Saturday, June 12, 2021

Vaccine slowdown?

 


Source. Everyone seems tired of covid. And sure, inflation, debts, "infrastructure," competing voting narratives and so on are more fun. But covid is still with us. 

The graph summarizes what I've read in lots of news stories: vaccination is slowing down. There is plenty of supply, but we are running in to people who do not go get the vaccine. 

This strikes me as a tragedy. (Disclaimer: this is an exploratory post, and I'm anxious to hear about it from more knowledgeable people). It means covid will remain with us as an endemic disease, occasionally breaking out as immunity fades and covid evolves. We're on the 20 yard line, folks, it's not time to punt.

I'm pretty darn libertarian, but not about vaccinations. The US should be pushing for near universal vaccination. This is like finishing your dose of antibiotics. 

We do not have to jump to compulsion. Can we at least allow incentives? Vaccine passports sound like a no-brainer even to a libertarian. Allow me to disclose that I am vaccinated, and allow owners of private property like restaurants, bars, airlines, and so forth to demand proof of vaccination. That provides a nice incentive for people to get vaccinated. 

Our policy makers seem so completely deranged by the tiniest "equity" concerns that even this simple step is off the table. On NPR the fact that some disadvantaged groups refuse the vaccine means the rest of us can't have passports. Republicans are also refusing the vaccine, and nobody cares about that! Yes, some immunocompromised people can't get vaccines. Well, on that altar are we going to allow everyone else off the hook, or push to get others vaccinated so they don't infect immunocompromised people -- who shouldn't be going to bars anyway. This debate goes on and on, and time is wasting. 

Even the public messaging has faded away. Our nudgers in chief should be nudging like crazy -- go get vaccinated, people! 

 


I think my best moment as a blogger last year may have been my SIR model with behavior  that predicted the reproduction rate would settle down near one. When it's larger than one, people are more careful, including getting the vaccine. When it's less than one, people slack off. We are seeing a massive case of people, and politicians, slacking off of the one most important step, full vaccination. 

37 comments:

  1. https://www.vanityfair.com/news/2021/04/republicans-anti-vaccine-herd-immunity
    https://www.nytimes.com/2021/04/14/us/politics/republicans-covid-vaccines.html

    The finger is being pointed plenty. Republicans are dooming the COVID effort due to partisan, anti-science fearmongering. Any article about vaccine slowdowns that doesn't specifically call out Republicans as the cause is failing to paint a true picture.

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    1. There is certainly significant hesitancy among some republicans. But there is also significant hesitancy in the African American community. My wife’s work has had vaccines available for anyone that wanted them for months now. Getting African Americans to take the vaccines has been a challenge.

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    2. There is certainly significant hesitancy among some republicans. But there is also significant hesitancy in the African American community. My wife’s work has had vaccines available for anyone that wanted them for months now. Getting African Americans to take the vaccines has been a challenge.

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  2. So what is your estimate for the percent of the population that had covid, and why do you believe that part of the population needs a vaccine?

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  3. About 80% of the over 65 year old population has been vaccinated in the United States. On the other hand, the survival rate of the under 65 US population is approximately 99.95%. Perhaps, the vast majority of people under 65 years of age simply don’t feel they need a vaccine under these conditions.

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    1. Scenario 1: So covid will forever be lurking, being spread by antiVaxxers, and will pop up whenever immunity fades. Fun fun Fun. or Scenario 2: covid goes down to a distant nightmare in the history books, rightfully blamed on dummy conservatives.

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    2. "dummy conservatives" great job moderating John!

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  4. Vaccine slowdown: Oooh, a logistic!

    Looks like Charlie Darwin will take care of the holdouts. He always does.

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  5. I have no idea what you are on about with the "equity" paragraph. I feel like everyone is talking about republican reluctance to vaccinate and libertarian horror at vaccine passports. I can't say I've heard much about "equity" getting in the way of that (see: Florida).

    Honestly, I think hesitancy would melt away for a lot of people with minor incentives. How about a mandated employer day off for your first shot and two for your second? I think a lot of people would value three days off more than their mild "ehh... it's not going to affect me, I'm Strong" hesitancy.

    aside: I agree that the behavioral model was your finest moment. It was a nice addition to the discourse. Sharing the Belgian (?) open letter was probably your worst.

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    1. To mandate workers' days off would be a 'taking' as well as imposing a clearly 'public cost tax' on employers who are victimized by an employee using the day off (with pay). A social benefit ought to pay its costs from general revenue.

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    2. Take the two extreme regimes: All are free to NOT get vaccinated OR all MUST get vaccinated. We can discuss which regime is more efficient, but for now, the regime is all are free to NOT get vaccinated.

      Then, those vaccinated must bribe the unvaccinated to get vaccinated!

      But we may all be free to NOT come into contact with the unvaccinated. Then, businesses would have the right to require masks or vaccination or whatever.

