...how many people in the world haven't even had one?

My first reaction was gratitude that I'd qualify in a few months for a booster to protect against what has clearly become a medical need to minimize Delta risk - Delta having become a more dangerous variant of COVID. This is especially so since it appears the level of immune protection from the first protocol is waning.

Then I started to read about the world reaction to what is widely seen as American selfishness. (Almost no one in Africa has had even a single shot.)

And I also got a letter from an Aussie friend, complaining that Biden had refused to sell them some of our huge stockpile of unused Pfizer shots. (Aussies are behind the curve in getting vaccinations and whereas they haven't yet experienced a major outbreak, they could.)

FWIW they ended up purchasing a million shots from Poland - no idea whether they were as effective or the same price. In any case, Biden is on their s**t list.

And not to forget the question of the collective good as it's expressed in this question. That is, the more COVID circles the globe (spurred most by the unvaccinated), the more it's a virtual certainty new and perhaps even more dangerous variants will opportunistically develop - thus endangering everyone.

(Remembering how safe Indonesia was for a long time, with their citizens well protected. Meanwhile, they ignored their many guest laborers who were kept together and apart from the populace, with no special efforts made to protect them.)

Only then when the workers developed a furious hot spot of COVID, it broke out and infected the formerly safe "worthwhile" citizens causing a tremendous spread amongst them (still going on).

In other words, what should be done with the still short supplies of vaccines to do the most good? Use them to extend the protection of the already vaccinated (here), or start trying to develop herd immunity amongst the most poverty stricken nations - who are also the most unvaccinated?

(I exclude from our allocation the most immunocompromised.)

Well, the vaccines are distributed globally according to the motivation of profit.

And I've made my thoughts clear enough about Fauci being evil and the CDC Director being a figurehead and out of her depth.

But I'll get the booster shots.

If the Titanic were sinking and there were a place in a lifeboat for you, would your natural reaction be, "I'd rather be eaten by sharks."?

People with an upper middle class sensibility tend to think a lot about ethics.

Oligarchs, not so much.

"mandated"??

When did the Aussies wake up and decide they needed the shots?

I don't think anybody yet responding has grasped (and responded to) the extreme complexity of our situation.

Apart from quarantining whole countries (How?) We sort of tried it early on when COVID was just a new thing, and it didn't work. That was in large part because the world is already so inter-related: economically, owing to the internationality of families and supply lines.

And that was before we realized even the most effective vaccines - made available to all or most humans - didn't solve the problem of mutations. The virus spread and developed ever more dangerous forms.

I wasn't accusing Americans of being selfish per se because of hoarding quality vaccines for their own (willing) citizens' consumption - although that argument could certainly be made.

It's rather a classic example of the tragedy of the Commons in an all new form. By saving vaccines for our own citizens (perhaps in ever improved forms in terms of how well they combat the waning effectiveness of the original forms), it appears we may be contributing to the spiraling development of increasingly dangerous mutations.

Mutations that wouldn't be occurring without the original strains' developing ever more dangerous forms among the maelstrom of the altogether unvaccinated.

Even if one wanted to be as "selfish" as possible there's an all-too plausible argument that it's impossible to do so truly protectively given the nature of the beast.

(Possible outcomes? For the only ultimate survivors being the minority of the species' who have some natural genetic resistance to all forms of the virus.)

What do YOU think is the safest choice for species' survival (in whatever minority)? To hog the most effective vaccines for our own nation (while neglecting the most impoverished with all the incumbent risks of so doing - which may inevitably come back to bite us)? Or to share vaccines as equitably as possible among the world's population (combatting all the most dangerous variants) in order to protect the greatest number of our own citizens?

If we ignore the risk of encouraging the spiral of lethal variants world-wide, what good have we done ourselves? (At the very least, we'd have to be continually tweaking the original vaccines we saved for ourselves - if we could!).

Gimme a time and place and I’ll be there to get my shot.

Now is not the time to debate the nuances of global politics.

It's not politics, Steve and. Daniel.

It's a question of where the vaccines do the most good in protecting us!

I'm referring entirely to research I've been reading about the causes of new variants' development - namely, overcrowding among the impoverished who haven't ever been given an opportunity to be vaccinated. Let new variants keep evolving and spreading among the never vaccinated, and our own "old" vaccines won't do us much good.

