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Who Should Get the Covid-19 Vaccine Next? A Debate

Bazelon: We need them!

Ezike: Right. I think, though, there’s a possible issue with the long-term-care population. Many of those people may die anyway, for other reasons, but then the conclusion could be, “Grandma got the vaccine and died the next week.” These are elderly people with co-morbidities, and their death will coincide with the period after vaccination, but it will not be caused by the vaccine. I think that will be confusing for many people, however. So having health care workers get vaccinated and survive — that helps people get the confidence to say: “OK, I’m ready now. I’m lining up.” I think there’s going to be this big push at the end when people are like, “So far, so good.”

Gonsalves: If you follow Peter’s age-based utilitarianism, we should give priority to immunizing the people in the Global South. That’s where most of the young people on this planet live.

Singer: I totally agree. Getting vaccines to the Global South should be a very high priority.

Gonsalves: But right now, most of the vaccinations are being sucked up by Europe, Australia, New Zealand, the U.K. and the United States and Canada. The People’s Vaccine Alliance, which includes Amnesty International and Oxfam, just released a report saying that in 70 lower-income countries, only one out of 10 people will get access to the vaccine in 2021. We’re setting up a kind of medical apartheid over the next couple of months, and even couple of years, in which the virus will be under control in the United States and Europe and some other places, but if you’re coming from another country with no proof of immunity and trying to get a student visa to the United States, good luck.

Ezike: Thinking more globally, as I think of Nigeria, my father’s birthplace — access to vaccine, access to testing, all of that is limited there. We’re not seeing a significant number of deaths in Nigeria, and that’s fortunate. But if transmission was rampant, given how much Nigerians travel abroad, it would have serious reverberations beyond the country’s borders.

Bazelon: Rich countries appear to be planning to hoard vaccine. The European Union has ordered enough to immunize its residents twice. Britain and the United States could inoculate everyone four times, if the supplies they have lined up are delivered, and Canada six times, according to a New York Times analysis of data on vaccine contracts. The World Health Organization and others have led an international effort called Covax, which commits a billion doses to less-wealthy countries. But that’s still not enough for anything like equitable distribution.

Gonsalves: Here we go again, right? I mean, I’m an epidemiologist. I’m also an AIDS activist. And in 1996 we had the advent of a highly active antiretroviral therapy, and where did it go? It went to the industrialized North. And within a few years, everybody was clamoring for it all over the planet.

Mukherjee: Companies in India are making hundreds of millions of doses of Covid vaccines. China and Russia have vaccines, too. But we don’t know whether any of these vaccines have been tested with the same rigor as the Pfizer and Moderna vaccines. To me, this is the most unfortunate thing about vaccine testing that’s happened by far. The only data that we have about the Chinese vaccine comes from the United Arab Emirates and Bahrain, and we don’t know the efficacy of it. They say it’s 86 percent; we don’t know real numbers. The Russian vaccine also has very little information released. Then there’s the AstraZeneca vaccine, which has run into data problems.

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