covid-19 vaccine US america
(Image: AP/Mark Lennihan)

In Both Sides Now, author and ethicist Leslie Cannold presents two sides of an argument and then it’s over to you: what do you think is true, and what do you think Cannold really believes?

Today: Israel is doing it, and the UK has started to give a third COVID “booster” shot too. As the Sydney and Melbourne lockdowns drag on — and other cities teeter on the edge — Australians want to know what can be done to put an end to outbreaks for good.

Yes: It’s simple. An extra vaccine booster is the only way out of rolling lockdowns. If we don’t want to continue slogging through intermittent outbreaks and oppressive restrictions, then the science suggests we need greater protection — and fast. No: No one is protected until everyone is protected, and if wealthy nations use vaccine supplies that could be donated elsewhere, struggling countries won’t be the only ones hurting — it means a breeding ground for new variants.

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Yes

Immunity is our only true form of protection against the ravages of COVID-19, other than public health measures like border closures, lockdowns, masks and social distancing.

Because Australia has been such a success story in keeping infections low, our only way to get this immunity is from vaccination. But as everyone not living under a rock knows, we only have access to two. The one most people will get, Pfizer, is 88% effective at protecting infection from the Delta variant after two doses, and 96% effective in preventing hospitalisation. The other, AstraZeneca, is 67% effective in preventing symptomatic cases with the Delta variant and 92% effective against hospitalisation after two doses.

With these efficacy rates, and a variant as virulent and transmissible as Delta, 90% of Australians would have to be fully vaccinated for us to dispense with lockdown and open our borders for good. As long as we can maintain our immunity, which fades over time.

Most experts doubt we can achieve vaccination rates this high, dooming us to an eventual overrun of our hospitals if we did throw caution to the wind and open up.

Instead they have suggested other options. Professor Tony Blakely’s team in Melbourne, for example, suggests we could open our borders with just 80% vaccinated if we were willing to accept “ongoing aggressive contact tracing, mask-wearing in high-risk settings and some physical distancing” as the new normal.

Boosting the coverage provided by vaccination is another option. Indeed, this is what a recent American study has called for after findings that the Johnson & Johnson vaccine — which has the same architecture as AstraZeneca — is “much less effective” against the Delta and Lambda variants.

Indeed, if we followed the data and the example of Canada, Denmark, Finland, France, Germany, Sweden, Norway, Spain and South Korea, who are mixing-and-matching different vaccines, we could provide a four-fold increase to the immune response of older Australians who had AstraZeneca by giving them a third Pfizer booster shot.

While we don’t yet have the data to say which booster those who’ve had Pfizer could get to boost their protection against Delta, studies to find out are in train.

Sticking your arm out again or wearing masks and waiting for the lockdown axe to fall again? I know what I think would be best.

No

We are experiencing a vaccine shortage. Not just here in Australia, where the problem is temporary. Already supplies of Pfizer are arriving and by next year we will hopefully be producing a mRNA vaccine here in Australia.

The real shortage is in the developed world, which is increasingly at the epicentre of the COVID-19 crisis. This includes our neighbour Indonesia which, despite 2,950,058 cases and 76,200 deaths, has only around 6% of the population vaccinated, many of them with the Sinovac vaccine, which has been so ineffective against the Delta strain those who got it require a booster.

In the face of this brutal reality, the discussion in the developed world of additional booster shots for those who’ve already received a full course leaves me breathless.

As the director-general of WHO put it, such grotesque vaccine disparities were driven by “greed”. WHO emergencies chief Dr Michael Ryan said that if rich countries decide to administer booster shots rather than donate them to the developing world, “we will look back in anger and I think we will look back in shame”.

But if the moral case doesn’t move you, here’s the practical one: with COVID, no one is protected until everyone is protected. While we may not feel the suffering and death of our Indonesian neighbours as acutely as our own pain over lockdown, uncontrolled spread anywhere gives birth to the variants — like Delta — that eat away at the protection existing vaccines provide everywhere. And as our protection goes, so will our freedoms.

We can live without extra shots, but those in countries like Indonesia and Papua New Guinea can’t. They belong in the arms of those around the world who most need them.

Which side do you think Cannold sits on? And what do you believe? Let us know by writing to letters@crikey.com.au with Both Sides Now in the subject line.

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Peter Fray
Peter Fray
Editor-in-chief
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