To think the vaccine shouldn't be given out by age criteria?

[studychick81]

I know the data says that the majority of people who get the virus and are most seriously ill or die are the elderly, over 82. But I was quite surprised by the potential order of giving out the vaccine.

1. people in care homes and care home workers- fair enough.

2. over 80s and health care workers.

3. age order oldest- youngest.

4. I don't agree with this. Surely all health care workers should get it before all people over 80? Shouldn't those 50 plus who have underlining issues which means catching it could be deadly get it over a normally healthy over 80 year old?

5. should kids who live with vulnerable adults/grand parents get it before a fit and healthy 40 year old?

6. should teachers, education workers get it before a fit 40 year old?

@tempnamechange98765

Is it? Higher than in care homes, and hospitals?

Do you have a source for that?

The ONS random sampling survey shows infection rates. You can’t use number of outbreaks or number of confirmed cases as a fair comparison because they are testing in care homes and not schools.

I said higher in the elderly, I don’t think they separate out elderly in care homes versus at home.

[quote WouldBeGood]@noblegiraffe.... the old people die. Get a grip and have some humanity[/quote]
Er, I haven’t the faintest idea what you are on about.

@WorksTheDinerAllDay

28 pages in and people still aren't getting the point of this initial wave of vaccinations.

It's not about saving specific lives etc. It's about preventing the NHS from being overwhelmed so that everyone who needs a bed can get one.

From a statistical point of view, the elderly are the most likely to be hospitalised, over those younger people with heath conditions. So they are vaccinated first to prevent them overwhelming the system.

Care homes need to be able to take residents from hospitals. Their residents are vaccinated because if care homes have outbreaks they cannot take more residents from hospitals, and then hospitals get overwhelmed with bed blocking on a mass scale.

Health staff are vaccinated because if they can't treat anyone, the system gets (drumroll)... overwhelmed and can't treat anyone.

These groups have been selected because it's the most efficient way to ensure that if you happen to be a clinically vulnerable person, or a teacher, or a child, then there will be a bed available for you because the system won't have been overwhelmed by those groups who are statistically more likely to have needed beds.

Once the initial programme is set up, I expect we will see new programmes with more people able to access one, in the same way we have with the flu vaccines. But in the meantime, steps have to be taken to ensure our health system continues to function, and this is the best way.

Indeed. Completely correct but many on here don't realise that it is the elderly that are filling up icu departments not teachers ....

@SheepandCow

Age is what makes people very vulnerable. It's the biggest risk factor.

This!

Jeezo it’s not hard to understand!

Even if individual over 80s “don’t mind if they get it” they will still overwhelm the NHS if too many of them do! Even if they “don’t care if they die” they will still die receiving medical care in hospital!

I’m not trying to kill the elderly, I was just correcting this statement:

the fact that covid is not spreading in schools at the same rate as in care homes!

I haven't read the first 30 pages of the thread, so perhaps someone has already raised this point. Assuming the vaccine is rationed initially until supply meets demand, I actually question if elderly/care home residents should be on the short list at all.

Bearing in mind that life expectancy in the UK is 81, I think from a utilitarian position the vaccines should be prioritized over people who would get more "return" from it. Should we leave younger people vulnerable in order to potentially extend the lives of the very elderly and/or infirm? I'm not sure if we should.

Should we leave younger people vulnerable in order to potentially extend the lives of the very elderly and/or infirm? I'm not sure if we should

Vaccinating less vulnerable people for whom this disease is very rarely fatal ahead of a group with a very high fatality rate would be completely immoral. Not to mention politically suicidal.

But @VinylDetective, perhaps we need to turn that thought process around. Firstly - the fact that a disease is "rarely fatal" in young healthy people does not mean that it cannot have life-long, devastating ramifications. Secondly - should we really be using scarce resources to potentially save the lives of (for example) octogenarians, when there are people with a much better chance of living longer lives, post-vaccine?

@Fungster

I haven't read the first 30 pages of the thread, so perhaps someone has already raised this point. Assuming the vaccine is rationed initially until supply meets demand, I actually question if elderly/care home residents should be on the short list at all.

Bearing in mind that life expectancy in the UK is 81, I think from a utilitarian position the vaccines should be prioritized over people who would get more "return" from it. Should we leave younger people vulnerable in order to potentially extend the lives of the very elderly and/or infirm? I'm not sure if we should.

Fucking hell!

Alternatively, how about we go by moral outlook? We could prioritise nice people over eugenicists?

Wrt age. Personally I value the life of 94 year old Sir David Attenborough over a 30 year old rapist.

@Fungster

I haven't read the first 30 pages of the thread, so perhaps someone has already raised this point. Assuming the vaccine is rationed initially until supply meets demand, I actually question if elderly/care home residents should be on the short list at all.

