Tag Archives: Vaccine Passports

In Praise of Voluntary Vaccination

31 Tuesday Aug 2021

Posted by in Coronavirus, Vaccinations

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I was vaccinated in March and early April and I’m damn glad to have done it. I have certain co-morbidities, and I’m of an age at which contracting COVID seems like a very bad idea, I felt a little run-down on the day after my second jab, but that was my only side effect, notwithstanding the unending litany of antivax hysterics to which we’ve all been subjected (even on certain sites to which I contribute).

Freedom Without Misinformation

In the context of the pandemic, it’s important to take a stand for liberty. In that spirit, I oppose the imposition of mandates requiring face masks and vaccinations against COVID. Furthermore, vaccination is at best unnecessary for those having acquired immunity from infection and for those at low risk, especially children. In fact, the younger, healthier, and fitter you are, the less important it is to be vaccinated.

It’s disappointing, however, to see completely innumerate people cite statistics purporting to show that COVID-19 vaccines are deadly or even particularly dangerous to those lacking contra-indications. Far worse, and far more idiotic, is to suggest that a conspiracy is afoot to kill large numbers of people via vaccination! I’m truly embarrassed to hear individuals who otherwise share my libertarian ideals say such irresponsible bullshit.

While the COVID vaccines seem to have more frequent side effects than earlier vaccines, they are not particularly risky. I’ll discuss the safety of the COVID vaccines in what follows. Even minuscule risks are unacceptable to some individuals, which of course is their right. However, others find these risks acceptable considering the far greater dangers posed by the early strains of COVID and even the more recent but less deadly Delta variant.

Unverified Adverse Events

The vaccine scaremongers often quote statistics from the CDC’s Vaccine Adverse Reporting Events System (VAERS). Here’s a disclaimer about the system from the CDC’s web site:

“Healthcare providers, vaccine manufacturers, and the public can submit reports to VAERS. While very important in monitoring vaccine safety, VAERS reports alone cannot be used to determine if a vaccine caused or contributed to an adverse event or illness. The reports may contain information that is incomplete, inaccurate, coincidental, or unverifiable.”

All kinds of reports are submitted alleging adverse events. For example, one observer cites the following reports from the system:

The link above refers to the following report as “Hulk Syndrome”, which was alleged to have been a side effect of the MMR vaccine:

Finally, we have this report related to the Pfizer COVID vaccine:

In case that’s hard to read, it claims that a COVID vaccine caused a third arm to grow from the reporting individual’s forehead, which constantly slaps him or her while trying to sleep. This report is a case of wonderful sarcasm, but it was submitted to VAERS! The real lesson is that the VAERS system collects many unverified accounts of side effects, so the aggregate counts of adverse events are not reliable, even by the CDC’s admission.

A More Sober Risk Assessment

Therefore, the VAERS system has obvious limitations. But even stipulating the use of VAERS reports, the risks of the COVID vaccines are vanishingly low. For example, roughly 198 million people in the U.S. have received at least one dose of a vaccine. As of last week, there had been about 13,600 reports of post-vaccination death in VAERS. The raw number is very high, and I don’t wish to minimize the seriousness of those losses. Nevertheless, if those deaths were all attributable to vaccination, and that is a BIG “if”, the risk of death from vaccination to-date is just 0.007%. That is seven thousandth of 1%. 

To put those VAERS deaths into perspective, I should first add the caveat that I am highly skeptical of the COVID case and death statistics. Nevertheless, let’s take the official U.S. COVID death toll of 646,000 at face value. I’m also treating reported vaccine deaths from VAERS at face value, which is a huge stretch. So, we have COVID mortality of 0.2% of the U.S. population, which is more than 28 times the risk of death from vaccination. I grant you the risk posed by COVID is lower going forward than in the past, which is due both to vaccinations and the declining virulence of the virus itself.

There are a range of vaccine side effects reported in VAERS, from pain near the injection site to such alarming conditions as anaphylaxis, Bell’s Palsy, and myocarditis/pericarditis. VAERS would attribute over 54,000 hospitalizations to the vaccines, a rate of 3 hundredths of one percent of those receiving at least one dose. Like COVID deaths, the number of COVID hospitalizations is likely inflated. Still, at 1.9% of the U.S. population, the risk of hospitalization from COVID is 68 times that of hospitalization from vaccine side effects reported in VAERS.

