a better phrasing)?

That all tracks with what I've heard. First shot is mostly just arm soreness (I've frequently heard it described as being punched in the arm). Second one is exactly as you described. Possible fever, chills and or just feeling lousy for 24 hours. But I've heard from a handful of people and everyone has said 24 hrs at most. Obviously there will be some exceptions I'm sure.

I won't hesitate to get mine when I'm able to.

One thing I have heard is the needle is bigger than the normal needle for getting a shot. Any truth to that?

In simple terms your immune system is primed from the first injection and the subsequent injection causes a more vigorous response from the memory in your T cells. Thus more symptoms.

Yes, the needle is longer and has a stopper on it so the depth is consistent. But you will hardly notice the stick. Essentially no different than a flu vaccine. None of those issues should frighten anyone away from getting vaccinated.