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Comment by kmeisthax | Hacker News Reader

Yes; however, prioritization lets us speed up the effects of population-scale vaccination by either...

1. Vaccinating people who are the most likely to get sick

2. Vaccinating people who are the most likely to spread the virus

Option 1 makes the death and hospitalization rates fall quicker, so that anyone we miss is more likely to still have a hospital bed to get treated in. Option 2 reduces the total number of people exposed to the virus.

The whole point of vaccination is to keep people from having to go to the hospital or dying - protecting the weakest first achieves that better than random vaccinations. Someone like me who basically lives in his room and works remotely can afford to wait for shots - someone who works in retail and has 1000s of exposures per day needs their shots yesterday.

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Vaccine trials have shown that approved vaccines reduce moderate to severe illness and death. There is no trial-based evidence that they prevent people from catching the virus and spreading it [1]. It's even possible that people who are vaccinated are more likely to be asymptomatic and more likely to unknowingly pass it on.

So "vaccinating people who are the most likely to get sick" is the only option supported by the evidence. Or preferably vaccinate people most likely to become moderately to severey ill, or die.

At this time we should not be "vaccinating people who are the most likely to spread the virus". We don't know if approved vaccines will help with this.

[1] https://www.bbc.com/future/article/20210203-why-vaccinated-p...

It’s arguable the point of the vaccine is secondarily about protecting individuals due to the immunity it confers, and primarily about accelerating herd immunity to kill the virus off, which would counterfactually save thousands of lives per day in perpetuity. (It’s in either case very close between the two.) Given this, it makes prioritization pretty tricky under a supply constraint after you’ve immunized people who are objectively in a revere risk pool. For example, if we knew someone would be a super spreader, but would be at a low risk of severe covid, the margin of lives saved by prioritizing them over others that are at more risk of severe covid may be much higher. (Fwiw, I am skeptical the current prioritization regimes are designed around this optimization problem.)

> Someone like me who basically lives in his room and works remotely can afford to wait for shots - someone who works in retail and has 1000s of exposures per day needs their shots yesterday.

I think this is an oversimplification. We are living in our rooms because we choose to; many who don't work in retail that could be living in their rooms are not, and are voluntarily engaging in 1000s of exposures per day. If those people are young and not in healthcare (mostly true), such potential superspreaders are not priorities for vaccination due to this convoluted priority system.

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