The first coronavirus vaccine is already dirty and should not be used before Friday evening.

The Federal Government Operation Warp Speed is accelerated and holds press conferences led by generals who promise a military style operation. But apart from the jokes about military precision, experts already expect a lot of confusion, a lot of fear and more than a little indignation.

The public needs to understand that there will be injustices or mistakes and sometimes downright stupidity, said Juliette Kayyem, a security expert at Harvard Kennedy School and former assistant secretary for interstate affairs in the Department of Homeland Security under Obama policy.

These are some of the problems the American public can expect with mass vaccination.

people have to wait.

Clearly, there isn’t enough vaccine for everyone who wants it right away. Pfizer is expected to deliver 2.9 million doses in the first few days and 2.9 million doses on day 19 of the study. December to deliver only up to 6.4 million doses, in line with the government’s cruising speed vaccination. Together, Pfizer and Modern can deliver up to 40 million boxes by the end of the month.

The vaccine advisors have already divided the priority groups into subgroups and have designated only the very first persons to receive the vaccines. Group 1a, appointed by the Immunisation Practice Advisory Committee, consists of primary health care workers and people living in care homes.

But even this small group is already outstripping the supply of vaccines. That’s about 24 million people, and 40 million doses only cover 20 million. Hospitals are planning a triage.

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I think we expect to run out of money with everyone at the same time. This won’t be an isolated event, said Dr. Marcie Dries of CNN, senior infection control specialist and epidemiologist ChristianaCare of Delaware hospital. We don’t know exactly how much vaccine we’ll get.

Moncef Slaoui, Warp Speed’s chief advisor, predicts that Pfizer and Moderna together will be able to produce and ship 60 to 70 million vaccines in January, and hopes that the other two vaccine manufacturers, AstraZeneca and Johnson & Johnson, will join the approved vaccines in the coming months.

We can vaccinate 20 million in December, 30 million in January and 50 million in February, according to the slow Tuesday at the White House. But he plans not to vaccinate the entire population until June.

As long as nothing happens to the production. Modernna and Pfizer say they could produce up to a billion doses by the end of 2021, but Modernna says this number could be half – it has never produced a product for sale – and Pfizer has already made serious adjustments to its vaccine delivery schedules due to unspecified production problems.

Distribution may appear unfair

The CPIA is the central group that advises the U.S. Centers for Disease Control and Prevention, which in turn make recommendations to the states. The state and local authorities decide for themselves who will be vaccinated and when. The decision to initially vaccinate health workers, nursing home residents and patients in rehabilitation centres was simple: people want doctors, nurses, technicians and others to be able to provide safe care for everyone, and nursing home residents are responsible for 40% of deaths so far.

But then it gets sticky.

Most Americans belong to one risk group or another – especially since obesity increases the risk of serious illness and more than 40 percent of Americans are obese. People over the age of 65, diabetics, people with kidney disease, ethnic minorities, people with other chronic diseases – it will be difficult to select just a few of these groups to continue.

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What about essential employees? Groups advising the CPIA, including Johns Hopkins University and the National Academies of Science, Engineering and Medicine, believe that it is advisable to vaccinate people working in the food industry and ambulances and in the public sector earlier than the general population.

Dr. Robert Atmar, a CPIA member and Professor of Contagious Diseases at Baylor Medical College, stated that CPIA is likely to place key personnel in Group 1b. These include teachers, law enforcement officials, firefighters and various other groups, and then it’s 1c for people with underlying medical conditions who have a higher risk of complications or death when they contract Covida-19, and that would include people over the age of 65, he said.

But even that might seem unfair, Kai said.

There are a lot of people who are 64 years and 300 days old and who will say In just a few weeks, I can get to the next pool, Kaiem said. It’ll seem a little insensitive.

Organisations representing patients with different chronic diseases have started lobbying to include their specific interest groups in the first focus groups.

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There is no doubt that our country must first provide access to the population most at risk for the most serious complications of Covida-19, including 34 million Americans living with diabetes, told Tracey Brown, CEO of the American Diabetes Association, CNN.com.

In discussing who should be eligible for Phase 1b of the vaccine, CPIA has so far discussed people at high risk of disease, namely cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), immunocompromising conditions in solid organ transplantation, obesity, severe sickle cell disease and type 2 diabetes, the Muscular Dystrophy Association wrote to CPIA.

MDA strongly believes that individuals with neuromuscular disease should be included in Phase 1b vaccination due to the complexity of neuromuscular disease exposure resulting in an additional disease with a high risk of adverse events for Covida.

Kayem also sees the separation between rural and urban areas. Chances are you want to take the Pfizer vaccine with you to urban areas because it needs to be frozen. In the cities this is easier to do than in the countryside, she says. For example, the head of the Hawaiian Health Association told CNN last month that no hospital in Hawaii has a freezing cold to store Pfizer’s coronavirus vaccine and that the government may not have enough access to dry ice to make good use of the company’s outlets.

