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Friesein Profile picture
Friesein
@Friesein
Clean air is a human right. SARS2 is a severe pathogen disabling millions. Let's use scientific modeling and engineering to solve both. Listen to patients.
4 subscribers
May 21 • 6 tweets • 3 min read
I can appreciate skepticism of long COVID as a concept. After all, it may instinctually seem like an epistemological overreach to assign a singular cause to such a heterogeneous disease presentation.

On the other hand, consider the localization of ACE2 throughout your body. Consider the reach of your blood vessels. Couple that with imaging studies that demonstrate spike persistence in areas such as the brain and skull. Consider also that viral persistence has been identified in the gut with replication competent virus.

In the last few years, I've interacted with tons of people on this platform, both vaccinated and unvaccinated, who have lost a significant amount of mobility after having had COVID infections. Healthy and unhealthy, comorbidities or not. People in their 40s are also dying of rare cancers. Athletes and soldiers are having a decrease in functional performance after a single COVID infection, let alone reinfections.

The deeper you look into viral persistence (look at the work Polybio and Erturk Lab are doing on imaging, for example), the more you'll find yourself willing to consider that COVID might play a role in it.

The key is in recognizing that the microvascular changes COVID causes are difficult to detect with off-the-shelf diagnostics. Once research develops more readily commoditized diagnostics, perhaps the condition will gain wider recognition. In the meantime we have a large segment of young, middle-aged, and previously healthy athletes succumbing to unusually debilitating chronic illness after COVID infections. That illness is real despite misgivings some may have. And so too is the underlying damage COVID causes, even if it's not straightforward to detect in all instances. Whatever you want to call the disease, those patients deserve medical treatment despite limitations in the diagnostic tools conventionally available.Image
Where in the body is it found? ACE2 is present in many cell types and tissues including the lungs, heart, blood vessels, kidneys, liver and gastrointestinal tract. It is present in epithelial cells, which line certain tissues and create protective barriers. The exchange of oxygen and carbon dioxide between the lungs and blood vessels occurs across this epithelial lining in the lung. ACE2 is present in epithelium in the nose, mouth and lungs. In the lungs, ACE2 is highly abundant on type 2 pneumocytes, an important cell type present in chambers within the lung called alveoli, where oxygen i...
Image
Image Long COVID in young Marines.

thelancet.com/journals/lanam…
May 11 • 10 tweets • 4 min read
The NB.1.8.1 variant seems to have originated in Hong Kong, then spread to several other countries in the region (including Singapore & Australia).

It's now spreading to Western US states such as California, which currently has the highest proportion of NB.1.8.1 across the US.🧵 Image
Image For the month of March, NB.1.8.1 went from having single digit prevalence in Hong Kong to 80%.

It achieved 100% dominance in HK by late April. Image
May 8 • 11 tweets • 4 min read
On the Novavax earnings call today, the head of R&D made an interesting claim.

She said that the Novavax COVID vaccine is capable of inducing mucosal antibodies that could protect against infection.

This lines up with previous data that has been published on the vaccine. 🧵 "Additional exploratory data in the context of our COVID vaccine have shown that our technology platform can induce mucosal antibodies. Mucosal protection is important not only for the person receiving the vaccine, but for instance for reducing virus transmission." —Ruxandra Draghia-Akli, MD, PhD, Head of Research & Development at Novavax Multiple non-human primate studies and human studies have supported the finding that Novavax reduces viral load in upper and lower respiratory tracts.

Some of this data was published as early as 2020. I've covered these findings over the last few years.

May 5 • 10 tweets • 5 min read
Take a look at these blood vessels.

Which one do you think was taken from someone who had COVID a year beforehand?

Answer in the next post. Figure 1 from https://rmdopen.bmj.com/content/11/2/e005469 In the photo on the left are what blood vessels near the fingernails are supposed to look like.

In the photo on the right are what blood vessels near the fingernails look like a year after COVID.

The right photo was taken from someone who wasn't diagnosed with long COVID. Figure 1 from https://rmdopen.bmj.com/content/11/2/e005469
Apr 30 • 6 tweets • 3 min read
SARS-CoV-2 hijacks the clotting system of your body for its own purposes.

