Thread by @DiseaseEcology

Why have we given up on targeted vaccination & dose sparing?

Many announcements like below. Seems great except most 50y+ aren't vaccinated in most states, nor are those w/ pre-existing conditions. Given surging cases & still limited vaccines this will lead to avoidable deaths.

https://twitter.com/BNODesk/status/1376594957100802049

In case folks have forgotten death is huge age-dependent (

https://twitter.com/DiseaseEcology/status/1293976338219458560

). It's ~10x higher for every 20 yrs of age. Same for hospitalizations. And yet most states are open to 16/18+ (nytimes.com/interactive/20…).

Remember all the discussions about ways to vaccinate faster? Half-doses? Large gap b/w doses? 0/1 doses initially for already infected? Now clear strong evidence for all these strategies, & yet...
silence.

In many places up to half of current shots are going to 2nd doses. Imagine if all those shots went to 1st dose protection in MI, NJ, MA, NY & other surging states? Imagine if they were targeted to hardest hit neighborhoods in Detroit instead of 20 yr olds in CA?

Cases are surging in many states, but not everywhere. Why not target vaccination geographically where the most lives can be saved & the most hospitalizations (& longcovid) is occurring? Where variants are likely contributing to spikes?

If/when there is plenty of vaccine then by all means - open eligibility. But that's not where we are & it's definitely not where the world is. Imagine if doses given to 18 yr olds in US were given to Brazil? Europe? Canada?

I'm not so naive I'd think most Americans would be happier w/ vaccines being given to other far needier countries (nor do politicians have backbone to do it), but I'd think within states - especially those surging (MI!) we'd do it. Nope.