I think it's mostly because NHS organisations are already well organised for distribution of vaccines to staff. They're large organisations with thousands of employees.
Care homes are all mostly small, with a handful of employees.
In Denmark where I live, a large proportion of infected people are age 20-29, and I wonder if it would make sense to vaccinate them first when you get to "rest of the population". Even though they have a smaller risk of getting seriously ill, that could be an effective way to lower transmission.
That is:
1. Immunize the age group that is dominating in the hospitalization statistics, then
2. Immunize the age group is accounting for the majority of transmission, then
3. Immunize the rest.
Because A.) Approx 1 20yo in a million will have life threatening complications. Plus B.) there are a lot more of them than their (are people who have non-negligible chance of dying + people around those with non-negligible chance of dying).
The lockdown is justified by certain measurable factors, such as hospitalization rates, the risk of death, and the risk of major complications, and as we vaccinate the population, these factors will decrease. They will decrease quickly at first and then very slowly taper off to zero. (Remember there will be idiots who avoid the vaccine altogether.) It makes sense to ask when Covid crosses the line from a risk that justifies lockdown to a risk that does not.
We don't know yet whether the vaccine stops people from being asymptomic spreaders. We do know that it is effective at stopping people from getting ill.
So we don't know how beneficial your 2 above would be.
So I should only get the vaccine if I fear for being sick, similarly to the flu, right? I do not want the vaccine. I have been exposed to many COVID-19 positive people and I am fine, thus, I do not want a rushed vaccine.
I don't know why you've been downvoted, because this is really important to point out. The vaccine does not, as far as we know, prevent you from spreading COVID; it simply tries to prevent you from having any symptoms. So while it will be effective at keeping people out of hospitals, it may not actually do anything to stop the spread of the virus.
From a sheer infection control standpoint it makes a sense to vaccinate hypermobile social superspreader nodes first. Anyone who comes into contact with lots of people is going to be responsible for more onward infection chains than a reclusive grandma. The butterflies among the young are probably key drivers of spread. Take them out of the susceptibility picture and everyone benefits.
If you want to keep the amount of dead people to a minimum, then it makes sense to first vaccinate those who are most likely to die.
HN-ians like to model stuff, and i get that. To do it properly we need to know how many "young"(active ppl) there are, how many old with lung problems, the rates of propagation in and between those, and probably other stuff. But the goal is to keep the deaths down, and my opinion is that by far the smartest way is to first vaccinate the vulnerable people and those who deal with them directly (nurses, etc.). There's also a lot of points about practicality. For example; If i get infected not much happens (i'd just have to isolate myself, even with heavier symptoms). But if my mother gets those severe symptoms she would need to go to the hospital, if she would live at all.
Even if the math says it's better to vaccinate the young ones first, i'd still argue that it's overall safer to vaccinate the vulnerable ones first.
Smartphone mobility and social graph data that’s already being collected and analyzed. Rather than just using existing tech to target ads and build surveillance capitalism profiles, it could be used in the public interest. On an opt in basis naturally; but as frictionlessly as possible via cookie tracker popups and updates to FAANG terms of service perhaps.
Stranger things have happened in 2020 than that! It’s a win-win. Superspreader nodes either get their vaccine or they become aware of how much they’re already tracked may begin to consider the nuances and implications.
There is a considerable Moral Hazard element to this, but it would make sense to vaccinate the most irresponsible people first, since they're the ones spreading it most.
How do you know whether someone is being 'irresponsible' before they catch the virus? Do you follow them around, taking photographs? Imagine the social stigma, for starters. Do you live in the real world, or a computer game?
It's not realy moral hazard, it's about what is the goal.
If the goal is to slow down the pandemic, then the "irresponsible spreaders" should be vaccinated first.
On the other side, if the goal is to punish "irresponsible spreaders", then they should be vaccinated last. But that also means that pandemics would not be slowed down, and the ones taking that decision will be responsible for further spreading.
There are far, far too many of them compared to the number of vaccination treatments currently available. It wouldn't make a dent. Better to treat the much smaller number of people in high risk groups.
I have a suspicion that once the vaccine rolls out and is working then everybody will throw caution to the wind. It’s going to be interesting to watch this unfold.
Fully expect the same. Basically, if you are less than 65 years old and not working in one of the early access professions, forget all concerns about vaccine safety. Buckle up to face the virus natively in that third wave that will sweep through unmitigated once the high mortality groups are vaccinated.
There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.
There's a good chance that situation will create a black market both for vaccines (real and fake) and forged proof of vaccination.
You are painting a scenario that could theoretically become an issue if vaccination somehow got stuck at some point close to or far beyond the 50% mark for some reason. E.g. to deliberately exclude some part of the population, or in some "the vaccine is actually a carrier for something else" movie plot. But if the limits of vaccination are just the confines of ramp-up and particularly if priority is given to the elderly, it's just a phantom fear. Not allowed to go to work unless you are older than 75? Right...
