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Concerns about the Ethics of the COVID Booster?


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I've read some people who claim that they will not get the booster until the vaccine is more available in Africa and South America. 

It is troubling that boosters are available in wealthy countries before the vaccine is available in poorer countries. 

I'm troubled by being allowed to get the booster before the vaccine is available to my child. 

Is anyone troubled by that? 

Vaccine equity is a human rights issue but it also makes us less safe. The spread of COVID in poorer countries will lead to mutations which will affect us. 

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I'm not troubled by boosters being made available.  Would it be good if the vaccine were more available in poor countries?  Of course.  But not taking a booster just because people elsewhere don't have the vax yet makes no sense to me. It's like going on a hunger strike here to protest hunger elsewhere. It doesn't change the situation for those without food in another country, and it may harm you.  I can't understand that way of thinking.

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1 minute ago, klmama said:

I'm not troubled by boosters being made available.  Would it be good if the vaccine were more available in poor countries?  Of course.  But not taking a booster just because people elsewhere don't have the vax yet makes no sense to me. It's like going on a hunger strike here to protest hunger elsewhere. It doesn't change the situation for those without food in another country, and it may harm you.  I can't understand that way of thinking.

In theory if we looked at this from a global perspective the resources needed for boosters in the USA could be diverted to producing vaccines for other countries. 

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Yes but no but yes.  Most likely the US will buy the booster shots anyway and it’s better you take it than waste it.  On a country level the ethical thing is for everyone to have a really good look at the supply chain needed to produce vaccines and figure out what contribution they can make toward producing more vaccine or even producing local supply.

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I am concerned about the decision to do boosters in the rich countries while most of the world has no access to the vaccination, yes. However,  if it is offered here, I will get my booster. Because me refusing my dose does nothing to make vaccine available elsewhere. Just admonishing a child to clean her plate because children are starving in Africa doesn't solve hunger.

Eta: we will donate to an organization that works to provide vaccine in developing countries. 

Edited by regentrude
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2 hours ago, Ordinary Shoes said:

I've read some people who claim that they will not get the booster until the vaccine is more available in Africa and South America. 

It is troubling that boosters are available in wealthy countries before the vaccine is available in poorer countries. 

I'm troubled by being allowed to get the booster before the vaccine is available to my child. 

Is anyone troubled by that? 

Vaccine equity is a human rights issue but it also makes us less safe. The spread of COVID in poorer countries will lead to mutations which will affect us. 

I got a third dose because I needed it as a moderetaly immune compromised person. 

I don't see any ethical issues with third doses or booster doses for us in the US>  We were the people who quickly facilitated the vaccines.  No, we are not responsible to cure every problem for other countries.  We do a very good job of being charitable =both on the governmental side and on American's personal charitable side.

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1 hour ago, Rosie_0801 said:

It's not ethical to let your immunity expire for want of a booster you had access to either.

Life is not fair.

Exactly.  What I thought was unethical was Abbot's destruction for vaccine tests in June because they idiotically thought there wasn't a market for them. A) there was a market for them by mid July in USA and a great market in August here, B) there was a market in places overseas too and C) there was always an option to donate to foreign sources, charities, etc and get a tax deduction for that credit

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I should add that quite a few epidemiologists don’t support boosters - not so much on ethical grounds but on the grounds that risk of variants from not vaccinating other countries is higher than the immunity boost provided to wealthy countries by boosters so we may be actually increasing our own risk of being in this situation indefinitely by using up shots as boosters.  I’m not sure how the newest info on transmission by vaccinated people plays into that though.  

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1 hour ago, Rosie_0801 said:

It's not ethical to let your immunity expire for want of a booster you had access to either.

 

 

10 minutes ago, regentrude said:

I am concerned about the decision to do boosters in the rich countries while most of the world has no access to the vaccination, yes. However,  if it is offered here, I will get my booster. Because me refusing my dose does nothing to make vaccine available elsewhere. Just admonishing a child to clean her plate because children are starving in Africa doesn't solve hunger.

What they said.

On my personal "nobody" level there's nothing I can do to make vaccines more available to poor countries. What I can do is try my best to not get Covid or spread it to others. 

It's no different than the environmental stuff, I don't think. I can't make countries change policies that have large global effects, but I do what I can on my tiny little level to reduce/reuse/recycle.

