"Enclosed is my (too?) quick effort to look at recent vaccination processes with specific attention to supply and demand networks."
[Philip J. Palin supports the FEMA-NIC Supply Chain Resilience Technical Assistance Program as a Subject-Matter-Expert. The background, points-of-view, and opinions expressed by Subject-Matter-Experts do not necessarily represent the positions or policies of the Department of Homeland Security or the Federal Emergency Management Agency.]
Vaccine delivery with speed, scale and equityKelley Hodge
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
In this webinar, Dr. Brian C. Castrucci President and Chief Executive Officer of the de Beaumont Foundation, presented new polling about vaccine confidence and Dr. Ayne Amjad, Commissioner and State Health Officer for West Virginia, and Dr. Costello, Assistant Professor of Pediatrics at West Virginia University School of Medicine, presented insights from their research and successful vaccine outreach campaign to rural communities in West Virginia. Dr. Lauren Smith, Chief Health Equity and Strategy Officer for CDC Foundation, moderated the conversation and an audience Q&A with Drs. Amjad and Costello.
Sponsored by the Public Health Communications Collaborative, this webinar features Dr. Nadine Gracia of Trust for America's Health and Dr. Joe Smyser of the Public Good Projects.
International Vaccines Summit 2021: The Language of Vaccine Confidence - Less...Mark Miller
Presentation to the International Vaccines Summit on September 22, 2021, reviewing communication best practices, polling findings, and lessons learned from the rollout of the COVID-19 vaccine in the United States.
Vaccine delivery with speed, scale and equityKelley Hodge
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
In this webinar, Dr. Brian C. Castrucci President and Chief Executive Officer of the de Beaumont Foundation, presented new polling about vaccine confidence and Dr. Ayne Amjad, Commissioner and State Health Officer for West Virginia, and Dr. Costello, Assistant Professor of Pediatrics at West Virginia University School of Medicine, presented insights from their research and successful vaccine outreach campaign to rural communities in West Virginia. Dr. Lauren Smith, Chief Health Equity and Strategy Officer for CDC Foundation, moderated the conversation and an audience Q&A with Drs. Amjad and Costello.
Sponsored by the Public Health Communications Collaborative, this webinar features Dr. Nadine Gracia of Trust for America's Health and Dr. Joe Smyser of the Public Good Projects.
International Vaccines Summit 2021: The Language of Vaccine Confidence - Less...Mark Miller
Presentation to the International Vaccines Summit on September 22, 2021, reviewing communication best practices, polling findings, and lessons learned from the rollout of the COVID-19 vaccine in the United States.
Vaccine delivery with speed, scale and equityKelley Hodge
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
Not Enough Shots’_ U.S. Faces ‘Vaccine Cliff’ On Monkeypox.pdfUmar Khan
Not Enough Shots’: U.S. Faces ‘Vaccine
Cliff’ On Monkeypox
Government authorities this week promoted the appearance of a huge number of extra
monkeypox immunization portions, proclaiming it as an achievement in the country's battle
against the episode. What they left out:
Insufficient shots U.S.faces 'immunization precipice' on monkeypox
immunization precipice , The United States is entering a basic three-month time span where
cases might keep on duplicating, yet no more immunizations are booked to show up until
October at the earliest. Indeed, even with the most recent shipments, there are just an adequate
number of vials of the two-portion Jynneos immunization to cover about 33% of the assessed
1.6 million gay and sexually unbiased men who authorities consider at most elevated hazard and
who are being asked to have the chances. Furthermore, with cases in the United States
multiplying consistently, some wellbeing specialists caution a deficit of immunization dosages
could undermine the country's capacity to contain the growing flare-up and keep the infection
from turning out to be forever dug in — a worry that a few government authorities secretly
surrender
At the point when you take a gander at what the prerequisites are … we're confronting some
intense sledding here," J. Stephen Morrison, overseer of the Global Health Policy Center at the
Center for Strategic and International Studies, said on a webcast Friday, adding that 3.2 million
portions would be expected to completely cover the in danger populace of HIV-positive men and
others focused on to get immunizations by the Centers for Disease Control and Prevention
The deficit of Jynneos, the main immunization precipice endorsed by the Food and Drug
Administration to safeguard against monkeypox, has wellbeing authorities at each degree of
government scrambling to think of systems. Those in hard-strike networks like New York City and
D.C. have selected to give out just a single portion for the present, against controllers'
recommendation, while pushing government authorities for bigger designations. A few
specialists likewise are upholding that individuals be urged to take a less positive immunization,
ACAM2000, which was supported for the connected infection of smallpox however not for
monkeypox.
In early 2020, when the novel coronavirus began to spread around the world, it became increasingly clear that the most effective way to combat the raging pandemic would be for the majority of the population to develop immunity — whether through natural infection or vaccination. After months of tireless effort, now that the vaccine has become a reality, we still find people hesitant to vaccinate.
n early 2020, when the novel coronavirus began to spread around the world, it became increasingly clear that the most effective way to combat the raging pandemic would be for the majority of the population to develop immunity — whether through natural infection or vaccination.
Should individual rights (e.g., parents’ right to decide whether to .docxmanningchassidy
Should individual rights (e.g., parents’ right to decide whether to vaccinate their children) be compromised to control the spread of communicable diseases for the good of society?
discussion. The childcare facility requirements/guidelines are every child must be vaccinated to attend this specific school. He was told a few schools in the community excepted exemptions for vaccinations, however not this school.
The definition of va
ccination is
to administer a injection to help the immune system develop protection from disease (Wikipedia, 2021). Vaccines contain a virus in a weakened, live, or killed state or proteins or toxins from the organism. Vaccines help prevent sickness from infectious disease by stimulating the body's adaptive immunity. When a large percentage of a population is vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them (Wikipedia, 2021). The vaccination policy in the United States is a subgroup of the U. S. health policy that deals with immunization against infectious disease.
