Please remind me again: Why are we vaccinating? Why are we boosting?

Last update: Friday 12/10/21 

Throughout 2020 everyone agreed that the purpose of vaccines was to protect people from severe illness and death. Our scientists developed highly effective vaccines in record time, "highly effective" as in: our vaccines reduced the likelihood of becoming severely ill or of dying by 95 percent compared to the severe illness and deaths suffered by unvaccinated persons. Things became a bit confused by mid-2021 with the sudden emergence of Delta as the dominant variant because Delta produced a substantial number of breakthrough cases, i.e., infections of vaccinated persons, even among persons who had been vaccinated within the previous three months.

Our confusion was exacerbated by the CDC's unfortunate initial declarations that breakthroughs were "rare". Breakthroughs were definitely not rare. Nevertheless, our vaccines were still highly effective against Delta. By August 2021, 98 percent of the people who were hospitalized were unvaccinated. 

Data emerged that showed that our vaccines lost some of their effectiveness after five or six months, a loss that caused additional breakthroughs. Even so, our "old" vaccinations still provided impressive protection against severe illness and death.

It was also discovered that two doses of our vaccines had never provided acceptable levels of protection against the virus for the oldest members of our communities nor for recipients whose immune systems were compromised. When scientists discovered that a third "booster" shot raised immunity for those groups to acceptable levels, it was quickly agreed that older people and immunocompromised people should receive booster shots.

Then came confusion. 

The eligibility for boosters was quickly expanded to include persons whose jobs were more likely to expose them to people who were infected ... to middle aged adults ... to young adults ... to teenagers ... despite the fact that there was no evidence that two shots of our vaccines failed to greatly reduce severe illness and death among people who were younger or whose immune systems were not compromised.

Why did this happen? 

It happened because our pandemic managers made a de facto change in our vaccination goals. Having failed to persuade 70 percent of our population to receive two vaccinations in order to reduce severe illness and death, our pandemic managers somehow convinced themselves that they could eliminate all infection, no matter how mild or asymptomatic, by persuading everyone to receive three vaccinations. They made this change in our goals before there was any data to indicate that two vaccinations were not effective against the emerging Omicron variant.

Is this new goal achievable? Is it ethical, given that billions of people in poorer nations have not received their first two shots and will thereby suffer high levels of severe illness and death? Is it ethical given that the U.S. and other wealthy nations are using their wealth to outbid poorer nations for a limited supply of vaccines in order provide their citizens with their third shots?

• "What Data Shows About Vaccine Supply and Demand in the Most Vulnerable Places", Keith Collins and Josh Holder,  NY Times, 12/9/21 
  
  
• "Warning of vaccine inequality, WHO again avoids endorsing boosters for general public", Adam Taylor, Washington Post, 12/10/21

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Related notes on this blog:

• "Omicron, Omega, and de facto Covid-Zero", Last update: 11/30/21
  
  
• "Acceptable costs of living with the virus", Last update:  10/24/21