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7 minutes ago, TravelingChris said:

I don't see any ethical issues with third doses or booster doses for us in the US>  We were the people who quickly facilitated the vaccines.  No, we are not responsible to cure every problem for other countries. 

But this one is not just a problem for the *other*countries - since the unvaccinated people around the world are breeding ground for new variants, it directly becomes our problem,  too. 

( I am glad you got the shot)

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3 minutes ago, regentrude said:

But this one is not just a problem for the *other*countries - since the unvaccinated people around the world are breeding ground for new variants, it directly becomes our problem,  too. 

( I am glad you got the shot)

Oh I certainly know that.  I am very much in favor of increased production and very much in favor of all the countries that can help others, do so. But it isn't our fault that Australia decided to depend on a vaccine produced in India.  It isn't our fault that many South Americans decided to depend on the worthless Chinese vaccines.  COVID is going to be a long disease,  It is here for years.

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11 minutes ago, TravelingChris said:

Oh I certainly know that.  I am very much in favor of increased production and very much in favor of all the countries that can help others, do so. But it isn't our fault that Australia decided to depend on a vaccine produced in India.  It isn't our fault that many South Americans decided to depend on the worthless Chinese vaccines.  COVID is going to be a long disease,  It is here for years.

For the record I think that’s NZ not Australia. We were relying heavily on AZ which was a different issue.

Edited by Ausmumof3
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Yeah.  I care about this a lot.  Africa, the continent I live in, is at about 2% vaccination.  I'm watching refugee friends see a clear uptick in deaths of family members in their home country, even though reported numbers are still very low.  I can't even imagine how they'll get vaccines to many people there when most people have almost no access to any kind of specialized medical care.  But that country is in an unusually difficult situation and there are ways to get vaccines distributed in many lower-income countries if they just were available.

But I've also given up on wealthy countries actually doing anything about it besides donating cheaper vaccines (that are often less effective or slightly more risky) and donating money, even though it's a medically foolish decision in the long run.  My country is now producing Sinovac and just started delivering doses.  They have 15 million ready to go and expect to produce 15-18 million doses a month to be distributed around Africa.  I'm not sure if any other African countries are also producing vaccine.  My country started the process to make corona vaccines in the summer of 2020.  

I wish more mRNA vaccines were available in Africa.  I wish that more people had already been vaccinated here.  I wish that Americans and others weren't pushing conspiracy theories about vaccines that scare at-risk people who are without access to good treatment if they get corona.  I wish that we'd actually start working together better to fight corona on worldwide scale, rather than on a local, state, or country scale.  I wish that Americans who possibly can would get vaccinated ASAP so that the US could then just keep shots for boosters on hand and send all the rest overseas.  I wish a lot of things about corona.

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I am troubled by this too. But, like someone else said, refusing a booster here doesn't make one available somewhere else. I would rather take my booster and also work to convince my Representatives push for vaccines in other countries too. Those are the people that currently have the ability to make something happen.

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In addition to the individual vs nation-level decision making that others have mentioned I’d feel worse about the decision to provide 3rd shots in the US if we didn’t have health systems on the verge of collapse.  It’s not like we’re doing just fine and are wanting 3rd doses just to feel good about it. We have hospitals overflowing, health care workers burning out, city water systems in danger because the liquid oxygen they use is going to hospitals instead.  Getting unvaccinated people vaccinated would help more, but it’s harder.  Third shots for already vaccinated people will be a much smaller improvement, but it’s easier.  While we’re working to get vaccine-hesitant people over the hump and to get doses to countries that have less access we should also do the easy task and hope it makes enough of a difference to hold off complete disaster here.  

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I really suspect that we could give everyone in my state who has been vaccinated boosters just from the vaccine secured with the goal of vaccinating 70% of the adult population. The uptake is just plain low in many areas and groups. So, while I am well aware that boosters are of much less benefit than vaccinating more people, I kind of feel that it's a "put on your own lifejacket first" sort of thing. Let's get as many shots into as many arms as we can-but realistically, we also need to keep the vaccinated folks healthy, because we're the ones who are having to do the heavy lifting while so many are out sick and unable to function. 