      If we are NOT free to avoid contact with the unvaccinated, we will want to bribe them to vaccinate.

      Real politics seems to think any option is free. It is not.

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    3. @Joe Let me play my smallest violin for the poor "victimized" employers. They are already so taken advantage of by their dastardly freeloading no good employees who have the gall to take federally mandated lunch breaks. Eat on your own time!

      Sure, a uniformly applied policy like this would improve the bottom line of businesses by more than they'd lose in vacation days (lower infection rates ---> more spending), but it's the principle of the thing!


      \s

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  6. Prof. John,

    With all due respect, you are not a libertarian because you do not believe that individuals must be free as a principle. This is clear when you defend that the government should order vaccination of the individuals. Ant it is the same position of democrats. The only disagreement is about which dictator is the best.

    Instead of a libertarian, you just seem like a good economist, who at least knows that free markets are nearly always the most efficient solution. But when the question gets outside economic efficiency, you show the same lack of appreciation for individual freedom of socialists, krungman, etc. I think that this is a pitty...

    About allowing private entities to discriminate, yes, I am in favor, as a true libertarian. But everyone must be free do discriminate based on whatever they want: Sex, race, religion, political affiliation, etc. This is not being discussed. In addition, the government is the one ordering vaccination to travel. Again, inconsistent with individual freedom.

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    1. We Libertarians recognize the "purists" among us; the "Hasidic" ideal of a purely voluntary, individualistic society is understood - like a Buddhist virtue. But in the lowly "practical" world of Aristotle it is clear "the best must not be the enemy of the good enough result. We understand a trade off."

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    2. What a beautiful religious speech! Sleep with that John.

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    3. I'm pretty sure being an ideologue isn't quite as commendable as this guy seems to think it is.

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  7. Completely eliminating Covid, in the USA or anywhere else, is likely to prove impossible. Even if every single person were vaccinated, there are millions of people in the USA with compromised immune systems in which the vaccine doesn't take well. Only one single viral illness - smallpox - has been wiped off the planet by vaccination. We have been struggling to eliminate polio for decades without success. The odds are very high Covid will become endemic, like influenza, and I suspect annual vaccination will be necessary to deal with mutations, just like influenza.

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  8. The CDC estimates that 114.6 million people in the US have already had COVID. Immunity acquired through COVID infection is at least as strong as immunity acquired through vaccination. There is no reason to vaccinate the 1/3 of our population that contracted COVID and is now immune.

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    1. Unknown.. the CDC also states clearly that vaccine development is a LONG process taking usually 10 years. go to their site and look it up. why I will pass on this vaccine has everything to do with #1 I never have had any flu vaccines don't get sick.. second. mRNA vaccinesx 3 of them in rapid speed of development have potential long term risks , they HAVE not been tested don't believe me go to the CDC site. FDA is sadly a political wing of big pharma. so they allowed passage with close to zero trial.

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    2. From my understanding, vaccine induced immunity is likely to be better than immunity achieved through natural infection. And so far, the best immunity is from having recovered from Covid and been vaccinated.

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    3. I wish you well when you undoubtedly get covid.

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  9. To be sure the Florida governor deSantis is at the forefront of disallowing vaccine passports, even for cruise lines. I’m not sure why one wouldn’t mention that unless there is partisanship involved Prof Cochrane.

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  10. To be sure the Florida governor deSantis is at the forefront of disallowing vaccine passports, even for cruise lines. I’m not sure why one wouldn’t mention that unless there is partisanship involved Prof Cochrane.

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  11. To be sure the Florida governor deSantis is at the forefront of disallowing vaccine passports, even for cruise lines. I’m not sure why one wouldn’t mention that unless there is partisanship involved Prof Cochrane.

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  12. John,

    I think your usually insightful comments have strayed. Early in the pandemic you were a strong proponent of rapid and cheap testing as a means of controlling the the infection. We still do not have them in scale and they are what we need. When I want admission to something it is irrelevant whether I have antibodies against COVID via prior infection or vaccination, only that I have the antibodies. If you want a passport, it should be an antibody passport, not a vaccination passport. Early in the pandemic it was estimated that 50% of the infections were asymptomatic, a number that can only be higher now that the vulnerable (who do get sick) have been taken out of the equation and replaced by the young (most of who do not get, or significantly, sick). The important measures, hospitalizations and deaths, are way, way down. Finally, you ignore the question of immunizing children, where the issues are most contentious and signivicant.

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  13. My preferred approach would be for health insurance to quick covering COVID related expenses for people that decline to be vaccinated for anything other than a verifiable health related reason. If someone wants to sell separate policies that cover COVID expenses, I'm fine with that, but don't make rational people subsidize the irrational.

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  14. I think the denominator is important here. The vaccine isn’t approved for children, so we shouldn’t be dividing by the whole population. If you divide by the adult population, the percentages are significantly higher. Granted, adolescents can now get it, but that is pretty recent. The data may not be available, but I think it would be better to break this logistic curve down by age group (75+, 55-64, 18-54, and 12-17).