And because the vaccines have to be stored carefully and two doses are needed, some local decisions can be made to use them effectively. For example, some districts may decide to vaccinate all nursing home staff and residents, including those who do not belong to certain priority groups. Others can offer vaccinations to family members so that they can visit their loved ones and help take care of them. Some hospitals may decide to vaccinate patients at the same time as staff in order to make effective use of the vaccines allocated to them.

There will be side effects

Susan Froehlich from Dallas was sure she was getting the real vaccine and not the placebo when she volunteered to participate in modern vaccine clinical trials. About 12 hours after I got the gas pedal, it was 2:30 in the morning, and I woke up with a terrible stomach ache and headache, and it was like I was at the beginning of a bad flu, Froehlich said at CNN City Hall last week about the coronavirus.

It was as if every part of my body had suffered for about four hours, Froehlich said. She felt better after she took the Naproxes.

It’s not sudden. Up to 15 percent of participants in the Pfizer and Moderna studies experience significant side effects, including nausea, body aches, headaches and chills, Slowy said.

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I think these side effects are quite common, Dr. Slouy-CNN said earlier this month. They are quickly resolved, but the CDC and other officials are concerned that they may prevent some people from getting a second dose of the vaccine and are developing training materials to warn people that the symptoms are a sign that the vaccine strengthens the body’s immune response and that it is harmless.

Hospitals and the army are also planning to make the staff sick after the shooting. Dris said they didn’t want to vaccinate everyone on the same day. Instead, several hospitals said they would shake hands with the vaccination if a significant number of workers were incapacitated a few hours or even a day after vaccination.

There will be terrible vaccines

Pfizer’s vaccine had already experienced its first panic, and two allergic reactions were reported in the UK when it was launched. Both patients recovered, but the incidents were enough to delay the USDA for several hours, while the U.S. Food and Drug Administration (FDA) reversed possible changes in vaccine labeling.

In September, AstraZeneca suspended trials with the coronavirus vaccine due to a serious adverse event among a volunteer. The company then reported that one volunteer had an undiagnosed case of multiple sclerosis, while the second volunteer had an unexplained disease. An internal company document referred to a rare neurological disorder called transverse myelitis. Testing resumed a few weeks later in the UK and other countries, but not before day 23. In October, the FDA approved the resumption of testing in the United States after it was determined that the case had nothing to do with the vaccine.

AstraZeneca had another terrible case when a volunteer who had participated in a study in Brazil died, but it turned out that the volunteer had been given a placebo and had died of Covida-19.

One of the groups on the waiting list for early-stage vaccines are residents of long-term care facilities, said Dr. Nancy Messonier, who heads the CDC Respiratory and Immunization Unit.

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They are given the vaccine at an early stage because they belong to the most vulnerable population groups – 40% of deaths are among these groups. They are medically vulnerable, Messonier said in an interview at the Aspen Institute on Monday.

If we vaccinate in the nursing home on Monday and someone dies on Wednesday, it would be a terrible tragedy. Maybe, but it probably has nothing to do with the vaccine. So I hope people aren’t trying to jump to conclusions.

These fears are likely to become more frequent as more and more people are vaccinated. The CDC plans to actively question people about their symptoms using a text-based application called V-Safe. At the same time, social networks can be filled with stories about people suffering from diseases or accidents and linking them to the vaccine – whether there is a direct link or not.

Dris said her hospital system was ready to hear from vaccinated workers and prepared an education campaign to help treat it. She said we really like the science behind this vaccine.

Errors will occur

Colorado had a surprise with the very first monster. The test batch of an auxiliary vaccine kit containing syringes, alcohol and other aids was accidentally sent to another state. This shipping error was caused by a printing error by a manufacturer. The manufacturer has solved the problem, but Colorado will not receive a second test shipment of a counterfeit help kit, according to a statement made earlier this month.

A hospital system in California trained its staff to get a powder vaccine from Pfizer. The Pfizer vaccine is actually delivered in a frozen liquid that needs to be diluted.

One issue that has not received much attention is that our schedule does not include a place where we can do a lot of practical training with the people who will administer the vaccines, said Dr Kelly Moore, deputy director of the Coalition for Immunization Action, which supports front line workers who will administer the Kovid 19 vaccines.

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Such mistakes can lead to a rude dedication, said Mike Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Administration and transition advisor to President-elect Joe Biden.

Having a vaccine doesn’t mean anything if it doesn’t lead to a vaccination. To do this, the vaccine must travel the last mile to arrive in the hands of the so-called vaccine on time, at the right temperature and at the right place, Osterholm said.

There’s a lot of room for error, Kaiem said.

Any supply chain where demand exceeds supply becomes difficult because you constantly have to make sales decisions. They make them all over the country, which is geographically dispersed, divided, and in the middle of a pandemic, said Kaiem.

Vaccines that need to be stored frozen at extremely low temperatures can defrost and should be disposed of. Vaccines can be sent to the wrong address. A nurse may shake an expensive vial of Pfizer vaccine vigorously – the package insert indicates that it may deteriorate, but instead the vial should be rotated gently several times to mix the contents. People will forget to come back for a second dose.

There will be course corrections, and sometimes someone will just do something stupid, Kaiem said.

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