A Note of Caution - don't bully the people into COVID-19 Vaccination - Part II.

In last week's article, we noted that it is an unfortunate reality that the COVID-19 pandemic is having a severe adverse impact on the economies of Caribbean countries, many of which are highly dependent on tourism. Many of our countries desperately want to return to some level of normalcy in order to save the economies from collapse.

But, while I get the anxiety created by the pandemic, I strongly implore our Caribbean governments not to bully the people into taking the COVID-19 vaccine as this is not good for our democracies. But some may say that the COVID-19 emergency situation requires tough measures to "in effect" compel residents to be vaccinated against COVID-19. In the last article, I noted that I hold a different view on that. I do not believe that the circumstances justify compelling people to be vaccinated. Let me explain my position.

First, if a government comes to a position that the current vaccines will be efficacious in significantly reducing the risks posed by the COVID-19 virus and in so doing assist the country to return to normalcy, then it is well within its rights to encourage its citizens and residents to take the vaccine. The government should consider all available information in arriving at its position and it should encourage its citizens to do the same in order for them to make good decisions about their health. Government sharing such information with citizens is encouraged, but the government must not share only the information that supports its position; it must also share all the contrary views as well and explain to the citizen why it arrived at its position. Many Caribbean governments do not do that well and this only leads citizens to distrust governments even more.

But if a government decides not to have honest discussions with citizens, it makes it even more abhorrent for them to ignore the genuine fears and concerns of the people. So, let us look at some more direct arguments regarding whether compelling people to be vaccinated with the current COVID-19 vaccines can be justified.

First, let us look at the true fatality rate from COVID-19 infections based on the global experience prior to the use of vaccines. A true fatality rate would compare deaths against the total number of infections. But total infections are not known and can only be estimated because the full scope of asymptomatic cases is difficult to measure. Based on such estimation, many experts believe the coronavirus likely kills 0.5% to 1% of people infected and they have noted that this risk varies by age, being extremely low among those below 20 years and as high as one in 6 among those over the age of 85.

Now the true fatality rate (TFR) is not the same as the case fatality rate (CFR) which is the rate of death from the disease when measured against the number of new infections confirmed by coronavirus testing. In the United States, that CFR was about 2% in August 2020. The COVID-19 CFR is generally expected to be significantly higher than the TFR.

Some studies suggest that the TFR could be much lower than 0.5%. In one such study, a team from Indiana University and Indiana University School of Medicine, using data for Indiana as of April 2020, showed that for the overall non-institutionalized population of the state, the infection fertility rate (IFR) came out to be 0.26 percent. In other words, for every 10,000 people in the community who had gotten infected, an estimated 26 died. Moreover, the average age at death was found to be 76.9 years.

For such a low mortality rate, is it justified to compel citizens to take a COVID-19 vaccine that entails the use of a technology that was not before used on the human population, one for which the likely long-term effects are debated by experts, one that has only been granted approval for emergency use in the US and Europe? In effect the current vaccine use is experimental especially given the nature of the technology. In that regard, even though the vaccines proved to be safe in clinical trials, there are those with grave concerns over the likely long-term impacts, and there is no scientific information to suggest that those concerns are misplaced. Moreover, even though the current vaccines are effective against the original strain of the virus which they were designed to fight, some experts are concerned that the current vaccines may not be effective against some potential new strains that may develop. In fact, evidence is beginning to surface regarding viral breakthrough cases, i.e. persons getting infected after they had been vaccinated. While that occurrence is currently very low in the US, there is mounting evidence that some new cases are attributable to new strains.

Do you see what we are saying so far? The circumstances do not seem to warrant compelling people to take the covid-19 vaccines. Let us continue to discuss next week.

Kent Vital Economist