Covid: Who Should be Vaccinated?
I recently wrote a piece comparing the risks of Covid vs the risk of vaccination:
It was specifically focussed on the relative risks for an individual, based on his/her specific circumstances, e.g. age and underlying health conditions.
I received some criticism from a number of people on the basis that we should be considering the benefit/risk for the whole population, not honing in on individuals.
The reason I wrote this article above was to correct false and misleading information regarding an individual’s risk, so I stand by the content.
However, below I will attempt to tackle the separate issue of the best vaccination strategy to benefit the entire population.
Why Vaccinate?
The first question to answer — I think there’s almost universal agreement that the aims are broadly to:
- Save lives
- Avoid severe illness and long term conditions
- Reduce the load on hospitals to allow other illnesses to be treated
Which people are at risk?
If that is the case, the next step should be to work out which people are at risk of losing their lives or becoming severely ill.
These studies have been done numerous times since Covid first occurred, an example of which is below:
There is not much dispute that the people at risk are typically older and suffer from underlying health conditions or comorbidities.
As the study above concludes, this group makes up around 4% of the overall population.
“We estimated that 349 million (UI 186–787) people — 4% (3–9) of the global population — are at high risk of severe COVID-19 and would require hospital admission if infected.”
Does vaccination reduce this risk?
Since vaccination rollouts started around the world, data has now become available to determine the effectiveness against severe illness and death. Most evidence appears to show that “breakthrough” infections are extremely rare.
“Out of 161 million US residents who were fully vaccinated as of July 19, just 5,601 caught a severe breakthrough infection and were hospitalized — an infinitesimal 0.0035 percent of the protected population, according to the latest CDC figures available on post-vaccination infections.”
Recent news articles are calling the current situation “A Pandemic of the Unvaccinated”. Example below:
“Unvaccinated Americans account for virtually all recent COVID-19 hospitalizations and deaths,” said Jeff Zients, the White House COVID-19 response coordinator. “Each COVID-19 death is tragic, and those happening now are even more tragic because they are preventable.”
However the above theme that this is “A Pandemic of the Unvaccinated”, throws the baby out with the bath water. I believe a more accurate wording might be: “A health crisis of the old and unhealthy who are untreated and/or unvaccinated”. I concede that this doesn’t sound quite as catchy.
Who should therefore be vaccinated?
With the above in mind, namely:
- 4% of the world population are at risk of serious illness and death
- Vaccination is almost 100% effective at preventing serious illness and death
Surely it makes sense to ensure that this 4% (who are easily identifiable by age and/or underlying health conditions) are completely vaccinated?
Motorcycle Risk Analogy
Consider this imperfect analogy:
People who ride motorcycles account for 1% of total road users, but around 20% of the deaths.
US data show that for every mile driven, motorcycles have a death rate that’s 26 times higher than that of passenger vehicles.
In response to this clearly elevated risk of a specific group of people, what steps have been taken to reduce their risk of death and injury?
- Helmets became mandatory for motorcycle riders
- Better awareness, training and education for riders have been encouraged
- Increased safety measures such as leathers and high visibility clothing
- Technology such as ABS has improved
You will note that almost 100% of the efforts to reduce motorcycle rider deaths has been and continues to be focussed on the population at risk, namely the riders. Which makes sense.
The majority of accidents where motorcyclists are killed or injured is when they are hit by other vehicles. This not necessarily the “fault” of the other vehicle, but simply a built-in characteristic of road travel — that sometimes there will be collisions. And where there are, regardless of fault, motorcyclists are far more likely to die.
Same with Covid-19 and a plethora of other viruses and diseases that are simply part of nature (the system of life). We cannot blame people who carry viruses, and expect them to make sacrifices for a tiny minority, when treatments and vaccinations are available to the minority. To me it makes sense to directly protect the vulnerable, and the best way to do that is to focus on them, not the unaffected and innocent majority.
It would be counterproductive and futile to focus on changing the behaviour of the 99% of drivers on the road who do not ride motorcycles.
Discussion
With the above in mind, why is it that there appears to be an almost universal fetish with everyone in the world being vaccinated, including 96% of the population who are not at risk of severe illness or death?
Why is there constant pressure on young healthy people to get vaccinated?
Why are vaccine passports and all of the associated rules and laws being pushed, when they have little or no impact on the 4% of at-risk people getting vaccinated, but instead infringe on the human rights of the 96% who are not at risk?
Yes, clearly Covid is contagious, and therefore healthy younger people may not be impacted directly, but may transmit the virus to the at risk population.
But once again, if the at risk population (only 4%) are fully vaccinated, and there is a near 100% protection, vaccinating the 96% healthy population is unnecessary. At the very least, would one need to concede that it is certainly not a priority?
There are of course, exceptions to the above, e.g. a small number of younger or healthy people who become ill, or older/unhealthy people who cannot take a vaccine, but such impactful policies and removal of rights should not be based on exceptions. And of course, everyone should have the option to take the vaccine if they so desire, regardless of age or health status.
So why is this logic not reflected in policy or in the media, or indeed in anyone’s conversations?