A large share of VAERS reports, covering all adverse events, are from middle aged individuals. It’s unclear how concentrated that reporting is among those with co-morbidities, including obesity, but I suspect they are heavily represented.

Coincidental Events

Perhaps less obvious is that many sincere reports to VAERS from both the public and health care providers represent coincidental events. A number of states have given heavy vaccine priority to the elderly and those with co-morbidities, and demand from those groups has been disproportionate in any case. Most of the VAERS-reported deaths also happen to be among the elderly and co-morbids.

For example, more than 38% of VAERS death reports come from the 80+ age cohort, accounting for roughly 5,200 deaths. That’s four hundredths of one percent of the 12.9 million people of ages 80+ in the U.S., most of whom have been vaccinated. Well over 1.2 million 80+ year-olds can be expected to die each year under normal circumstances. That a few would occur within days, weeks, or months of a vaccination should be expected. Furthermore, it would not be surprising, given the controversy surrounding vaccines and the suggestive power of antivax propaganda, for families or some caregivers to imagine a connection between vaccination and subsequent death. File a report! Who knows? Perhaps a class action award might be in it someday.

This is not to deny that a small number of individuals could be in such weakened states, or perhaps have unknown vulnerabilities, that the vaccines have catastrophic consequences. No doubt there are a few deaths precipitated by COVID vaccines in combination with other conditions. However, a large share of the deaths reported to VAERS are likely to have been coincidental. Likewise, people develop conditions all the time… sore joints, rashes, coughs, and headaches. It runs the gamut. Some of the VAERS reports of a less serious nature are undoubtedly coincidental, and perhaps some are due to the vivid imaginations of a subset of those having consented to the vaccine with great reluctance.

What Kills and What Doesn’t

Everything comes with a risk, and tradeoffs between risks must be balanced. The COVID pandemic was deadly, and I’ll be the first to admit that I underestimated its potential to kill. However, its deadliness was magnified by the non-pharmaceutical interventions imposed in many jurisdictions. Lockdowns and closures took a massive toll on the health of the population, cutting short many lives due to economic and personal despair as well as deferred and cancelled health care. While those interventions were deadly, I do not believe that kind of harm was intended. I do suspect the concomitant assault on liberty was welcomed in certain circles.

There are certainly downsides to the COVID vaccines. There have been more side effects and deaths than have ever been reported relative to earlier vaccines. It’s also a shame that public health authorities refuse to recognize the superior effects of natural immunity and the heightened risk of vaccinations to those with prior infections. And it’s a travesty that “vaccine passports” are now being demanded for various forms of travel, entertainment, and entry to some places of business. Despite these issues, it’s blatantly false to assert that the vaccines are generally harmful. Many more of the remaining vaccine-hesitant can benefit from vaccination. Let’s advocate for better assessments of risk by age and co-morbidity, and simply avoid the vaccines if that is your preference.

Addendum: I just came across this nice piece entitled “A Statistical Analysis of COVID-19 Breakthrough Infections and Deaths“. I thought I should share the link in case anyone supposes that so-called breakthrough infections somehow invalidate some of the comparisons I made above. This chart is particularly revealing:

Give Back My Stolen Face

24 Saturday Apr 2021

Posted by in Coronavirus, Grateful Dead, Social Control

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She looks good in a mask, and I grant you: masquerades often convey exciting undertones of sexual adventurism. But masquerades and masks should be novelties, not a constant way of life dictated by over-precautious public health authorities.

That brings me to the subject of an outdoor concert I’m attending with some friends on May 8th. It’s to be held at a grassy amphitheater along the Mississippi River in south St. Louis County. Unfortunately, the county health department imposes idiotic rules at this and other outdoor facilities. In the document at the link, it’s clear the rules were given some spin by the band who will perform that night, Jake’s Leg, a very good Grateful Dead cover band. And I get it: these guys just want to play music and perform for their fans, who will be happy to soak in the sounds, party, and dance the night away. Still, some of the rules are absurd and fly in the face of “the science”.

