Elderly tend to be more so infection endpoints, they don't propagate it. If the vaccine prevents transmission effectively, it seems more effective a method to target the prominent vector of transmission.
The staff moving in and out of LTC for instance should be a high priority choice, and among the few groups where they should be fired if they don't want the jab.
The elderly may not transmit it as much as younger people, but they still do--who do you think disproportionately goes to churches, doctors, and hospitals.
Since we don't know whether the vaccines prevent transmission but we do know that they prevent the disease, instead of vaccinating those a few times more likely to spread it, we should vaccinate those with a relative risk of death that is hundreds of times greater (85+ age group's relative risk of death is over 4,000 greater than the 16-24 age group and over 1,000 greater than the 25-34 age group).
Yes to the LTC staff getting it first.
If you're trying to limit infections, you'll do essential workers, including teachers. Also, essential workers are also more likely to live in multi-generational housing.
The main aim should be to reduce deaths. The surest bet (since a) we don't know know whether the vaccines prevent transmission [they probably do] and b) we don't have sufficient supplies to make a major dent in the R0) is to give it to the very oldest and then move to the next oldest age group until differences are no longer meaningful.
Also, essential workers are also more likely to live in multi-generational housing.
Some essential workers live in multi-generational housing and some of that housing contains the elderly and if some of those essential workers are vaccinated they may be prevented (not know for sure) from infecting the elderly in that housing. Surely, if the end game is to protect the elderly in that housing--just vaccinate the elderly.
Here is Germany's priority list:
GROUP 1 — HIGHEST PRIORITY:
1. Those over 80 years old.
2. Care workers who work in elderly people's homes or regularly look after the elderly or the mentally ill.
3. Health care workers with a high risk of exposure to COVID-19, especially those working in intensive care units, emergency rooms, and first responders.
4. Health care workers who primarily treat patients with a higher risk of dying from COVID-19.
GROUP 2 — HIGHER PRIORITY:
1. Those over 70 years old.
2. Those with underlying health conditions that significantly increase the risk of dying from COVID-19. These include those with dementia or a similar mental health issue, those recovering from an organ transplant, and those with Down Syndrome.
3. Those who live or work in close contact with people in care or pregnant women.
4. Doctors and other health care workers who have a higher risk of exposure to COVID-19.
5. Essential workers who maintain public hospital infrastructure.
GROUP 3 — HIGH PRIORITY
1. Those over 60 years old.
2. People with underlying health conditions that significantly increase the risk of serious illness from COVID-19. These include, but are not limited to, people with diabetes, cancer, chronic kidney or liver conditions, HIV or other immune-deficiency conditions, heart conditions, asthma, and clinical obesity.
3. Health care workers not already included in the first two groups.
4. Those vital to maintaining the state apparatus, including the government, police, fire departments, disaster relief, and parliamentarians.
5. Other critical infrastructure workers, including those maintaining power, water, and food supplies, telecommunication networks, the transport system, the pharmacy network, and refuse disposal.
6. Teachers and daycare workers.
7. Those in precarious part-time jobs, including meat-processors, and warehouse workers.
8. Retail workers.
Look how far the list you have to go before you get to essential workers (non health care)!
Let's see the UK:
- Residents in a care home for older adults and their carers
- All those aged 80 and over, frontline health and social care workers
- All those aged 75 and over
- All those aged 70 and over, clinically extremely vulnerable individuals
- All those aged 65 and over
- All individuals aged 16-64 with underlying health conditions
- All those aged 60 and over
- All those aged 55 and over
- All those aged 50 and over