The spike protein binds to fibrin, rendering it toxic. Those toxic fibrin proteins damage blood vessel walls and drive an inflammatory response.

Other viruses don't do this. 🧵 We've known for a while that fibrin plays a role in acute severe disease and long COVIDbut not how this worked. The SARS-CoV-2 virus "hijacks the clotting system for its own purpose," with recent research showing its spike protein binds to fibrin, turning it into a "toxic form," Professor Crabb says. The activated toxic form of fibrin lays down deposits on blood vessel walls, he explains, driving a "big inflammatory response" that causes the microvascular damage responsible for neurological and cardiovascular symptoms. It also suppresses natural killer cells.... When fibrin builds up in organs, it weakens the blood brain barrier, making it easier for things to pass through that shouldn't.

This includes spike proteins from SARS-CoV-2, which have been found in long COVID patients.

Fibrin deposition is linked to neurodegenerative disease. Increased BBB permeability associated with parenchymal fibrin deposition is a feature of COVID-19 neuropathology. In the brain of some patients with COVID-19, detection of spike and viral RNA suggests potential neuroinvasion. Our data and previous literature support that, while spike can enhance fibrin toxicity, even in the absence of spike, fibrin is deleterious in diseases such as multiple sclerosis, Alzheimer’s disease, rheumatoid arthritis, colitis and periodonditis. Thus, fibrin may be deposited either together with spike when spike is present in the brain45 or through an open BBB afte...
Mar 9 • 9 tweets • 3 min read
Over the last 5 years we've seen weapons-grade disinformation tactics applied to stop people from talking about the damage that COVID is doing to their bodies.

The ensuing "fog of war" allowed libertarian extremists to use government for advancement of COVID denialism policies. A tree stands alone in the fog. And the most interesting thing is that key factions involved in this scheme, self-assured in their own understanding, will not recognize the role they played in perpetuating this state of affairs.

And they don't recognize the role they continue to play.

Feb 17 • 17 tweets • 6 min read
We are clearly in the midst of an anomalously severe flu season.

Although H5N1 has not been detected in high numbers among humans, there's a good chance that it's quietly playing a significant role without even infecting humans directly.

How, exactly? Let's lay it all out: 🧵 A graph of influenza specimens tested for influenza in California. 2024/2025 shows a trend peaking above previous 4 years at 27% vs ~22% and lower peaks. If you want the answer up front without having to read through a detailed explanation, you can skip to the summary and conclusion in the last few posts of the thread.

Otherwise, read on! To summarize the hypothesis: Human-transmissible H1/H3 influenza A subtypes may have already acquired genetic material from H5N1 through reassortment, via mammals simultaneously infected with H1/H3 virus and H5N1. This could explain why we're seeing increased clinical severity.
Feb 11 • 15 tweets • 6 min read
There's been a sharp increase in unsubtyped influenza A detected in Canada and beyond over the last few weeks.

Compared to the previous two seasons, influenza only passed the epidemic threshold (5% test positivity) in January compared to a October/November start.

What's up? 🧵 Image
Image By definition, influenza A without a subtype remains unidentified.

However, given that influenza A shares a gene with H5N1, it is still possible that at least some of those positive results are in fact H5N1.

Feb 10 • 7 tweets • 3 min read
If H5N1 were spreading in humans, would conventional tests for influenza A be expected to detect it?

Yes it would, potentially, since influenza A testing typically targets the M gene for detection.

This gene is conserved between seasonal influenza A in humans and H5N1.🧵 Most tests listed below for the detection of seasonal influenza may be capable of detecting influenza A/H5N1, which is a subtype of influenza A. However, only tests specifically designed for subtyping will be able to determine if the person has seasonal flu, or influenza A/H5. The pictured quote above is from a page on the FDA's website where they list out approved medical devices for the detection of influenza.

fda.gov/medical-device…
Feb 3 • 12 tweets • 4 min read
Amid the gloom and doom, I'm excited to share news that gives me hope.