There is a certain libertarian streak among Grateful Deadheads, though in terms of realpolitik, probably the majority is of a more collectivist persuasion (not me). Some in the crowd will welcome the rules and might even go so far as to rat-out anyone whose behavior they find “unsafe”. Others will just go along with the rules as they interpret them. Some like me might push the envelope. But as the evening wears on… what a nice expression, … “as the evening wore on…”, it will be interesting to see whether forces tear loose from the prescriptive axis.

I’ve excerpted some of the rules below and added brief commentary. They appear in the order listed in the document, though it might seem a bit jumbled. I’m sorry to have left out most of the friendly color added by the band:

“Bring a cloth or paper face covering. You will not be allowed entry if you do not have one. Gaiters, bandanas and full-face shields are not acceptable as primary or only face covering. Face coverings must completely cover the nose and mouth. Children under 2 years old are not required to wear a face covering.”

The chances of contracting COVID outdoors are virtually nil, and don’t tell me we’re just learning these details … we’ve known that since almost the beginning of the pandemic. Second, in any case, cloth and paper masks are ineffective at stopping the aerosols responsible for most viral transmission. That’s been known for many years. Our public health experts are only now starting to admit these facts. Allowing toddlers to go maskless is the only concession, and it’s true that transmission by children is unlikely and COVID severity in children is very low. But that goes for older children as well, not just toddlers. Asymptomatic spread is similarly rare, so if you feel good enough to go (and they’ll check your temperature at the gate), you are unlikely to present a risk to anyone.

“Please bring small personal coolers only (no coolers w/ wheels) for your favorite beverages (cans and non- breakables please), along with snacks and food, chairs, blankets and personal use items for you and your small group.”

So, maybe not so bad… it’s about like the usual charade at restaurants: we must enter wearing masks, but then we can rip them off as soon as we find a spot to enjoy the music, our snacks, beverages and those all-important personal use items. Hmm, I guess the unsanitary passing of spleefs ist verboten. A hookah with several hoses could accommodate a small group, but that never goes over with an event staff! Edibles are fine!

“Have your ticket ready to be scanned … and always maintain at least 6 feet social distancing while you’re in line. Markers will be placed as a reminder for you.”

Even indoors, three feet of distancing has been acknowledged as adequate by the undeservedly celebrated Dr. Anthony Fauci.

“Please spread out and maintain at least six feet social distancing from other attendees outside of your small group. There is plenty of room to move and dance.”

More of the same hogwash. Note that the requirements offer no definition of “small group”. To appreciate the absurdity and unnecessary ass-covering inherent in all this, let me point out that my “small group” will consist of six or seven friends who haven’t met as a group in more than a year, We are almost sure to mix with other friends whom we’ll see at the show. So group members will migrate between groups, or small groups might merge into somewhat larger “small groups”. This will be happening all over, and it’s a pretty sure bet there will be lapses in mask compliance. If you happen to be spinning or dancing, the last thing you should do is wear a mask. You need oxygen, and you should avoid trapping hot breath and spittle right up against your face (see the latter part of this article).

“Once you’ve found a place to watch the show, please stay with your group at your area. If you must leave your space, you must wear a face covering at all times whenever you are not able to maintain at least 6 foot social distancing.”

Uh-huh… “Distancing” is not always clear-cut behavior. You pass people coming and going and dancing around. Are you “distancing” on average? Will you be ejected if you briefly come within a few feet of another concert-goer, sans mask? These are matters of uncertain degree, and it’s generally why police don’t enforce mask mandates in pedestrian areas, aside from a few draconian “mask traps” outside stores. Outdoors, it’s absurd.

“Please wash/sanitize your hands before and after using all restroom facilities. Always be kind, think of others and practice social distancing when waiting.”

Post-toilet hand washing is always a good practice, of course, but these guys are nuts! When I arrive at the restroom, I’m generally not worried about the remote chance that my hands will pass the virus to my genitals or vice-versa, and we know that the virus isn’t transmitted from surfaces. It’s also regrettable that masks and distancing will limit those sometimes entertaining conversations in bathroom lines.