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I am definitely feeling the "put your own oxygen mask on first" element of it too.  Like if our hospitals are collapsing, people are dying here from health care not being available, our economy becomes unstable, we are not in a great position to help everyone else.  I do wish there was better data on who boosters really help.  But as someone who is 51 and who is overweight with family history of heart disease (I walk 70+ miles a month, get a CSA, rarely eat processed foods and live with thin people, weight is not as simple as plenty of people like to think.  If I could take a tested  vaccine for that, I would as well.), yep, I will be getting one and my husband too.  I do wonder about my vaccinated 20 and newly 17 year old (fully vaxed at 16) and their need for one but if the data looks like they should when it comes around, they will.  

I also think in terms of this "booster" really probably being more of an initial dose.  We are learning as we go.  Many of our vaccines come in a series.  I do the flu shot every year too.  We will see.  

I will also always support politicians and charities that will help distribute vaccines and other aid to developing countries.  I also support mandates under certain conditions.  I am concerned about African countries in particular.  The current data has about 33.4% of the world's population at least partially vaccinated.  That is really unprecedented distribution when you look at the time table so far.  As that number goes up, more countries will be in a position to share and distribute.  

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It is an ethical problem… and there is an ethical problem whether or not we do boosters here.

I do believe in boycotting to make a statement.  I will not need to decide this for my family until early 2022, so we’ll see.

Similar ethics apply to young, healthy people getting two mRNA shots … or arguably even one shot when most frail people around the world can’t get it.  But we will be denied certain rights if we don’t have that “vax passport” (which I also don’t totally agree with).  Thus we don’t have free choice to act just based on ethics.  Will that also happen with boosters, and is that problematic to ethically minded people?

Edited by SKL
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The trouble is, from my perspective here in Africa, you all already have life jackets/oxygen masks on because of a medical system that is significantly more functional, even now during a delta wave, than the medical systems in almost every country on this continent during normal times.  You have economic systems that can weather financial crises better.  You’re still traveling and vacationing. You’re first in line for everything.  

I have a friend here who has been stuck since corona started and hasn’t been able to return to her home in Micronesia because there are too many legs on her flight that go through countries that won’t allow her to fly through.  She has children and grandchildren in Micronesia, including a grandchild that she would usually be caring for. I truly don’t know when she’ll be able to go home, but her situation is not unique. Death rates look low in most of Africa, but we’re not even close to knowing what is going on with corona in most of this continent.  Almost every refugee in Africa, and there are many millions, is living in a country that cannot help them in any way and the UN doesn’t have enough resources to even make sure refugees have enough of the most basic food.  Food insecurity has increased significantly in the last 18 months.  Children aren’t going to school and they’re already receiving a lower quality education than an American child would.  There certainly aren’t virtual schooling options.  Some countries have other significant issues that a pandemic only exacerbates.

I realize that I probably sound extreme here, but the disparity is glaring from here, even more so than in normal times.  Americans have complained more than anyone on this planet about corona in spite of having more advantages in getting through it.  Just shut up, get vaccinated, wear your masks, quit spreading conspiracy theories, send as many high-quality vaccines as possible to other countries, donate to COVAX, and realize this isn’t over because there still are a lot more people who need help getting through this.  

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The US has already donated 110 million doses (of which roughly 20 million went to Africa), and has agreed to purchase and donate another half-billion doses of Pfizer. But the issue is a lot more complex than just "rich countries need to stop vaxing their own populations and send the rest of their vaccines to poor countries." Many poor countries do not have the infrastructure to support a fast mass roll out of the vaccine, and vaccine skepticism is not limited to the US. Many African countries have had to destroy donated vaccines because they were not able to use them before they expired. There was a BBC story in June explaining some of the issues:

"Malawi destroyed almost 20,000 doses of the AstraZeneca (AZ) vaccine, while South Sudan announced it would destroy 59,000 doses. Both countries had received these vaccines from the African Union, but had not been able to administer them by their expiry date of 13 April. The Democratic Republic of Congo, meanwhile, said it could not use most of the 1.7 million AZ doses it received under the global Covax scheme for poorer countries. South Sudan is also handing back 72,000 doses it got through the Covax scheme. It had received 132,000 doses of the AZ vaccine in March, with an expiry date of the end of June. Of these, South Sudan has been able to administer just 10,000, but has kept a further 50,000 to distribute before they expire.
.....
Many countries failed to prepare adequately before receiving the vaccines, Phionah Atuhebwe, from the WHO in Africa, says. "That is one of the reasons we are seeing the slow pace of rollout," she says. South Sudan says in addition to the problem of limited financial resources, the country has also struggled because of a reluctance by health care workers to get vaccinated. A health ministry official there has also pointed out that its parliament was slow in approving the vaccines, along with delays in training health workers for the task. "The continent as a whole knows how to vaccinate and has been vaccinating for other diseases," says John Nkengasong, head of the Africa Centres for Disease Control (CDC), "but the key is how do you scale that up - and at speed?" For DR Congo the problem is not only weak health services but also a very poor transport network - making the delivery of vaccines to remote areas a major issue. 
.....

