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NNadir

(33,517 posts)
Fri Aug 13, 2021, 09:28 AM Aug 2021

COVID boosters for wealthy nations spark outrage

The news item I'll discuss in this post comes from the prominent scientific journal Nature. It's here: COVID boosters for wealthy nations spark outrage: COVID boosters for wealthy nations spark outrage. It's probably open source, no subscription required.

It is important to note that like Climate Change, another international disaster that has become highly politicized, Covid involves all humanity. In my view, it is our responsibility in the first world to attend to the third world. We can do this because we are good and noble people, or we can do this for selfish self-interest; it doesn't matter.

The Delta variant, for which the mRNA vaccines are highly effective at saving lives, arose in India, probably among the poor but certainly among the unvaccinated.

Some text from the news item:

Israel has announced plans to begin giving booster shots to older adults next week, in the hope of increasing their protection against COVID-19 — and a number of other wealthy countries are considering the same. But global-health researchers warn that this strategy could set back efforts to end the pandemic. Each booster, they say, represents a vaccine dose that could instead go to low- and middle-income countries, where most citizens have no protection at all, and where dangerous coronavirus variants could emerge as cases surge.

Data do not yet show that extra doses are needed to save lives, researchers say, except perhaps for people with compromised immune systems, who might fail to generate much of an antibody response to the initial COVID-19 shots.


COVID vaccines to reach poorest countries in 2023 — despite recent pledges

An internal analysis from the World Health Organization (WHO) estimates that if the 11 rich countries that are either rolling out boosters or considering it this year were to give the shots to everyone over 50 years old, they would use up roughly 440 million doses of the global supply. If all high-income and upper-middle-income nations were to do the same, the estimate doubles.

The WHO maintains that these shots would be more useful for curbing the pandemic if they were sent to low- and lower-middle-income countries, where more than 85% of people — some 3.5 billion — haven’t had a single jab. “The priority now must be to vaccinate those who have received no doses,” said WHO director-general Tedros Adhanom Ghebreyesus at a briefing on 12 July.

All of the COVID-19 vaccines authorized by most high-income countries reduce a person’s risk of hospitalization and death by more than 90%. Scientists don’t yet know how much more a booster — typically an extra jab of an mRNA-based vaccine on top of the standard doses — would protect the average person, although data are beginning to trickle in. The effects of not receiving any vaccine are more certain. On the African continent, where only 2% of people have been vaccinated, COVID-19 rates are escalating, with fatality rates higher than the global average...

...What’s more, evolutionary biologists say that countries with low vaccination coverage are ripe for the emergence of further dangerous variants of the coronavirus SARS-CoV-2. “Right now, our destiny relies on distributing vaccines so that continued transmission doesn’t occur,” says Nahid Bhadelia, director of the Center for Emerging Infectious Diseases Policy and Research at Boston University in Massachusetts. “We don’t want to be chasing our tail in terms of new variants.”

Contemplating boosters

Israel is not alone in considering boosters for older people. Spurred partly by data1 suggesting that antibody levels wane over time, the United Kingdom has drawn up plans — but not given final approval — for a booster programme to begin in September for older people, front-line health workers and others at high risk of COVID-19...


A graphic from the article:



There are people selling, in my view, panic.

On this website, I have twice encountered the name of Dr. Eric Topol, who seems to be selling panic for the reward of some kind of fame.

Not all scientists are immune from human frailty, including the spread of hype and outright misinformation.

While I am not claiming to be a Covid expert myself - surely I am not - as a scientist involved in the treatment of human disease, I have been closely monitoring the scientific literature. It may be true that at some point, variants will arise that will require booster or new vaccines. My view is that we're nowhere near that, and that our chief responsibility is to get other human beings, the stupid resistant types as well as the poor vaccinated.

As for media "experts:" I expressed my view of the need for critical thinking when listening to self declared "experts" elsewhere:

In general, the media's job no longer to provide information, but rather to sell advertising.

This requires the use of click bait in internet times.

It is reasonable to ask who exactly "Eric Topol" is, and what is his area of expertise?