“All attendees must adhere to these guidelines regardless of vaccination status.”

This also is sheer stupidity, and I’m complaining only because it reflects the “Zero COVID” mentality of the public health authorities holding us hostage. I guess I’d rather not bring my vaccination card along in any case, and at least they aren’t requiring “vaccine passports” for entry to the venue. But just in case I’m misunderstood, the chance that a fully vaccinated individual will catch or transmit the virus is very low and not even worthy of concern in any rational balancing of risk and benefit.

“Disclaimer: All venue initiatives to prevent the spread of COVID-19 are strictly followed and enforced. Those on premises are subject to compliance with all venue safety procedures and protocols. Non-compliance will result in refused entry or ejection from venue without refund. Upon purchasing tickets for the event, you acknowledge and agree to adhere to all venue policies.”

Again, as a practical matter, some of the rules listed above are virtually unenforceable, but we’ll see how the evening unfolds with a crowd of free-wheeling Deadheads. It could be all strangers stopping strangers, just to bump their elbows. Either way, if past is prelude, the amphitheater will be something of a heart-of-gold land.

Bottom-Line Booster Shots

17 Saturday Apr 2021

Posted by in Coronavirus, Public Health, Vaccinations

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The barrage of precautionary COVID missives continues, and with a familiar “follow-the-money” twist. The CEOs of both Pfizer and Moderna say that booster shots are likely to be needed a year after initial administration of their COVID vaccines, and almost certainly every year thereafter. Of course, this message is for those who felt compelled to be vaccinated in the first place, whether out of concern for their own health, high-minded community spirit, fear of social ostracism, or fear of possible vaccine passport requirements. It’s probably also intended for those who acquired immunity through infection.

There are reasons to believe, however, that such a booster is unnecessary. This case was made a few days ago in a series of tweets by Dr. Monica Ghandi, an infectious disease expert and Professor of Medicine at UCSF. Ghandi says immunity from an infection or a vaccine can be expected to last much longer than a year, despite the diminished presence of antibodies. That’s because the immune system relies on other mechanisms to signal and produce new antibodies against specific pathogens when called upon.

So-called B cells actually produce antibodies. Another cell-type known as T cells act to signal or instruct B cells to do so, but so-called “killer” T cells destroy cells in the body that have already been infected. Dr. Ghandi’s point is that both B and T cells tend to have very long memories and are capable of conferring immunity for many years.

While our experience with COVID-19 is short, long-lasting immunity has been proven against measles for up to 34 years, and for other SARS-type viruses for at least 17 years. Dr. Ghandi links to research showing that survivors of the 1918 flu pandemic were found to have active B cells against the virus 90 years later! The COVID vaccines cause the body to produce both B and T cells, and the T cells are protective against COVID variants.

A last point made by Dr. Ghandi is intended to dispel doubts some might harbor due to the relatively ineffectual nature of annual flu vaccines. The flu mutates much more aggressively than COVID, so the design of each year’s flu vaccine involves a limited and uncertain choice among recent strains. COVID mutates, but in a more stable way, so that vaccines and adaptive immunity tend to retain their effectiveness.

While I’m sure the pharmaceutical companies believe in the benefits of their vaccines, there are undoubtedly other motives behind the push for boosters. There is money to be made, and much of that money will be paid by governments eager to jump on the precautionary bandwagon, and who are likely to be very insensitive to price. In fact, the vaccine producers might well have encouraged those pushing vaccine passports to include annual booster requirements. This would be another unwelcome imposition. The very discussion of boosters gives government officials more running room for other draconian but ultimately ineffective mandates on behavior. And the booster recommendation gives additional cover to public health “experts” who refuse to acknowledge real tradeoffs between the stringency of non-pharmaceutical interventions, economic well being, and other dimensions of public health.

