Covid Vaccine Booster Shots: Immoral or Necessary?

[Ray Kamada guest writes. Ray is a retired atmospheric physicist from NOAA/DoD, and is now mostly involved in climate change and renewable energy studies.]

People on both sides of the political aisle have claimed (though with differing motives) that any American who gets a Covid booster shot is taking one away from a low-income nation, where Covid's raging and vaccination rates are still in the low, single digits. Ergo, "Boosting Americans is immoral."

For example, Paul Henley, the British host of a recent BBC/NPR broadcast, used that claim to blast the US for providing boosters for immuno-compromised Americans, and starting this week, seniors and high-exposure adults as well.

This, despite the UK and much of the European Union having already approved their own booster programs!

Yet, beyond "the pot calling the kettle black", is Henley's claim even valid on its own merits? I think not, as it collapses completely under proper scrutiny. 

Let's begin with one stark fact. Pfizer vaccine-based immunity to Delta-driven infection and hospitalization seems to have faded roughly twice as fast as that based on the Moderna vaccine. 

Thus, if each nation aims to minimize its own Covid transmission rate, then, besides prophylactic measures, boosting its immunity via the Moderna vaccine at 8 months seems about optimal. But, contrary to the current CDC stance, it really looks like only about 4 months for Pfizer. Note that these tipping points are well-supported by the Israeli and Mayo Clinic data, plus more recent, multi-state reports collated by the CDC. (Read here, here and here)

Next, in reviewing infection rates, it's rather ironic that three nations with fairly high vaccination rates: the US, UK, and Israel,  also top the global charts for Covid infection and hospitalization rates per capita. 

For Israel, it's likely due to bad timing induced by having, by early spring, dosed most of its seniors and immuno-compromised with the Pfizer vaccine. Case rates then fell dramatically with the outdoor season and, thinking Covid had been brought under control, social restrictions were lifted. So, when the Delta variant suddenly became dominant, the most vulnerable succumbed in large numbers because they were initially, sadly unaware that their immunity had already fallen to low levels. 

Moreover, in the UK and US, despite their fairly decent vaccination rates, unevenly timed and applied prophylactic measures (sanitation, masking, social distancing, school closures, lock-downs, quarantines, testing, and contact tracing), and a sizeable set of entrenched, anti-maskers/vaxxers have also contributed to high case loads. 

This shows that the claim that the US has no need for booster shots is untenable. Yet, one WHO (World Health Organization) official likened boosters to people grabbing two life preservers when they only need one. But really, it's more like the one preserver we have is leaking. 

Then again, the Biden administration acknowledges its role as a global leader and also recognizes that a pandemic knows no borders. Thus, so long as Covid exists anywhere, the threat of a mutation even more virulent than Delta and/or less prone to our current vaccine arsenal could arise anywhere in the world and spread within a matter of weeks. Therefore, the US has already donated 160 million doses of the Pfizer vaccine, more than all other nations combined, and pledges to donate about a billion more to the global supply, more than triple what's now required to vaccinate all remaining, unvaccinated Americans. 

Even so, these WHO officials still chastize the US for not doing enough. One may respond defensively that, to a virus, one part of the globe is as good as another. But any responsible government's initial and primary duty must be to protect, as well as defend, its own citizens. Dovetailing with that at a personal level is the flip side of kinship/friendship altruism - who among us wants to find that, by foregoing a booster, we may eventually infect our own family and friends? 

Yet, such purely ethical discussions overlook a major technical detail. And that is - the Moderna and Pfizer vaccines require unbroken chains of ultra-cold transport and storage that simply aren't available in ~40% of the globe. And this void exists mostly in the same nations that have low vaccination rates. So, together with their high production costs, the two mRNA-based Covid vaccines, produced entirely in the US, are by nature ill-suited for such nations. 

On the other hand, the AstraZeneca vaccine is based on older, simpler, DNA technology, thus needs no refrigeration and costs six to eight times less to produce. So, it's a much better fit for most low-income nations.  Which is why AstraZeneca built a factory near Mexico City, from which they, since late July, have been exporting millions of doses throughout Latin America. 

So, instead of bashing the US, maybe the WHO should ask itself why it's not doing more to support and promote the distribution of the more effective among the six non-mRNA vaccines? 

That is, as of 9/26/21, at least eight vaccines are being actively distributed, such that more than 44% of the globe have already received at least one dose, a higher fraction than the vaccinated of Alabama. 

Meanwhile, India has long been the world's largest exporter of low cost vaccines to low-income nations and has thus begun Covid vaccine exports on a massive scale.  (Read here and here) 

Intertwined with the above issues, we also mention that, as of late August 2021, at least 15 million US doses had spoiled and gone to waste, due mostly to lack of interest or even an outright disdain, promoted largely by red state governors who, unsurprisingly, have all been vaccinated. (Wasted doses reports here, here, here, here, here and here) 

That is, for the months prior to last weekend, one could have walked, unannounced, into almost any Walgreens, Rite-Aid, or CVS pharmacy in America, certainly our local ones, to be dosed in minutes with the Pfizer or Moderna vaccines, because their online appointment books were all nearly blank! 

So, considering these facts and details, not just the immoral US booster claim, but even the claim that jumping the US booster queue was somehow substantively unethical, strikes me as more than a bit dubious. 

*To steal or rob.