Notice: the state vaccine priority plan is an obstacle to collective immunity

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Linn Goldberg and Louis Speizer

Goldberg, MD, is professor emeritus at Oregon Health and Science University. He lives at Lake Oswego. Speizer, holder of a doctorate in physiology, works in the pharmaceutical and biotechnology industry. He lives in Flemington, New Jersey.

Life will not return to normal until enough people are vaccinated, limiting the spread of COVID-19. This “collective immunity” approach takes on greater importance with the identification of new strains of Coronavirus that are even more contagious. If these new strains become widespread, more people will need to be vaccinated to limit the spread of the disease between people.

Although COVID vaccines are available, millions of doses are on shelves in the United States, and those distributed in Oregon are be injected at a snail rate. While Oregon has improved its rollout and provided about 105,000 vaccinations as of Jan. 11, nearly two-thirds of vaccine doses remain in refrigerators. Meanwhile, Oregon has recorded nearly 127,000 cases of COVID and 1,613 deaths.

Like the Centers for Disease Control and other states, Oregon is instituting a tiered immunization response, offering vaccines based on people’s priority levels. Health workers and residents of long-term care facilities are at the highest level and are currently receiving vaccines. Vaccinating this group makes sense to begin with: 50% of COVID deaths have occurred among residents of long-term care facilities, and we need people to take care of those who are sick. In addition, these facilities are equipped to immediately deliver vaccinations.

The next group should include teachers. It may also include other “critical workers,” people with underlying health conditions, and people 65 years of age and older, although the groups are determined by a vaccine advisory committee. The group most likely to spread the virus to other Oregonians is not specifically mentioned. These are Americans between the ages of 18 and 44 who can transmit illnesses asymptomatic or before symptoms appear.

Unfortunately, a complex, multi-layered approach presents a barrier to vaccine delivery. Who will make sure that a person is a critical worker or suffers from a certain illness? Do you bring a pay stub or a note from your doctor to the clinic or pharmacy? What is considered an underlying condition? This adds delay and can lead to vaccine wastage if vaccinators don’t have enough people available to receive vaccines before doses expire, as an Oregonian / OregonLive story reported.

Oregon’s current strategy will not mitigate the spread of the disease; it allows infections to increase.

If the goal is to stop the spread of COVID-19, stop the spreaders as well. This means inoculating everyone as soon as possible. To achieve sufficient immunity in Oregon, it takes nearly 33,000 vaccinations per day for 6 months using a two dose per person approach. As of January 10, 5,422 doses were administered in Oregon.

We are experiencing the most serious public health crisis in more than 100 years. Oregon’s plan should be simple and straightforward, as it was in New York City in 1947, when six million people were immunized against smallpox in less than a month. We suggest immunizing anyone who wants a vaccine as far as supplies allow, including those who are more likely to spread the disease. This is consistent with President-elect Biden’s plan to release nearly all available vaccine doses for immediate use. Since many people are already wary of vaccines, we should try to convince reluctant Oregonians to get vaccinated through public service announcements and professional advice.

We don’t need thousands of vaccines to go through refrigerators, or vaccine panels to tell us who should be vaccinated next. We should end the airline boarding strategy or we will delay the implementation of collective immunity.

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