Ballot “Access” Or Fraud, Vote “Suppression” Or Security

15 Monday Mar 2021

Posted by in Election Fraud, Voting Rights

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Do a search of “suppression” on Twitter and you’ll be treated to an uninterrupted stream of lefty hallucinations and shrieks about GOP efforts to bring back Jim Crow, subvert democracy, and deny people their right to vote. Every state-level initiative to shore up election integrity is labeled suppression. Well, what we should suppress is the country’s headlong plunge into ballot debasement and jobbery. Election fraud is not new, as the Supreme Court noted in 2008. Ballot harvesting is not new. And we knew well ahead of the 2020 presidential election that the usual safeguards against election fraud were being severely compromised. These changes leveraged vulnerabilities that were of concern to the Left in the not too distant past. Now, any mention provokes indignance!

You Gotta Get Up To Participate

Voting is usually a hassle, but the right to vote does not mean voting must be made effortless; it does not relieve the right-holder of obligations to exert what effort might be necessary, including minor inconveniences to verify that their vote is legitimate. COVID-19 gave momentum to those seeking to eliminate certain obligations associated with voting. After all, exposure to a deadly virus at a polling place would have represented more than a minor inconvenience. In response, 28 state governments instituted changes to expand mail-in voting in 2020 in addition to compromises such as allowing late ballots to count, and the changes were often made without legislative authority.

Predictably, these changes enabled widespread fraud, Even now, after many lawsuits over 2020 election fraud were dismissed on procedural grounds, there remain a large number of election fraud cases in the courts. A substantial share of the voting public believes that fraud occurred on a massive scale. The perceived illegitimacy of the 2020 election represents a real threat to the stability of our Republic.

For the People?

It’s unfortunate that relieving the minor inconveniences imposed on voters creates major opportunities for fraud, but it appears to be in the interest of some factions to loosen those screws. Thus, we have a piece of federal legislation called the “For the People Act”, or H.R. 1 (the omnibus election transformation bill), which has passed the House on a strictly partisan vote and is now in the Senate. The bill would completely usurp the primary (though not exclusive) power of states to regulate elections under the Elections Clause of Article I of the Constitution. The breadth and reach of H.R. 1 would be deemed unconstitutional under any sane interpretation. Here is Hans von Spakovsky:

“H.R. 1 would mandate same-day and automatic voter registration, and encourage vote trafficking of absentee ballots. It would eviscerate state voter ID laws and limit the ability of states to verify the accuracy of their voter registration lists.”

And there is much more in the bill that would undermine the integrity of elections, including registration of the many disenfranchised 16- and 17-year-olds who have long been denied votes. A somewhat more detailed summary of H.R. 1 is provided by Conrad Black. It would:

“…compel states to accept mailed-in votes for 15 days prior to and 10 days after Election Day; set up automatic and online voter registration; prohibit review of the eligibility of voters; compel acceptance of ballots cast in the wrong precincts; bar the removal of the ineligible voters from the rolls; permit ballot harvesting; ban any voter identification laws; consign to unelected officials the redrawing of congressional districts; infringe upon free speech by the imposition of ‘onerous legal and administrative burdens on candidates, civic groups, unions, and non-profit organizations’; and establish a disturbingly named ‘Commission to Protect Democratic Institutions’ in order to end-run the courts.”

IDs Required When It Suits Them

We are told that the disenfranchised can’t be expected to produce identification. Is that so? But identification is required in most jurisdictions in order to receive a COVID vaccination, and there are discussions of how we’ll need to produce cards or “vaccine passports” to participate in a wide variety of activities. But an ID for voting is “suppression”?

Lacking identification, how are individuals expected to become “enfranchised” as a functioning members of society? Yes, if they are citizens then they have a right to vote. But one person, one vote requires some means of verified identity. If they know so much as to vote their pocketbooks, yet will not fulfill a simple obligation to produce identification in order to exercise that right, should they be accommodated?

Of course, there are individuals who need a “helping hand” in order to obtain proper identification, but short of inserting subcutaneous microchips, those individuals must be entrusted to keep it in their possession. That certainly doesn’t provide an excuse to cast aside rules intended to safeguard election integrity.

Is it unfair to expect everyone to vote on Election Day? There must be exceptions for those away from home or unable to appear at a polling place for health reasons. Absentee ballots have long been a feature of our voting system, but they must be mailed on time to prevent the gaming we witnessed in 2020. Having the resources to process all voters in one day might be challenging, so perhaps it’s not unreasonable to allow in-person voting over several days. I would also support a holiday for national elections.