I did this, since I never heard of him, by entering his name in Google Scholar and looking at his most recent publications. He's done a lot of work on telemedicine.

While some of his primary papers in the last year relate to Covid, many do not. Opening a few of them leads me to suspect that he is not the world expert in virology.

There is lots and lots and lots and lots and lots of papers published on the subject of the Delta variant, and his remarks do not strike me, even remotely, as consistent with what I read in broader scientific publications.

As for the Nymag reporter, and his choice of whom to designate as the absolute authority, I stand by my claim that one can usually not get a degree in journalism of one has passed a college level science course with a grade of C or better.

Dr. Topol may be a fine scientist, but he is certainly not the only scientist on the planet studying Covid-19, by a long stretch.

If one searches "Delta variant" and BNT162b2 one can see hundreds of papers. The one that comes up for me "Since 2021," is this one from the New England Journal of Medicine, published a week or so ago: Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant

It's a little less panicked than Dr. Topol, with all due respect.


Be safe, be well.
28 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
COVID boosters for wealthy nations spark outrage (Original Post) NNadir Aug 2021 OP
We must keep in mind that boosters in rich countries lots of profit for companies NH Ethylene Aug 2021 #1
Israel is having a delta covid outbreak despite being highly vaccinated. LisaL Aug 2021 #2
My "grains of salt" generally include the use of published data in scientific journals. NNadir Aug 2021 #5
Israel is having a covid outbreak of delta. LisaL Aug 2021 #7
That is not a scientific publication. We are also having a major outbreak of the Delta variant. NNadir Aug 2021 #17
Yea, lets wait on scientific publications while vaccinated people are getting infected. LisaL Aug 2021 #18
I'd like to leave disrespect for science and scientists to the Republicans, thank you. NNadir Aug 2021 #19
Yes. Let's wait. NH Ethylene Aug 2021 #21
More info on Israel's covid outbreak. LisaL Aug 2021 #10
If a high majority of vaccinated people are avoiding serious illness with Delta Covid NH Ethylene Aug 2021 #20
Post removed Post removed Aug 2021 #8
Link to that claim please. And 28% effective at what? Parenting all Celerity Aug 2021 #15
That's not what Pfizer said last week. NH Ethylene Aug 2021 #22
In some of these countries people don't want to vaccinate. LisaL Aug 2021 #3
Politicians and scientists are always going to put their JoanofArgh Aug 2021 #4
Sorry we have to look after our own... I think we can do both things, Demsrule86 Aug 2021 #6
Especially since our country is providing vaccines to the world jimfields33 Aug 2021 #9
We should start giving boosters to those who got vaccines more than six months ago. LisaL Aug 2021 #11
I agree. Not sure what the hold up is. jimfields33 Aug 2021 #12
Beats me. LisaL Aug 2021 #13
Big time true. jimfields33 Aug 2021 #14
Good article. LisaL Aug 2021 #16
It looks like this is just not necessary yet. NH Ethylene Aug 2021 #23
Moderna numbers in your link don't include Delta. LisaL Aug 2021 #24
I'm not sure why you think that Delta is not included in the Moderna study. NH Ethylene Aug 2021 #26
Major reason we have years of new variants ahead of us, rest of the world is largely unvaccinated madville Aug 2021 #25
That's why I don't think we should rush into boosters for all. NH Ethylene Aug 2021 #27
I do believe that you're on to an important point. NNadir Aug 2021 #28

NH Ethylene

(30,811 posts)
1. We must keep in mind that boosters in rich countries lots of profit for companies
Fri Aug 13, 2021, 09:34 AM
Aug 2021

I take the Pfizer urging of boosters for all with a giant grain of salt, and would be suspicious of those who would push for it without strong supportive data.

LisaL

(44,973 posts)
2. Israel is having a delta covid outbreak despite being highly vaccinated.
Fri Aug 13, 2021, 09:52 AM
Aug 2021

You can take it with a grain of salt, Israel obviously doesn't, and with a good reason.