Invivyd has announced positive initial findings from an ongoing clinical trial of a monoclonal antibody to be used as a pre-exposure prophylactic to prevent COVID-19 infections.

Here are the highlights: 🧵 RELEASE DETAILS INVIVYD ANNOUNCES POSITIVE PHASE 1/2 CLINICAL DATA FOR VYD2311, A MONOCLONAL ANTIBODY DESIGNED TO BEA SUPERIOR ALTERNATIVE TO COVID- 19 VACCINATION FOR THE BROAD POPULATION
VYD2311 Serum Concentration (nanogram/mL) over time. Logarithmic scale. From the image, the red dots represent observed serum concentrations of VYD-2311 IM (n=8), with error bars indicating variability. The concentration is plotted on a logarithmic scale (y-axis) ranging from approximately 10 µg/mL to 1000 µg/mL over a time period of 0 to 65 days (x-axis). Range Observed in Red Dots: Lowest Value: Around 10 µg/mL at the earliest time points (Day 0). Highest Value: Around 300-400 µg/mL at peak concentration (around Day 7). Declining Phase: Gradual decrease, staying above 100 µg/mL throu... Invivyd has been developing a monoclonal antibody to prevent COVID infection.

The idea is you'd get it once or twice a year and get better protection against COVID than available vaccines.

This could make it much easier to avoid long COVID, especially combined with respirators.
Jan 16 • 7 tweets • 4 min read
One needs to ask the question: qui bono?

Who benefits from the perception that certain diseases are viewed as psychological when there are clear physiological causes?

Medical diagnoses don't get created in a vacuum. They exist in service of underlying economic interests. 🧵 Image My question was rhetorical. The answer is insurance companies.

Have you heard of the biopsychosocial model?

It is an academic framework that tries to define chronic illness more in terms of personal responsibility and psychological factors vs biology.

tandfonline.com/doi/full/10.10…These harms derive from an empirically unsubstantiated, neoliberal narrative emphasising the role of personal responsibility and effort in ‘recovery’ from ill-health, ignoring socio-structural contributors to chronic illness and disability. Notably, this biopsychosocial model ignores the health-related impact of welfare and disability insurance reforms which the model has been employed to justify.
The model was, however, largely developed through the work of the Centre for Psychosocial and Disability Research at Cardiff University, for some years sponsored by disability insurance giant Unum (then, Unum Provident). The centre was directed by Mansel Aylward, formerly Chief Medical Advisor, Medical Director and Chief Scientist at the Department of Work and Pensions (DWP) with Waddell as honorary professor, whilst some of the centre’s research was commissioned by the DWP (Rutherford 2007a; Stewart 2019). Although Waddell and Aylward were key architects of the BPS model, a number of other...
Jan 6 • 9 tweets • 4 min read
People are starting to take notice of one of COVID's unpleasant effects: increased susceptibility to fungal overgrowth.

This points to the long term effects COVID causes in your immune response. 🧵 Figure 1 from https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1080822/full A graphical summary demonstrating how COVID-19 infection contributes to increased susceptibility to invasive fungal disease. COVID-19 causes significant and immune dysregulation and mucosal damage (e.g., cilia loss).

This can create conditions for invasive fungal diseases such as Aspergillus, Mucorales, and Candida infections.

frontiersin.org/journals/immun…
Jan 6 • 9 tweets • 2 min read
Long COVID is like quicksand.

You could be walking around having a great time until suddenly you're faced with the single most important problem you've ever faced.

Except, nobody is going to even try pulling you out. And most people deny that the quicksand even exists. Need a rope to get out of that quicksand?

Too bad, all we've got is a rubber band. Pull too hard and it will snap back and cause you to sink further.
Dec 21, 2024 • 8 tweets • 3 min read
Polarization kills and leaves people disabled in its wake.

On one extreme: a complete rejection that COVID causes any harm.

On the other end of the ideological spectrum: the idea that vaccines are the final solution even though the virus finds ways to evade it.

Both are wrong. To those operating under the assumption that COVID causes no harm:

I will refer you to the voluminous scientific literature demonstrating the cumulative harm COVID causes physiologically.