Federalism Vs. Centralized Power

Again, it’s no secret that loosely controlled mail-in ballots are ripe for fraud. A drastic expansion of vote-by-mail facilitates efforts to harvest ballots and even manufacture votes. In 2020, deadlines for ballot delivery were extended indiscriminately. Signature verification was sidestepped. Ballots were shredded. Documented chains of custody were often lacking. Despite all that, even now there are many bills in state legislatures that would expand “voter access” in various ways. These are usually steps that would expose the public to more fraudulent elections and devaluation of legitimate votes.

But there is pushback: as of late February, there were 165 bills in 33 states designed to tighten election security, according to the Brennan Center for Justice:

“These proposals primarily seek to: (1) limit mail voting access; (2) impose stricter voter ID requirements; (3) slash voter registration opportunities; and (4) enable more aggressive voter roll purges. These bills are an unmistakable response to the unfounded and dangerous lies about fraud that followed the 2020 election.”

Conservative states can also resist federal efforts to control elections via nullification: arguably unconstitutional attempts by the federal government to regulate elections should not be recognized and enforced by states. Steve Baldwin asserts that the Tenth Amendment gives states the power to do so:

“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

There is, however, some ambiguity in Article I regarding the federal government‘s power to regulate elections. Despite the “secondary” nature of that federal power, it has certainly been invoked over the last 150 years, primarily in establishing voting rights previously denied on the basis of race and gender. H.R. 1 does not represent an unambiguous defense of voting rights of that kind, however. Instead, by facilitating fraud, it represents wholesale debasement of voting rights.

Let’s hope traditionally conservative states are aggressive in pressing their primary power to regulate elections on multiple fronts: legislative, nullification of federal overreach, as well as court challenges. And let’s hope H.R. 1 goes down to defeat in the Senate, but it will be tight.

Allocating Vaccine Supplies: Lives or “Justice”?

29 Tuesday Dec 2020

Posted by in Pandemic, Public Health, Uncategorized, Vaccinations

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There are currently two vaccines in limited distribution across the U.S. from Pfizer and Moderna, but the number and variety of different vaccines will grow as we move through the winter. For now, the vaccine is in short supply, but that’s even more a matter of administering doses in a timely way as it is the quantity on hand. There are competing theories about how best to allocate the available doses, which is the subject of this post. I won’t debate the merits of refusing to take a vaccine except to say that I support anyone’s right to refuse it without coercion by public authorities. I also note that certain forms of discrimination on that basis are not necessarily unreasonable.

The vaccines in play all seem to be highly effective (> 90%, which is incredible by existing standards). There have been a few reports of side effects — certainly not in large numbers — but it remains to be seen whether the vaccines will have any long-term side effects. I’m optimistic, but I won’t dismiss the possibility.

Despite competing doctrines about how the available supplies of vaccine should be allocated, there is widespread acceptance that health care workers should go first. I have some reservations about this because, like Emma Woodhouse, I believe staff and residents at long-term care facilities should have at least equal priority. Yet they do not in the City of Chicago and probably in other areas. I have to wonder whether unionized health care workers there are the beneficiaries of political favoritism.

Beyond that question, we have the following competing priorities: 1) the vulnerable in care homes and other elderly individuals (75+, while younger individuals with co-morbidities come later); 2) “essential” workers of all ages (from police to grocery store clerks — decidedly arbitrary); and 3) basically the same as #2 with priority given to groups who have suffered historical inequities.

#1 is clearly the way to save the most lives, at least in the short-run. Over 40% of the deaths in the U.S. have been in elder-care settings, and COVID infection fatality rates mount exponentially with age:

To derive the implications of #1 and #2, it’s more convenient to look at the share of deaths within each age cohort, since it incorporates the differences in infection rates and fatality rates across age groups (the number of “other” deaths is much larger than COVID deaths, of course, despite similar death shares):

The 75+ age group has accounted for about 58% of all COVID deaths in the U.S., and ages 25 – 64 accounted for about 20% (an approximate age range for essential workers). This implies that nearly three times as many lives can be saved by prioritizing the elderly, at least if deaths among so-called essential workers mimic deaths in the 25 – 64 age cohorts. However, the gap would be smaller and perhaps reversed in terms of life-years saved.

