The case from human rights is the only one that really works
Those who have the capacity to understand the science must also accept the political situation in the US today. Many will simply reject a moral argument for worldwide vaccination. To use the jargon, targeted advertising appealing to the tribal instincts we are witnessing will be the only means of persuading many in our population.
Let me see if I can spin this: "Do unto others as you would have them do unto you."
As expected, you have once again provided great reporting, analysis, and values.
It's a bit the same as the "we should have told people that masks protect them instead of others" argument... do I wish people were more serious about wearing masks and properly at that? Yep! Do I think we should lie to them because a non-trivial amount of them are selfish pricks? Nope...
I’m not sure this argument actually means much—unlike the mask issue, this is not a matter that will be determined by ordinary citizens. In fact, there doesn’t really seem to be a question of whether people in the developing world will be vaccinated—the question is how soon, whether it requires waiving patents and whether/when the US will release its surplus vaccines, as noted in your NY Times column. But the audience for the argument are world leaders, not regular folks or even academia, and we should consider that maybe those folks are less susceptible to “hippy dippy” arguments than the average human (who still have a high tolerance for basic-human-rights violations happening far away). I actually think the argument in the Times column—that the US and Europe should maybe use this as a golden opportunity for some “soft power” diplomacy to get ahead of the Chinese and Russians (who have their own, possibly less effective, vaccines) is the most persuasive argument for the people actually in a position to decide.
There's a popular karmic narrative that will often surface when people discuss this topic, whereby anyone who ignores the developing world will find the virus coming back to haunt them for their hubris and selfishness. But as you point out, the arc of viruses doesn't automatically bend toward justice. Sometimes viruses.....just. The world (even or especially as revealed by science) can be a really unfair, unpredictable place. Maybe it's enough to simply make the moral argument for its own sake as you suggest, and if people want to assign karma they can do so without relying on epidemio-logic.
I totally agree that we shouldn't lead with the "selfish & practical" argument, but my sense is Stroehlein was invoking this more as a Plan B for those who are unreachable otherwise, a kind of rhetorical last-ditch appeal. "Hippy dippy wishful thinking" isn't his own characterization of the moral argument, more like an interpretation of the other person's dismissal.
Speaking of selection pressures, would the usage of the viral vector vaccines or the mRNA ones which target the spike protein lead to newer resistant variants? It looks like these vaccines are less effective against variants where the spike protein mutates. Is there a parallel here with the remdesivir chain of events leading to the creation of the UK variant?
Hi Zeynep! Your post has two facets to it -- is the selfish claim true, and is it effective. To avoid muddying things up, I'll just reply to the latter point.
Would you agree that, if you had a Magic 8-Ball that could accurately tell you which message was more effective, that you would use the effective message even if you considered it morally inferior? If not then we don't need to debate effectiveness. 8-)
There are very large numbers of people whose job it is to predict what messaging will be most effective, such as advertising execs and political consultants. I'm leery of our year-long history of trying to guess at what messages will work. Is there not a more rigorous way to decide? Or maybe just do targeted advertising? Your posts are so often about data and facts, but this facet is of necessity handwavey.
We had people who tried to outguess people by telling them not to wear masks, lest they engage in unsafe conduct. Even Saint Fauci originally said that only about 60% of Americans would need to take the vaccine in order to contain the virus, but later admitted that he was lying because he thought the real number would be too intimidating. Individuals untrained in marketing are making marketing decisions.
There's also been a lot of conversation about whether to give people enough info to decide for themselves how to stay safe, versus giving people clear and terse tweet-sized summaries.
I wish we had an area-expert to turn to so that the most highly educated elite people on the planet are not trying to guess the psychology of the mainstream of humanity.
You said: "Plus, even if there were some completely rational but coldly calculating individuals who might be suspect to such reasoning..." Libertarians and xenophobes -- both of which the USA has in abundance -- would prefer the selfish argument. Perhaps not completely rational, but none of us are if we're honest with ourselves.
Selection pressure is certainly important in the formation of new variants, but so is absolute number of viral replications. There are many sub-clades of virus found via viral genome sequencing that are unlinked to immunocompromised hosts. These are also "variants" and, by chance, may end up being more or less lethal/transmissible.
I think it is difficult to determine causality in the formation of new variants; though, of course, selection pressure via (non-efficacious) plasma and pharmaceutical interventions won't help. Similar to antibiotic resistance, that one.
But I think the selfish argument of "we don't want more variants circulating so let's vaccinate everyone" is very well plausible to be a good strategy to prevent immune evasion.
On the other side of the coin, of course, is the idea that the mutational landscape of SARS-CoV-2 (or any virus, for that matter) is limited due to the necessity of ACE-2 binding by the RBD. This leads many to believe that new SARS-CoV-2 variants will be limited in their ability to become a "superbug" a la B117. With evolution, though, who knows but God?
Anyways, we agree: world-wide vaccination is a priority. I believe in this firstly due to basic human morality. Secondly, and perhaps more convincingly to the Kissinger-types, we must help the world to keep us from a potential future disaster.
Let's keep it simple. WHO distributes Kf94 masks to everyone world wide while they are waiting for vaccinations. Good value for the money.
While this is an engaging argument, - I don't think it is of much practical importance. The premise gives too agency to "us" and not enough to "them". We are no longer the movers and shakers of the world, if ever we were. Most large countries have the technology to make a decent vaccine and those that don't can purchase them in the quantities they need. For example, Mali may need our help but Nigeria won't. And Mali will get the vaccine from countries with the variety of motives states are known to have.
Australia watching PNG where transmission of COVID19 is well ahead of vaccinations.
Am I wrong that by the time the booster shots make it into my arm, they will likely be a full year out-of-date with respect to new strains? This wouldn't make me (or others) feel safe from variants.
The NYTimes reported last week that in large parts of Africa and Asia the virus does not seem to have spread. A follow-up report based on input from researchers suggests that the correlation of susceptibility to the virus correlates inversely with obesity within the population at large.
Assuming there is some accuracy to these claims, how would they modify your position? Would you still aim to vaccinate people in countries where the virus has not taken hold simply on a humanitarian basis? Or would you focus on regions where it has taken a hold?
Why choose? Each message can work, depending on who hears it. They integrate well under the "We're all in this together" umbrella.