I feel the individual rights of the parents who made a conscious decision not to vaccinate their child should not be persecuted. The parents' decision should be respected, but when the decision to not vaccinate their child may negatively affect the lives of others, the parents should be held accountable legally and financially. A population that is appropriately vaccinated against highly infectious diseases is a common good to its members' very society. Is it ethical to subject my child to the risk associated with receiving vaccines, and another parent is hesitant or refuses to have their child vaccinated? Is it right for that child to reap the benefits of herd immunity? The "herd immunity" or "community immunity" is fragile for measles. It does not take many unvaccinated individuals to approach the tipping point at which vaccine coverage levels are low, resulting in increased preventable infection levels (Hendrix et al., 2016). Many parents choose not to vaccinate their children, which is globally causing a resurgence in vaccine-preventable diseases. Parents are hesitant to vaccinate because religious beliefs are usually linked to the refusal of all vaccines or personal beliefs. Some parents believe natural immunity is better and more effective than immunity acquired from vaccinations. Safety concerns are the most significant reason parents are hesitant and refusing to vaccinate their children, especially with the known link between vaccines and autism. The desire for additional information causes hesitancy and refusal because parents feel more in-depth information about the vaccines should be accessible to review, enabling them to make better-informed decisions (Akoum, 2019).
In the United States, many safety precautions are required by law to help ensure that the vaccines we receive are reliable and safe. CO ...
Course Project: How U.S. COVID-19 Vaccinations Have Varied Over Time in Each Age Bracket
Project Proposal
Our project examines the data collected on COVID-19 vaccinations of U.S. residents, and more specifically by the age brackets obtained by the CDC. Our overarching goal in our analysis is to determine how U.S. vaccination rates in different age brackets have varied over time. The COVID-19 vaccine was rolled out in phases, some of which had age restrictions. A Gannt chart of this timeline is shown in Figure 1. These dates will affect our expectations for vaccination rates by age category. Accordingly, we will factor these skewed numbers into our analysis given the rollout timeline. We are more specifically going to examine the vaccination rates of age groups next to their corresponding eligibility date to see if there was a spike in vaccinations immediately following the eligibility date, or whether there was a delay. In our data there will be varying age groups being vaccinated, even from the very beginning. Although age restrictions were in phases 1b and 1c, other eligible groups such as healthcare workers had the potential to include younger age brackets (Dooling, MD et al.). For this reason, we assume that our data will be spread out among age brackets, and we will carefully consider the vaccine eligibility timeline when drawing conclusions.
“Vaccine hesitancy remains a barrier to full population inoculation against highly
infectious diseases” (Dror et al.). The U.S. is facing this problem right now regarding the COVID- 19 vaccines and may continue to face it about healthcare decisions in the future. Performing descriptive analytics on vaccination rates by age bracket is a first step in how to remedy this
issue. With our project’s summaries, prescriptive analytics can be applied as a next step to target groups with lower vaccination rates. Although many demographics take part in affecting vaccination rates and vaccine hesitancy, age is a broad place to begin that may encompass many different factors contributing to this hesitancy. Understanding this data will play an important role in speeding up the process of herd immunity.
We acquired our raw dataset, “COVID-19 Vaccination Demographics in the United States, National” from the official Centers for Disease Control and Prevention (CDC) website. It is a real-time update dataset which contains records of vaccinations and vaccine ratios in the United States from December 13, 2020 to the present day. Although the dataset is continuously updating, for our project’s purposes we decided to analyze data from 12/13/20 through
11/12/21. There are various types of data such as, “administered_dose1_pct_known” which represent the percent among persons with at least one dose who are Hispanic/Latino. The data found in these columns were incomplete and not useful to our future analysis. Since the only two phenomena we decided to examine are the number of vaccinated people by age group for both part ...
the graying of america challenges and controversies spring 20.docxoreo10
the graying of america: challenges and controversies spring 2012 17
Can Health Care
Rationing Ever
Be Rational?
David A. Gruenewald
Case Study
Mr. M. was a 77-year-old decisionally incapacitated
long-term nursing home resident with chronic schizo-
phrenia who was admitted to the hospital with a
bacterial pneumonia. His past medical history was
notable for deteriorating functional status over the
past 2-3 years, urinary retention requiring chronic
indwelling bladder catheterization, and two recent
hospitalizations for urinary tract infections leading
to sepsis. He developed respiratory failure soon after
admission and was intubated and placed on mechani-
cal ventilation. Follow-up studies suggested worsen-
ing pneumonia and acute respiratory distress syn-
drome (ARDS), as well as worsening kidney function.
The patient was unable to participate in any decision
making. His guardian requested that cardiopulmo-
nary resuscitation and all other intensive care be pro-
vided if necessary, including dialysis should Mr. M.’s
kidney failure continue to worsen. After five days of
mechanical ventilation, the patient was weaned from
the ventilator and extubated. The palliative care ser-
vice was consulted following the extubation; his criti-
cal care team questioned whether it would be appro-
priate to re-intubate the patient if he again developed
respiratory failure. The palliative care team contacted
Mr. M.’s brother, his only living relative, who felt the
patient’s quality of life was poor and believed the
patient would not want aggressive medical care. The
staff at his nursing home was contacted, as well as
the patient’s mental health case manager, who had all
known Mr. M. for many years. All concurred with his
brother’s assessment. Additionally, the nursing home
staff said that Mr. M. would not be able to return there
if the plan was to continue more intensive medical
management of his worsening health conditions. Hos-
pice care was discussed with these parties, and it was
thought that choosing hospice would best represent
the patient’s wishes under the circumstances. The pal-
liative care team contacted his guardian and explained
the patient’s medical situation and its implications
for his ongoing care (including the need for physical
restraints, loss of stable nursing home placement, and
confinement to the acute care hospital environment
for the duration of his acute illness). Based on this new
David A. Gruenewald, M.D., is an Associate Professor of
Medicine at the University of Washington School of Medi-
cine in Seattle, Washington, and the Associate Director of the
Palliative Medicine Fellowship at the University of Wash-
ington. He is the Medical Director of the Palliative Care and
Hospice Service at VA Puget Sound Health Care System in
Seattle, Washington. He received his Bachelor of Arts (B. A.)
degree from Reed College in Portland, Oregon, and his Medical
Doctor (M.D.) degree from the University of C ...
