Even vaccinated elderly, especially those inoculated with an inactivated vaccine, could still die from Covid-19 because full protection may not be possible. Thus, every member of nursing homes should exercise their civic responsibility to fellow residents and be fully vaccinated by March 2022. For those who are unvaccinated without a valid medical reason, they should undergo a weekly self-financed RT-PCR test. While the apprehension of the elderly getting vaccinated is understandable, this fear is simply unfounded.
We should also vaccinate all children (and all members of households with elderly) to prevent them from infecting the seniors, as often happens with the seasonal flu. School outbreaks have been reported in the UK and Singapore as many children and adolescents have yet to receive or have just received approval for vaccination. Their parents may also be reluctant to allow them to get vaccinated due to the fear of vaccine-induced myocarditis, the risk of which can be minimized if the vaccine is given intramuscularly at the thigh, or if they receive an inactivated vaccine, such as Sinovac.
The US Federal Drug Administration (FDA) has approved the use of the BNT vaccine in children and adolescent aged five to 11 years old, when the dose is reduced to a third of that for adults. The risk of myocarditis is, therefore, further reduced. Hong Kong currently recommends adults to receive BNT as the booster dose to prepare for the impending threat of Omicron, where the recommendation on a third dose in children and adolescent is yet to come. Sinovac is expected to develop new vaccines targeting the Omicron variant, hopefully giving parents a second option.
While the antiviral drug Molnupiravir could benefit Covid-19 patients who are unvaccinated due to major underlying illnesses or old age, a study revealed that it only has a relative risk reduction of 30 percent, compared to 67 to 95 percent for Covid-19 vaccines. Moreover, Molnupiravir has been shown to be mutagenic in animal studies and should be avoided in pregnant individuals. Another antiviral, Nirmatrelvir, belonging to the protease inhibitor group, has also recently been approved for use. Although the drug can also reduce the risk of hospitalization and death, it is not without side effects and can interact with other drugs.
Ultimately, the benefit and expenses of vaccination to prevent severe death markedly outweigh the risks. Indeed, if most of the population are fully vaccinated, the Omicron variant can essentially be a good natural intra-nasal vaccine that may boost the airway mucosal immunity of the healthy population with no underlying diseases.