This applies both in the acute and chronic phase of the disease

Nov 16, 2024 • 5 tweets • 2 min read
One reason things are so chaotic right now is that there are competing fantasies about what happened with COVID.

Liberals are under the impression that Biden solved COVID and saved the economy.

MAGA is convinced that COVID was a nothingburger, and are acting vindicated. The Gauntlet How COVID Helped Trump Win Biden never ended the pandemic, but he did end government efforts to mitigate its worst impacts JULIA DOUBLEDAY AND WALKER BRAGMAN NOV 15, 2024 They're both wrong, of course.

COVID is still spreading rampantly and shutting down hospital departments.

And people aren't making the connection between new onset cardiovascular damage, walking pneumonia, various other conditions and their past COVID infections. CityNews Overflowing pediatric hospitals in Montreal: parents asked to cooperate Montreal Children's Hospital Montreal Children's Hospital on June 14, 2024. (Johanie Bouffard, CityNews Image) By Katrine Desautels, The Canadian Press Posted November 15, 2024 12:35 pm. Last Updated November 15, 2024 12:43 pm. As Montreal’s two pediatric hospitals experience overflow in their emergency departments, parents are being asked to keep their children home if they don’t require immediate care.
Nov 14, 2024 • 9 tweets • 3 min read
Mass exodus from this site would be a tactical mistake & cause irreparable harm to left-leaning/COVID-informed communities.

When vital information is isolated between platforms, it limits our overall safety and effectiveness.

Right now we desperately need interconnectedness.🧵 Join or Die cartoon, inspired by Benjamin Franklin Copyright Libby Bush https://www.reddit.com/r/Art/comments/ircdci/join_or_die_2020_edition_after_ben_franklin_me/ To create accountability via public pressure, we need a lot of reach.

For example: under Biden's FDA, without any reason provided, Novavax access was limited to those who hadn't had mRNA.

We rallied against that here. The net result? FDA changed course.

Oct 23, 2024 • 7 tweets • 3 min read
COVID increases the risk of secondary infections by impairing mucosal clearance.

"Our results demonstrate profound ciliary loss in the nasal epithelium even in subjects with mild disease and shed light on mechanisms that... probably predispose patients to secondary infections." Scatter plots of pCC (percent ciliary coverage), CBF (ciliary beat frequency), PCL (periciliary layer depth), and MCT (mucociliary transport rate) measurements of healthy control subjects (blue) compared with subjects with COVID-19 (red) are shown. Scatter plots consistently demonstrate a reduction in each of the above while infected with COVID. This study has a small sample size, but similar results have been replicated elsewhere.

We should be looking further into these effects at the population level in relation to opportunistic infections (especially Mycoplasma pneumoniae).

Link to study: pmc.ncbi.nlm.nih.gov/articles/PMC10…
Sep 27, 2024 • 7 tweets • 3 min read
"The Novavax vaccine has this unique adjuvant, a chemical that actually enhances the immune response to the vaccine...

It may be the ideal vaccine to get to boost your previous immunity from prior infection or previous mRNA vaccine.

Personally, that's the vaccine for me."
What are some potential advantages to using a vaccine with an adjuvant?

Durability, for one.

Sep 15, 2024 • 5 tweets • 3 min read
In 2020, the original Novavax formulation was able to protect against upper and lower respiratory tract infection in animals.

Since then, more evidence has emerged supporting this finding.

In human trials, Moderna reduced nasal viral load by 100x. Novavax decreased it by 600x.



Panel comparing viral load reduction between vaccination products in human clinical trials. Novavax viral reduction is the most significant vs Moderna, AstraZeneca, Janssen. See study 3 in last post in thread.
Panel showing viral load reduction in a non-human primate study. See study 1 in final post below.
Following intranasal and intratracheal challenge with SARS-CoV-2, immunized macaques were protected against upper and lower infection and pulmonary disease. See study 1 in final post below.
A panel comparing viral load reduction in non-human primates infected with Omicron. Novavax shows a lower amount of nasal viral load than mRNA (Moderna). See study 2 in final post below. Of course, there are caveats to the above evidence.