Some experts and politicians blame concerns over the safety and efficacy of vaccines in general for the slow uptake in many countries in Africa - but it is hard to quantify that impact. "It took a while to convince people," Sierra Leone Health Minister Austin Demby tells BBC News "So it is not just vaccine hesitancy, it is like [having] vaccine sceptics to start with."  Malawi virologist Gama Bandawe says mistrust of vaccines has played a role in the country being unable to use all the supplies it has received. And South Africa's decision to stop using the AstraZeneca vaccine, amid concerns around cases of blood clots, may have added to these doubts. "The government did the best they could - but perhaps the general public has not been as receptive as was expected," he says.

A study commissioned by the Africa CDC on Covid-19 vaccine perceptions in 15 countries indicated a significant proportion of people had concerns around vaccine safety. On average, about 20% of respondents said they would not have a vaccine - but the proportion varied from below 10% in Ethiopia, Niger and Tunisia to 41% in DR Congo."

https://www.bbc.com/news/56940657

Edited by Corraleno
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Agreeing with how Rosie put it.

I see an ethical issue with vaccine distribution, but I don't have control over that beyond making my voice heard with politicians. I only have control over my own decisions and it would be unethical to not take the shot when it prevents this disease.

Getting vaccinated and keeping the vaccine up is something we do for others as well as ourselves. It's the best thing I can do for everyone here. Just like sending more vaccine abroad is the best thing government and corporations can do to end Covid.

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I just want to say I haven't traveled, been on a plane, been in a restaurant, or socialized in a typical way since March of last year.  We've seen local grandparents primarily outdoors maybe a handful of times.  We have been avoiding clinics and dropping in single appointments between peaks when we can.  I have spent ONE night in a hotel with an air purifier avoiding the halls and masked for a necessary college kid run.  I know the news is highlighting a lot of ridiculousness and selfishness.  I am all for ending conspiracy theories, supporting COVAX, and just getting  vaccine out there in arms as fast as possible.  I just don't see individuals selecting not getting a booster lending to help that.  Having spent time in the 3rd world and following this, I also have concerns about distribution of these less stable multi dose vaccines in particular.  There are a lot of other things still in trial, I hope we see more shelf stable single dose kind of options and therapeutic options rise to the surface.  

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51 minutes ago, Amira said:

The trouble is, from my perspective here in Africa, you all already have life jackets/oxygen masks on because of a medical system that is significantly more functional, even now during a delta wave, than the medical systems in almost every country on this continent during normal times.  You have economic systems that can weather financial crises better.  You’re still traveling and vacationing. You’re first in line for everything.  

I have a friend here who has been stuck since corona started and hasn’t been able to return to her home in Micronesia because there are too many legs on her flight that go through countries that won’t allow her to fly through.  She has children and grandchildren in Micronesia, including a grandchild that she would usually be caring for. I truly don’t know when she’ll be able to go home, but her situation is not unique. Death rates look low in most of Africa, but we’re not even close to knowing what is going on with corona in most of this continent.  Almost every refugee in Africa, and there are many millions, is living in a country that cannot help them in any way and the UN doesn’t have enough resources to even make sure refugees have enough of the most basic food.  Food insecurity has increased significantly in the last 18 months.  Children aren’t going to school and they’re already receiving a lower quality education than an American child would.  There certainly aren’t virtual schooling options.  Some countries have other significant issues that a pandemic only exacerbates.

I realize that I probably sound extreme here, but the disparity is glaring from here, even more so than in normal times.  Americans have complained more than anyone on this planet about corona in spite of having more advantages in getting through it.  Just shut up, get vaccinated, wear your masks, quit spreading conspiracy theories, send as many high-quality vaccines as possible to other countries, donate to COVAX, and realize this isn’t over because there still are a lot more people who need help getting through this.  

