Sunetra Gupta, Professor of Theoretical Epidemiology at the University of Oxford and a founding member of the Great Barrington Declaration, says there is no case for a full roll-out of Covid vaccine ‘booster’ doses. Writing in the Telegraph, she suggests that while it is “reasonable” to offer the extremely vulnerable a booster jab, “it can be to no-one else’s individual gain to submit to a third jab, having already reduced the risk of severe disease (which was very small in the first place for most) by receiving two inoculations.”
For there to be the collective benefit of herd immunity, the booster would have to provide life-long protection against infection – unless we are willing to accept repeated mass vaccination into the foreseeable future. Aside from being a colossal diversion of limited resources, that would open the door to a permanent state of lockdown as we lurch from one booster campaign to the next.
All of these speculations and ethical entanglements can be avoided by acknowledging that the vaccines have already brought focused protection to those who needed it in the U.K. and that now the best course of action is to rely on natural immunity to maintain and consolidate a normal state of living with this virus. These booster shots should be going into the arms of the many vulnerable people around the world who have yet to receive a single dose. It is shameful that we have not done this instead of pushing vaccines onto those who were in no need of them in the vain hope of preventing the spread of the virus in more affluent countries.
It is also deplorable that it is being argued that we should vaccinate the rest of the world in order to prevent them from remaining a breeding ground for new variants. It is unlikely that a mutant will arise which evades immunity against severe disease conferred either by vaccination or natural infection. It may be better able to cause reinfections which will then allow it to displace the prevailing variant, just as the delta variant has taken over in many places.
However, these ‘take-overs’ do not imply that the incoming variants are hugely more transmissible. It is crucial that we learn to accept that new variants may outcompete established variants but that these will not increase the burden of disease in a population where the vulnerable have been vaccinated or experienced natural infection prior to becoming vulnerable.
In the unlikely event of the evolution of a variant which resists immunity to severe disease, we will have to develop new vaccines tailored to such variants rather than relying upon boosting pre-existing immunity. It is reassuring that the technology is there to do this on a short timescale, as the success of the current vaccines has shown.
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