Bearing in mind that life expectancy in the UK is 81, I think from a utilitarian position the vaccines should be prioritized over people who would get more "return" from it. Should we leave younger people vulnerable in order to potentially extend the lives of the very elderly and/or infirm? I'm not sure if we should.

Leaving the fact that suggesting we just leave people to die is repugnant to once side for a moment...

Giving vaccines on a “returns” basis is a hell of a slippery slope to go down.

If it’s acceptable to leave one group of people to die because they are not worthy enough for the vaccine then how quickly will be acceptable to leave out another group?

What about the CEV group? That contains a lot of people who could die anyway? Plus you’ll have a lot of disabled people in that group who don’t contribute economically so should we leave them out because of their “return value”?

Then what about the unemployed? What’s their return? Or drug addicts? People with long term health conditions that don’t make them vulnerable to this, but might make them expensive long term?

Slippery slope that should never, ever be contemplated.

Indeed. Completely correct but many on here don't realise that it is the elderly that are filling up icu departments not teachers ....

Hospitals, possibly (I don't know the figures) but the average age (median) in ICU is 62, with very few over 80 and large numbers of 50 to 70 year olds. Depends how you define elderly I suppose.

(Half of the people in ICU are under 62 and 70% are under age 70.)
mobile.twitter.com/john_actuary/status/1325499727463510019

@lyrararara

Yes, well said. I think there are a frightening amount of people who would abandon the disabled.

I can see how frustrating and maddening this is for all of you. And, were I there, I would be in favor of the elderly and younger people with physical impairments of various organs having first go at the vaccine. Or, that's my first thought.

However, I am here, and thus far our only plan is, "We will have a vaccine. A very good vaccine. I have a General who is ready to hand it out." And that is very close to a direct quote. Even a plan that needs a lot of tweaking is better than that.

I presume that the vaccine will be given out a bit like the flu vaccine is. So the data in the GP system will determine which group / priority you are in.

The surgery database will identify you by age, by sex, by health condition, etc. It won't identify you by occupation. So its straightforward for you to get an automatic invite to a vaccination clinic if you have COPD, for example. It's not at all straightforward for you to get an invite based on the fact you're a TA or teacher.

Leaving the fact that suggesting we just leave people to die is repugnant to once side for a moment

But is it "leaving people to die", @lyralalala? Is it really any different than choosing to have a DNR for someone who is unlikely to survive a manual resuscitation, for example? Or in an emergency situation, triaging and prioritizing the patients most likely to survive? Deciding what kind of end of life treatment is too much?

If you were on a sinking ship with more people than life vests, who would you prioritize? The 80 year olds, or the teenagers? It's a terrible choice to make, to be sure, but that doesn't mean it shouldn't be considered.

@Fungster

Leaving the fact that suggesting we just leave people to die is repugnant to once side for a moment

But is it "leaving people to die", @lyralalala? Is it really any different than choosing to have a DNR for someone who is unlikely to survive a manual resuscitation, for example? Or in an emergency situation, triaging and prioritizing the patients most likely to survive? Deciding what kind of end of life treatment is too much?

If you were on a sinking ship with more people than life vests, who would you prioritize? The 80 year olds, or the teenagers? It's a terrible choice to make, to be sure, but that doesn't mean it shouldn't be considered.

We’re not on a sinking ship though or in an emergency situation that requires an either or choice.

Choosing to exclude an entire group based on their worthiness is completely different to having a DNR for a specific person. It’s disingenuous to suggest otherwise

And it absolutely is leaving people to die.

Vaccination will not take covid away completely, just as the flu jab doesn’t eradicate flu completely.

It will simply give the most vulnerable people the best chance to survive it, and for others it will allow them to avoid it, or decrease their illness if they catch it (and will protect those we don’t know are vulnerable).

It will still be around, and if we leave the most vulnerable unvaccinated then we’ll be leaving them at the mercy of an outbreak. An outbreak which we know is statistically more likely to kill them than any others.

Actually I agree that the DNR was not a good analogy, @lyralalala. But I disagree that this is not an emergent situation.

For context, I am in the US. Infection rates are skyrocketing and are worse now than they were in the late spring. Hospitals here are almost full and patients from neighboring states are being brought here because their states' hospitals are full. (Which I'm sure has nothing to do with the lack of mask mandates 🙄) Please God you don't have a heart attack or stroke anytime soon, because there's a shortage of "space, staff and/or stuff" to treat you.

My three children have not been in school since March and we've been told (off the record) that they will probably not return to in-person learning until the academic year 21-22. That's 18 months of isolation from classmates. Of having to work full-time and also "supervise" three kids' schooling. My doctor friends are close to collapse and substantially all the parents I know are clinging on by their fingertips, figuratively speaking.

This pandemic is the greatest crisis of a generation and despite the (data free, non-peer reviewed) announcement from Pfizer, there is nothing to suggest that the vaccine can be manufactured, stored (ultra frozen) and distributed at anything near the rate it is needed.

