Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here.
My post the other day argued that self-interested people should not vaccine shop but, instead, get the first vaccine available to them because they can always make up any difference with a booster shot later. That elicited some response (some of it via email) and I thought it was worthwhile responding to the main criticisms.
Just to set up the issue: what time (T) would you be willing to wait, to get a ‘good’ vaccine rather than another vaccine? I was arguing effectively for T = 0 but others see a week or perhaps a month as worthwhile. The main drivers for waiting are:
Fear of getting sick with Covid-19 after the first dose and before getting a booster perhaps a year away.
Fear of infecting non-vaccinated people with Covid-19.
Against waiting is the notion that not accepting the first vaccine offered does not necessarily guarantee that T will be T. I have to say that, in Canada, where there is supply uncertainty mainly due to the US’s continued policy of America First (and you can read my post about vaccine nationalism to think about the morality of that) that factor alone drives me towards T = 0.
Nonetheless, the point of my post the other day was to call for public health officials to be better and more realistic about messaging and choice for vaccine type. I don’t favour restricted choice and I don’t favour glossed over information. I actually think people should be able to choose T but that we need to be realistic about it.
Let me, however, briefly address the two reasons given above to set T > 0.
First, on vaccine efficacy, there is a challenge. Are you more likely to contract Covid-19 with some vaccines (or a first dose only) than others? It looks like it. The question is: what type of Covid-19 do you contract? The hospitalisation/fatality data strongly suggest that all vaccines prevent severe Covid-19. That likely moves the whole severity curve meaning that any Covid-19 you contract with a vaccine dose will be much less severe than it would otherwise have been. (See this post by Zeynep Tufekci about this).
Second, on the possibility of spreading, there is evidence that the mRNA vaccines are preventing this. The jury is still out on the others. So this is a legitimate concern. In other words, it may well be that your behaviour would be different with one vaccine than the other.
For my part, I don’t really expect to be doing much interaction with others until the economy is back open again. But I would like to be less anxious overall and so would be happy to continue to set T = 0. It makes sense that, if you are interacting with people or want to, you want the vaccine that, at the time you take it, is less likely to involve you spreading Covid-19 to others. I personally think that should favour giving those doses to people who, in fact, have little choice in having to interact with others rather than those who currently don’t but would like to. But that is a public allocation rationale, not an individual preference rationale.