and hear some guy from WHO say similar things, but I can’t, for the life of me, figure out a mechanism that makes this true.
Sure, there are ethical issues with getting some kids slightly more protected while leaving other elders vulnerable to a high risk of death. But that’s because elders need the protection more than kids, not because elders are more likely to prompt the virus to mutate.
Or are they?
Honestly, it seems to me that the best way to reduce mutations is to create and distribute as much vaccine as possible. And just maybe, more profits helps do that. But we have both profits and government funding, and the vaccine manufacturers ARE ramping up production. I think we were expected to have a surplus of vaccine in late 2022. (I’m sure that doesn’t translate to “everyone gets it”, because there are still all sorts of logistical problems, not to mention vaccine hesitancy.) Does it hurt the effort to get the world vaccinated by vaccinating kids in wealthy countries? We have learned that kids DO get infected and do spread the virus, so I would naively think that vaccinating them we help as much as vaccinating anyone else.
I don’t think it’s inequity per se, but, rather, all the unvaccinated people. Adding the next million doses into the most vulnerable arms would do the most to reduce mutations, compared to wherever else the doses could be added. However, it’s not a zero sum game. The biggest challenge for the most vulnerable arms is getting vaccine distributed there, not making it. In fact, it could be that greater demand for vaccine would make it more available, as supply catches up and then turns vaccine into more of a commodity.
The issue is not the specific risk of death in the person getting covid, it’s that mutations become more likely the more covid there is around. Reducing transmission means giving lots and lots of people their first shots rather than giving one group of people their first shots, then their second shots, then their third shots before Group 2 has a crack at anything.
This is why people argue about vulnerable-first vs front-line first vaccination strategies - vulnerable-first protects individuals from severe sickness and death, but frontline-first reduces transmission which helps everybody.
All-the-developed-world-first is not either of these strategies, and is bad from every point of view.
But I’ve read that a first shot doesn’t do much against Delta. It’s not like at the start of the pandemic when one shot made a huge difference. So I’m dubious.
“Developed world first” is not as good as “frontline first”, but I don’t see why it’s obviously worse than “vulnerable first” in terms of spread. And yet, people keep saying that.
Given the state of the world, it’s a certainty that “developed world first” was going to happen no matter how hard anyone tried to make it different. And only one of the reasons for this is first world selfishness. There are other reasons that we have no control over. So you may as well stop complaining about it.
I just looked up some stats on vaccine effectiveness, and it seems like for AZ even with Delta, one dose is about half as effective as two, in which case it’s a wash (less good for Pfizer, but that wasn’t the case when people were first considering vaccination strategies)
But in any case, if you want to limit the total number of opportunities for mutations to happen, it’s still better to target people at high risk of spreading it, not people at high risk of getting sick - that probably means healthcare workers in whatever country you can find them.
Yes. But it’s human nature to try to protect your own. It’s not just wealthy countries that have done this. When India was hit by Delta, it stopped exporting vaccine and prioritized its own citizens.
I think it was always somewhat naive to think that people with access to vaccine would choose to leave themselves, their kids, and their friends exposed in order to ship that vaccine to strangers across the world.
If there were really a strong argument that doing so would reduce their own risk (reduce variants) then perhaps there would have been an argument, in a delayed gratification way. But i don’t think there is a strong argument for that since Delta.
I think we should be exerting our moral effort on expanding vaccine production – although at this point, that’s already happening pretty quickly, and i think the global vaccine industry is on-track to exceed demand around June '22.
There will still be distribution issues, of course. But i think that people who aren’t worried about their kids’ access may be more motivated, not less, to chip in to facilitate global access. A politician seen as removing critical resources from the people who elected them is likely to lose their position. One who is merely helping the unfortunate is much more likely to be reelected.
I didn’t ask if it’s a good strategy. I asked if it actually increases the risk of variants.
I suspect that we don’t decrease that risk until everyone has some immunity. The rich, the poor, the old, the young. There’s a huge moral and practical imperative to increase the total availability of vaccines, which requires both production and distribution.
