I both agree and disagree with this thread. Agree about @&@! vaccinate. Disagree that even low priority vaccinations are a plus. Certainly better than trash can. But right now, every low risk/low exposure vaccination does nothing to reduce deaths or maintain functioning societyhttps://twitter.com/zeynep/status/1348627964578168832 …
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Replying to @walidgellad
Why? My main objection to this bureaucracy is that it is slowing down efforts to higher-risk folks and we should let people self-certify... but vaccinating even low-risk for severe disease people will reduce transmission (to some degree—possible a lot but definitely somewhat).
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Replying to @zeynep
Agree that if we open things up we likely get more high risk folks vaccinated. Every vaccination to a low-risk person helps that low risk person. Maybe it has a tiny impact on overall disease transmission. But that vaccination would have much higher impact in high risk person.
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Replying to @walidgellad @zeynep
every vaccination to a low risk person also puts one additional vaccine dose in the freezer for 3-4 weeks unavailable to a high risk person. You and I both disagree with that policy, but it's reality now.
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Replying to @walidgellad
I am for—and was very much for vaccinating by risk, primarily age, even back before ACIP changed its final draft (moving away from completely focusing on younger essential workers because of equity & transmission concerns)—but lowering transmission is still a gain, not a waste.
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Replying to @zeynep @walidgellad
But, yeah, the main problem is that this bureaucratization is contributing to slower roll out for high-risk people. Along with a mobilization for speeding things up, I think we can let people self-certify—if a few people cut-in line, it's not a huge loss. So I think we agree.
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Replying to @zeynep
we agree almost completely here. I just don't want to overstate the benefit of vaccinating low risk people right now, or understate the opportunity cost.
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Replying to @walidgellad
If it were up to me, I'd start with risk of illness, which mostly means age (simplest schema and biggest risk) so I agree, though I think we're beyond "unproven" for transmission reduction—just don't know how much—but even with that, I'd agree risk of illness/mortality is key.
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So, even while I think the benefit of lowered transmission is real and likely substantial, I agree with your point the benefit of lowering illness/severity is clearly much more important, plus the elderly transmit more, which all supports that point.
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