Some studies were done early in the pandemic. Strains have changed. More doses were given. Animals can have a different response than humans, etc.

Also, vaccination is the last line of defense (vs respirators), not the first.
Sep 13, 2024 • 8 tweets • 7 min read
Novavax Availability Update 📢

CVS Stock - September 13, 2024

First of all, if you're in AL, FL, GA, NC, SC, TN, or VA, use Publix instead of CVS. CVS does not deserve your business. CVS has made the Novavax rollout incredibly difficult with their untrained staff, poor inventory management, and lackluster customer support. This may seem odd to say on a post listing out CVS stock, but I'm here to support breathing people, not corporations. Publix now has their vaccine finder online on Novavax's site (see reply to this post).

If you must use CVS, first try to get a real person on the phone. Use my cheat code posts below. If that doesn't work, then leave a voicemail. Failing that, go in person, and if they don't have stock, ask them to check their inventory at other local stores (which they can do within a limited radius).

CVS corporate is monitoring stores closely to see which ones need more stock ordered. By sending me your CVS addresses where you got Novavax, we can feed into that demand signal and make it available to more people. This may seem like a contradictory message on a post denouncing CVS as a chain, but I'd rather get more vaccines in arms.

If you don't see your state or city listed here, that doesn't mean there's no Novavax at your local CVS, it just means that nobody reported it to me.

NOTE: From early reports, the CVS phone tree does not necessarily give out accurate Novavax stock information. However, I do know that in some cases stores had Novavax sitting in a refrigerator and didn't even make it into inventory, so ask staff to check their refrigerator even if their computer says no.

Someone reported that there's a GoodRx coupon to save money on CVS vaccines, so I'll include it below.

If you know of any locations (regardless of pharmacy chain) offering Novavax JN.1 in these states, please let me know! If you're feeling bored, antsy, and want to help other people find Novavax, cold call pharmacies and let me know what you find! And please, send me the full address of the locations you're finding. If you send me incomplete info that's a google search per location. And I get hundreds of locations.

Here are states I'm especially looking for availability data from: AK, AL, AR, CT, DE, GA, HI, ID, IN, KS, LA, ME, MO, MS, MT, ND, NE, NM, NV, OH, OK, RI, SC, SD, TN, VT, WV, WY, MI, HI

Tweets preferred but DMs are also fine. I want to make sure I'm respecting everyone's privacy. I get so many DMs that I can't respond to everyone; so thank you for all the reports you've been sending!

And if CVS bothers you with their approach this season, please use the feedback form I'll include in a reply to this thread. Tell them what they're doing wrong. Channel your rage!

---

These are the CVS pharmacies people sent me in the last 24 hours that had Novavax JN.1 stock. Call to confirm:

Arizona (AZ):
522 Finney Flat Suite a Camp Verde, AZ
2601 S. Houghton Rd. Tucson, AZ (Houghton and Golf Links)

California (CA):
17170 Camino Del Sur San Diego, CA (Target)
5501 Ball Rd 90630, Cypress, CA
8008 Firestone Blvd, Downey, CA
670 El Cerrito Plz El Cerrito, CA (on San Pablo)
1675 Hollenbeck Ave Sunnyvale, CA
511 N. Hollywood Way Burbank, CA (LA)
2462 Foothill Blvd, La Verne, CA (Target)
Los Angeles, CA (Unspecified location)
1570 Rosecrans Ave, Manhattan Beach, CA
580 Moraga Rd in Moraga, CA
50 Moraga Way Orinda, CA
13021 Victory Blvd, North Hollywood, CA
Pasadena, CA (Unspecified location)
1324 San Carlos Ave San Carlos, CA
2314 Santa Clara Ave Alameda, CA (3 doses left)
2505 Santa Monica Boulevard Santa Monica, CA
12940 Saratoga Sunnyvale Rd Saratoga, CA
1451 Shattuck Ave Berkeley, CA (or maybe 2187 Shattuck location?)
929 Sierra St Kingsburg, CA
Studio City, CA (Unspecified location)
1730 Sweetwater Rd National City, CA
12143 Ventura Blvd Studio City, CA

