Commentary
With the seasonal increase in Covid infections in the Northern United States, vaccines are important to keep the death counts down. To save lives, nothing is more critical than to ensure mass vaccination of older people who haven’t yet had Covid.
While the protection against infection and disease wanes a few months after vaccination, the protection against hospitalization and death is more durable and wanes more slowly. Hence, we should urge all older people who have not yet had Covid to get the vaccine as soon as possible. When the booster shots were approved by the FDA, we knew very little about their efficacy, but a recent observational study suggests that they reduce the risk of both infection and severe disease for those without prior infection.We are now making the same mistake again. Instead of intensifying efforts to vaccinate more of our older citizens, most of whom are retired, the public discourse is focused on vaccinating children and vaccine mandates for students and working age adults, many of whom already have natural immunity after Covid recovery.
Unfortunately, we have entered a tug-of-war between vaccine fanatics who want to vaccinate everyone and vaccine skeptics. The biggest battlegrounds are children and work-place vaccine mandates, while the old are forgotten once again. Forgotten and left to die.
Vaccine fanatics and vaccine skeptics have one thing in common. Together, they have contributed to a level of vaccine hesitancy never seen before in the United States. What the latter failed to accomplish over several decades, the vaccine fanatics have achieved in less than a year. How? Here are some examples:
For older people, who are at high risk of dying from Covid, the benefit of the vaccine greatly outweighs the small risks of a serious adverse event, so it is a no-brainer to be vaccinated.
The same is not true for children. Their Covid mortality risk is miniscule and less than the already low risk from the annual influenza, so the vaccine benefit for healthy children is very small. It will take a few years until we know the Covid vaccine risk profile, and until then, we do not know whether there is more benefit or harm in vaccinating children. When government officials ignore these important issues, trust in vaccines declines among everyone.
There are some health risks with most drugs and vaccines. It is natural that everyone, including vaccine skeptics, want reliable data on this, and it is important to both monitor and be honest about it.
As another example, CDC is releasing raw counts from the Vaccine Adverse Event Reporting System (VAERS) without distinguishing between counts that are above versus the same as one would expect by chance. By doing so, CDC is not properly evaluating potential adverse reactions while inadvertently inviting people to erroneously think that every reported adverse event was caused by the vaccine.
All of this reduces vaccine confidence.

Making the vaccine freely available is not enough. We must honestly explain how the vaccine can save their lives even though others, such as their younger family members, may reasonably not want the vaccine. We must especially intensify outreach to hard-to-reach Americans in rural areas and to those that are poor or homeless.
Rather than forcing the vaccine on the young or those with natural immunity, we should focus on vaccinating more older Americans, as well as older people in other countries. That is what will keep the mortality numbers down. That is what will keep our country together. It may even help keep the world together.