I listened to Bill Mahr this morning 9n s tweet I got. This opening for his show he had was from early last week or the previous week.   He talked about he never liked super rara Americans but he can't abide all those people who keep complaining about how awful the USA is.  He said specifically as a comic, he may have politicians complain or even sue him, but he diesnt fear death like in many places.  He mentioned a comic killed by the Taliban this month.  And  he mentioned how in talking w many immigrants here, all thought their situationss better here than where thry came from.   Too mzny Americans hzve no idea how lucky we are.

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47 minutes ago, SKL said:

It is an ethical problem… and there is an ethical problem whether or not we do boosters here.

I do believe in boycotting to make a statement.  I will not need to decide this for my family until early 2022, so we’ll see.

Similar ethics apply to young, healthy people getting two mRNA shots … or arguably even one shot when most frail people around the world can’t get it.  But we will be denied certain rights if we don’t have that “vax passport” (which I also don’t totally agree with).  Thus we don’t have free choice to act just based on ethics.  Will that also happen with boosters, and is that problematic to ethically minded people?

I have little doubt that if boosters are available and show a benefit for young adults, my child's school will require them.  Because you know what works better than closing campuses and making students do all classes online? Healthy students and faculty. And with a 98+% vaccination rate, it's a LOT more likely that they'll be able to ride this wave out with minimal disruption. Which is why COVID and a long list of vaccines are required, and why student health will be coming through and vaccinating the entire campus population save the small number with medical waivers for the flu in early October. 

 

And you know what? Choices have consequences. My child's choice to attend a school that requires vaccination also means turning down scholarship money at schools that do not. My choice to not go places that do not require masking last year (and again this fall) means not attending church in person. I have lost students due to requiring masking. I've also gained some who have parents who appreciate that I do. 

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Distribution is a major issue in some parts of Africa.  Not where I am, since there have been a number of major and successful public health campaigns here in the last 50 years. Vaccines aren’t getting wasted here and there was a lot of prep before any vaccines arrived.  But there had also been significant investment in the health care system for decades before, especially from USAID, that is again proving to had been a good investment in my opinion.  There are separate political reasons why the US has been willing to invest in this country that don’t exist for most African countries so most get left behind, unfortunately.  I’m not really sure if even a year’s prep time would have made any difference at all in a country like South Sudan where corona has been around fourth or fifth on their list of crises in the last 18 months.  Food insecurity, war, drought, locusts, displacement and mental health trauma from 30 years of war haven’t really been dislodged by corona.  It kind of feels to me like blaming the victims when people bring up the fact that many African nations aren’t using their limited vaccines. That means that in addition to providing vaccines, wealthier countries also need to support delivery to individuals rather than just dropping off vaccines and then saying that doesn’t work. Wealthy countries also had time over the last year to work on creating that infrastructure, and that’s an investment that will continue to pay off later with other health care emergencies.

There’s a lot of vaccine hesitancy in my country, especially about any vaccine from China. People do say they’d be more willing to get an American vaccine.  It’s so important for people with easy access to vaccines to not spread vaccine misinformation because it doesn’t only convince their friends not to get vaccinated, but people all over the world.  That is a tangible thing Americans can do that would actually make a difference.  

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14 minutes ago, FuzzyCatz said:

I just want to say I haven't traveled, been on a plane, been in a restaurant, or socialized in a typical way since March of last year.  We've seen local grandparents primarily outdoors maybe a handful of times.  We have been avoiding clinics and dropping in single appointments between peaks when we can.  I have spent ONE night in a hotel with an air purifier avoiding the halls and masked for a necessary college kid run.  I know the news is highlighting a lot of ridiculousness and selfishness.  I am all for ending conspiracy theories, supporting COVAX, and just getting  vaccine out there in arms as fast as possible.  I just don't see individuals selecting not getting a booster lending to help that.  Having spent time in the 3rd world and following this, I also have concerns about distribution of these less stable multi dose vaccines in particular.  There are a lot of other things still in trial, I hope we see more shelf stable single dose kind of options and therapeutic options rise to the surface.  

I would give just about anything for an effective shelf stable single dose vaccine that could be produced in Africa within a few months of coming on the market.