The Review of Economics and StatisticsVOL- XCIII MAY 2011 NUMBER 2INSI.docxharrym15
The Review of Economics and Statistics VOL. XCIII MAY 2011 NUMBER 2
INSIDE THE WAR ON POVERTY: THE IMPACT OF FOOD STAMPS
ON BIRTH OUTCOMES
Douglas Almond, Hilary W. Hoynes, and Diane Whitmore Schanzenbach*
Abstract—This paper evaluates the health impacts of a signature initiative of the War on Poverty: the introduction of the modern Food Stamp Pro- gram (FSP). Using variation in the month FSP began operating in each U.S. county, we find that pregnancies exposed to FSP three months prior to birth yielded deliveries with increased birth weight, with the largest gains at the lowest birth weights. We also find small but statistically insig- nificant improvements in neonatal mortality. We conclude that the sizable increase in income from FSP improved birth outcomes for both whites and African Americans, with larger impacts for African American mothers.
I. Introduction
IN this paper, we evaluate the health consequences of a sizable improvement in the resources available to Ameri-
ca’s poorest. In particular, we examine the impact of the Food Stamp Program (FSP), which in 2007 provided $34 billion in payments to about 13 million households, on infant health. Our paper makes two distinct contributions. First, although the goal of the FSP is to increase the nutri- tion of the poor, few papers have examined its impact on health outcomes. Second, building on work by Hoynes and Schanzenbach (2009), we argue that the FSP treatment represents an exogenous increase in income for the poor. Our analysis therefore represents a causal estimate of the impact of income on health, an important topic with little convincing evidence due to concerns about endogeneity and reverse causality (Currie, 2009).
We use the natural experiment afforded by the nation- wide rollout of the modern FSP during the 1960s and early 1970s. Our identification strategy uses the sharp timing of the county-by-county rollout of the FSP, which was initially constrained by congressional funding authorizations (and ultimately became available in all counties by 1975). Speci- fically, we use information on the month the FSP began operating in each of the roughly 3,100 U.S. counties and examine the impact of the FSP rollout on mean birth weight, low birth weight, gestation, and neonatal mortality.
Throughout the history of the FSP, the program para- meters have been set by the U.S. Department of Agriculture (USDA) and are uniform across states. In the absence of the state-level variation often leveraged by economists to eval- uate transfer programs, previous FSP research has typically resorted to strong assumptions as to the comparability of FSP participants and eligible nonparticipants (Currie, 2003). Not surprisingly, the literature is far from settled as to what casual impact (if any) the FSP has on nutrition and health.
Hoynes and Schanzenbach (2009) use this county rollout to examine the impact of the FSP on food consumption using the PSID. They found that the introduction of the FSP in.
History of vaccine preventable disease in usJeffrey Stone
Estimates of the percent reductions from baseline to re- cent were made without adjustment for factors that could affect vaccine-preventable disease morbidity, mortality, or reporting.
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
CHAPTER IV- DATA AND ANALYSISIntroductionBased on the collecJinElias52
CHAPTER IV- DATA AND ANALYSIS
Introduction
Based on the collected data from the previous chapter, the information supports the first hypothesis that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of low-income American households with health insurance by 70%. The data also support the second hypothesis that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of ethnic and racial minority households in the United States with health increased by 20%. Finally, the data support the last hypothesis of the study that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of ethnic and racial minority households in the United States with health insurance by 20%.
The paper examines the difference in health care coverage in the underrepresented American households before and after the implementation of the Affordable Care by analyzing the data from six different sources. The policy was enacted to primarily expand American’s access to insurance and improve the quality of health care services that American citizens get access to. As such, the reform has resulted in a significant impact regarding the health status of different groups living in America, especially among the minorities. Besides, the introduction of the reform has, over the years, been associated with a reduction in disparities in the U.S health care system.
Notably, before A.C.A, various groups of color had limited access to health insurance coverage which adversely affected their health care conditions. Similarly, individuals from low-income families also experienced this effect. In this regard, the paper aims at answering a question that: Has the introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentages of minority and lower-and middle-class households with health insurance significantly?
The paper implements the statistical procedure used in the articles identified and whose data have been included in the research. In this regard, the paper depends on more than one method for analyzing data that will be used in answering the research questions. Additionally, the chapter explores data presented in all the articles and analyzed them to determine whether they support, partially support, or reject the hypotheses.
Hypothesis #1
The first hypothesis that the paper is focused on is: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of low-income American households with health insurance by 70%.
One of the research articles that the paper uses in testing the hypothesis outlined above is the study by Sommers et al. (2017). Based on the methods used by the researchers, the study found that 72 percent of the respondents living in Kentucky were affected with chronic conditions, 69 percent in Arkansas, and 55 percent in Texas. According to the results, the disease prevalen ...