Colorado (CO):
2800 Pearl Street, Boulder, CO
Unspecified location, CO
14451 Orchard Pkwy, Westminster, CO
Westminster, Colorado (Unspecified location)

Connecticut (CT):
Waterford, CT (out of doses, see if they'll reorder)

District of Columbia (DC):
4555 Wisconsin Avenue, Nw Washington, DC (not minute clinic)

Florida (FL):
294 37th Ave N, Saint Petersburg, FL

Georgia (GA):
Unspecified location, GA

Hawaii (HI):
377 Keahole St, Honolulu, HI (Long's Drugs, owned by CVS)
5156 Kalaniana'ole Hwy, Honolulu, HI (Long's Drugs, owned by CVS)
1130 Kuala St. Pearl City, HI (O'ahu)

Illinois (IL):
1725 W Boughton Rd, Bolingbrook, IL (Helpful staff)
3951 W. 103rd St. Chicago, IL
500 Dundee Ave. Elgin, IL

Kentucky (KY):
2000 Harrodsburg Rd Lexington, KY

Maine (ME):
51 Market St. South Portland, ME
Unspecified location, Portland Area, Maine

Maryland (MD):
5700 Bou Ave Rockville, MD
5700 Bou Ave in Rockville, MD (inside Target)
1301 Lamberton Drive Silver Spring, MD
10233 Old Georgetown Road Bethesda, MD (Wildwood Shopping Center)
8501 Fort Smallwood Rd, Pasadena, MD

Massachusetts (MA):
264 Trapelo Rd. Belmont, MA (4 doses left)
Somerville, MA (Assembly Row)
399 Main St, Southbridge, MA
10 Main St, Tewksbury, MA
1735 Massachusetts Ave., Lexington MA
36 White Street Cambridge, MA

Michigan (MI):
2506 Niles Ave, St Joseph, MI (if not this location, somewhere else near Benton Harbor)
57090 Ten Mile Road South Lyon, MI

Minnesota (MN):
1515 County Road B W, Roseville, MN
Twin Cities, MN (Unspecified location)

Mississippi (MS):
305 Meadowbrook Rd. Jackson, MS

New Hampshire (NH):
4 Plaistow Rd, Plaistow, NH
250 Plainfield Rd. West Lebanon, NH (No stock yet but expecting soon)

New Jersey (NJ):
200 Promenade Blvd, Bridgewater, NJ (Target)
18-35 River Road, Fair Lawn, NJ (Very helpful staff, apparently)
400 Kings Hwy, Haddon Heights, NJ
4 White Horse Pike, Oaklyn, NJ

New York (NY):
255 Greenwich St New York, NY (Target)
685 Park Avenue Rochester, NY 14607
61-15 Metropolitan Ave. Ridgewood, NY (Queens)
807 White Plains Rd, Scarsdale, NY (Skeptical pharmacist. Does not anticipate restock or demand. Can we prove them wrong?)

North Carolina (NC):
1718 N Fordham Blvd., Chapel Hill, NC
Durham area, NC (Unspecified location)

Oklahoma (OK):
10101 S. Memorial Dr. Tulsa, OK

Oregon (OR):
345 SW Harrison St, Portland, OR
640 SW Broadway, Portland, OR

Pennsylvania (PA):
101 Reeceville Rd., Coatesville, PA
1206 N. Gravel Pike Zieglersville, PA
1218 E. Lancaster Ave Bryn Mawr, PA
1201 5th Street, Perkasie, PA
6701 Ridge Ave, Philadelphia, PA

Rhode Island (RI):
481 Angell Street in Providence, RI
799 Hope Street Providence, RI

Tennessee (TN):
9137 Middlebrook Pike, Knoxville, TN
2398 New Salem Hwy. Murfreesboro, TN
Unspecified location, Nashville, TN (multiple locations)

Texas (TX):
7203 Skillman St, Dallas, TX 75231 (Very helpful staff)
4885 Eldorado, Frisco, TX