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4 hours ago, Amira said:

Yeah.  I care about this a lot.  Africa, the continent I live in, is at about 2% vaccination.  I'm watching refugee friends see a clear uptick in deaths of family members in their home country, even though reported numbers are still very low.  I can't even imagine how they'll get vaccines to many people there when most people have almost no access to any kind of specialized medical care.  But that country is in an unusually difficult situation and there are ways to get vaccines distributed in many lower-income countries if they just were available.

But I've also given up on wealthy countries actually doing anything about it besides donating cheaper vaccines (that are often less effective or slightly more risky) and donating money, even though it's a medically foolish decision in the long run.  My country is now producing Sinovac and just started delivering doses.  They have 15 million ready to go and expect to produce 15-18 million doses a month to be distributed around Africa.  I'm not sure if any other African countries are also producing vaccine.  My country started the process to make corona vaccines in the summer of 2020.  

I wish more mRNA vaccines were available in Africa.  I wish that more people had already been vaccinated here.  I wish that Americans and others weren't pushing conspiracy theories about vaccines that scare at-risk people who are without access to good treatment if they get corona.  I wish that we'd actually start working together better to fight corona on worldwide scale, rather than on a local, state, or country scale.  I wish that Americans who possibly can would get vaccinated ASAP so that the US could then just keep shots for boosters on hand and send all the rest overseas.  I wish a lot of things about corona.

Yeah this. 

I've read about anti-vax initiatives that begin in the West (usually the USA) that spread to Africa. It's evil. 

I feel like we're watching a dress rehearsal for climate change (although in truth, COVID is probably related to climate change itself). People in the west will hoard resources which will lead to tremendous suffering in Africa and South America. Of course the irony being that we had more control over climate change than those people. I keep using the word "evil" but I can't think of a better word. It is evil. 

I'm not much of an orthodox believer in Christianity anymore but I guess that I believe in heaven and hell. I think that wealthy privileged Americans spreading anti-vax conspiracies and letting doses expire are going to have that conversation with Jesus from Matthew, "when did I refuse to give you something to eat when you were hungry, when did I refuse to clothe you, take care of you when you were sick or visit you in prison?" 

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2 hours ago, Amira said:

The trouble is, from my perspective here in Africa, you all already have life jackets/oxygen masks on because of a medical system that is significantly more functional, even now during a delta wave, than the medical systems in almost every country on this continent during normal times.  You have economic systems that can weather financial crises better.  You’re still traveling and vacationing. You’re first in line for everything.  

I think a lot of us here feel like we’re on the Titanic.  There’s a great deal of conspicuous luxury that’s taking up resources that should be better distributed.  And a lot of dancing and feasting people that have no idea how easily the whole thing could sink.

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10 hours ago, Amira said:

Distribution is a major issue in some parts of Africa.  Not where I am, since there have been a number of major and successful public health campaigns here in the last 50 years. Vaccines aren’t getting wasted here and there was a lot of prep before any vaccines arrived.  But there had also been significant investment in the health care system for decades before, especially from USAID, that is again proving to had been a good investment in my opinion.  There are separate political reasons why the US has been willing to invest in this country that don’t exist for most African countries so most get left behind, unfortunately.  I’m not really sure if even a year’s prep time would have made any difference at all in a country like South Sudan where corona has been around fourth or fifth on their list of crises in the last 18 months.  Food insecurity, war, drought, locusts, displacement and mental health trauma from 30 years of war haven’t really been dislodged by corona.  It kind of feels to me like blaming the victims when people bring up the fact that many African nations aren’t using their limited vaccines. That means that in addition to providing vaccines, wealthier countries also need to support delivery to individuals rather than just dropping off vaccines and then saying that doesn’t work. Wealthy countries also had time over the last year to work on creating that infrastructure, and that’s an investment that will continue to pay off later with other health care emergencies.

There’s a lot of vaccine hesitancy in my country, especially about any vaccine from China. People do say they’d be more willing to get an American vaccine.  It’s so important for people with easy access to vaccines to not spread vaccine misinformation because it doesn’t only convince their friends not to get vaccinated, but people all over the world.  That is a tangible thing Americans can do that would actually make a difference.  

I don't think it's victim-blaming to report factual information regarding the limitations of vaccine distribution in the poorest countries. It's tragic when desperately needed vaccines go to waste because the infrastructure to distribute them doesn't exist. It's also tragic when vaccines go to waste because people who do have access to them won't take them because of lies and misinformation — and that is also a problem that exists in poor countries. These are complex, systemic, and in some cases intransigent, political and socio-economic problems, and asking Americans to put their own health at risk as their immunity wanes does not even begin to address those problems.

