Booster vaccines: humanitarian disaster or vital protection?

By Joseph Gellman

As the people of the United Kingdom enjoy their freedoms in a post-lockdown summer, epidemiologists around the country are wary of the fact that autumn is looming. If immunity from the initial Covid-19 vaccinations wear off and cases begin to rise with the return to schools and universities (coupled with colder weather), then the NHS may begin to struggle again, and the country could face a return to restrictions.

To avoid this potentially disastrous outcome, many members of the medical world are proposing that vaccine booster shots should be given out later this year, targeted at the most vulnerable who were vaccinated earlier and would therefore be more likely to have less immunity by the start of the autumn and winter months.

In order to decide whether a booster scheme is desirable, one first needs to verify whether it would even work in the first place. Fortunately for those making the decisions in the UK, Israel has already begun giving those aged 50 and over a third jab, and preliminary data suggests that it does lead to an increase in immunity when compared to those who have only had two jabs. As such, it does seem initially desirable to undertake a booster programme.

Many deem it morally repugnant that citizens of advanced countries should be receiving third jabs when those in developing countries haven’t even received their first.

However, there are reasons to oppose a booster programme from a more humanitarian basis. By most metrics, the UK has had a very successful vaccine programme. Over 70% of the entire population has received at least one dose so far. Much of this is due to our privilege of being a rich, advanced country.

Many developing countries on the other hand have not fared so well. One example is Bangladesh, which currently has one of the highest numbers of new Covid-19 deaths in the world. As such, it is not particularly surprising when one finds out that less than 10% of the population have received their first vaccine dose. This story is repeated all over the developing world and many deem it morally repugnant that citizens of advanced countries should be receiving third jabs when those in developing countries haven’t even received their first.

As well as this, allowing Covid-19 cases to spread rapidly in certain parts of the world risks the rise of another variant that the vaccines could potentially be less effective against. Although it is unlikely for a variant to fully escape the neutralising effects of the vaccines, it is not worth being complacent.

We have also seen how a variant can still spread through a highly vaccinated population, as has occurred with the Delta variant in the UK and Israel. This gives further credence to the view that we should focus on vaccinating the developing world before we start booster schemes in more advanced countries.

The same appeals to humanitarianism can be made in favour of the booster scheme.

Whilst these arguments against having a booster scheme are strong, I do not believe them to be convincing enough for two key reasons. Firstly, the same appeals to humanitarianism can be made in favour of the booster scheme. The reason the scheme is being discussed in the first place is because of the risk of a serious spread of Covid-19 in the autumn and winter which could lead to many vulnerable citizens being hospitalised and dying. Whilst it is fair to argue that Western governments have a duty to the rest of the world, their primary duty is to protect their own citizens; such is the role of any government.

Further to this, a lack of a booster scheme heightens the chance of Covid-19 rapidly spreading through the UK again. Such a scenario could lead to the rise of another variant, just the same way that a variant could mutate in the developing world. We have already seen this potentiality occur at the end of 2020 as the Alpha variant (which was believed to have originated in Kent) eventually came to dominate the world’s Covid-19 case numbers.

To summarise, it is clear from preliminary data that a vaccine booster scheme would help mitigate the negative effects of Covid-19 in the coming autumn and winter months. Despite this, many are still against such a scheme based on humanitarian concerns for the developing world and the risk of variants that follow. However, when one considers the impact of not giving out third jabs in the UK, I believe having such a scheme once again becomes permissible and desirable.

Image: Nick Fewings via Unsplash

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