Overall arguments made in “Requisition Big Pharma!” (Solidarity 580) are important and good. The implicit rejoinder to demands to bump school workers up the queue is apt. Yet the article imbalances further than justifiable, or necessary.
It notes “[t]he carefully-reasoned elderly-first vaccination schedule designed by scientists. (They explain its advantages over “no, vaccinate me first” cries from rival younger groups).
“The vaccines probably reduce transmission to some degree; maybe a lot, but we don’t know. It will be difficult finding out. (If transmission drops in Britain now, is that because of lockdown or because of vaccines?)”
The JCVI schedule is right to prioritise strongly according to age, but that is not all it argues for:
“[F]irst priorities [currently] should [include] protection of health and social care staff and systems. Secondary priorities could include vaccination of those... at increased risk of exposure, and to maintain resilience in essential public services.”
The top two of nine priorities in the first phase include carers and “frontline health and social care workers”, because:
“Protecting them protects the health and social care service and recognises the risks that they face in this service. Even a small reduction in transmission arising from vaccination would add to the benefits of vaccinating this population, by reducing transmission from health and social care workers to multiple vulnerable patients and other staff members.”
The article is right to highlight the difficulty in assessing how much vaccination reduces transmission. But implication that evidence will be sought on country-wide bases is misleading.
The day the editorial was published, a paper submitted to The Lancet, although not yet peer reviewed, found a 76% reduction in positive PCR results from the Oxford/AstraZeneca vaccine. The Oxford vaccine team interpret this as translating to an equivalent reduction in infections, hence sources of transmission.
We should not overstate this tentative result. Better would be more direct evidence of reduced transmission. This could be attained through very controlled (e.g. “human challenge”) trials, perhaps even through a very well-functioning functioning and fleshed out track-and-trace system.
Once the most vulnerable have been vaccinated, if firm evidence demonstrates that vaccines do significantly reduce transmission,perhaps targeting “transmission belts” will reduce the number of vulnerable people exposed to the virus at all; protecting better than continued vaccination in order of clinical vulnerability.
“The labour movement cannot second-guess the scientists”, the article rightly states. This brings an obligation to balanced reporting.