We are a week away from the originally planned distribution date of COVID-19 vaccine here in NYC. Of course, we are patient. Hopeful that the original date will be kept but we are also prepared that there may be last minute schedule adjustments.
In the absence of clear instructions before the New Year weekend, I am trying to make some preparations even though the details are very hazy.
1. The response of people to last week’s blog was unprecedented. On the public media the chatter of the anti- vaccine crowd is very loud. In contrast, my subscribers’ desire to get the vaccine quickly is overwhelming.
2. To quickly review. If you are getting this email you are on my email update list. You will be notified as soon as we have more details to share. That notification email will tell you how to make appointments and what else you need to know. If you are concerned about a friend you are welcome to add them to the email list. Simply go to the subscribe tab on the website and add their email address. This way they will also get the updates.
3. Please refrain from calling the office now about receiving the vaccine. At this point we cannot give vaccine appointments for two simple reasons. 1. NYC has given us neither a shipment date nor a shipment quantity. 2. NYC Department of Immunization may still impose conditions to prioritize recipients, by age, illnesses and occupations. We will have to give out appointments in a fashion that respects these rules. Originally it was hoped that once the private doctors received a supply of vaccine we would be in phase 2, which is less restrictive. Because of the nature of my practice I expect that most of my patients will qualify for the earlier phases ( called 1b and 1c) and I will be able to distribute the vaccine widely.
4. I believe that everyone should know their antibody status. Many individuals who did not have an apparent case of COVID-19 are surprised to find out that they do have antibodies from a silent case. These individuals are permitted to get the vaccine according to the present national guidelines. Nevertheless, I feel that individuals with antibodies are largely protected and can delay getting the vaccine for now.
5. There has been public reporting of great bottlenecks in getting the vaccine off warehouse shelves to vulnerable individuals. The Mayor announced his desire to quickly vaccinate a million citizens and I anticipate that he will instruct his departments to use all the possible channels. This should work in our favor as the government looks for the largest number of avenues to distribute the vaccine. As a sign of my optimism, when the Department of Immunization requested a formal order requisition on Dec 29, I increased my request by 50% over the number that I submitted with my initial application. The response to my last email makes it clear that there is a great demand for the vaccine.
6. Planning in an information vacuum is very difficult. If the vaccine is distributed slowly in small quantities, I plan to use my office and the staff and computers that are in place. There is always a chance that I am granted a larger fraction of the thousands of vaccines that I ordered. Just in case, I have already started to scout out larger areas with multiple large entrances where large numbers of people can enter and exit safely and quickly. A larger venue will entail more staff and a robust computer installation to send the Department of Immunization the records that they are asking for.
7. A reminder here. An individual is only regarded as successfully vaccinated 10 days after the second dose. The two Moderna doses are given 4 weeks apart. The doses cannot be given closer together. If the supplies dry up and there is an extra wait for the second dose, it creates a delay in achieving maximum immunity but does not invalidate the first dose.
8. A second reminder is that the older than 60 crowd has what is termed 85% immunity, not the 95% immunity that is advertised. Frankly 85% is not bad. But it will become increasingly better as larger numbers of people get vaccinated and the chance of meeting an infected person decreases. I maintain that for older people the return to normal social activity should not be sudden but a slow resumption to match the distribution of vaccine in the community.
9. The early returns regarding vaccine safety are better than anything Medicine has ever experienced. The first 250,000 doses have generated less than 6 allergic reactions. This is undoubtedly the safest vaccine or medicine that has ever been distributed.
9. Lastly for my stoic patients who have endured 9 months of a prison- like existence this is not the time to give up, but rather to increase vigilance against getting infected because at the worst we are only a few weeks away from substantial vaccine generated immunity that will make circulating in crowds safe again.
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