At first glance forgery seems like a very real threat considering how hard it is to tell vaccine from sodium chloride (entire testing procedures are based on this), but the same difficulty is also working against a black market: why pay if the seller can't give event the slightest indication that it's not a fake and the fake has no intrinsic value at all? You'd have to fake the distribution structures and not the product and an elaborate fake structure isn't something that suddenly pops up from some dark market investment, it could only evolve from simpler black market schemes. But those won't happen, at least not in time (except maybe in places with a truly corrupt regular distribution system, where it would start with "redistributed" real vaccine and then slowly shift over to fakes)
There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.
The UK government has ruled out having a vacination passport (for good reason in my opinion).
As I recall, the UK government very loudly and repeatedly refused to rule out a second national lockdown, despite calls to do so. Now, Boris Johnson said that he really didn't want to carry out a national lockdown and that it was a last resort, but that's not the same thing at all. Didn't stop the press calling it a u-turn anyway of course.
The Flip-flop / U turn complaint has always irked me. People don’t know the future, people change their minds. I would be disappointed if government were given new information and didn’t change their mind if it was now clear they should do so.
I am not saying that the government can't change their minds, new things pop up, future is hard. I am just saying that relying on "they promised us to not do that" is dumb. They will do anything once circumstances change.
This isn't a fair comparison, or reasoned in good faith.
The UK government changed their mind about a second lockdown given new evidence. The virus got much worse and they responded. What new evidence is there that the UK government is going to start vaccination passports? Has something changed?
That's the wrong question. The right one is "may something change in the future?" And an answer on this: "maybe, we don't know, nobody knows the future".
That being said, extrapolation of the exponential curve a month forward is one of relatively simple ways to predict the future. And yet, it was _completely_ unexpected for the UK government. Think about that.
that has already been ruled out in the UK and by many other nations and it is also not something that the WHO advocates so I dont see that getting leverage ever. Except in authorotarian regiemes where it would not be about the vaccine anyway.
There are people far smarter than I am developing plans for this, but I'm assuming the thinking is "it's better to vaccinate the person who could die from Covid than to vaccinate the person who could potentially give it to them".
I have no doubt there are some pretty interesting models being developed to determine the best course of action.
This only would makes sense if there would be evidence that the vaccines are so-called _sterile_ vaccines. Which means vaccinated people cannot transmit the virus to others. But, absolutely no covid-19 vaccine can be considered as sterile, because there is just no data for it. So, it is, for now, just a self-protection vaccine.
Older Adults' is a shortened term for certain divisions e.g. Older Adults' Mental Health in UK medical circles. it's a bit of a catapostrophe, but I suspect it was copied, pasted, then added to without due attention
Would the vaccine work on those groups? My understanding is that you need baseline immuno-response to develop the resistance with help of vaccine.
Isn't one point of vaccination of population to protect exactly that population who can't receive the vaccination?
I'm going through the transplant pipeline right now, and I've been told to expect that it should still work, but probably at a lower effectiveness than someone not on a post-transplant drug regimen. I'm really hoping the timing works out so I can get it pre-transplant though.
I'm Canadian, so I imagine it's a completely separate system (for example, I don't know what a "trust" is). I go to my local hospital which has a pretty large nephrology department.
At first I missed NHS staff on the list; it's tucked in the second bullet point as part of "health and social care workers". A footnote attached to it says:
> The final decision on the prioritisation for health and social care workers will be dependent on vaccine characteristics and the epidemiology at the start of any programme.
So in the UK we have a really good set of expert bodies that put forward reccomendations on these things, the JCVI being the vaccines body. They are every bit as good as the current government are terrible.
The FDA already recommended (it's not binding) that front-line healthcare workers and seniors in long-term care are the first wave of 20M people (40M doses).
20% points seems to be the drop as the rapid approval process became a victim hyper-partisanship in the US. The push for a rapid approval has been viewed, by the left, as a political ploy by the right instead of a well-planned & scientifically supported approval process. Early polls about taking a vaccine showed much higher support for it before it was politicized. [0]
Support dropped by 20%. Surprisingly, it dropped by about the same amount for both the political right & left, although support on the left started at a higher level. This may indicate that even people on the right were influenced by the perception of a too-rapid approval process.
Having worked in the pharmaceutical industry, if I ever said my FDA approved drug was "safe and effective" I'd have the FDA dropping the hammer on me.
The FDA does not prove a drug is safe. No drug is 100% safe. The FDA determines whether the risks of the treatment are outweighed by the benefit.
I have no doubt that additional safety signals will pop up from Covid vaccines as the treated population expands by 100x. Most likely they will not be severe and the risk will still outweight the benefit.
But to say "we've tested the vaccine on a 15,000 people so we know it's safe to vaccinate 1B+ people" is not something the FDA would agree with.
Nothing is 100% safe. The word "safe" is used by almost everyone to mean a feeling they get. Something is safe to them if it feels safe. Flying is "safe" if you don't fear flying. It is not if one is afraid of getting on an airplane. Is driving a car "safe"? It is if you don't feel scared when driving in a car. Any other use of the word would need to have some statistical evaluation of the situation. Saying the risks of the treatment are outweighed by the benefit is a great rational way of saying drug is safe enough to use, but most people don't use the word safe in that way.
