If the Objective is Herd Immunity, on Whom Should it be Built?

Area of Science:

• Epidemiology
• Public Health Policy
• Bioethics

Background:

• The COVID-19 pandemic necessitates strategies for achieving herd immunity.
• Younger populations exhibit significantly lower mortality rates compared to older adults (70+ years).
• Existing ethical frameworks do not adequately value younger lives over elder lives in risk-benefit analyses.

Purpose of the Study:

• To propose an age-specific herd immunity strategy.
• To evaluate the ethical implications and potential welfare gains of such a strategy.
• To offer a method for protecting vulnerable elderly populations during a pandemic.

Main Methods:

• Comparative analysis of mortality rates across different age groups.
• Ethical consideration of intergenerational risk transfer.
• Modeling of an age-specific deconfinement strategy versus non-targeted herd immunity.

Main Results:

• A strategy focusing herd immunity on younger generations is rational due to their lower mortality risk.
• Protecting elders through confinement while younger generations develop immunity can drastically reduce overall deaths.
• This approach can decrease the global death toll by over 80% compared to non-targeted strategies.

Conclusions:

• An age-specific herd immunity approach offers substantial welfare gains.
• This strategy exemplifies intergenerational solidarity by prioritizing the protection of the most vulnerable.
• Recommending confinement for elders until herd immunity is achieved in younger populations is a viable public health measure.