NNadir

(33,517 posts)
5. My "grains of salt" generally include the use of published data in scientific journals.
Fri Aug 13, 2021, 10:17 AM
Aug 2021

For instance, there is this article from May 2021: Eric J Haas, Frederick J Angulo, John M McLaughlin, Emilia Anis, Shepherd R Singer, Farid Khan, Nati Brooks, Meir Smaja, Gabriel Mircus, Kaijie Pan, Jo Southern, David L Swerdlow, Luis Jodar, Yeheskel Levy, Sharon Alroy-Preis, Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data, The Lancet, Volume 397, Issue 10287, 2021, Pages 1819-1829.

If you have scientific data showing that the rates of infection, hospitalization, and death in Israel among the vaccinated is comparable to the rates in countries lacking access to vaccines, that would better support the "good reason" statement you make.

I agree with the outrage to which the Nature article refers. I am personally outraged. This is not about Israel per se, if that's your problem. It's about the whole first world. I think we should be donating vaccines to the third world before reducing minor risks among ourselves.

LisaL

(44,973 posts)
7. Israel is having a covid outbreak of delta.
Fri Aug 13, 2021, 10:24 AM
Aug 2021

They are almost to the level of infections they observed before vaccinations.

"Health officials are warning that Israel could face a fourth lockdown during the Jewish holiday season in September if the country doesn’t deliver more booster shots and improve on its wider vaccination rate; 60% of the total population are fully vaccinated, making up around 80% of adults."

https://www.wsj.com/articles/israel-80-vaccinated-suffers-another-covid-19-surge-11628769603

NNadir

(33,517 posts)
17. That is not a scientific publication. We are also having a major outbreak of the Delta variant.
Fri Aug 13, 2021, 11:30 AM
Aug 2021

The Wall Street Journal, a Murdoch publication, is not a place to seek scientifically valid insight.

Our outbreak is among the unvaccinated, a population that exists largely owing to Murdoch media rhetoric.

The question is whether it is among the vaccinated or the unvaccinated and what is the level of severity among the vaccinated.

Israel has nobly offered the entire country as a "Clinical Trial Nation" for the Pfizer BNT162b2 vaccine. It certainly merits a close watch on the long term implications of this trial, particularly with respect to the length of time for which the vaccine is effective. However the vaccination rate in Israel is not now, and never has been 100%.

Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 vaccination program (Rosen, B., Waitzberg, R., Israeli, A. et al. Isr J Health Policy Res 10, 43 (2021))

This unreviewed preprint suggests that economic and ethic disparities in vaccination rates exist in Israel as is the case elsewhere:

Socioeconomic Disparities and COVID-19 Vaccination Acceptance: Experience from Israel (Gil Caspi, Avshalom Dayan, Yael Eshal, Sigal Liverant-Taub, Gilad Twig, Uri Shalit, Yair Lewis, Avi Shina, Oren Caspi doi: https://doi.org/10.1101/2021.01.28.21250716 MedRxiv.)

My feeling, from watching the situation carefully, is that ultimately we will need to modify the RNA sequences of both the Moderna and Pfizer vaccines. This change is relatively straight-forward if required.

This, however, is nowhere near the same as giving "booster shots."

The real problem with access, swiftly being addressed relates to the ionizable lipids allowing for cellular transport. This infrastructure has expanded and will continue to grow as this technology moves beyond Covid into other disease areas. To the extent this existing infrastructure can be applied to poor countries, I regard it as a moral duty to apply it there.

The measurable antibody concentrations generated by the BNT162b2 vaccine is known to fall, but this does not seem to impact effectiveness, since the trough level for effectiveness has yet to be determined. We also do not know very well the genetic HLA status of those for whom breakthroughs occur. Certainly, the the extent that breakthroughs happen around the world, the populations displaying it do need to be sampled to map their genome for relevant sequences, not only in Isreal, but elsewhere.