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  15. Or maybe people are just rationale risk analyzers. Going out and getting Covid and dying is about as likely as dying in an auto accident. If you've been vaccinated it's about as likely as dying from an insect bit.

    And people don't care about R nought. They only care about the likelihood of going out and dying or killing someone, which is a function of both R0 and the current number of active infections.

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  16. The most likely path for the coronavirus was to reach low grade endemicity and the growing apathy of the masses for vaccines is understandable (a similar phenomenon happened after the H!N1 episode in 2010).
    A reasonable effort should be made to reach those who hesitate (not sure, lazy etc) but it is what it is.

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  17. Super great post! Very informative and I applaud your willingness to think logically and not let libertarian ideology get in the way of sound public policy. As someone who is "libertarian at the margin" to steal a phrase from G. Mankiw I share your view.

    I fully agree that the externality associated with getting vaxxed is so large that it should somehow be incentivized. I wonder, however, if PAYING PEOPLE is the right way. More specifically, I view anti-vaxxers as inflicting a negative externality on everyone else. In that case the appropriate policy is a tax and not subsidy. Accordingly, I favor taxing non-vaxxers. The tax need not be pecuniary. They can be restricted from entering public spaces or places of work, their kids can be forced to do online schooling from home and so on and so forth. Until you are willing to "join the team" I favor penalizing non-vaxxers to internalize the negative externality they inflict on society. In some sense it doesn't matter as Coase implies that the payment flow follows the endowment of property rights. In this case, however, I do not think we should begin with the presumption that you have a right not to be vaccinated. There are a number of vaccines you must have to attend school - mumps, rubella, tested for TB and so on. The case for defaulting to "you must get vaccinated" seems far stronger here.

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  18. It's time to start pushing those vaccine doses out in the world at large, instead of hording them. Don't send them to COVAX. Put the vaccine doses out via U.S. A.I.D.--get them into the hands of those who most need them. Vaccinating the rest of the world will do as much or possibly even more than holding the vaccines back in the hope that you can use the vaccines domestically.

    Aside: Hovering at a R0 level of 1 does not make the virus go away--it simply means that the number or proportion of infecteds is stationary.

    Further aside: The continental U.S.A. does not fit the assumptions that enables the S.I.R. model to accurately predict the course of the pandemic. Using R0, based on the S.I.R. model assumptions, to determine whether the pandemic is currently active or has converted to an endemic makes for news headlines, but little else.

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  19. Companies should definitely make their workers get vaccinated. They have a fiduciary obligation to not employ people who are willingly putting coworkers and customers at risk.

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  20. Almost no one is at risk that hasn't accepted that risk. Kids sail through, the elderly have mostly been vaccinated, and others are waiting to see the efficacy of all this. Makes perfect sense to me. I'm glad I live in Florida!

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  21. Unfortunately I cannot listen to a word you say about vaccines until you address the ivermectin evidence.

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  22. I'm good, no pre existing conditions and have already had it. You can have my vaccine. And the boosters. And shot 3 and 4, as something needs to be done with the stockpiles.

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  23. Journal of Economic Perspectives, Vol. 35, Issue 3, Summer 2021.
    https://www.aeaweb.org/issues/646 On-line access to the articles in this issue is 'complementary' (free).

    "Symposium: COVID-19" -- three articles that explore specific aspects of the cost of the pandemic and related responses by federal, state, and local governments. Speaks, in part, to your concerns expressed last year concerning the cost of economic shut-downs. The evidence is coming in now.

    "Effects of the COVID-19 Recession on the US Labor Market: Occupation, Family, and Gender" (#2)
    Stefania Albanesi and Jiyeon Kim
    Full-Text Access (Complimentary) [ https://www.aeaweb.org/atypon.php?return_path=/doi/pdfplus/10.1257/jep.35.3.3&etoc=1 ] | Supplementary Materials

    "The Great Unequalizer: Initial Health Effects of COVID-19 in the United States" (#3)
    Marcella Alsan, Amitabh Chandra and Kosali Simon
    Full-Text Access (Complimentary) [ https://www.aeaweb.org/atypon.php?return_path=/doi/pdfplus/10.1257/jep.35.3.25&etoc=1 ] | Supplementary Materials

    "Tracking the Pandemic in Real Time: Administrative Micro Data in Business Cycles Enters the Spotlight" (#4)
    Joseph Vavra
    Full-Text Access (Complimentary) [ https://www.aeaweb.org/atypon.php?return_path=/doi/pdfplus/10.1257/jep.35.3.47&etoc=1 ] | Supplementary Materials

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Thanks to a few abusers I am now moderating comments. I welcome thoughtful disagreement. I will block comments with insulting or abusive language. I'm also blocking totally inane comments. Try to make some sense. I am much more likely to allow critical comments if you have the honesty and courage to use your real name.