To me a chainsaw is a safe tool to use. Dangerous, but safe. To others it is not. Is a chainsaw a "safe" tool?
It might be a matter of "do as I say, not as I do". If you look up prior FDA violations, you'll see the FDA get pretty ticked about not clearly laying out the safety risks of a medication - as such, using language such as "our drug is safe" would go directly against that.
The FDA is incredibly strict when it comes to advertising. I remember reading about one violation where the ad had a tagline for an ADHD medication "So you can concentrate on the important things" and showed a picture of a child studying. The FDA said "the image implies that your medication will improve the ability of a child to study and you have submitted no data to the FDA to support this claim".
Oh boy, these people completely have missed the approved, and then later withdrawn medications. There have been quite a fuckton of them, or late black box warnings.
A seatbelt might strangle you in one in a million crashes, but colloquially, we can all agree that seatbelts are safe.
No drug is safe, but in this case, not taking a drug is not safe. If it's safe enough to vaccinate 15,000 people, when 300 of them are expected to die without vaccination, it's incredibly unlikely that side effects discovered on 1 billion people will not make the vaccine the safe choice.
Conversely, I am finding the reaction to anti-vaccine sentiment from some politicians to be pretty creepy. Already there is talk of compulsory vaccination or "vaccine passports". Labour (the UK opposition party) were even calling for spreading "misinformation" online to be illegal.
I find this ridiculous considering the massive challenge we have ahead of us just to get the vaccine to the millions of people who desperately want it.
Sure, if we get to the point where everyone who wants the vaccine has had it, and there are still people dying from COVID, then we can discuss illiberal measures to increase vaccine take-up. (I'd still be opposed to them).
Getting worked up about this stuff when not a single person (outside of the trial groups) has been vaccinated yet just demonstrates our politicians' (on all sides) tendency towards authoritarianism.
I'm not sure I agree. The maths says that we need about 70% of the population to take the vaccine in order for it to no longer be a threat. We also have polling that says about 53% will refuse to take the vaccine. So we're already at the point where something else must be done such as adding incentives, a passport system or better advertising etc. OR continued lockdown measures and enforcement of mask wearing. It's not a theoretical problem we're already there.
> The maths says that we need about 70% of the population to take the vaccine in order for it to no longer be a threat
...to no longer be a threat to an unvaccinated person.
This isn't like the childhood vaccines, where we need herd immunity to protect the children who are too young to be vaccinated.
Provided that everyone who wants the vaccine can get it, I don't see the problem with letting everyone else make their own decision.
The current priority list of people is nowhere near 70% of the population anyway. Most people under 50 won't have the opportunity to be vaccinated for months. So this absolutely is a theoretical problem, at least for now.
Given that Covid is such a mild disease for most young people, I predict that by the time the elderly and vulnerable have been vaccinated, this will be a non-issue anyway.
Yeah, the only reason I'm holding to the guidelines is for elderly and immunocompromised. I don't care about catching covid and nor anybody I know not in one of those categories.
This whole thing becomes moot once the vulnerable are vaccinated, no need for creepy immunity passports.
I used to agree but a few of my 20-29 year old friends have had much worse experiences than expected. One had some neurological side effects, which is rare but happens, that affected his eye movement and made it impossible for him to read or work comfortably.
It wasn't healing and it turned out he had an undetected issue processing folic acid I believe, which has an effect on how your body heals from neurological damage. He's recovering now after 3 months but has to take folic acid and other supplements 5 times a day.
Other friends have had persistent diminished lung capacity for months on end; these are folks who had no co-morbidities and in their 20s.
Yea I'm not totally concerned about catching it but if I do, I increase my likelihood of hurting others. That's been the logic of most of my peers (early 30s, late twenties).
However, through my partner I am friends with many classical singers. They are absolutely worried about damaging their instrument.
>This isn't like the childhood vaccines, where we need herd immunity to protect the children who are too young to be vaccinated.
It's not only too young children who might not be legitimately unvaccinated...some people who are immunocompromised or otherwise medically unable to take certain vaccines must also rely on herd immunity for protection.
> ...I don't see the problem with letting everyone else make their own decision.
Pandemics have, since time immemorial, been an exception to the "I can do what I want" rule.
Much like allowing parents to fall into conspiracy theory traps and refuse to allow their children to be vaccinated against measles, resulting in that disease suddenly becoming a threat again, if we're going to get back to normalcy we can't let half the population ignore the vaccine.
But, since we are going to let half the population ignore the vaccine, prepare for a long, drawn-out period of time during which the disease will flare up, lockdowns will be imposed, more people will needlessly die, and conspiracy theories will continue to make a mockery of civilization.
It's still unknown whether vaccines convey sterilizing immunity. Even if they don't, there will be no political will to institute lockdowns if the people who are getting sick could have been vaccinated. If unvaccinated people getting Covid-19 creates undue strain on the healthcare system, the calls will be for mandatory vaccination, not for lockdowns.
Restricting social interaction and business is a crushing approach to solving the problem, with severe consequences to health and economics. It's brute force, like securing a computer using an air gap. The only reason lockdowns have been used in 2020 is because we have no other options available, but a free and readily-available vaccine changes the calculus.