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
More Related Content
Similar to An early assessment of vaccine utilization rates
Vaccine delivery with speed, scale and equityKelley Hodge
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
Not Enough Shots’_ U.S. Faces ‘Vaccine Cliff’ On Monkeypox.pdfUmar Khan
Not Enough Shots’: U.S. Faces ‘Vaccine
Cliff’ On Monkeypox
Government authorities this week promoted the appearance of a huge number of extra
monkeypox immunization portions, proclaiming it as an achievement in the country's battle
against the episode. What they left out:
Insufficient shots U.S.faces 'immunization precipice' on monkeypox
immunization precipice , The United States is entering a basic three-month time span where
cases might keep on duplicating, yet no more immunizations are booked to show up until
October at the earliest. Indeed, even with the most recent shipments, there are just an adequate
number of vials of the two-portion Jynneos immunization to cover about 33% of the assessed
1.6 million gay and sexually unbiased men who authorities consider at most elevated hazard and
who are being asked to have the chances. Furthermore, with cases in the United States
multiplying consistently, some wellbeing specialists caution a deficit of immunization dosages
could undermine the country's capacity to contain the growing flare-up and keep the infection
from turning out to be forever dug in — a worry that a few government authorities secretly
surrender
At the point when you take a gander at what the prerequisites are … we're confronting some
intense sledding here," J. Stephen Morrison, overseer of the Global Health Policy Center at the
Center for Strategic and International Studies, said on a webcast Friday, adding that 3.2 million
portions would be expected to completely cover the in danger populace of HIV-positive men and
others focused on to get immunizations by the Centers for Disease Control and Prevention
The deficit of Jynneos, the main immunization precipice endorsed by the Food and Drug
Administration to safeguard against monkeypox, has wellbeing authorities at each degree of
government scrambling to think of systems. Those in hard-strike networks like New York City and
D.C. have selected to give out just a single portion for the present, against controllers'
recommendation, while pushing government authorities for bigger designations. A few
specialists likewise are upholding that individuals be urged to take a less positive immunization,
ACAM2000, which was supported for the connected infection of smallpox however not for
monkeypox.
In early 2020, when the novel coronavirus began to spread around the world, it became increasingly clear that the most effective way to combat the raging pandemic would be for the majority of the population to develop immunity — whether through natural infection or vaccination. After months of tireless effort, now that the vaccine has become a reality, we still find people hesitant to vaccinate.
n early 2020, when the novel coronavirus began to spread around the world, it became increasingly clear that the most effective way to combat the raging pandemic would be for the majority of the population to develop immunity — whether through natural infection or vaccination.
Should individual rights (e.g., parents’ right to decide whether to .docxmanningchassidy
Should individual rights (e.g., parents’ right to decide whether to vaccinate their children) be compromised to control the spread of communicable diseases for the good of society?
discussion. The childcare facility requirements/guidelines are every child must be vaccinated to attend this specific school. He was told a few schools in the community excepted exemptions for vaccinations, however not this school.
The definition of va
ccination is
to administer a injection to help the immune system develop protection from disease (Wikipedia, 2021). Vaccines contain a virus in a weakened, live, or killed state or proteins or toxins from the organism. Vaccines help prevent sickness from infectious disease by stimulating the body's adaptive immunity. When a large percentage of a population is vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them (Wikipedia, 2021). The vaccination policy in the United States is a subgroup of the U. S. health policy that deals with immunization against infectious disease.
I feel the individual rights of the parents who made a conscious decision not to vaccinate their child should not be persecuted. The parents' decision should be respected, but when the decision to not vaccinate their child may negatively affect the lives of others, the parents should be held accountable legally and financially. A population that is appropriately vaccinated against highly infectious diseases is a common good to its members' very society. Is it ethical to subject my child to the risk associated with receiving vaccines, and another parent is hesitant or refuses to have their child vaccinated? Is it right for that child to reap the benefits of herd immunity? The "herd immunity" or "community immunity" is fragile for measles. It does not take many unvaccinated individuals to approach the tipping point at which vaccine coverage levels are low, resulting in increased preventable infection levels (Hendrix et al., 2016). Many parents choose not to vaccinate their children, which is globally causing a resurgence in vaccine-preventable diseases. Parents are hesitant to vaccinate because religious beliefs are usually linked to the refusal of all vaccines or personal beliefs. Some parents believe natural immunity is better and more effective than immunity acquired from vaccinations. Safety concerns are the most significant reason parents are hesitant and refusing to vaccinate their children, especially with the known link between vaccines and autism. The desire for additional information causes hesitancy and refusal because parents feel more in-depth information about the vaccines should be accessible to review, enabling them to make better-informed decisions (Akoum, 2019).
In the United States, many safety precautions are required by law to help ensure that the vaccines we receive are reliable and safe. CO ...
Course Project: How U.S. COVID-19 Vaccinations Have Varied Over Time in Each Age Bracket
Project Proposal
Our project examines the data collected on COVID-19 vaccinations of U.S. residents, and more specifically by the age brackets obtained by the CDC. Our overarching goal in our analysis is to determine how U.S. vaccination rates in different age brackets have varied over time. The COVID-19 vaccine was rolled out in phases, some of which had age restrictions. A Gannt chart of this timeline is shown in Figure 1. These dates will affect our expectations for vaccination rates by age category. Accordingly, we will factor these skewed numbers into our analysis given the rollout timeline. We are more specifically going to examine the vaccination rates of age groups next to their corresponding eligibility date to see if there was a spike in vaccinations immediately following the eligibility date, or whether there was a delay. In our data there will be varying age groups being vaccinated, even from the very beginning. Although age restrictions were in phases 1b and 1c, other eligible groups such as healthcare workers had the potential to include younger age brackets (Dooling, MD et al.). For this reason, we assume that our data will be spread out among age brackets, and we will carefully consider the vaccine eligibility timeline when drawing conclusions.
“Vaccine hesitancy remains a barrier to full population inoculation against highly
infectious diseases” (Dror et al.). The U.S. is facing this problem right now regarding the COVID- 19 vaccines and may continue to face it about healthcare decisions in the future. Performing descriptive analytics on vaccination rates by age bracket is a first step in how to remedy this
issue. With our project’s summaries, prescriptive analytics can be applied as a next step to target groups with lower vaccination rates. Although many demographics take part in affecting vaccination rates and vaccine hesitancy, age is a broad place to begin that may encompass many different factors contributing to this hesitancy. Understanding this data will play an important role in speeding up the process of herd immunity.
