bambinomartino

I am taking this thought from another thread, as it may be more appropriate to continue it here.

Basically I wonder what effect the relatively high vaccination rate in Canada among young people might have on the spread of Delta. Canada was the first country to approve Pfizer for use in children ages 12 and up, and my province Alberta wasted no time making it widely available, within days of the May 5 approval. In Alberta ages 12-34 are currently at 60-65%/35-45% first/second dose already, with the latter climbing steadily. Many of the Delta hotspots in Europe and the US are nowhere close to those percentages. I believe that even Israel, despite their early start, is lagging Canada in these age groups, or at least in the youngest ones (I can't find any data but based on news reports that seems to be the case).

All restrictions have been lifted here in Alberta, although you still see the odd mask here and there. But life has been pretty much back to normal for over 2 weeks. Daily cases have plummeted, as has the positivity rate, although the decline has leveled off in the past week, with the R value reportedly ticking up slightly, but still below 1. Delta has been here for a couple of months so far, but accounts for just a quarter to 40% of new cases. Perhaps a more clear picture will emerge over the next two weeks.

Could there be something to that? People in certain age groups tend to socialize amongst each other, and some news stories appear to blame that for the surge in cases among the younger demographic. I guess a way to restate it is that total vaccination percentages may not be as important . Two countries may be at 60% of total population vaccinated but have different outcomes when it comes to variants, if one is at 90% of ages 45+ but only 20% for the rest, whereas another is a solid 50-70% across all age groups.

Diplomatico

Long post and I'm not even certain what the question is.

Bottom line: the more people that are vaccinated, the less spread of the virus and fewer hospitalizations and deaths.

People who refuse the vaccine (and they tend to be younger, I think) put themselves and everyone else at risk.

tauphi

Correct, it's just like wearing a mask. Not only are you giving yourself some protection, you're also protecting the community.

mdkowals

Doing so would be a massive shift in American ideology and culture. I can see proof of vaccinations for International travel as determined by the arrival country, US included, but that's about it [via the ESTA or Visa application process].

The slope will slide, if you have to show a vaccination passport anyway for COVID, why not add polio, Hep B/Hep C, flu, MMR, etc... to the list of required vaccinations to board a plane?

Is there a certain residual risk when you abandon this requirement, or does this become an additional step that is permanently added to the process of travel? Is it more likely or not that the residual risk would be at a sufficiently low level by the time the system got off the ground anyway? (unknown, depends on estimates of what it takes for the system to get off the ground) [Note: If it's like anything else coming out of government, the plan will be to get rid of it "as soon as possible" and then never get rid of it, because Homo sapiens in general are pretty bad at understanding risk].

And who checks it? The only Federal employees at an airport are the TSA. Do we add to that process?

Spacious and outdoor National Parks by nature should carry a very low baseline risk of transmission.

For trains/buses/sporting events, etc...that currently don't require identification to partake in, do those services now need to require ID? This would be the only way to link the vaccination to the individual.

corporate-wage-slave

Yes the precise composition of both a population, the number vaccinated and the age cohorts vaccinated coverage makes a difference with Delta specifically and viruses generally.

Delta has a gene based vairant which makes the Spike Protein component better able to latch on to the body. So with Delta you can catch it more easily than baseline COVID-19 because it needs less time and less viral transmission for the virus to score a hit. If you are not wearing a mask, not keeping your distance, your risk goes up a lot more with Delta. Younger people tend to have large social circles, which change a lot, combining school, college, siblings, family, extended family, social groups, churches, play areas, cultural sites and so on. They also tend to have a smaller personal boundary in terms of being comfortable with people close to them. An older couple, perhaps a bit set in their ways, may be more virus conscious, keep their distance, wear masks, have a smaller and fixed (this is quite critical) social circle, won't go night clubbing and so on. The vaccines knock back the chance of catching Delta by two thirds and separately cut transmission by half. If you have say 100 risky contacts - in both directions - by being young, compared to say 6 if you are old, well you can do the sums for yourself. That is why Delta is so much a younger person's disease, but a disease that can kill older people. I know we often think "oh thank goodness that the kids don't really suffer from COVID" but you can equally see that the virus has latched on to this and uses children and younger people as vectors to do its terrible work.

So far so good. But the problem here is that however you look at it, COVID complications are greater the older you are. so over 70 = very high risk, 60 = high risk. 50 = significant risk. Being obese, COPD, diabetic, impaired immune system (etc, etc) bumps up your risk profile and in some cases you may not know you have a risk, if you are younger. So this cohort really must get ideally 100% vaccine coverage to prevent a hospital visit and/or death. Whereas for younger people that's rarely on the agenda. If your older population won't get to say 90% coverage then unfortunately you may end up using kids as proxies for the hesitancy of older people. It still saves lives overall but for the individual kid concerned who gets a vaccine it may not change their particular health risk profile by very much in either direction. Hence the absolute priority is to jab everyone over 50 and all those medically at risk under 50 before youngsters. But if you can't find anyone else to do, then giving jabs to youngsters may be the least worst outcome - as distinct from the best outcome.

JNelson113

This makes me nervous. if the vaccine poses zero risk to kids, then okay . . . but we now know that it does pose some risk. We can't negatively impact kids to protect the old/obese because they refuse to take responsibility for their own health.