Not "virtue signaling" - really trying to figure out the merits of the public policy angle of the medical issues.

(Don't think I'll turn down my booster, for sure. I wonder where the human race is headed in regards to pandemic evolutions if we don't plan on the broadest scale, though.)

Find myself remembering again and again, Poe's "Masque of the Red Death".

I wondered the same thing Amanda did, namely whether it is a better public health strategy to get vaccines more broadly administered before giving better protection for a much smaller group of people. The longer the virus is active and widespread, the more likely it is to mutate into yet another form that might or might not be covered by the vaccine.

It's a really complicated issue. Distribution and administration of the vaccine worldwide is a huge logistics challenge. Even here in the US, with our enormous resources and accessibility, in an eight month period we've only gotten at least one shot in the arm of 70% of the people that are eligible to get the vaccine. That still leaves those who refuse to get the vaccine, and all the kids under 12 who are not yet able to get it. And we're a country of 330 million or so. Scale that effort up to the world and the magnitude of the effort is obvious.

I don't have any answers, but I know we have a huge problem.

The article is about why India was so vulnerable to Covid. And out of this mess came Delta...

"India’s failures parallel those in other countries both rich and poor. A decentralized health system dependent on private industry pushed much of the cost of medical care onto individuals and families, exposing deep disparities between the haves and have-nots — a familiar narrative in the US. As in other developing economies, including Brazil and Colombia, systemic failures and insufficiencies resulted in overwhelmed hospitals and patients left to die without care."

https://www.vox.com/coronaviru...deaths-delta-variant

I'll get a booster when it's available.

This is an issue of life and death.

It seems that whether a booster is the way to go is still an open question....

https://www.bbc.com/news/health-58270098

The truth is we do not have a world-wide solution yet. I'll gladly take the local one, while acknowledging there is yet much to be done.

Because I take an immunosuppressant for arthritis, I am getting antibody tested Monday. We will see how that turns out.

Are you going to get an actual titer, Mik? And did you get the order through your doctor, or are you doing this on your own?

I know Labcorp does the positive/negative antibody test, but I was wondering if I could get a real test..

The titer levels, through my PC. Yes or no doesn't tell me much.

Yea, I know. That's why I was looking for the titer test, but I'm not scheduled to see my doctor for any reason.

I wonder if he'd order it if I ask for it via a MyChart message....there's really no medical reason. I'm just curious.

I understand your point, Amanda. We really have no clear idea how the distribution of vaccine globally would affect the kinds of variants we get. Some scientists have (intelligently) speculated about this, but it is still just abstract speculation about probabilities.

In the current world, governments will protect their own people first. Shock! That applies to democratic and authoritarian regimes alike. Vaccine will be given away to others based largely, though perhaps not exclusively, on how the giveaway affects the interests of whatever group holds power. If we truly cared about the welfare of low-income foreigners, our foreign aid budget wouldn't be so low and so obviously directed toward foreign policy goals.

China didn't give away vaccine because it was nice, or cared about reducing the likelihood of a killer variant emerging, but because it wanted to score political points in the competition with the US for influence in SE Asia. Now that the Sinovac is shown to be rather ineffective compared to mRNA vaccines, the calculations have changed, and the Chinese giveaway is proving less beneficial to Chinese foreign policy goals. The US sees an opening to change the balance again, so Biden is pushing out some free vaccine in that direction.

This is a political calculation about national interests, not a non-political and scientific calculation about global social benefit against mutation. We may wish it were otherwise, but Bolivians won't vote in the 2022 and 2024 elections. The hypothetical risks from not giving away vast quantities of doses don't dominate the very real political risks of doing so at a perceived cost to domestic citizens who do vote.

If we want to end the prisoners dilemma of each nation acting in its own interests and everyone becoming worse off as a result, we need to have the median citizen of the world able to direct policy in the major nation-states of the world.

Dani Rodrik wrote an excellent (now old) article about this, laying out a global political trilemma. International economic integration, mass politics, and the nation state as the main political actor are in tension. Pick two, any two. Not easy to have all three.

How Far Will International Economic Integration Go?