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It would matter for those who can’t be vaccinated (the immuno compromised, very young children) or for those whom the vaccine might not be effective (very elderly with weak immune responses)

It would also matter for eradicating the virus. If it keeps circulating, and vaccines only provide protection for less than a lifetime, then we will have to keep vaccinating just about everyone in the world indefinitely. Any place that falls into civil strife could also expect a virus outbreak eventually.

It would still be great to have vaccine that merely made the virus without effect! But eradication would be better.




> then we will have to keep vaccinating just about everyone in the world indefinitely.

Which is to say, it'll be like the seasonal flu and not a pandemic. Yeah, we can tolerate that.


Well, it really depends on the timeframe. If we need a new one every two years, no problem. If every six months, that’s worse.

Current flu vaccine coverage is 24-50% depending on jurisdiction, once per year. So, aiming at, say, 80% coverage twice per year would be 3-6x the current level of flu vaccination effort.

Not awful, but tiresome.


You don't need 80% coverage though. Influenza would be a pandemic too (and has been!) but is well controlled by the existing regimes. There's nothing all that notable about covid really, beyond its novelty. Once the bulk of the population has some immunity, even if incomplete and even if it needs a regular refresh, we hit herd immunity: R0 drops below 1 and the disease stops spreading. There's no reason to expect this to work any differently.


There are a lot of diseases that everybody gets vaccinated for routinely and regularly. I thought the assumption was this was going to be one of those, it is just a (currently unknown) matter of how frequently you'd need to get it.

Are any epidemiologists talking about possibly eliminating it completely? Seems like the toothpaste is out of the tube for that.


Yes. Devi Sridhar has mentioned it as a goal, fairly sure I have seen others.

We have only eliminated one virus globally (smallpox) but plenty of others have been eliminated nationally. Then to travel to those countries from a country where the disease is endemic you generally need proof of vaccination.

There are also many countries that have basically eliminated the virus at present. They’re not going to want to import the virus just because other countries failed.

Once you have two things the probable future becomes clear: a vaccine, and very fast tests. Combined, they will make it fairly easy for a well governed country to eliminate the virus.

Then, any entering traveler from an endemic country would require proof of vaccination and a quick test at customs to confirm. That would keep the virus out of eliminated countries.

After that it would be a global effort to eradicate the virus country by country, just like we’ve been doing with other diseases such as polio.

A key feature of sars-cov-2 is that it is not like the flu. Coronavirus spreads in clusters and this is containable.




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