The US is donating $4 billion to COVAX that can be used, along with millions in donations from other countries, to help poor countries train HCWs and develop vaccine delivery systems. That cash is in addition to the 110 million vaccine doses the US has already shipped and the 500 million Pfizer doses they have agreed to purchase and donate. As of last month, the US had sent 5.7 million vaccine doses to South Africa, 4 million to Nigeria, 1.6 million to Ethiopia, 1 million to Tanzania, and 300-600K doses each to 21 other African countries. Asking Americans to risk their own health by forgoing booster shots will have about as much impact on vaccine problems in Africa as switching to reusable straws has on climate change. 

Could we do more? Of course, we could always do more. We could also feed the millions of children in this country who go hungry every day, provide health care to Americans who die of preventable diseases because they can't afford to see a doctor or buy needed medication, and provide housing to the hundreds of thousands of homeless men, women, and children in this country. But we don't. The fact that we don't is shameful, inexcusable, profoundly unethical — and also unlikely to change. Millions of people want it to change, and would vote for people who would implement those changes, but the reality is that a large percentage of the population just doesn't give a damn about other people and there's not much anyone can do about that. 

Edited by Corraleno
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3 hours ago, Amira said:

It’s so important for people with easy access to vaccines to not spread vaccine misinformation because it doesn’t only convince their friends not to get vaccinated, but people all over the world.  That is a tangible thing Americans can do that would actually make a difference.  

This is such a good point. I’m actually curious what anti-Covid vaccination people in the US feel about people in developing countries getting vaccinated. Do they feel like people in poor countries with less access to healthcare should get their shots when they finally have access to them?

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31 minutes ago, KSera said:

I’m actually curious what anti-Covid vaccination people in the US feel about people in developing countries getting vaccinated. Do they feel like people in poor countries with less access to healthcare should get their shots when they finally have access to them?

Don't you think the answer would depend on WHY they are against the vaccine?  People who don't want the vaccine are not a homogeneous group.  If they are convinced it will cause those who get it to suffer long-term harm or if they think it's part of an international take-over of society, they likely would be against anyone getting it.  However, if they just want to see long-term safety data before getting it, particularly for their dc, they may not care what choices others make, here or abroad, other than wanting everyone to have the freedom to choose for themselves.  

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1 hour ago, klmama said:

Don't you think the answer would depend on WHY they are against the vaccine?  People who don't want the vaccine are not a homogeneous group.  If they are convinced it will cause those who get it to suffer long-term harm or if they think it's part of an international take-over of society, they likely would be against anyone getting it.  However, if they just want to see long-term safety data before getting it, particularly for their dc, they may not care what choices others make, here or abroad, other than wanting everyone to have the freedom to choose for themselves.  

Well sure, of course. I didn’t mean I thought it would be the same reason for everyone, I was just commenting that it would be interesting to me.

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For me, the booster shot would be way, way down the list of things I worry about the ethics of--lower than flying on airplanes (which I haven't done for a few years, but our first-degree relatives live in another part of the country), being too busy to pester my senators very often, and probably several other things. We continue to mask and distance, but it's not enough. Any behavior that keeps people (myself and others) from needing health care resources IMO falls into the category of better options.

For anyone else who would like to give financial support for Covid prevention and care in lower-resource countries, Partners in Health has a long history of helping in Haiti, and the WHO is doing its best to respond in a number of places. Other folks may be able to chime in with more opportunities.

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Highly relevant op-ed just published, from Peter Hotez:

https://www.latimes.com/opinion/story/2021-08-29/covid-vaccines-boosters-global-supply-shortage

He refers to Corbevax, which is a vaccine candidate not yet licensed, but that is designed to be able to be made in high volume for the developing world, in India. It's too bad that it is taking much longer than the others. It hasn't gotten the same amount of support. https://www.texasmonthly.com/news-politics/covid-vaccine-corbevax-india/

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39 minutes ago, KSera said:

From the article: "At a minimum, for every booster shot for Americans, we need to commit to paying for and donating a dose of mRNA vaccine. This sends an important message that we are committed to global health and fairness."

We've already committed to doing much more than that: we will be buying and donating more than 600 million doses, which is 2-3 times the number of booster shots we'll be using in the next 6-8 months. 

