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I am really struggling with the direction we’re going in the US, in terms of vaccinating adolescents right now. I know this breaks with the viewpoints of a lot of people I respect a lot. But, a 
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First off, I’m not really disagreeing with the EUA itself. There are lots of debates about what constitutes an ‘emergency’ and if the FDA was right to give the EUA under these circumstances. I’m not really qualified to say one way or another and I don’t want to. 2/n
Rather, this is about where the Biden Administration chooses to allocate scarce vaccine supplies right now. And, in 2021, it’s a zero-sum game. Vaccinate one population and you don’t vaccinate another. 3/n
The US is broadly taking a strategy of herd immunity with vaccination. That is, the goal is not just to prevent deaths in the vaccinated, it’s to try to keep R below 1 and case counts very low. 4/n
I could honestly argue with this framework (it’s questionable as to if even vaccinating me, a healthy 28-year-old, is a good idea while supplies are still constrained), but I’ll take it as a given for now. 5/n
There’s a critical piece of evidence here: it seems you can reach herd immunity by vaccinating adults, because Israel did it. I was surprised by this. But look at Israel’s case rates. Tiny even amongst unvaccinated children. 6/n
https://ourworldindata.org/grapher/israel-covid-19-cases-by-age
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https://ourworldindata.org/grapher/israel-covid-19-cases-by-age
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Additionally, the harms for cases in this demographic (which can be low even from just vaccinating adults!) are just not that high. Death rate comparable to seasonal influenza in this age group.
7/n https://github.com/mbevand/covid19-age-stratified-ifr">https://github.com/mbevand/c...
7/n https://github.com/mbevand/covid19-age-stratified-ifr">https://github.com/mbevand/c...
This isn’t to say that the harm to children from the virus is 0. I don’t think that at all, and in a world with no scarcity, I would fully support vaccinating children (pending the proper safety / efficacy tests). 8/n
But, it really makes it hard for me to believe that rushing to vaccinate adolescents in the US is anywhere close to the ideal way to maximize lives saved. A little back of the envelope math here.
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And, what about returning to normal levels of social contact, school, etc.? I desperately want that. And I also believe the Israeli evidence shows that vaccinating children isn’t a precondition for it to happen. 10/n
So, yes, I am suggesting that the Biden Administration should prioritize exporting vaccines for vulnerable adults worldwide ahead of vaccinating adolescents in the US. At the very least, I wish this were a more live debate in this country. 11/n
I fail to understand how *not* doing that won’t cost many, many lives, without any benefit in terms of creating normalcy. And, as a progressive, I just can’t feel comfortable with this. 12/n
I don’t have children, and I may never. I recognize that this may slant my viewpoints, and I wish to be honest about that. I don’t mean to disregard the concerns of parents. And, I welcome disagreements.
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