Utah (UT):
11525 S Parkway Plaza Dr South Jordan, UT
11506 S 4000 W South Jordan, UT
7777 S. Redwood Rd. West Jordan, UT

Virginia (VA):
7859 Heritage Dr, Annandale, VA
Poquoson, Virginia (Unspecified location)
811 Town Center Dr, Waynesboro, VA

Washington (WA):
Kennewick, WA (Unspecified location)
19507 Highway 99 Lynnwood, WA
1106 N Columbia Center Blvd Kennewick, WA

Wisconsin (WI):
2 South Bedford St., Madison, WI
6701 Mineral Point Rd, Madison, WI
N83 W15550 Appleton Ave, Menomonee Falls, WI 53051
1650 N Farwell Ave, Milwaukee, WI 53202
2135 Silvernail, Pewaukee, WI 53072
1130 W Sunset Dr, Waukesha, WI 53186

Wyoming (WY):
1708 Dell Range Blvd. Cheyenne, WY (Target) Publix vaccine finder update:

Sep 12, 2024 • 4 tweets • 5 min read
Novavax Availability Update 📢

CVS Stock - September 12, 2024 (scroll to end of post for list of stores). 108 stores today. 85 the day before.

It seems that people liked the format of the last post so I'll continue using it. It seems that this first batch of stock is limited to 10 doses per store in many cases. Hopefully the demand signals are permeating through the system and making their way up the chain to corporate office.

In light of the small quantities shipped, for each roll-up post like this one, I'll only include reports from the last 24 hours to keep the data fresh. You can always browse my previous posts by using Twitter advanced search (something like from:friesein NY for example, and then sorting by latest).

I found out that took a step backward in usability and removed the ability to search for a specific vaccine type. This is pretty disappointing, because I was naively thinking that everything would work itself out this year and I wouldn't need to take as active a role in connecting the dots for Novavax stock. But all the same, I'm happy to do what I can to help people in my limited time, at least until it's available in most places. This is too important to ignore.

By this time next week, I'm expecting most Costco stores to be stocked which should relieve a lot of pressure on the system. Rite Aid should be not too long after that. Publix is coming online now, and I'm seeing Meijer and Kroger stores pop up. Indie pharmacies are popping up occasionally (keep sending me them). Hang in there, you will find what you're looking for.

To contact a CVS store and speak to a person, try the instructions I'll be including in a reply to this post.

I'm adding some fresh insurance billing tips to the end of the thread, both for private insurance and Medicare.

One last note: If you send me pharmacy availability updates, it helps a lot if you send a full address including state abbreviation, and include the pharmacy brand. I have to search up each location to ensure its valid otherwise. This will become important as other stores beyond CVS come online. When people give me a wider area, I include that instead of the address.

---

Arizona (AZ):
Tucson AZ

California (CA):
990 Avenida Vista Hermosa San Clemente, CA
380 E H St, Chula Vista, CA
650 San Ramon Valley Blvd, Danville, CA
1871 El Camino Real Burlingame, CA
8585 Elk Grove Blvd, Elk Grove CA
7030 Hollister Avenue Goleta, CA
336 N. Milpas St Santa Barbara, CA
855 El Camino Real, Palo Alto, CA
Paso Robles, CA
12358 Poway Rd, Poway, CA
1059 Hyde St. San Francisco, CA
499 Haight St. San Francisco, CA
2314 Santa Clara Ave Alameda, CA
14735 Ventura Blvd, Sherman Oaks, CA
3939 State St Santa Barbara, CA
8915 Towne Centre Dr San Diego, CA
12100 Ventura Blvd Studio City, CA
2630 W El Camino Real Mountain View, CA
4110 N. 1st Street San Jose, CA

Colorado (CO):
7930 Northfield Blvd, Denver, CO
460 S Vance St, Lakewood, CO
10445 Reed St Westminster, CO
7899 Wadsworth Blvd Arvada, CO

Florida (FL):
Estero, FL
Fort Myers, FL
4292 N Atlantic Ave Cocoa Beach, FL
3102 W. Gandy Blvd. Tampa, FL

