{"id":9930,"date":"2020-12-20T13:43:42","date_gmt":"2020-12-20T18:43:42","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9930"},"modified":"2020-12-21T15:58:40","modified_gmt":"2020-12-21T20:58:40","slug":"with-vaccine-rollout-a-mixture-of-gratitude-envy-and-cautious-hope","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/with-vaccine-rollout-a-mixture-of-gratitude-envy-and-cautious-hope\/2020\/12\/20\/","title":{"rendered":"With Vaccine Rollout, a Mixture of Gratitude, Envy, and Cautious Hope"},"content":{"rendered":"

\"\"<\/a>I. Gratitude<\/strong><\/p>\n

Did I think we’d have two vaccines for COVID-19 available for distribution before 2021? Two vaccines with 95% efficacy in preventing disease, and nearly 100% in preventing severe<\/em> disease? Vaccines that work across different patient populations, including the most vulnerable — especially older people?<\/p>\n

Not a chance. I’ve probably been quoted half a dozen times saying that we likely wouldn’t be seeing vaccines before next year. Some “expert,” ha.<\/p>\n

And yet, here we are. In this interview yesterday, you can clearly hear the excitement in my voice<\/a> as I discuss the second emergency use authorization for the Moderna vaccine. Giddy.<\/p>\n

Yes, it’s time to celebrate, to shed tears of joy when receiving the vaccine, to display happily the image of a bare biceps and the injection taking place, both vaccinator and vaccinated clearly smiling beneath the masks.<\/p>\n

It’s even time to dance!<\/p>\n

https:\/\/twitter.com\/JournalsDance\/status\/1339875341628821506?s=20<\/p>\n

II. Envy<\/strong><\/p>\n

Several friends and family members have asked — have you received your COVID-19 vaccine?<\/p>\n

Answer:\u00a0 Not yet.<\/p>\n

Can’t blame them for asking — I’m an ID doctor, after all, and finished a rotation of inpatient service just before Thanksgiving, and am about to start another over the the Christmas holidays. Most of us have been working solidly since March, no encampment to our country estates.<\/p>\n

They might also ask after my wife, a primary care pediatrician who sees sniffly and coughing kids every day in her office practice, kids accompanied by their parents — many of them young adults at high risk for community acquisition of COVID-19.<\/p>\n

Not yet for her, either.<\/p>\n

The harsh reality is that there’s not yet enough vaccine to go around. Not even close.<\/p>\n

In my hospital system, the overwhelming volume to sign-up for “Wave 1” of vaccine administration (of which I’m a part), initially caused the process to crash<\/a>. It then reopened for approximately 15 minutes before the schedule filled. The supply is limited due to distribution issues beyond the hospital’s control<\/a>.<\/p>\n

Some did successfully sign up, but the first-come, first-served nature of the process allowed people to time their participation — you can be sure many set their phone alarms to go off at the precise moment the schedule came online again. Perhaps this process excluded those working the hardest, with the irony of this disconnect not lost on some<\/a>.<\/p>\n

But problems notwithstanding, I (and others in this first wave) likely will get the vaccine soon — I’m optimistic since with this second vaccine’s authorization, our hospital system’s supply should increase quickly.<\/p>\n

My wife can’t be so certain. She and her partners own their practice, and their primary hospital does not have enough vaccines for affiliated primary care pediatricians or their staff.<\/p>\n

Meanwhile, thousands of doctors (including several of our friends), nurses, respiratory therapists, and other frontline workers around the country have been vaccinated. Hooray! Plus, notably, some politicians blue<\/a> and red<\/a> — even Santa Claus<\/a>.<\/p>\n

Good for them. We’re happy<\/em> for them.<\/p>\n

But we’re envious, too. And if we feel this way, imagine how the broader public feels — those sequestered away the last 9 months, tired of the isolation, many older and at risk for severe COVID-19 and terrified. No accurate timeline for their vaccines. No wonder people are trying to jump the queue<\/a>.<\/p>\n

And yes, it’s hard to see those vaccine selfies, ouch.<\/p>\n

https:\/\/twitter.com\/DrSandman11\/status\/1339565524213182464?s=20<\/p>\n

III. Cautious Hope<\/strong><\/p>\n

Hard to be hopeful right now. Cases continue to increase across the United States — now well more than 200,000 a day<\/a>, with our country’s cumulative death toll over 300,000.<\/p>\n

And unlike earlier surges, which targeted different regions at different times, this time it’s everywhere. <\/em><\/p>\n

\n

For the first time.
All red USA, now including Hawaii, for out of control covid.https:\/\/t.co\/BpmBybV8U5<\/a> pic.twitter.com\/Zyt8Uiaeq8<\/a><\/p>\n

— Eric Topol (@EricTopol) December 16, 2020<\/a><\/p><\/blockquote>\n