It is absolutely an emergency and as terrible as it is, tough decisions may need to be made about who gets the vaccine.

I didn’t say it wasn’t an emergency. I said it wasn’t an emergency situation that requires an either or response. Totally different things

And bad management of the pandemic by your government (and other governments) should not be mandate to effectively leave a group to die from the virus.

Like I said, where does that end? The elderly? The disabled, the unwell, the unworthy...

Any discussion for governments should be about in which order the vaccine is given. Not which groups are worthy of it

Any discussion for governments should be about in which order the vaccine is given. Not which groups are worthy of it

In times of scarcity it's the same thing.

My guess is that the vaccination priority list - at this stage - is just speculation.

When a vaccine comes up for evaluation, and before the approval for public use is granted, the experts will be looking at the efficacy and safety data collected during the phase 3 trials. The approval will also state who should receive the vaccine and who should not (e.g. contra-indications) and what dosage should be applied.

For example, we've been told that the vaccine will not be given to children, because it hasn't been tested on children during the Phase 3 trials. But has the vaccine really been tested on octogenarians? Maybe a few, but almost certainly not in large numbers - large enough to be able to give precise efficacy and safety data.

So why would the oldest people be amongst the first on the vaccination list? I'd guess it could be justified as follows:-

1. long term side effects of these very new types of vaccines (RNA never used before for any vaccine, ever) are completely unknown. Older people probably won't live long enough for the long term side effects to exhibit, whereas if one vaccinates a child, there's a whole lifetime ahead of that child for any unknown side effects to show.

2. The older a person is, the higher the chance of COVID-19 causing a serious illness, perhaps death. It's a case of balancing the odds - how well can a very old person tollerate the side effects of the vaccine (short term known side effects, medium and long term effects unknown) versus the probability of catching COVID-19 and suffering serious illness. I guess that in care homes, the risk of catching COVID-19 is so high that it trumps any risks of adverse side effects.

Has the vaccine been trialled on people with complications, like imuno-suppressed patients, diabetics, people with heart conditions? I guess not, because the BBC list doesn't say that people with high risk existing conditions, who most need the protection of the vaccine, will be prioritised for vaccination.

I'm not an expert on this topic, but it seems to me that the prioritisation list for vaccine will depend on several factors:-

on which groups has the vaccine been trialled enough to know the short term side effects with confidence? (that's probably the young, strong and healthy people)
in which groups of people is the risk of long term unknown side effects minimised? (that would be the very elderly people)
which groups of people are most likely to produce strong antibodies / immunity for the longest period of time? (not known)
which groups of people need the vaccine most (those who can't escape the environments where there's likely to be a high viral load - i.e. health workers, people in indoor institutions 24/7 like care homes, prisons, transport workers on buses and trains)

I found it very odd that no one knows whether a person who has been vaccinated can still be infectious to others or not. I thought that the vaccine was the way towards reaching herd immunity, but is it? The idea behind herd immunity is that if you can't catch it, you can't pass it on to others.

I just can't get my head round the concept that you can still infect others even if you can't catch the illness because you've been successfully vaccinated!!! A vaccine is not medication:- the vaccine is preventative - it stops you from becoming infected with the virus (so you can't infect anyone else because you're not infected yourself), while medication is used to treat your illness once you've caught the virus (and then you definitely are infectious). Someone needs to explain this to us.

@Fungster - you're making a big assumption, that the vaccine is like a life vest. You wrote:-
If you were on a sinking ship with more people than life vests, who would you prioritize? The 80 year olds, or the teenagers? It's a terrible choice to make, to be sure, but that doesn't mean it shouldn't be considered.

The reality is that the vaccine hasn't had more than a couple of months worth of Phase 3 trials. Medium term and long term side effects are completely unknown. There might not be any, but we won't know for several years.

Young people have their whole lifetimes before them - plenty of time for any long term side effects to show themselves. Someone in their 80's might not have enough of their natural lifespan left for the long term side effects to become obvious. The impact of the unknown risk is therefore far greater the younger you are.

Titanic myth got it right - "women and children first". That makes sense, because women and children are the next generation. Women are limited in how many children they can have, therefore you need a large number of women to survive. Men can father a very large number of children, so you only need to save a few. That's the theory behind the "women and children first" adage, but only if you are sure that the life vest will save their life. If the life vests have an unknown flaw, the result could be that you sink the next generation. So you have to be very careful...

@Fungster

Any discussion for governments should be about in which order the vaccine is given. Not which groups are worthy of it

In times of scarcity it's the same thing.

It’s not. And there’s no need for long-term scarcity when any successful vaccine (should there only ever be one found, which is unlikely) could be made (and funded) worldwide.

So, which other groups are you willing to sacrifice or is it just the elderly? Because you know that once you start with a scale of worthiness it will continue