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A few points to clarify vaccine distribution in Ontario.
1. We get ~400K doses of Pfizer weekly. It shows up like clockwork. It gets distributed throughout the province in ~1-2 days & there is very little at the end of the week. This is administered at mass vaccine clinics. https://twitter.com/ASPphysician/status/1382153670452723712
1. We get ~400K doses of Pfizer weekly. It shows up like clockwork. It gets distributed throughout the province in ~1-2 days & there is very little at the end of the week. This is administered at mass vaccine clinics. https://twitter.com/ASPphysician/status/1382153670452723712
2. We get several hundred thousand doses of Moderna every 2 weeks. Also rapidly shipped to locations in the province. For various reasons, Moderna shipments are occasionally delayed. There is very little Moderna in freezers at the end of the 2 weeks.
3. We have infrequent large boluses of AstraZeneca. This is administered by primary care in 6 Public Health Units, and by ~1400 pharmacies throughout the province.
It is available to anyone 55 years of age and older.
It is available to anyone 55 years of age and older.
4. On the day of vaccines delivery, for a brief period of time there are a lot of vaccines. Kind of makes sense.
Throughout the week they are quickly administered.
It looks like most of the provinces are comparable in terms of their ratio of delivered:administered @jm_mcgrath
Throughout the week they are quickly administered.
It looks like most of the provinces are comparable in terms of their ratio of delivered:administered @jm_mcgrath
5. So what is the deal with so many "in the freezer"?
Well at the beginning of the week there is plenty of Pfizer/Moderna but that quickly get administered. We then wait for the next shipment.
There is ~2 day supply for wiggle room if there are supply chain issues.
BUT
Well at the beginning of the week there is plenty of Pfizer/Moderna but that quickly get administered. We then wait for the next shipment.
There is ~2 day supply for wiggle room if there are supply chain issues.
BUT
6. What's left in the freezer?
AstraZeneca.
A lot of it.
It's not exactly flying off the shelves for the 55+ crowd unfortunately.
AstraZeneca.
A lot of it.
It's not exactly flying off the shelves for the 55+ crowd unfortunately.
7. Even with ~1400 pharmacies & PHUs administering AstraZeneca, it moves SLOWLY in many areas.
Expanding primary care's role and outreach would help, but perhaps may not solve this issue.
See below: https://twitter.com/nilikm/status/1382033517618548740?s=20
Expanding primary care's role and outreach would help, but perhaps may not solve this issue.
See below: https://twitter.com/nilikm/status/1382033517618548740?s=20
8. It's pretty clear why the uptake of AZ is slow. There have been some preventable & perhaps less preventable communication (& policy?) issues at various levels.
@picardonhealth has a great article today that is relevant here: https://twitter.com/picardonhealth/status/1382662482095837188?s=20
@picardonhealth has a great article today that is relevant here: https://twitter.com/picardonhealth/status/1382662482095837188?s=20
9. We could probably administer significantly more AstraZenca vaccine through some combination of:
1) transparent & effective communication
2) lowering age cutoff below 55
3) expanding role of primary care
4) other/etc.
1) transparent & effective communication
2) lowering age cutoff below 55
3) expanding role of primary care
4) other/etc.
10. There are several of areas for improvement on the vaccine rollout , like improving access in high-burden neighbourhoods, sorting out confusing sign-up systems, communicating ever-changing guidance, lowering barriers, etc.
BUT having said all that...
BUT having said all that...
11. Ontario is administering >100000 vaccines on most days.
While I am grateful for the increased supply of Pfizer & Moderna (this really kicked in on March 22nd), we truly don't have enough to vaccinate everyone is Phase 2 now, and still have to triage.
While I am grateful for the increased supply of Pfizer & Moderna (this really kicked in on March 22nd), we truly don't have enough to vaccinate everyone is Phase 2 now, and still have to triage.
12. But we are making significant headway.
A few examples of lowering barriers in communities most in need:
1. https://bit.ly/32fzwRR
2. https://bit.ly/3mMSyIG
3. https://bit.ly/3dZyMWk
There are more examples & this will expand with growing supply.
A few examples of lowering barriers in communities most in need:
1. https://bit.ly/32fzwRR
2. https://bit.ly/3mMSyIG
3. https://bit.ly/3dZyMWk
There are more examples & this will expand with growing supply.
13. I appreciate how this particular topic of distribution & freezers can get politicized & can be rather polarizing.
I really try my best to avoid all that & get to the actual issues at hand.
I hope this clarifies a few points.
I really try my best to avoid all that & get to the actual issues at hand.
I hope this clarifies a few points.
14. There are obvious areas for improvement on the vaccine rollout (see above), but somethings are still going rather well.
We have to quickly address the issues & continue to work toward a rapid & equitable #COVID19 vaccination program.
We have to quickly address the issues & continue to work toward a rapid & equitable #COVID19 vaccination program.
Addendum: @GurdeepA and I discussed some of this today on @CP24Breakfast. https://twitter.com/CP24Breakfast/status/1382699508593725444?s=20
Last point: Reading through some of the comments - I wouldn't attribute hesitancy as the sole contributor to slow AstraZeneca rollout, but it cannot be ignored either.
Really the last point:
To sum up...
Burn rate for Pfizer: Fast
Burn rate for Moderna: Fast
Burn rate for AstraZenca: Slower (for various reasons)
To sum up...
Burn rate for Pfizer: Fast
Burn rate for Moderna: Fast
Burn rate for AstraZenca: Slower (for various reasons)
