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In Denmark where I live, a large proportion of infected people are age 20-29, and I wonder if it would make sense to vaccinate them first when you get to "rest of the population". Even though they have a smaller risk of getting seriously ill, that could be an effective way to lower transmission.

That is:

1. Immunize the age group that is dominating in the hospitalization statistics, then 2. Immunize the age group is accounting for the majority of transmission, then 3. Immunize the rest.

I have a suspicion that once the vaccine rolls out and is working then everybody will throw caution to the wind. It’s going to be interesting to watch this unfold.

Fully expect the same. Basically, if you are less than 65 years old and not working in one of the early access professions, forget all concerns about vaccine safety. Buckle up to face the virus natively in that third wave that will sweep through unmitigated once the high mortality groups are vaccinated.

There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.

There's a good chance that situation will create a black market both for vaccines (real and fake) and forged proof of vaccination.

There may be places you won't be allowed to go and things you won't be allowed to do (like work, maybe) unless you show proof of having been vaccinated.

The UK government has ruled out having a vacination passport (for good reason in my opinion).

The UK government had also ruled the second national lockdown, but here we are. Is there a counter since the last U-turn of the UK government?

This isn't a fair comparison, or reasoned in good faith.

The UK government changed their mind about a second lockdown given new evidence. The virus got much worse and they responded. What new evidence is there that the UK government is going to start vaccination passports? Has something changed?

>>Has something changed?

That's the wrong question. The right one is "may something change in the future?" And an answer on this: "maybe, we don't know, nobody knows the future".

That being said, extrapolation of the exponential curve a month forward is one of relatively simple ways to predict the future. And yet, it was _completely_ unexpected for the UK government. Think about that.

As I recall, the UK government very loudly and repeatedly refused to rule out a second national lockdown, despite calls to do so. Now, Boris Johnson said that he really didn't want to carry out a national lockdown and that it was a last resort, but that's not the same thing at all. Didn't stop the press calling it a u-turn anyway of course.

The Flip-flop / U turn complaint has always irked me. People don’t know the future, people change their minds. I would be disappointed if government were given new information and didn’t change their mind if it was now clear they should do so.

Strong opinions, loosely held.

I am not saying that the government can't change their minds, new things pop up, future is hard. I am just saying that relying on "they promised us to not do that" is dumb. They will do anything once circumstances change.

You are painting a scenario that could theoretically become an issue if vaccination somehow got stuck at some point close to or far beyond the 50% mark for some reason. E.g. to deliberately exclude some part of the population, or in some "the vaccine is actually a carrier for something else" movie plot. But if the limits of vaccination are just the confines of ramp-up and particularly if priority is given to the elderly, it's just a phantom fear. Not allowed to go to work unless you are older than 75? Right...

At first glance forgery seems like a very real threat considering how hard it is to tell vaccine from sodium chloride (entire testing procedures are based on this), but the same difficulty is also working against a black market: why pay if the seller can't give event the slightest indication that it's not a fake and the fake has no intrinsic value at all? You'd have to fake the distribution structures and not the product and an elaborate fake structure isn't something that suddenly pops up from some dark market investment, it could only evolve from simpler black market schemes. But those won't happen, at least not in time (except maybe in places with a truly corrupt regular distribution system, where it would start with "redistributed" real vaccine and then slowly shift over to fakes)

I think folks will be looking for forged documentation that they received the vaccine.

that has already been ruled out in the UK and by many other nations and it is also not something that the WHO advocates so I dont see that getting leverage ever. Except in authorotarian regiemes where it would not be about the vaccine anyway.

Why are you being down-voted? Our politicians are saying exactly this. If you do not get vaccinated, you will have to remain at home.

There are people far smarter than I am developing plans for this, but I'm assuming the thinking is "it's better to vaccinate the person who could die from Covid than to vaccinate the person who could potentially give it to them".

I have no doubt there are some pretty interesting models being developed to determine the best course of action.

We don't know yet whether the vaccine stops people from being asymptomic spreaders. We do know that it is effective at stopping people from getting ill.

So we don't know how beneficial your 2 above would be.

I don't know why you've been downvoted, because this is really important to point out. The vaccine does not, as far as we know, prevent you from spreading COVID; it simply tries to prevent you from having any symptoms. So while it will be effective at keeping people out of hospitals, it may not actually do anything to stop the spread of the virus.

Exactly, as explained here:

https://www.medscape.com/viewarticle/941030?src=soc_tw_20111...

The results announced up to now just showed that the vaccines reduce chance of a vaccinated person becoming sick.

So I should only get the vaccine if I fear for being sick, similarly to the flu, right? I do not want the vaccine. I have been exposed to many COVID-19 positive people and I am fine, thus, I do not want a rushed vaccine.

Because A.) Approx 1 20yo in a million will have life threatening complications. Plus B.) there are a lot more of them than their (are people who have non-negligible chance of dying + people around those with non-negligible chance of dying).

You essentially reiterated their first point without really addressing their second point.

