To knock out COVID-19, we may have to vaccinate the undeserving
By Tom Baxter
Should the most deserving always be the first to get their shots? It’s an uncomfortable question, but one that does arise as the nation tackles the largest logistical problem it has ever faced.
With supplies of COVID-19 vaccines still limited, the highest priority has gone to healthcare personnel, who are essential in the battle against the virus, and those who are most vulnerable due to age or medical condition.
Already, despite delays in the rollout, the vaccines seem to be having an impact on infection rates in the United States and United Kingdom. But you have to wonder. What if we targeted the undeserving: the bar flies and keg partiers, the street racers and their posses, the unmasked and the incautious. In short, what if we met the super-spreaders head on?
What if we set up kiosks at college sporting events and paid students $10 a shot? What if there were party buses rolling up and down Roswell Road offering shots and shots? Want to throw a maskless pool party? Sure. Just have all your guests get their shots.
That would be striking a blow at the virus in the places where it now finds protection, possibly cutting off the flow of infection at its source before it can be transmitted to the doctors and nurses and the grandparents.
Nothing even close to this approach is going to happen, at present. But just as viruses mutate, so may the thinking about how to deal with them most effectively. Actually that is happening already. On “Meet the Press” last Sunday, infectious diseases expert Michael Osterholm said the emergence of more virulent strains of the virus had increased the urgency of getting more people vaccinated. Instead of holding any vaccine back to administer second doses, the priority now should be to get as many single doses into people over 65 as possible, he said.
Getting any many shots into as many arms as possible involves sending the vaccines through a vast maze of federal, state and local health agencies, grocery store chains, doctor’s offices and drug stores, while the people who want the shots attempt to work through the maze starting at the other end. No wonder it’s often frustrating, and no wonder the larger goal sometimes gets obscured, as it has in the tiff between the Georgia Department of Health and Medical Center of Elberton.
The state suspended the center’s vaccine supply for six months because it was vaccinating teachers, who are not yet eligible for the shot. Later in the week the DOH agreed to send additional doses to other facilities in Elbert County, which took some of the sting out of the suspension, but it was a politically deadly moment nevertheless.
The state was in an uncomfortable position, it’s true. It reportedly was receiving complaints from other providers that Medical Center of Elberton was jumping the line, so it couldn’t simply look the other way when the center was clearly flouting the state guidelines.
On the other hand, telling teachers they aren’t a priority is never politically advisable, and if the goal is to get as much vaccine out in the community as possible, vaccinating teachers doesn’t sound like such a bad idea. It’s a shame the two sides couldn’t work out their differences without the suggestion that people who need them wouldn’t get their shots. Ultimately, the most effective strategy for dealing with the virus is likely to be one with clear guidelines at the top and a certain amount of flexibility at the local level.
So far, health officials have had to pursue strategies of scarcity while preparing for the broadest vaccination program possible. That has led to situations where available vaccines have failed to make it into eligible arms, while large numbers of eligible recipients have lost their way in the bushes of internet scheduling.
The quickest cure for these problems would be the arrival of many more doses of vaccine, very soon. For months the shots have been longed for as relief from the weariness of months of pandemic, but the arrival of the new and more deadly UK, South African and Brazilian variants has given a new urgency to the speed of the supply chain. We have to get ahead of the virus soon, or these past long and painful months will soon seem like a warmup.