Furthermore, this is a short-run calculation. Over a longer time frame, if essential workers are responsible for more transmission across all ages than the elderly, then it might throw the advantage to prioritizing essential workers over the elderly, but it would take a number of transmission cycles for the differential to play out. Yes, essential workers are more likely to be “super-spreaders” than work-at-home, corporate employees, or even the unemployed, but identifying true super-spreaders would require considerable luck. Moreover, care homes generally house a substantial number of elderly individuals and staff in a confined environment, where spread is likely to be rampant. So the transmission argument for #2 over #1 is questionable.

The over-riding problem is that of available supply. Suppose enough vaccine is available for all elderly individuals within a particular time frame. That’s about 6.6% of the total U.S. population. The same supply would cover only about 13% of the younger age group identified above. Essential workers are a subset of that group, but the same supply would fall far short of vaccinating all of them; lives saved under #2 would then fall far short of the lives saved under #1. Quantities of the vaccine are likely to increase over the course of a few months, but limited supplies at the outset force us to focus the allocation decision on the short-term, making #1 the clear winner.

Now let’s talk about #3, minority populations, historical inequities, and the logic of allocating vaccine on that basis. Minority populations have suffered disproportionately from COVID, so this is really a matter of objective risk, not historical inequities… unless the idea is to treat vaccine allocations as a form of reparation. Don’t laugh — that might not be far from the intent, and it won’t count as a credit toward the next demand for “justice”.

For the sake of argument, let’s assume that minorities have 3x the fatality rate of whites from COVID (a little high). Roughly 40% of the U.S. population is non-white or Hispanic. That’s more than six times the size of the full 75+ population. If all of the available doses were delivered to essential workers in that group, it would cover less than half of them and save perhaps 30% of minority COVID deaths over a few months. In contrast, minorities might account for up to two-thirds of the deaths among the elderly. Therefore, vaccinating all of the elderly would save 58% of elderly COVID deaths and about 39% of minority deaths overall!

The COVID mortality risk to the average white individual in the elderly population is far greater than that faced by the average minority individual in the working age population. Therefore, no part of #3 is sensible from a purely mathematical perspective. Race/ethnicity overlaps significantly with various co-morbidities and the number of co-morbidities with which individuals are afflicted. Further analysis might reveal whether there is more to be gained by prioritizing by co-morbidities rather than race/ethnicity.

Megan McArdle has an interesting column on the CDC’s vaccination guidelines issued in November, which emphasized equity, like #3 above. But the CDC walked back that decision in December. The initial November decision was merely the latest of the the agency’s fumbles on COVID policy. In her column, McArdle notes that the public has understood that the priority was to save lives since the very start of the pandemic. Ideally, if objective measures show that identifiable characteristics are associated with greater vulnerability, then those should be considered in prioritizing individuals who desire vaccinations. This includes age, co-morbidities, race/ethnicity, and elements of occupational risk. But lesser associations with risk should not take precedence over greater associations with risk unless an advantage can be demonstrated in terms of lives saved, historical inequities or otherwise.

The priorities for the early rounds of vaccinations may differ by state or jurisdiction, but they are all heavily influenced by the CDC’s guidelines. Some states pay lip service to equity considerations (if they simply said race/ethnicity, they’d be forced to operationalize it), while others might actually prioritize doses by race/ethnicity to some degree. Once the initial phase of vaccinations is complete, there are likely to be more granular prioritizations based on different co-morbidities, for example, as well as race/ethnicity. Thankfully, the most severe risk gradient, advanced age, will have been addressed by then.

One last point: the Pfizer and Moderna vaccines both require two doses. Alex Tabarrok points out that first doses appear to be highly effective on their own. In his opinion, while supplies are short, the second dose should be delayed until all groups at substantially elevated risk can be vaccinated…. doubling the supply of initial doses! The idea has merit, but it is unlikely to receive much consideration in the U.S. except to the extent that supply chain problems make it unavoidable, and they might.