It may be the case that a select subset of the population is genetically predisposed to breakthroughs. However, this is not a justification to doubling down on the neuroses of rich countries at the expense of poor countries. This is an issue for humanity as opposed to the populations defined by national borders. This does not mean we have to go wild getting shot after shot after shot even as the bulk of the planetary population lacks one.

NNadir

(33,517 posts)
19. I'd like to leave disrespect for science and scientists to the Republicans, thank you.
Fri Aug 13, 2021, 01:10 PM
Aug 2021

We in the scientific community are proud of our accomplishment in providing these vaccines at all.

Some of us argue that the work belongs to all humanity, not just the rich and the paranoid rich.

It was a great accomplishment and personally, as a scientist, I deplore the disrespect for science that trivializing science in order to justify hysteria, fear and ignorance entails.

Throughout this brief - but overly long given its uselessness - conversation, I have appealed to scientific literature, only to have a nonsensical response expressing contempt for science, while providing no real verifiable information, only a Murdoch publication link.

There is a moral implication connected with ignorance and its spread. I certainly don't expect everyone to get it, even here at DU.

Have a nice day.

NH Ethylene

(30,811 posts)
21. Yes. Let's wait.
Fri Aug 13, 2021, 06:28 PM
Aug 2021

Thankfully there is still a very high (88%, I think) protection from serious disease. Those who are more vulnerable should be invited to get a booster shot.

LisaL

(44,973 posts)
10. More info on Israel's covid outbreak.
Fri Aug 13, 2021, 10:27 AM
Aug 2021

"The rate of positive coronavirus tests also rose from Wednesday's figure of 4.62 percent to 5.02 percent on Thursday, making it the highest number since early March."

https://www.haaretz.com/israel-news/covid-in-israel-positive-test-rate-highest-since-march-new-daily-cases-top-6-000-1.10114701

NH Ethylene

(30,811 posts)
20. If a high majority of vaccinated people are avoiding serious illness with Delta Covid
Fri Aug 13, 2021, 06:25 PM
Aug 2021

Then we don't really need a booster just yet (with exceptions for the immunocompromised, of course).

I might add that Pfizer was saying we needed a booster before Delta was a major player here.

Response to NH Ethylene (Reply #1)

Celerity

(43,349 posts)
15. Link to that claim please. And 28% effective at what? Parenting all
Fri Aug 13, 2021, 10:35 AM
Aug 2021

transmission? 28% effective at preventing symptomatic disease? Preventing hospitalisation? Preventing ICU? Preventing death?

That is the lowest effectiveness rate I have see so far for Pfizer at a 6 month post vaccine point, and I often follow this subject.

NH Ethylene

(30,811 posts)
22. That's not what Pfizer said last week.
Fri Aug 13, 2021, 06:42 PM
Aug 2021
Moderna announced Thursday that its COVID-19 vaccine is 93 percent effective six months after the second dose, the Associated Press reported.

The announcement came after Pfizer announced its COVID-19 vaccine remained 97 percent effective in preventing severe disease and had become a top seller.


https://www.newsweek.com/moderna-says-covid-vaccine-shows-93-percent-efficacy-6-months-after-second-dose-1616557

LisaL

(44,973 posts)
3. In some of these countries people don't want to vaccinate.
Fri Aug 13, 2021, 09:53 AM
Aug 2021

Countries like Russia, where they had a vaccine for a long time, but citizens for the most part don't want it.

JoanofArgh

(14,971 posts)
4. Politicians and scientists are always going to put their
Fri Aug 13, 2021, 10:02 AM
Aug 2021

own country first. That’s just the way it is.

jimfields33

(15,793 posts)
9. Especially since our country is providing vaccines to the world
Fri Aug 13, 2021, 10:27 AM
Aug 2021

I think we continue to help the world which is good. With all our warts, we still try to do the right thing at the end.

LisaL

(44,973 posts)
11. We should start giving boosters to those who got vaccines more than six months ago.
Fri Aug 13, 2021, 10:28 AM
Aug 2021

ASAP. Otherwise our infection rates will get even worse than they are now, come this fall.