 

Edited by Corraleno
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13 hours ago, Corraleno said:

I don't think it's victim-blaming to report factual information regarding the limitations of vaccine distribution in the poorest countries. It's tragic when desperately needed vaccines go to waste because the infrastructure to distribute them doesn't exist. It's also tragic when vaccines go to waste because people who do have access to them won't take them because of lies and misinformation — and that is also a problem that exists in poor countries. These are complex, systemic, and in some cases intransigent, political and socio-economic problems, and asking Americans to put their own health at risk as their immunity wanes does not even begin to address those problems.

The US is donating $4 billion to COVAX that can be used, along with millions in donations from other countries, to help poor countries train HCWs and develop vaccine delivery systems. That cash is in addition to the 110 million vaccine doses the US has already shipped and the 500 million Pfizer doses they have agreed to purchase and donate. As of last month, the US had sent 5.7 million vaccine doses to South Africa, 4 million to Nigeria, 1.6 million to Ethiopia, 1 million to Tanzania, and 300-600K doses each to 21 other African countries. Asking Americans to risk their own health by forgoing booster shots will have about as much impact on vaccine problems in Africa as switching to reusable straws has on climate change. 

Could we do more? Of course, we could always do more. We could also feed the millions of children in this country who go hungry every day, provide health care to Americans who die of preventable diseases because they can't afford to see a doctor or buy needed medication, and provide housing to the hundreds of thousands of homeless men, women, and children in this country. But we don't. The fact that we don't is shameful, inexcusable, profoundly unethical — and also unlikely to change. Millions of people want it to change, and would vote for people who would implement those changes, but the reality is that a large percentage of the population just doesn't give a damn about other people and there's not much anyone can do about that. 

I agree with this.  To be clear, I’m not advocating that Americans shouldn’t get boosters when they’re due for them.  The way the system is set up, it’s best for them to get boosters and any other vaccines possible. And I don’t think you personally are victim blaming, Corraleno, because I know you wouldn’t do that, but I have heard the excuse too many times that we just shouldn’t help someone because they’ll misuse the assistance that is given, rather than putting the responsibility on the giver to make sure the right type of help is offered.  

I do think there’s no getting around the fact that the entire system advantages and will continue to advantage the wealthy, whether on a community, state, country, or international scale.  And I do think that Americans have become even more insular than usual in the last 18 months, which means they’re even less likely to try to change the system.  It really doesn’t make sense on a worldwide scale for people with the best healthcare systems to get three shots before people who have no healthcare system get any shots in the middle of a pandemic that doesn’t care about borders.  It is unethical and foolish to set up the system that way.  But within that system, anyone who can get shots should because refusing shots won’t solve anything and makes things worse, in some ways.

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I haven't read any of the replies to the OP.  The OP is interesting to me because it mentions South America and we live in Colombia. Until approximately 2 weeks ago, we seemed to have a very study supply of COVID-19 vials coming in by air freight to Bogota and being distributed throughout the country. Now, suddenly, the vaccines do not seem to be arriving here. I don't know if that is because of production issues in the factories (Colombia has purchased from various companies) or a huge increase in demand or even logistics in the air freight shipments.  I remember reading about 1.5 years ago, that there were approximately 50 of the super freezers available here for storage of PfizerBioNTech and Moderna vaccines at very low temperatures, so they were bringing in Lots of approximately 500K or 550K doses each time, because of that logistical storage issue.  Colombia has purchased these vaccines so it is not a matter of our receiving them as donations.  BTW, Colombia did receive approximately 6 (?) million doses as donations a month or 2 ago. I believe all of them came from the USA. I suspect they were nearing their expiration date but am not sure about that.  The USA donated vaccines to approximately 60 countries and Colombia was one of the countries on the list.

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I think it's ethical to provide boosters to immunocompromised people plus any other specific groups of people who are demonstrably unusually vulnerable and likely to become not-vulnerable through a booster directly. Leftovers from booster batches issued to serve these people should be used locally to help whoever they will most help. I'm not convinced the evidence base is there yet for elderly people in general, but it certainly is there for immunocompromised people, and plenty of people are keeping a close eye on the research.

Otherwise, people who have not had the opportunity to vaccinate (be it children/formerly-vaccine-hesitant people in the USA, or adults in countries where few vaccination supplies have arrived) should have priority.

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