If you believe that we must, then let's get Novavax approved ASAP. From what I know of it Novavax would be safer for kids than, say, the Pfizer vaccine, since it uses an older, more established platform. I've read that it's actually more effective against Delta and 100% effective against serious illness/death.

stimpy

Agree, but I think that time will show that kids were much more impacted by locking them in at home and preventing them from going to school. And making kids wear masks at outdoor youth sporting events, etc. Those types of things impact a vastly higher percentage of children than the smaller percentage of vaccine issues.

corporate-wage-slave

This goes to the heart of medical ethics, whole university courses have been devoted to this sort of issue. For example, is it in the best interests of a child that their parent dies prematurely? Clearly not. But what about grandparents or uncles? What if the absence of vaccines means schools are disrupted? What if the best teacher in the school happens to be immune compromised and doesn't respond well to vaccines? We know that the risks connected with impaired education are significant. Now I don't have the answers to all of this, but I'd be wary of anyone who says "we should definitly vaccinate teenagers" and just as wary of someone saying "we definitely should not vaccinate teenagers". But if there is a surge and led by youngsters it may be necessary to throw everything at the problem.

outgoing

@ mdkowals -> I think this is more about psychological effect. See what happened in France just from announcement of the mandate. You can do it two ways really: (1) tie to FEDs funding and/or (2) tie to employment (as e.g., some hospitals and unis do). For example, my school mandated vaccines for students but not for faculty (which I actually think is inequitable), however, if you want to be unvaxed they really make your work life miserable with restrictions and testing regimes. Then the third way is really what EU/Cali/NY is doing i.e., digital certificates. The same way you have pre-check you can have vaccine QR code for wherever you need to purchase a ticket.

@ bambinomartino -> I think what Canada is doing is pretty amazing. I really wish people in the US would behave as socially responsibly as Canadians. Yes the government botched the initial access issue but once you got your hands on doses the rollout is amazing. Kind of like what's happening in Singapore.

@ ethics -> this is a tough one but I think the same way we can think about "unknown yet" side effects of vaccines we can also have "unknown yet" effects of COVID exposure. To my lay understanding this is a tricky diseases that can really wreak havoc and the exact phenotype (beyond the basics like obesity etc. mentioned above) of victims is not really understood. This kind of forces us to do less targeted intervention to protect as many people as we can. Furthermore, what we're seeing is that more and more young people are getting seriously sick while the side effects from vaccines are really extremely rare to my understanding (i.e., more rare than e.g., PIMS).

vanillabean

Yes, you would think they have been adults long enough to take responsibility for their actions!

There are youngsters <15, and then there are youngsters 15-30.

lobo411

Yep. The CDC has been leaning in this direction since the spring, and now they've gone all-in.


https://news.yahoo.com/cdc-guidance-...180100796.html

outgoing

Also let's just get a data perspective here. To my understanding currently in the US there were 3 deaths linked causally to the vaccine and these are the J&J blood clot issues (so none in children?). Here are 10 leading causes of death in US from 2018: https://www.cdc.gov/injury/images/lc..._1100w850h.jpg. In age group 10-14 we had 596 suicides and 168 homicides. According to these data: https://data.cdc.gov/NCHS/Provisiona...-Age/9bhg-hcku we had 335 deaths from COVID in age group 0-17 and 116 in 5-14. I'd thus argue that we should focus more on just getting kids jabbed and go back to normal b/c COVID is orders of magnitude more deadly for kids than vaccines (actually assuming that we have zero cases of deaths in kids due to vaccine then it's infinitely more deadly) while mental health issues are more deadly than COVID but may be increasing b/c of COVID if we do not get our society together. CDC is slow in releasing the data but UK will release their suicide data up to mid 2020 in 2 months so we may have some better picture then.

Let's get it straight and simple: vaccine hesitancy actually kills people (and unfortunately not only those who are hesitant b/c this is an infectious disease!). This is involuntary manslaughter. I for one would be devastated to know that I might have killed someone due to my recklessness.

JNelson113

I 100% agree with this. My third grade daughter was terribly impacted by the lockdown and having to go to virtual school. Unless the virus mutates to pose a far more serious risk to children themselves we cannot do this again. I don't look at it as an either/or though.

stimpy

The President of France agrees with you. He refuses to even entertain a discussion about keeping kids out of school anymore, no matter what the teachers unions say. It is a terrible policy on so many levels. Yet many politicians around the world are still trying to force this to happen.

doctoravios

A "surge" of what exactly? PCR positivity becomes increasingly meaningless as a greater fraction of the population is vaccinated. The fact that the UK is even trying to isolate/contact trace at this point in their epidemiological trajectory is farcical. Why are we testing people who have already been vaccinated? What purpose does it serve?

We know COVID-19 will eventually settle into endemecity with seasonal winter outbreaks just like every other airborne respiratory virus. The definition of endemicity necessitates ongoing, active transmission. We will never reach a stable, steady state of endemicity if we do not normalise ongoing transmission of the virus.

Rather than worrying about vaccinating children in the US/Europe (when the majority of the world's vulnerable/elderly population haven't even received a single dose) we should be asking ourselves at what point we are going to stop routine PCR testing/isolation/contact tracing. It makes absolutely no sense to me that we are even trying to isolate/contact trace when we have vaccinated the majority of the vulnerable/elderly population.