The Times Australia
The Times News

.
Men's Weekly

.

Why COVID-19 vaccines need to prioritize superspreaders

  • Written by Dana Goldman, David Conti and Matthew E. Kahn




Once safe and effective COVID-19 vaccines are available, tough choices will need to be made about who gets the first shots.

A committee of the National Academies of Sciences, Engineering, and Medicine – at the behest of the Centers for Disease Control and Prevention and National Institutes of Health – has proposed an equitable way to allocate the vaccine.

They recommend first responders and health care workers take top priority. Older adults in congregate living situations would also be part of a first vaccination phase, according to the plan.

We are faculty at Johns Hopkins University and the University of Southern California who have spent decades studying health economics and epidemiology. One of us is a member of the National Academy of Medicine.

Having seen firsthand the real risks of rapid, asymptomatic spread of COVID-19 among younger adults, we disagree with some of the recommendations. Asymptomatic spread is shutting down schools and universities nationwide and threatening surrounding communities.

We argue that this pandemic requires a different model for making vaccination choices. After taking care of essential workers, vaccinations should be given to the biggest transmitters of the virus – mostly the young – and only then to the most vulnerable.

Lessons from 2009 flu epidemic

The textbook vaccine model goes out the window when novel viruses emerge.

Some lessons can be drawn from the 2009 H1N1 flu epidemic, which killed an estimated 500,000 people around the world. In the U.S, President Barack Obama declared the spread a national emergency.

A vaccine was developed as early as the fall of 2009. However, only 16 million doses were initially available. The CDC was required to make some difficult decisions about allocation. Some states requested 10 times the amount they were allocated.

In the end, the CDC allocated the vaccine strictly in proportion to a state’s population – that is, on a per capita basis. States then allocated them, often with priority to infants and the elderly, along with people at high risk.

This priority – to protect the most frail – has been public policy since at least the 1957-1958 influenza pandemic.

Later studies, however, have shown that a better way to protect older people was to control spread among the young, which often has meant vaccinating school-age children early.

One of the lessons from these past pandemics is that vaccinating the likely asymptomatic spreaders early can avert multiple infections with others.

[You need to understand the coronavirus pandemic, and we can help. Read The Conversation’s newsletter.]

The superspreaders

The experience of the past few months has shown how important it is to check transmission with COVID-19. A recent study found that as few as 10% of those infected lead to 80% of the infection cases. What has made it more difficult is that up to 40% of those who carry the virus, often known as superspreaders, show no symptoms at all.

Very few of the COVID-19 superspreaders are elderly. It is the younger people who have a much greater propensity to resume social lives at schools and in other venues.

Among the young are a subset of highly social people with wide circles of friends who become the most fertile ground for the spread of COVID-19. These young people also have a much lower risk of death or even severe symptoms, which also means they are more likely to infect others.

Cases have been spiking in the 15- to 25-year-old age group, another likely sign that they are propelling the spread of the virus. A recent outbreak on the University of Southern California’s fraternity row infected at least 40 people.

Several universities cancelled in-person classes after a spike in cases. AP Photo/Gerry Broome

The American Academy of Pediatrics and the Children’s Hospital Association reports that at least 338,000 children have tested positive for the virus through July 30, with more than a quarter of that number having tested positive in just the last two weeks of that month.

More broadly, younger residents in the virus hot spot of Los Angeles County make up the majority of positive new cases. In California, young people between 18 to 34 years of age account for more than one-third of cases.

Young versus old

Anticipating that young people will engage in activities that spread the virus, many universities put their fall classes exclusively online. Some that decided to go in-person had to close after as little as a week on campus.

With or without a vaccine, the best strategy for older Americans, especially those with underlying medical conditions, is avoiding contact with potential carriers.

Optimally, older people will drive down deaths by staying home in large numbers, and younger people will drive down infections by getting vaccinated in even larger numbers. It all works if the vaccine is effective and enough people take it.

We predict the pressures and politics around prioritizing vaccine distribution will be intense. We argue that they key will be to take the most beneficial route, not the most obvious one. With a full-scale public health campaign behind it, that will mean prioritizing those who are driving transmission, not those who are most vulnerable.

As counterintuitive as such a strategy may appear, plenty of evidence shows this would be the right approach.



This article first appeared in The Conversation. It is republished with permission.

Times Magazine

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Science Behind Reverse Osmosis and Why It Matters

What is reverse osmosis? Reverse osmosis (RO) is a water purification process that removes contaminants by forcing water through a semi-permeable membrane. This membrane allows only water molecules to pass through while blocking impurities such as...

Foodbank Queensland celebrates local hero for National Volunteer Week

Stephen Carey is a bit bananas.   He splits his time between his insurance broker business, caring for his young family, and volunteering for Foodbank Queensland one day a week. He’s even run the Bridge to Brisbane in a banana suit to raise mon...

Senior of the Year Nominations Open

The Allan Labor Government is encouraging all Victorians to recognise the valuable contributions of older members of our community by nominating them for the 2025 Victorian Senior of the Year Awards.  Minister for Ageing Ingrid Stitt today annou...

CNC Machining Meets Stage Design - Black Swan State Theatre Company & Tommotek

When artistry meets precision engineering, incredible things happen. That’s exactly what unfolded when Tommotek worked alongside the Black Swan State Theatre Company on several of their innovative stage productions. With tight deadlines and intrica...

Uniden Baby Video Monitor Review

Uniden has released another award-winning product as part of their ‘Baby Watch’ series. The BW4501 Baby Monitor is an easy to use camera for keeping eyes and ears on your little one. The camera is easy to set up and can be mounted to the wall or a...

The Times Features

Vietnam's "Gold Coast" Emerges as Extraordinary Investment Frontier and Australian Inspired Way of Life

$2 Billion super-city in Vung Tau set to replicate Australia's Gold Coast success story A culturally metamorphic development aptly named "Gold Coast" is set to reshape Vietna...

Choosing the Wrong Agent Is the #1 Regret Among Aussie Property Sellers

Selling your home is often one of the largest financial transactions you’ll make, and for many Australians, it’s also one of the most emotional. A new survey of Australian home se...

Travel Insurance for Families: What Does it Cover and Why it’s Essential

Planning a family trip is exciting, but unexpected mishaps can turn your dream vacation into a stressful ordeal. That’s where travel insurance comes in—it’s your safety net when ...

Essential Post-Surgery Care Tips for Dental Implants

Getting dental implants is a big investment—not just in your smile, but in your confidence too. But even the best implant won’t last without proper care right after surgery. Den...

First Home Buyers in Melbourne: 3 Key Statistics Proving Why Home & Land Packages Are Your Best Bet in 2025

Stepping into the Melbourne property market for the first time can feel like navigating a maze without a map. Prices, deposits, and decisions stack up fast. But here’s the good n...

International lager claims crown as Australia’s most preferred beer

Launching its inaugural ‘Brand Map of Australia’, Tracksuit reveals Corona as the nation’s most preferred beer  Sydney, Thursday, 29 May 2025 - From iconic mass-produced lager...