The lockdown is justified by certain measurable factors, such as hospitalization rates, the risk of death, and the risk of major complications, and as we vaccinate the population, these factors will decrease. They will decrease quickly at first and then very slowly taper off to zero. (Remember there will be idiots who avoid the vaccine altogether.) It makes sense to ask when Covid crosses the line from a risk that justifies lockdown to a risk that does not.

There are far, far too many of them compared to the number of vaccination treatments currently available. It wouldn't make a dent. Better to treat the much smaller number of people in high risk groups.

From a sheer infection control standpoint it makes a sense to vaccinate hypermobile social superspreader nodes first. Anyone who comes into contact with lots of people is going to be responsible for more onward infection chains than a reclusive grandma. The butterflies among the young are probably key drivers of spread. Take them out of the susceptibility picture and everyone benefits.

You just have to identify them. I also wonder if a social butterfly has a bigger contact network than the average church goer or retail employee.

Smartphone mobility and social graph data that’s already being collected and analyzed. Rather than just using existing tech to target ads and build surveillance capitalism profiles, it could be used in the public interest. On an opt in basis naturally; but as frictionlessly as possible via cookie tracker popups and updates to FAANG terms of service perhaps.

"Based on tracking your GPS and behavior on Facebook, we need you to come in for an injection."

Where do I sign up?!

Stranger things have happened in 2020 than that! It’s a win-win. Superspreader nodes either get their vaccine or they become aware of how much they’re already tracked may begin to consider the nuances and implications.

There is a considerable Moral Hazard element to this, but it would make sense to vaccinate the most irresponsible people first, since they're the ones spreading it most.

It's not realy moral hazard, it's about what is the goal.

If the goal is to slow down the pandemic, then the "irresponsible spreaders" should be vaccinated first.

On the other side, if the goal is to punish "irresponsible spreaders", then they should be vaccinated last. But that also means that pandemics would not be slowed down, and the ones taking that decision will be responsible for further spreading.

How do you know whether someone is being 'irresponsible' before they catch the virus? Do you follow them around, taking photographs? Imagine the social stigma, for starters. Do you live in the real world, or a computer game?

You could go to karaoke bars, or other danger areas and hand out vaccination vouchers.

Or you could go by demographics. The hardest hit groups in the worst spreading areas. Etc.

You're right that it's not a trivial thing, but if you wanted to do it, reasonable approximations could be found.

If you want to keep the amount of dead people to a minimum, then it makes sense to first vaccinate those who are most likely to die.

HN-ians like to model stuff, and i get that. To do it properly we need to know how many "young"(active ppl) there are, how many old with lung problems, the rates of propagation in and between those, and probably other stuff. But the goal is to keep the deaths down, and my opinion is that by far the smartest way is to first vaccinate the vulnerable people and those who deal with them directly (nurses, etc.). There's also a lot of points about practicality. For example; If i get infected not much happens (i'd just have to isolate myself, even with heavier symptoms). But if my mother gets those severe symptoms she would need to go to the hospital, if she would live at all.

Even if the math says it's better to vaccinate the young ones first, i'd still argue that it's overall safer to vaccinate the vulnerable ones first.

This only would makes sense if there would be evidence that the vaccines are so-called _sterile_ vaccines. Which means vaccinated people cannot transmit the virus to others. But, absolutely no covid-19 vaccine can be considered as sterile, because there is just no data for it. So, it is, for now, just a self-protection vaccine.

The Dutch said they would consider vaccinating people aged 20-29 first if the infection rate had dropped low enough once the vaccine became available.

From what I've understood -- it is not yet known whether having the vaccine will prevent or reduce transmission.

I believe that most experts are expecting it won't.

What a strange apostrophe (it's in the official list). Or am I misreading it?

Older Adults' is a shortened term for certain divisions e.g. Older Adults' Mental Health in UK medical circles. it's a bit of a catapostrophe, but I suspect it was copied, pasted, then added to without due attention

That apostrophe is bad for my mental health

Isn’t it just plural possessive?

It is not. Its is possessive, and I don’t think I would use it to describe more than one thing.

Daaaad get off my internet!

"The resident, who is the property of the older adults..."

Looks like it was already withdrawn and superseded by this: https://assets.publishing.service.gov.uk/government/uploads/...

Seems to have missed the extreme risk group ie those on imuno suppressants transplant patients etc.

Would the vaccine work on those groups? My understanding is that you need baseline immuno-response to develop the resistance with help of vaccine. Isn't one point of vaccination of population to protect exactly that population who can't receive the vaccination?

I'm going through the transplant pipeline right now, and I've been told to expect that it should still work, but probably at a lower effectiveness than someone not on a post-transplant drug regimen. I'm really hoping the timing works out so I can get it pre-transplant though.

Fingers crossed :-) I have a call with the Post transplant team this after noon so will ask.

Which hospital / trust are you with? I had mine done at Royal Free.

I'm Canadian, so I imagine it's a completely separate system (for example, I don't know what a "trust" is). I go to my local hospital which has a pretty large nephrology department.

At first I missed NHS staff on the list; it's tucked in the second bullet point as part of "health and social care workers". A footnote attached to it says:

> The final decision on the prioritisation for health and social care workers will be dependent on vaccine characteristics and the epidemiology at the start of any programme.

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