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Paul Vallely: This necessary injection of principle

11 December 2020

It is right that the elderly are being vaccinated first, declares Paul Vallely


William Shakespeare, 81, receives the Pfizer/BioNTech Covid-19 vaccine at University Hospital, Coventry, on Tuesday

William Shakespeare, 81, receives the Pfizer/BioNTech Covid-19 vaccine at University Hospital, Coventry, on Tuesday

MY HEART lifted to see 90-year-old Maggie Keenan become the first recipient of the vaccine against Covid-19 early on Tuesday morning. And it was more than euphoria at the arrival of the first of vaccines that, we hope, will bring an eventual end to the devastating pandemic that has held us prisoner for most of 2020.

There was a particular joy in seeing it delivered to someone of her age; for pandemic panic had earlier let loose some highly dubious thinking about the allocation of resources in the fight against the virus.

At the outset, the Government embraced the strategy of allowing the virus to spread in a controlled manner in the hope of building up natural herd immunity in the general population. It was only abandoned when they realised that, thanks to the exponential nature of transmission, this would swiftly overwhelm the NHS and might also result in as many as half a million deaths before immunity was achieved or a vaccine arrived.

The immorality of exposing so many vulnerable people to the considerable risks of illness and death for the sake of protecting the bulk of the population was evident even to the most utilitarian thinkers. But some of the alternatives then proposed were equally doubtful.

One Oxford academic argued that, in a pandemic, we should not value every life equally. Old people, Hugo Slim, a researcher on the ethics of war, said, had lived what he called their “biological lives”. In contrast, “the young are having their biographical trajectory dramatically changed by reduced education, socialising and employment.” So, the young should be prioritised over the old.

Another argument that tried to side-step the fundamental principle that all lives have equal intrinsic value suggested that children should be vaccinated first. It was true that children were the group who were safest from harm from Covid-19, a group of academics in the Journal of Law and the Biosciences admitted, but vaccinating children first would most quickly spread immunity through the population, thus providing indirect protection to the elderly and other vulnerable groups. There were thus, it was argued, strong ethical and practical reasons to vaccinate the young to protect the old, since the ageing of the immune system made a vaccine less effective among the elderly.

This ingenious piece of sophistry was as unpersuasive as the idea that vaccines should be distributed according to postcodes, with the most deprived coming first. Deprivation is clearly an indicator of Covid risk, as is ethnicity and a number of other factors. But the overwhelming general risk factor is age, and by an exponential rate (and, in fact, the Pfizer vaccine is 93.8 per cent effective in those over 55).

The crudest utilitarianism came with the suggestion that vaccines should go first to those who drove the economy, from bankers and high financiers to factory workers, utility workers, delivery drivers, and supermarket staff. But value is not confined to function. Leave aside the fact that Maggie Keenan worked in a local jewellery shop until she was 86, she is — as the media are ever fond of characterising older women — a “grandmother of four”. Those children need their grandmother, and Maggie Keenan needed this vaccine.

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