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How to handle booster backlash

“Global health advocates are pushing back on the Biden administration’s anticipated plans to start offering Americans a booster dose of coronavirus vaccine, arguing it will only deepen global inequalities,” The Hill reported on Tuesday, August 17, 2021.

“Biden officials are set to formally announce as early as Wednesday a plan to provide booster doses of Pfizer and Moderna vaccines to ensure lasting protection for Americans amid the highly contagious delta variant,” The Hill said. Read story here.

And why is that a problem? Because, “Advocates argue that the evidence on boosters is not strong enough to justify widescale use, and the U.S. needs to focus its attention on sending more doses abroad in order to stop the pandemic from worsening.”

For example, Jenny Ottenhoff of the ONE Campaign complains, “Low income countries still don’t have enough vaccines to give a single dose to even their most vulnerable people. This is just one more step that our government is taking that will widen the gap between the haves and the have nots. And this is not just some moral stain on wealthy nations; it’s really prolonging the pandemic for the entire world.’

(Wikipedia describes the ONE Campaign as “an international, nonpartisan, non-profit, advocacy and campaigning organization that fights extreme poverty and preventable disease, particularly in Africa, by raising public awareness and pressuring political leaders to support policies and programs that are saving lives and improving futures” — details here.

Let’s review, starting with the need for booster shots. There are a couple of things to unpack here.

First, the latest data indicate the vaccines’ effectiveness at preventing infections weakens after a few months, although they remain highly effective at preventing hospitalizations and deaths. Based on this, and the much greater transmissibility of the Delta variant and growing number of “breakthrough” cases (vaccinated people getting infected; i.e., the virus “breaking through” the protective barrier), the CDC seems poised to recommend getting a booster shot after 8 months (story here).  Expert opinion about the need for boosters is still evolving, but that’s where things stand right now.

So it’s not like there’s no evidence of a need for boosters, and that body of evidence is growing by the day.

Next is the question of getting the pandemic under control. Early in the pandemic, a World Health Organization expert posited that Covid-19 may never entirely go away. (See story here.) This narrative seems to have gained greater currency lately. But how much of a threat is that, really? There’s a theory that the odds of a virus wiping out humanity are very low, for various reasons. (See illustrative story here.)

In which case it’s not an existential threat, merely a major inconvenience, to human civilization. Not everyone agrees with that. But even if you eliminated Covid-19, that still wouldn’t eliminate the risk of an asteroid strike, nuclear war, or all the other ways humanity could end. So the notion of vaccinating the entire world really is based on humanitarian impulses, not survival instincts, because our individual and collective survival isn’t assured anyway.

On the flip side, there are those who believe the pandemic will eventually “burn itself out” of its own accord. Representative of this camp is a University of Hong Kong pathology professor who said, “I think it will burn itself out in about six months.” (See story here.) That quote was published on February 11, 2020, so at best, he was off on the timeline. Others may think he’s off his rocker completely. However, there’s some history to back up the notion that epidemics and pandemics eventually run their course, although if you look closely, the development of vaccines often seems to have a lot to do with that.

This brings us to the crux. These vaccines were developed in America, using American talent and technology. American taxpayers are paying for it. Given that context, is taking care of our own people ahead of others being selfish? That’s what you expect your own government to do. I think you’d find close to zero public support for making our own citizens wait while we fly planeloads of doses to Africa. That, as they say, won’t fly.

But wait. We have this weird situation of having doses up to our ears that our citizens don’t want. Remember when people waited for hours in their cars to get a shot? And vaccination appointments were being scheduled weeks out? Seems like a long time ago. Now, you can’t give shots away. We’ve already gone through those who can be bribed to get vaccinated (up to $1 million in some cases, but more typically $100 or $10). Now we’re talking about boosters with half the country still unvaccinated. People are literally rioting against getting vaccinated.

When we talk about boosters, and who will get these precious (?) doses, there’s a couple ways of doing it. You can initially limit booster shots to the vulnerable population — the elderly, immunocompromised, health care workers and first responders, etc. — similar to what was done when the vaccines first came out and demand exceeded supply. This wouldn’t take very many doses away from Africa.

Or you can offer boosters to everybody in America who wants them. That might be half the population. Or maybe only half of the vaccinated half. We don’t know. There’s no telling what the demand for booster shots might be. But this probably would take more doses away from Africa than the first option, unless the boosters are a unique formula, different from the first two shots, and usable only as booster. That would make them useless in Africa, and then there’s no issue, right?

I have a couple of ideas here, one selfish, the other altruistic.

Let’s start with the selfish one. Stopping the virus globally by vaccinating the entire human population is all well and good, selfish people will say, but will question the practicality and argue for stopping it in the good ol’ USA first and worrying about the rest of the world later. This doesn’t necessarily require shots, there are other ways, but we’re clearly not going there (riots, again). So how do you vaccinate the unvaccinated half of our population? To do that, you use child psychology. You show them 300 million doses and say, “See all these shots? You’d better take ’em, or we’re sending them to Africa.” This will be like dangling a toy in front of a kid and threatening to give it to another kid. You’d better not be standing between them and the vaccination table when you do that, or you may get run over.

Now for the altruistic idea. You show them the 300 million doses and say, “These are yours if you want them.” Silence. “Free.” More silence. “Okay, I guess we’ll give them away.” Not a stir. Then you load them on planes and fly them to Africa. That should make everyone happy — the vaccine resisters (because they’re still vaccine-free), the America First crowd (because you put your citizens at the front of the line), and the One Worlders (because Africa got the doses).

And once you’ve done jumped through those hoops, there should be no more noise about Americans getting boosters while Africans are begging for their first shot. The only begging you’ll hear is in the red-state ICU wards.

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