We acquired our raw dataset, “COVID-19 Vaccination Demographics in the United States, National” from the official Centers for Disease Control and Prevention (CDC) website. It is a real-time update dataset which contains records of vaccinations and vaccine ratios in the United States from December 13, 2020 to the present day. Although the dataset is continuously updating, for our project’s purposes we decided to analyze data from 12/13/20 through
11/12/21. There are various types of data such as, “administered_dose1_pct_known” which represent the percent among persons with at least one dose who are Hispanic/Latino. The data found in these columns were incomplete and not useful to our future analysis. Since the only two phenomena we decided to examine are the number of vaccinated people by age group for both part ...
the graying of america challenges and controversies spring 20.docxoreo10
the graying of america: challenges and controversies spring 2012 17
Can Health Care
Rationing Ever
Be Rational?
David A. Gruenewald
Case Study
Mr. M. was a 77-year-old decisionally incapacitated
long-term nursing home resident with chronic schizo-
phrenia who was admitted to the hospital with a
bacterial pneumonia. His past medical history was
notable for deteriorating functional status over the
past 2-3 years, urinary retention requiring chronic
indwelling bladder catheterization, and two recent
hospitalizations for urinary tract infections leading
to sepsis. He developed respiratory failure soon after
admission and was intubated and placed on mechani-
cal ventilation. Follow-up studies suggested worsen-
ing pneumonia and acute respiratory distress syn-
drome (ARDS), as well as worsening kidney function.
The patient was unable to participate in any decision
making. His guardian requested that cardiopulmo-
nary resuscitation and all other intensive care be pro-
vided if necessary, including dialysis should Mr. M.’s
kidney failure continue to worsen. After five days of
mechanical ventilation, the patient was weaned from
the ventilator and extubated. The palliative care ser-
vice was consulted following the extubation; his criti-
cal care team questioned whether it would be appro-
priate to re-intubate the patient if he again developed
respiratory failure. The palliative care team contacted
Mr. M.’s brother, his only living relative, who felt the
patient’s quality of life was poor and believed the
patient would not want aggressive medical care. The
staff at his nursing home was contacted, as well as
the patient’s mental health case manager, who had all
known Mr. M. for many years. All concurred with his
brother’s assessment. Additionally, the nursing home
staff said that Mr. M. would not be able to return there
if the plan was to continue more intensive medical
management of his worsening health conditions. Hos-
pice care was discussed with these parties, and it was
thought that choosing hospice would best represent
the patient’s wishes under the circumstances. The pal-
liative care team contacted his guardian and explained
the patient’s medical situation and its implications
for his ongoing care (including the need for physical
restraints, loss of stable nursing home placement, and
confinement to the acute care hospital environment
for the duration of his acute illness). Based on this new
David A. Gruenewald, M.D., is an Associate Professor of
Medicine at the University of Washington School of Medi-
cine in Seattle, Washington, and the Associate Director of the
Palliative Medicine Fellowship at the University of Wash-
ington. He is the Medical Director of the Palliative Care and
Hospice Service at VA Puget Sound Health Care System in
Seattle, Washington. He received his Bachelor of Arts (B. A.)
degree from Reed College in Portland, Oregon, and his Medical
Doctor (M.D.) degree from the University of C ...
The Review of Economics and StatisticsVOL- XCIII MAY 2011 NUMBER 2INSI.docxharrym15
The Review of Economics and Statistics VOL. XCIII MAY 2011 NUMBER 2
INSIDE THE WAR ON POVERTY: THE IMPACT OF FOOD STAMPS
ON BIRTH OUTCOMES
Douglas Almond, Hilary W. Hoynes, and Diane Whitmore Schanzenbach*
Abstract—This paper evaluates the health impacts of a signature initiative of the War on Poverty: the introduction of the modern Food Stamp Pro- gram (FSP). Using variation in the month FSP began operating in each U.S. county, we find that pregnancies exposed to FSP three months prior to birth yielded deliveries with increased birth weight, with the largest gains at the lowest birth weights. We also find small but statistically insig- nificant improvements in neonatal mortality. We conclude that the sizable increase in income from FSP improved birth outcomes for both whites and African Americans, with larger impacts for African American mothers.
I. Introduction
IN this paper, we evaluate the health consequences of a sizable improvement in the resources available to Ameri-
ca’s poorest. In particular, we examine the impact of the Food Stamp Program (FSP), which in 2007 provided $34 billion in payments to about 13 million households, on infant health. Our paper makes two distinct contributions. First, although the goal of the FSP is to increase the nutri- tion of the poor, few papers have examined its impact on health outcomes. Second, building on work by Hoynes and Schanzenbach (2009), we argue that the FSP treatment represents an exogenous increase in income for the poor. Our analysis therefore represents a causal estimate of the impact of income on health, an important topic with little convincing evidence due to concerns about endogeneity and reverse causality (Currie, 2009).
We use the natural experiment afforded by the nation- wide rollout of the modern FSP during the 1960s and early 1970s. Our identification strategy uses the sharp timing of the county-by-county rollout of the FSP, which was initially constrained by congressional funding authorizations (and ultimately became available in all counties by 1975). Speci- fically, we use information on the month the FSP began operating in each of the roughly 3,100 U.S. counties and examine the impact of the FSP rollout on mean birth weight, low birth weight, gestation, and neonatal mortality.
Throughout the history of the FSP, the program para- meters have been set by the U.S. Department of Agriculture (USDA) and are uniform across states. In the absence of the state-level variation often leveraged by economists to eval- uate transfer programs, previous FSP research has typically resorted to strong assumptions as to the comparability of FSP participants and eligible nonparticipants (Currie, 2003). Not surprisingly, the literature is far from settled as to what casual impact (if any) the FSP has on nutrition and health.
