On Friday I stood on a COVID testing line for four hours, a lovely day, chatting with my line mates, their bosses had given them time off; they needed a negative COVID test in order to fly somewhere. The test, the nose swab, took minutes and my phone beeped with the results before I was home. (Negative). I’m staying at home for Thanksgiving.
Two vaccine developers, Pfizer and Moderna announced vaccines with 90 plus percent protection rates; at least five other companies are near competing trials and China and Russia report they’re already distributing vaccines.
The final hurtle is less than a month away, the CDC/FDA will probably approve the vaccines for use around December 10th.
The distribution procedures, called Operation Warp Speed (Read here) created a nationwide network, over 60 regions with distribution networks in each region, from hospitals down to pharmacies.
Warp Speed has been criticized by the scientific community as being too tied to big pharma and not transparent.
It will take months, perhaps many months to ramp up production, in the meantime who gets to stand at the front of the line is still hazy. The nation began preparing for a possible pandemic in 2008 with Obama’s creation of a national vaccine plan (See 2008 plan here). The Trump administration ignored the plan,
There are a number of advisory groups who are recommending priorities: who gets to the front of the line,
…a panel of experts …the priority setting framework for the National Academies of Sciences, Engineering, and Medicine chose … to focus on the factors that create the risk for some people of color — systemic racism that leads to higher levels of poor health and socioeconomic factors such as working in jobs that cannot be done from home or living in crowded settings.
The Advisory Committee on Immunization Practices, (ACIP); part of the CDC, has laid out another strategy for prioritizing distribution of the vaccine
ACIP is considering four groups to possibly recommend for early COVID-19 vaccination if supply is limited:
- Healthcare personnel
- Workers in essential and critical industries
- People at high risk for severe COVID-19 illness due to underlying medical conditions
- People 65 years and older
The opinions in the scientific community vary, competing priorities: preventing deaths among the elderly or slowing the transmission.
Because Covid-19 is especially lethal for those over 65 and those with other health problems such as obesity, diabetes, or asthma, and yet is spread rapidly and widely by healthy young adults who are more likely to recover, mathematicians are faced with two conflicting priorities when modeling for vaccines: Should they prevent deaths or slow transmission?
The consensus among most modelers is that if the main goal is to slash mortality rates, officials must prioritize vaccinating those who are older, and if they want to slow transmission, they must target younger adults.
Vaccination requirements for schools rests with the states, the federal government can recommend, urge, cajole; it’s highly unlikely, it can mandate COVID vaccinations.
All states require the long established vaccinations for students, although the regulations vary and many states allow “religious and/or philosophical exemptions.” See New York State Department of Health vaccination requirements here
In order to attend or remain in school or day care, children who are unvaccinated or overdue must receive at least the first dose of all required vaccines within the first 14 days. They also must plan to receive all follow-up doses at the ages and intervals (time between doses) listed in the recommended vaccination schedule.
Vaccines required for day care, pre-K, and school attendance
- Diphtheria and Tetanus toxoid-containing vaccine and Pertussis vaccine (DTaP or Tdap, Hepatitis B vaccine, Measles, Mumps and Rubella vaccine (MMR), Polio vaccine, Varicella (Chickenpox) vaccine
There is resistance to requiring vaccinations for school age children. The anti-vaccination movement (“antivaxxers”) assaulted the State Education Department a year ago, pushing past guards, racing through the building, unfurling banners, pounding on doors, all in vain, the vaccination regulations are issued by the Department of Heath, not the Board of Regents or the Department of Education.
The general public is not wholly committed to COVID vaccinations.
Some argue that the combination of COVID survivors and the vaccinated will create herd immunity. While experts differ Dr Fauci suggests around 80% of the population must be vaccinated or have anti-bodies for herd immunity to be in effect; however, the percent is disputed (Read discussion here)
A key question: can vaccinations be mandated by states?
In 1905 the Supreme Court said, yes.
… the Supreme Court (Jacobson v Massachusetts) said that states have under their police powers, … under the Constitution, the authority to enact reasonable regulations as necessary to protect public health, public safety, and the common good.
The court said: “The rights of the individual may at times, under the pressure of great dangers, be subjected to such restraint to be enforced by reasonable regulations as the safety of the general public may demand.”
Vaccination mandates constitute exactly that kind of permissible state action to protect the public’s health. …this continues to be the benchmark case on the state’s power to mandate vaccination.
The New York State Bar Association recommended that the state consider requiring vaccinations across the state (See press release here)
Yes, with some exceptions, Dorit Reiss, a law professor from the Hasting School of Law in San Francisco wrote,
“It’s perfectly legitimate for an employer to regulate to make the workplace safer … They can certainly fire you if you don’t want to follow health and safety rules.”
Employees who are part of a union may be exempt from the vaccine requirement.
Anti-discrimination laws also provide some limits. If you can’t get the vaccine for medical reasons, that could be a disability under the Americans with Disabilities Act, which would require an employer to accommodate you. That could mean requiring you to wear a mask on the job or have limited contact with other people,
In my totally unscientific poll: Are you going to get the COIVD vaccination?
- Yes, as soon as possible
- Yes, not right away, my cell upgrades frequently have glitches.
- Probably not until I’m convinced it really works
- No, I don’t trust politicians.
- I’m waiting to see what President Trump says …
I’m on the “yes” side, I trust science.
Listen to Leonard Cohen, “Democracy is coming to the USA”