Thread by @aaronsibarium

Some scientists are now arguing we don't need boosters because the vaccine remains effective against severe disease. But those same scientists have spent months warning that Delta necessitates a return to masks and social distancing—even for the vaccinated.freebeacon.com/coronavirus/cr…

The scientists from the WHO and FDA who weighed in against boosters this week have consistently opposed lifting public health restrictions in the face of new variants. But that guidance that seems to contradict their argument about the mildness of breakthrough cases.

The vaccinated "need to continue to wear masks," the World Health Organization's chief scientist, Soumya Swaminathan, tweeted in August, adding that the Delta variant "demands that."

https://twitter.com/doctorsoumya/status/1424588541082804229

The FDA officials who resigned over the Biden administration's plan to offer booster shots later this month, Philip Krause and Marion Gruber, likewise touted masks and social distancing in July as a way to "control viral variants." nejm.org/doi/full/10.10…

Of the 18 scientists who criticized boosters, more than half are on record as supporting other, more burdensome interventions since the summer surge.

I asked those scientists why, if boosters aren't necessary, masks and social distancing are. None of them responded.

The tension is the latest example of how confused the campaign against COVID has become. Part of that confusion reflects scientific debates—there's real uncertainty about how fast immunity wanes—but much of it also reflects a political debate about what beating COVID should mean.

That political debate has been complicated by concerns about what the World Health Organization calls "vaccine equity" and by the way scientists have framed those concerns as a matter of impartial expertise.

The first world is on track to receive its third dose while the third world has not received its first, the scientists opposed to boosters stress. But they also say that decisions about boosting should be "informed by reliable science more than by politics."

The back-and-forth over boosters is a proxy for the debate over the pandemic endgame. Some data from Israel suggest that a third dose strongly boosts protection against even mild cases, making it a potentially powerful tool in the zero COVID arsenal. But...

If the goal is just protection against severe disease, additional shots seem superfluous—as do measures like masks for the already vaccinated. It's hard to argue that breakthroughs are so serious we need to suspend normal life indefinitely, but so mild a third shot is overkill.

Then again, many U.S. public health officials, including some in the Biden administration, lean toward the zero COVID approach that logically favors boosting. To sell those officials on vaccine equity, some haziness on goals might be necessary.

One of the WHO scientists who came out against boosters this week, Dr. Peter Figueroa, has explicitly warned against moral arguments in the booster debate. "The cry of Inequity is unlikely to elicit an increase in global access to COVID-19 vaccines," he said in August.

More effective arguments would appeal to enlightened—but not necessarily epidemiological—self-interest. For example, Figueroa said, it's possible that "wider distribution of vaccines" will "reduce illegal migration to developed countries."