Back to the actual question, vaccinating the most vulnerable would do more to reduce mutation than vaccinating the less vulnerable, all else being equal. If a strong, healthy person gets infected, and their immune system fights it off on their own over the course of a week, that’s a lot less opportunity for the virus than if a weaker person gets it and spends six months fighting it. In the real world, of course, it’s not the only factor that makes a difference: You also want to increase the priority for those interacting with a lot of others, especially those interacting with others who are likely to already be or to become sick. But it’s definitely one factor to consider.
And yes, of course, the best option of all is to vaccinate everyone. But there’s a finite supply of vaccine, and a finite rate at which we can make and distribute more.
The working hypothesis is that the new Omricon variant emerged after exposure to an HIV patient. So yeah, we do need to vacciniate the vulnerable first.
Professor Francois Balloux, Chair in Computational Biology Systems at University College London, has been quoted as suggesting it’s possible that the virus mutated during a chronic infection of a person whose immune system was already weakened by an untreated HIV/Aids infection.
No. It’s one groups first shot, second shot, third shot….then that groups zoo animals…(not a joke)
then I am guessing pets, frozen embryos, agricultural livestock, then junkies start cutting heroin with it………then maybe group2 most vulnerable.
Though no doubt each and every step would have people claiming “challenges and difficulties” , like on this thread and elsewhere.
Although, if your immune system is bad enough, vaccines don’t help. (And in a global level, have been wasted.) A friend who is immune compromised was tested by her doctor to see if the had any antibodies after being vaccinated, because that was in question. (She did. But at i said, that was in doubt.)
That leads to the suggestion that immune compromised people worldwide should be prioritized for treatment, however. I hope there’s a push to get some of the new drugs in development around the world. They are likely to become available just about when the world has enough vaccine for everyone.
Thinking some more about this, part of our global COVID-19 strategy should be aggressively treating people with HIV. There are lots of reasons for people to be immune compromised, and most can’t be helped. But with proper treatment, most people infected with HIV can be restored to normal or nearly normal immune function. And there’s no global shortage of those drugs, just a shortage of money to get them to poor people in less wealthy nations. And there are countries with massive numbers of people with untreated or poorly treated HIV.
I mean, there’s a pretty strong moral argument for treating those people anyway. But it seems there’s currently also a self-interested argument for the first world to help provide drugs to the rest of the world.
Which is something that we should be doing anyway, covid or no covid. With the right medicines, HIV patients can live a basically normal life. So they should get those right medicines.
Yes, of course. But people (and nations) are often more generous when it’s in their interest to be so. And it looks to me like it is currently very much in the interest of the people who can afford to pay for those drugs to do so.
Although, the situation isn’t as bad as I thought it was. Apparently South Africa, in particular, has been doing a decent job of getting treatment to people in recent years.
I don’t think it is possible to give a definite answer to the question.
Mutations are and were inevitable. Given the rate of ramp-up for production and the problems surrounding supply and medical support it was never going to be possible to have enough people vaccinated to prevent mutations.
So what to do? do you concentrate the vaccines in the countries worst affected and the people most likely to die?
Or do you distribute equally to poorer countries in Africa for example where the populations are younger, less at risk, with lower levels of infection and deaths but that may provide a breeding ground for mutations?
Do countries with such lower levels of both disease and vaccination actually present the greatest risk for mutation?
Does a shortage of vaccine supply appear to be a factor in the rise of mutations (incidentally, South Africa does not appear to have a vaccine shortage but may have issues with uptake, that’s a different kettle of fish).
Ultimately we don’t know for certain precisely what the best approach is. Opinions vary. We are particularly blind when it comes to knowing what bullets we actually have dodged by the courses of action taken so far.
The Omicron may be a concerning mutation but the real deciding factor of that will be its ultimate lethality. There is no evolutionary advantage to it killing more people, it could be equally be much less lethal and yet still more transmissible. Indeed, in a perfect world for the virus it would infect you, you wouldn’t know it, it wouldn’t incapacitate you and you’d go on spreading it much more widely.
If that turns out to be the case then in fact, having conditions that brought about that mutation could be argued to be a good thing.