Finally: White House directs vaccines to pharmacies

It took a few weeks and a boost in supply, but the US will finally get the most efficient distribution channels involved in its mass-vaccination program. Doses of COVID-19 vaccines will start coming directly to pharmacies for general-population inoculations by the end of next week, a change from the previous limitations of government operations and health-care clinics. The latter only started getting their doses within the last couple of weeks in some states, but the expansion promises a speedier and more efficient rollout:

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Even this isn’t exactly a “new” plan, as NBC’s Today show frames it. The original distribution plans always envisioned a major role for retail pharmacies to conduct vaccinations. (The major pharmacy chains did get vaccine doses early, but only for deployment into nursing homes.) This is more of an acceleration, but it’s still limited by supplies and by the same state-based age restrictions that are slowing down access, perhaps necessarily — but also somewhat counterproductively. While the idea of targeting narrow demographics based on risk is very understandable and arguably supportable, the smarter strategy would be to quickly inoculate as many people as possible to slow down the transmission and therefore the mutations of the COVID-19 virus. The slower the vaccinations progress, the more likely that variants will emerge that could threaten the vaccines’ effectiveness.

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A new study from Oxford on the effects of the AstraZeneca vaccine demonstrate the potential for curbing transmission — even after only one dose:

The Oxford-AstraZeneca Covid-19 vaccine appears to substantially reduce transmission of the virus, rather than simply preventing symptomatic infections, UK researchers have suggested.

The rate of positive PCR tests declined by about half after two doses, according to preliminary results by researchers at the University of Oxford that have yet to be peer reviewed.

Their analysis, released as a preprint Tuesday, also supports spacing out doses and estimates good efficacy after just one shot of the Oxford-AstraZeneca vaccine.

The study did not measure transmission directly — for example, by tracing contacts who were infected by study volunteers. But the researchers did collect regular nasal swabs from some participants and found that the rate of positive PCR tests fell by half after two doses of the vaccine. After one dose only, the rate of positive tests fell by 67%.

The two-dose regimen is still required, but this shows that second doses should not be held in reserve for long, especially if production can be goosed. Getting that first dose to more people means much less potential for transmission, and lowering the chances of new variants developing rapidly among unprotected communities. The White House has accelerated the pharmacy strategy, but it also needs to accelerate its thinking on access. The more arms the merrier in this case, and at this point it might make more sense to just use a first-come, first-served approach to incentivize the rapid adoption of the vaccines.

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