Illinois (IL):
1701 E. Empire St. Bloomington, IL (inside Schnucks)
800 Broadview Village Sq Broadview, IL (I'm told the staff are "incredibly friendly")
1700 E Rand Rd Arlington Heights, IL
Indianapolis, IL
200 N. Vine St. Urbana, IL

Indiana (IN):
Bloomington IN

Iowa (IA):
104 E. First St. Ankeny, IA

Kentucky (KY):
Florence, KY
Owensboro, KY
1157 Ridgeway Avenue Falmouth, KY

Maryland (MD):
15600 Columbia Pike Burtonsville, MD
1503 Potomac Ave. Hagerstown, MD
9920 Key West Ave Rockville, MD
7955 Tuckerman Lane, Rockville, MD

Massachusetts (MA):
16 Boston Road Chelmsford, MA
1341 Boylston St Boston, MA
21 Austin St., Bunker Hill Mall Charlestown, MA
481 Pittsfield Rd. Lenox, MA
999 Watertown Street West Newton, MA
36 White Street Cambridge, MA
539 Main St #545, Winchester, MA

Michigan (MI):
5529 Sashabaw Rd. Clarkston, MI
5529 Sashabaw Rd., Clarkston, MI
525 East 4th Street Royal Oak, MI

Minnesota (MN):
8225 Flying Cloud Dr Eden Prairie, MN
900 Nicollet Mall Minneapolis, MN
6540 Penn Avenue South Richfield, MN
4152 Lakeland Av N, Robbinsdale, MN
Twin Cities MN

Nevada (NV):
100 S. Nevada Hwy 160, Pahrump, NV

New Hampshire (NH):
One West Road Stratham, NH
125 Dublin Rd. Peterborough, NH

New Jersey (NJ):
600 Kings Hwy N, Cherry Hill, NJ
1 Route 70 East Cherry Hill, NJ
Egg Harbor Twp, NJ
360 RTE 73 South, Marlton, NJ
387 Pompton Ave, Cedar Grove NJ
175 Rock Road Glen Rock, NJ
CVS in Union NJ
Lawrenceville NJ

New York (NY):
1276 Upper Front St, Binghamton, NY
1 Columbus Place New York, NY
259 Saratoga Rd. Glenville, NY
Ithaca, 625 W Clinton St, Ithaca, NY 14850 (Had it, ran out of stock, will get more soon)
241 West 57th St., New York, NY
39 Park St, Owego, NY
38 Warren Street New York, NY 10007

North Carolina (NC):
4810 Hope Valley Rd, Durham, NC
Durham, NC
8101 Kensington Dr. Waxhaw, NC

Ohio (OH):
8000 Oak Point Rd Amherst, OH

Oklahoma (OK):
15103 N MacArthur Blvd, Edmond, OK

Oregon (OR):
Portland, OR
14th Ave Se Albany, OR

Pennsylvania (PA):
1826-30 Chestnut Street Philadelphia, PA
2320-26 Fairmount Avenue Philadelphia, PA
159 N MacDade Blvd, Glenolden, PA
835 Old York Rd. Jenkintown, PA
1101 Moosic St. Scranton, PA
316 E Lancaster Ave, Wayne, PA

Texas (TX):
5195 Lake Ridge Pkwy. Grand Prairie, TX
4755 Westheimer Rd. Houston, TX (next to the Grotto)

Utah (UT):
5305 South 1900 West Roy, UT

Virginia (VA):
Ashburn, VA
415 E Monroe Avenue Alexandria, VA
208 East Main Street Charlottesville, VA
15250 Washington St. Haymarket, VA
3053 Nutley Street Fairfax, VA
Central VA

Washington (WA):
30 Bellis Fair Pkwy Bellingham, WA
Everett, WA
Renton, WA
Seattle, WA
9400 192nd Ave E Bonney Lake, WA
1401 2nd Ave Seattle, WA
26301 104th Ave Se Kent, WA

Wisconsin (WI):
2200 Brackett Ave, Eau Claire, WI
7520 W Blue Mound Rd Wauwatosa, WIvaccines.gov Medicare billing guidance from a former pharmacy tech: