Covid-19 vaccination: the dangers of “values” imperialism

Abstract

Shyan Goh orthopaedic surgeon In response to Schwartz on equitable global access to covid-19 vaccines,1 Lloyd-Sherlock and colleagues2 consider Indonesia’s approach to vaccination programmes as ageist. They attribute the prioritisation of working adults under 60 years over older people to age discrimination and injustice. I ask fellow readers to consider the following: • Trials involving the main vaccine (Sinovac) recruited volunteers under 60 years3; efficacy above this age is largely unknown. Initial focus on younger people is evidence based • In Indonesia (population 267 million), 9% are 60 years and older with an average life expectancy of 72 years; the UK has a population of 66 million, with 16% who are at least 60 years old, with an average life expectancy of 814 • A significant proportion of older people in UK are socially and financially independent, whereas in Indonesia many older people are both socially and financially reliant on their children. The economic fallout from travel restrictionsonunvaccinatedpeopleofworkingagedirectly impact their olderdependants • The UK has multiple safety nets, including the NHS (worth 10% of gross domestic product (GDP)) which delivers “free at point of care” services. Indonesia’s public healthcare system (3% of GDP)5 strives to deliver affordable services but is not considered in the same class as the NHS.