Hoynes and Schanzenbach (2009) use this county rollout to examine the impact of the FSP on food consumption using the PSID. They found that the introduction of the FSP in.
History of vaccine preventable disease in usJeffrey Stone
Estimates of the percent reductions from baseline to re- cent were made without adjustment for factors that could affect vaccine-preventable disease morbidity, mortality, or reporting.
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
CHAPTER IV- DATA AND ANALYSISIntroductionBased on the collecJinElias52
CHAPTER IV- DATA AND ANALYSIS
Introduction
Based on the collected data from the previous chapter, the information supports the first hypothesis that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of low-income American households with health insurance by 70%. The data also support the second hypothesis that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of ethnic and racial minority households in the United States with health increased by 20%. Finally, the data support the last hypothesis of the study that: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of ethnic and racial minority households in the United States with health insurance by 20%.
The paper examines the difference in health care coverage in the underrepresented American households before and after the implementation of the Affordable Care by analyzing the data from six different sources. The policy was enacted to primarily expand American’s access to insurance and improve the quality of health care services that American citizens get access to. As such, the reform has resulted in a significant impact regarding the health status of different groups living in America, especially among the minorities. Besides, the introduction of the reform has, over the years, been associated with a reduction in disparities in the U.S health care system.
Notably, before A.C.A, various groups of color had limited access to health insurance coverage which adversely affected their health care conditions. Similarly, individuals from low-income families also experienced this effect. In this regard, the paper aims at answering a question that: Has the introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentages of minority and lower-and middle-class households with health insurance significantly?
The paper implements the statistical procedure used in the articles identified and whose data have been included in the research. In this regard, the paper depends on more than one method for analyzing data that will be used in answering the research questions. Additionally, the chapter explores data presented in all the articles and analyzed them to determine whether they support, partially support, or reject the hypotheses.
Hypothesis #1
The first hypothesis that the paper is focused on is: The introduction of healthcare under the Affordable Care Act (Obamacare) increased the percentage of low-income American households with health insurance by 70%.
One of the research articles that the paper uses in testing the hypothesis outlined above is the study by Sommers et al. (2017). Based on the methods used by the researchers, the study found that 72 percent of the respondents living in Kentucky were affected with chronic conditions, 69 percent in Arkansas, and 55 percent in Texas. According to the results, the disease prevalen ...
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Similar to An early assessment of vaccine utilization rates (20)
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS
An early assessment of vaccine utilization rates
1. PAGE 1
AN EARLY ASSESSMENT OF VACCINE UTILIZATION RATES
Executive Summary
On December 13, 2020 Pfizer began shipping its covid-19 vaccine. On December 20, the Moderna
vaccine began to be shipped. Initial product flows have been directed to individual states and other US
jurisdictions in proportion to each jurisdiction’s population and consistent with each jurisdiction’s
explicit plans. In the first three weeks of sustained flow, roughly twenty-million doses of vaccine were
distributed. Since January 6, an average of more than one million doses per day are being shipped.
As of Friday, January 8, California had vaccinated over 586,000 people and utilized roughly a quarter of
its available vaccine inventory. New York had consumed almost 39 percent of its inventory vaccinating
430,000. After three weeks of vaccine shipments, nationwide about thirty percent of available vaccines
have been consumed. That outcome has prompted some alarm that sluggish vaccination speed will
result in more disease and death and further delay economic recovery. The recent confirmation of a
more contagious variant of coronavirus contributes a further sense of urgency.
Do early variations in vaccination speed across jurisdictions tell us anything substantive about how to
increase vaccination speed? What, if anything, are higher speed jurisdictions doing that could be helpful
in other venues? Or have we mostly experienced the shake-out of processes typically associated with
large-scale start-ups, further complicated by the holiday season?
While limited in scope, this analytic snapshot finds no evidence that, to date, supply limitations have
constrained planned and targeted vaccinations. Differences in vaccination throughputs are mostly a
function of open and flexible vaccination demand criteria. In other words: the more arms you are
willing to jab, the more arms are likely to be jabbed. Variation in vaccination velocity (speed in a specific
direction) does reflect explicit choices and behaviors by individual jurisdictions and “consumer-facing”
vaccination providers. This early and provisional assessment also finds potential tension between
vaccination velocity versus vaccination speed. But this assessment does not conclude that current
priority allocations should be discontinued. Rather, a focused and flexible vaccination strategy is
recommended as the most effective path to faster vaccinations.
United States: Rolling seven-day average of vaccine doses administered daily
Collated and displayed by Our World in Data
2. PAGE 2
Patterns of Demand and Supply through January 6
Based on CDC data between December 13 and January 6 more than 17,250,000 doses of vaccine (Pfizer
and Moderna) had been delivered to US jurisdictions. Since these vaccines have been distributed, about
5.3 million individuals were reported to have received an initial vaccination by January 6. This generated
a national Vaccine Utilization Rate (VUR) of roughly 30 percent for this intensive start-up period.
During this same period jurisdictions have demonstrated considerable differences in VUR. This
analytical snapshot gives particular attention to:
• Tennessee: Vaccine Doses Delivered: 328,500, Vaccinations Completed: 166,389,
January 6 VUR: about 50 percent.
• Illinois: Vaccine Doses Delivered: 542,200, Vaccinations Completed: 189,660,
January 6 VUR: about 35 percent
• Texas: Vaccine Doses Delivered: 1,375,800, Vaccinations Completed: 489,003,
January 6 VUR: about 35 percent
Among states receiving more than 300,000 doses, Tennessee, Illinois, and Texas each have a
comparatively high VUR. States receiving more than 300,000 doses have had particular difficulty
exceeding a 25 percent Vaccine Utilization Rate. As is often the case, the more volume flowing, the more
friction in the channel(s).
From a supply chain perspective, vaccination is consumption. Consumption can be complicated by a
wide range of factors, but three classic impediments are:
1. Lack of sufficient supply capacity (or disruption of capacity)
2. Lack of sufficient distribution capacity (or disruption of distribution)
3. Lack of sufficient demand (or disruption of demand)
Current supplies of vaccine are limited. These are entirely new vaccines. Production capacity is still
being scaled to meet projected demand. In anticipation of limited supplies, allocation phases have been
established. The allocation priorities reflect ethical and epidemiological judgments intended to mitigate
morbidity and mortality and to facilitate ongoing healthcare and essential commercial activity. On
December 3, 2020, the Advisory Committee on Immunization Practices (ACIP) established two covid-19
vaccination targets for Phase 1a: 1) health care personnel and 2) residents of long-term care (LTC)
facilities. Each state, however, has independent authority to finalize and operationalize any such targets.
While most states have confirmed the priority ACIP gave health care personnel and LTC residents, some
state-specific twist or two or three is common. LTC facility staff has become a common addition.
Within the limits of available flow (averaging close to one million doses per day over the first three
weeks) each State and related jurisdictions received a number of doses proportional to its population.
The initial volume of vaccine deliveries was less than some states were expecting, but by the last week
in December volume and velocity expectations were largely calibrated to actual flow. Transportation of
supplies from Pfizer (Kalamazoo, Michigan) and Moderna (via Olive Branch, Mississippi) have achieved
schedules and volumes consistent with projections.
3. PAGE 3
As a result, while vaccine supply has been limited, it is equally limited for each receiving State. There is
no evidence that divergence in the timing or volume of vaccine supply has had any influence on the
divergence in Vaccine Utilization Rates between States. As of January 6, every state had at least 30
percent “excess inventory” on hand. Most states had at least 60 percent of inventories on hand.
Tennessee, Illinois, and Texas have pursued different distribution strategies that could have capacity
implications. Both Illinois and Tennessee are organized around a hub-and-spoke structure. Illinois
depends on ten hubs. Tennessee depends on 28 hubs (maybe just cross-docks). Texas has distributed its
allocated vaccinations directly to 1036 local vaccination venues. These are, obviously, three distinct
geographies and, perhaps, three very different sources of demand. During the first full week in January
there were reports in each state of smaller population counties and vaccination venues running out of
inventory (Tennessee example), even while significant inventories remain available to each state. Still,
official and media reports have not -- yet -- exposed significant variation in local ("last mile")
availability of vaccines among these three States. At least in these three cases, their different network
structures and distribution strategies appear to have a neutral impact on vaccination throughputs. The
inability to resupply smaller vaccination venues from available stocks does signal potential problems
with inventory management, demand signaling and/or transportation resources. But these do not seem
to have emerged from differences in distribution strategy or structure.
If supply and distribution are not significant sources of VUR variation, that leaves demand. Since mid-
December, vaccine consumption has been limited mostly to sub-populations that meet each State’s
allocation criteria. As of January 6, Tennessee, Illinois, and Texas – and most other jurisdictions – had
only been engaged in so-called Phase 1a vaccinations. The Illinois definition of 1a populations includes
both ACIP groups and LTC facility staff. Tennessee and Texas include these same groups and then add
other targets. Tennessee has added first responders and "adults who cannot live independently". Texas
has added, all "Texans over age 65 and people with medical conditions that put them at higher risk of
disease or death from covid-19." These are very different sources and sizes of demand. The broader the
allocation criteria, the easier to attract throughput for currently available doses.
Many epidemiologists have suggested over 250 million residents of the United States should be
vaccinated to suppress the pandemic. Surveys suggest that 170 to 200 million residents of the United
States are currently willing to be vaccinated. Three weeks after vaccines had begun shipping, 5.3 million
Americans had been vaccinated, even though roughly 20 million doses had been shipped. Consumption
is pulling slower than supply is pushing. Demand – while variable – is far from being fulfilled.
Tennessee, Illinois, and Texas have demonstrated higher than average Vaccine Utilization Rates. A major
element differentiating Vaccine Utilization Rates in these three States from jurisdictions with lower
VURs appears to be the size of the allocation pool being served and the demand-orientation of
vaccination planning and execution.
Three States Compared with other Jurisdictions
In mid-November the Kaiser Family Foundation assessed the vaccination plans of forty-seven states.
According to this analysis:
Every state plan highlights the following broad categories as being priority populations for Phase 1
efforts: health care workers, essential workers, and those at high risk (older people and those with
pre-disposing health risk factors). Most plans recognize (and CDC indicated in its guidance) that there
4. PAGE 4
will likely not be enough vaccines at first for all individuals identified in these Phase 1 priority groups.
Even so, plans show that some states are much further along in defining prioritization categories and
enumerating the number of people that fall into those categories. For example:
• Less than half (19 of 47, or 40%) of state plans reviewed include a numerical estimate of the
number of individuals in different priority populations; the majority of states report they are still
developing their data sources and methodology to calculate the number in their priority groups.
• Some states report already developing specific estimates of the numbers of health care workers
likely among the first individuals targeted for vaccination, while other states do not include these
estimates, or mention that they are working on developing methods to identify the numbers to be
targeted in this group.
State vaccination plans submitted to the Centers for Disease Control by Tennessee, Illinois, and Texas all
demonstrate significant prior awareness of potential demand for each phase of vaccination.
The amended Vaccination Plan developed by the Tennessee Department of Health does not specify the
size of Phase 1a target populations, but both the plan and easily available online resources demonstrate
that Tennessee has carefully sized each priority population consistent with Tennessee targets.
The updated Vaccination Plan developed by the Illinois Department of Public Health specifies numerical
estimates for each phase. The plan also references state investment in a sophisticated population-
focused, demand-oriented data tool for managing the rollout of vaccinations in Illinois.
The original draft Vaccination Plan for the Texas Department of State Health Services details specific
numbers for each Phase 1a (and subsequent) target populations per each state public health region,
please see the chart below. The Texas plan also outlines data sources and analytical methods that are
being used to more fully characterize the size and location of target populations.
Texas Department of State Health Services
5. PAGE 5
Principal Observations, Analysis, and Starting toward Strategic Synthesis
Lower volume jurisdictions should be able to move and consume lower volumes of supply more quickly.
This has not always happened, but through January 6 this has been reflected in those jurisdictions
showing the highest rates of vaccine consumption. Failure to effectively move and consume lower
volumes (e.g., less than 150,00 doses between December 13 and January 6) is cause for rigorous
strategic and operational examination and potential intervention.
Through January 6, supply capacity has not been a constraint on planned and targeted vaccine
consumption. All states had significant vaccine stocks on hand. Only three states had administered
more doses than they continued to have in inventory. Most states had in inventory almost double the
number of doses they had administered through January 6.
In three higher volume states with above-average consumption of doses—Tennessee, Illinois, and
Texas—it is noted that each of these states share a comparatively sophisticated attention to population
demand factors. Two of the three states have also significantly expanded their demand pools for initial
vaccinations.
Priority allocation is intended to maximize the life-saving potential of limited supplies. Hospital
healthcare workers are especially vulnerable and essential to saving the lives of those most seriously
affected by covid-19 and other health emergencies. The allocation priorities set out are appropriate to a
supply constrained context. There are both ethical and epidemiological benefits where allocation
targets can be confidently achieved in a timely way. But a variety of factors—including high demand for
acute health care—have limited the speed of consumption by health care providers. Some level of
vaccine hesitancy also exists. Prioritizing – and thereby limiting – vaccination to any narrow population
erects an impediment to increasing speed and total vaccination throughputs.
In any demand and supply network there can be tension between speed and velocity. Velocity is speed
in a specific direction. Speed downhill will be slower than the same distance uphill. Texas and
Tennessee have shown higher VURs at least in part because they have expanded their demand pools
by including much larger target populations in their initial allocation priorities. They have chosen
pathways that flexibly favor general speed over specific velocities.
Illinois has retained the narrow population pool originally recommended by ACIP, but Illinois has also
given priority to serving these target populations in locations (usually hospitals) where case counts are
most rapidly growing and hospitalizations most endanger ICU capacity. According to one Illinois official
interviewed for this report, “Demand [for vaccine] tends to reflect perceived risk. Perceived risk is
highest where disease is most obvious. So far we are focusing supply where perceived risk is pushing
demand.” This is also a population-oriented, demand-sensitive vaccination strategy.
It is also true that while Tennessee, Illinois, and Texas have achieved higher than average Vaccine
Utilization Rates, none have achieved a rate that will support their own public health objectives.
Strategic Assessment
The United States is currently shipping more than one million vaccine doses per day. According to CDC
reports, on January 7 the United States vaccinated 768,813 individuals. There is no evidence to suggest
lack of supply or ineffective distribution is substantially slowing planned and targeted vaccination
(consumption). There is evidence that full-speed vaccinations are being complicated and delayed by
efforts to restrict vaccinations to allocation priorities.
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Achieving the current allocation priorities will result in a more resilient health care system, preserve
essential commerce, and advance the wellness of the whole population. Priority can and should
continue to be given to those population groups most at risk and most essential. But in the current risk
context – especially given the highly contagious variant now spreading – these priorities should also be
calibrated to ensure a full-speed flow of available vaccines. As demonstrated by Tennessee and Texas,
opening vaccinations to demand beyond the tightest allocation priorities need not impede fulfilling
demand among the priority populations. Both can be advanced.
One way to conceive of accommodating allocation priorities with full-speed vaccinations is to “time-out”
consumption of doses. For short periods of time a set of doses can be reserved for designated priority
populations and delivered as conveniently as possible to that population. At the end of this short
period, the doses can be made available – preferably on a reservation-basis – to general population
vaccination venues. For example, in some jurisdictions where grocery workers have current allocation
priority, when a store has completed vaccinating all available workers and still has doses left, an
announcement has been made allowing customers to be vaccinated. Where there is excess demand for
these “pop-up doses”, vaccination staff have attempted to sequence recipients consistent with ACIP
and/or State priorities. Focused and flexible is the path to fast effective vaccinations.
In the current context, effective vaccinations involve fulfilling current demand in a manner that will
reinforce consumption of second doses, increase overall demand (reduce vaccine hesitancy), reduce
overall US morbidity and mortality, and maintain flows of essential resources. While increasing
vaccination speed is necessary, short-term spikes that do not meet these minimally effective
characteristics would be strategically counterproductive. There is also a need to reinforce public
understanding that given realistic vaccine volumes and effective vaccination practices, a phased
approach focused on priority populations while proactively facilitating others is the best way to reduce
shared vulnerabilities and ensure economic continuity.
Strategic Recommendation:
• Maintain current risk-based allocation priorities while explicitly and systematically articulating
policies to promote “consumer-facing” flexibility to increase the speed of consumption for
available vaccines.
• Offer methods and training to achieve consumer-facing flexibility to increase speed of
consumption.
• Establish explicit time-windows for consumption of vaccine inventories to achieve population
health and risk reduction objectives. Train, promote, monitor, measure, and manage as
necessary to ensure consumption time-windows are achieved.
• Develop methods, train, monitor, measure, and manage to facilitate intra-state movement of
vaccine inventories as a last-ditch effort to ensure consumption time-windows are achieved.
• Give positive national attention to “consumer friendly” vaccination procedures and, especially,
scheduling for friction-free, time-minimized vaccinations. (Super-charged scheduling software
may need to be the next big investment in this process).
This analytic snapshot was quickly developed by Philip J. Palin in response to a special
request. It was completed on Sunday, January 10, 2020. Readers are welcome to share with
others. To state the obvious: decisions, actions, and outcomes are changing rapidly.