LisaL

(44,973 posts)
13. Beats me.
Fri Aug 13, 2021, 10:32 AM
Aug 2021

The hospitals are already getting overwhelmed with all the un-vaxxed.
Do we really want them filling up with vaccinated people who are not boostered?
There is no room in many states already.

LisaL

(44,973 posts)
16. Good article.
Fri Aug 13, 2021, 11:07 AM
Aug 2021

"As July turned into August, the federal government’s message was “you don’t need a booster” — even though each day, more Americans stepped over that six-month threshold. The folks who were vaccinated first were front-line health-care workers, residents and staffers at long-term-care facilities, and the elderly and the immunocompromised — the ones we least want to see experiencing a breakthrough infection."

https://www.nationalreview.com/the-morning-jolt/wading-through-the-covid-booster-messaging-mess/

NH Ethylene

(30,811 posts)
23. It looks like this is just not necessary yet.
Fri Aug 13, 2021, 06:45 PM
Aug 2021

This was from last week:

Moderna announced Thursday that its COVID-19 vaccine is 93 percent effective six months after the second dose, the Associated Press reported.

The announcement came after Pfizer announced its COVID-19 vaccine remained 97 percent effective in preventing severe disease and had become a top seller.


https://www.newsweek.com/moderna-says-covid-vaccine-shows-93-percent-efficacy-6-months-after-second-dose-1616557

LisaL

(44,973 posts)
24. Moderna numbers in your link don't include Delta.
Fri Aug 13, 2021, 06:51 PM
Aug 2021

And Pfizer effectiveness against delta infection is pretty low.

"Moderna was 76% effective against infection, and Pfizer was only 42% effective"
https://www.axios.com/coronavirus-vaccines-pfizer-moderna-delta-biden-e9be4bb0-3d10-4f56-8054-5410be357070.html

NH Ethylene

(30,811 posts)
26. I'm not sure why you think that Delta is not included in the Moderna study.
Fri Aug 13, 2021, 07:05 PM
Aug 2021

I'm not seeing a link to the study itself in the article I posted, so can't look at the dates.

I'm dubious about the other study you reference here. None of these have been peer-reviewed, of course, so we can't take any of them as gospel. But in addition, the authors have conflicts of interest. And these kinds of numbers are not evident anywhere else.

https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v1

madville

(7,410 posts)
25. Major reason we have years of new variants ahead of us, rest of the world is largely unvaccinated
Fri Aug 13, 2021, 06:55 PM
Aug 2021

We are going to be dealing with this for years to come. Our unvaccinated folks are just a drop in the bucket globally, it's a given we are going to see many more new variants emerge from the large poor parts of Africa, South America, Asia, etc.

At some point just a booster of the current stuff won't be enough and they'll have to reengineer the vaccine specifically for the new variants and we start all this over again.

I see vaccination status becoming kind of like a pyramid, say 90% of America gets the first version. Then 50% of those get a booster. But a year later there's a new version of the vaccine that is more effective against newer variants and 80% of the 50% of the original 90% get that one. Eventually you have many different tiers of vaccination status. If I got a J&J shot in 2021, does that mean I can use that vaccine card to enter a concert in 2023 even if it is less effective against whatever new variant that has emerged?

I think we are still in the simple phase of all this mess. It's just going to get more and more complex as new variants emerge, boosters become available, new versions of the vaccine become available, etc.

NH Ethylene

(30,811 posts)
27. That's why I don't think we should rush into boosters for all.
Fri Aug 13, 2021, 07:14 PM
Aug 2021

Over the next few months, we may need adjustments to the mRNA to be effective against new variants. People aren't going to want to take a booster in September only to be told they need another one in December.

NNadir

(33,517 posts)
28. I do believe that you're on to an important point.
Sun Aug 15, 2021, 02:17 PM
Aug 2021

Booster shots of vaccines whose long term benefit will be merely temporal, especially without widespread distribution among all of humanity, will prove to be wasteful.

What impresses me is the flexibility of the new technology; this said, the longer we restrict it to the wealthy nations, the longer this tragedy will persist.

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