Vaccine Boycott
I realized the other day that there are some perverse incentives when it comes to vaccination. Those of us who are eligible for the vaccine but are feeling bad because we are low-risk are being shamed, because "the more vaccines we get in arms, the safer we will be". On the surface this seems like it is a reasonable argument, but it is not correct.
What is the goal here? I can think of the following goals:
Minimizing the number of COVID deaths.
Minimizing the number of ICU beds being used, so we do not have to triage patients. This was the original goals of the lockdown.
Minimizing the number of infections that result in long-haul symptoms. If somebody has figured out who is most susceptible to long-haul symptoms, then we could optimize for this goal, but as far as I know we don't have a great sense of this yet.
Minimizing the overall number of infections. This is the proxy we are all using for the other two goals.
Getting as many vaccines into as many arms as possible is no guarantee you are achieving any of these goals. Once you have completed the goal and vaccines are in every arm, then you are fine. But you could be in trouble along the way if you vaccinate arms that are at a low-risk of contracting the disease (cushy work-from-home types) before those at higher-risk (vulnerable populations, poor people living in crowded housing conditions, minimum-wage workers at service jobs). Not every arm is equal when you are trying to minimize spread.
Although the government has made some moves towards vaccinating more vulnerable workers first, it has not prioritized vaccinating the minimum-wage workforce that is working those service jobs. I do not know for certain that those workers are at higher risk for catching COVID than those of us sitting at home, but it seems plausible. Furthermore, if some precariously-employed worker gets the sniffles, it is tempting to go into work anyways, which could result in a lot of people being exposed to whatever virus that worker has.
It is also worth asking why exactly I am now eligible for the Oxford/AstraZeneca vaccine. One reason is that the National Advisory Committee on Immunization declared that Oxford/AstraZeneca was safe for those 18 and over. But the Ontario government lowered the threshold to 40, not 18. Why?
I think the reason has a lot to do with how slowly Oxford/AstraZeneca has been moving off the shelves. Those who were at the previous threshold of 55 were not snapping up the vaccine. If they had, then my guess is that the Ontario government would not have lowered the age at all.
Don't get me wrong. Knowing that unused vaccines expiring in fridges is infuriating. For a while I thought that making sure we used every dose we had access to should be the top priority of health officials, regardless of politically-set age thresholds. I still feel that rage, but that rage might not be rational. If somehow those between 40-55 years of age had also boycotted the Oxford/AstraZeneca vaccine, then the government might have lowered the age threshold further, so those people in minimum-wage service jobs would have been eligible. Despite wasting those vaccine doses, this might have actually gotten us closer to our goals of keeping the overall Ontario population safe than having 40-55 year olds stampede to use up the Oxford/AstraZeneca doses.
We don't live in that world, of course. 40-55 year olds are stampeding to use up the Oxford/AstraZeneca vaccine. Refusing a vaccine dose in the hopes the Ontario government will magnanimously lower the eligibility age is futile. I have not signed up for a vaccine dose yet, but I intend to do so in a few weeks after the initial rush dies down.
There are also parallels to the situation worldwide. Canadians are grumpy because the USA is vaccinating people faster than we are (and therefore we can't be smug for once) but Canada is a rich country and is buying up a whole lot of vaccine doses worldwide. Should vaccinating all Canadians take precedence over vaccinating those in poorer countries who have worse outbreaks and don't have the wealth to wait out the pandemic the way Canada does? I don't think so, but it looks like that is how vaccinations are playing out. As of this writing, the COVAX initiative to distribute vaccines to lower-income countries is underperforming (although maybe the numbers will be better by the time you read this. Getting poorer countries vaccinated before rich ones is probably more important than dealing with inequities in Ontario, because several countries with huge outbreaks (Brazil, India, the UK) have incubated virulent mutations. It is good that COVAX exists, but it is not good that domestic concerns outweigh international ones.