In the setting of many unknown's, my preference is to assume and act on the worst-case scenario, and hope for the best-case scenario.
With these studies of IFR (infection fatality rate) varying from 0.00% (smh) to
0.5% to 1.3%, there are so many unknowns.
- How reliable is data collection in USA vs. OECD vs. ex-OECD countries?
- How reliable are serologic tests for prior SARS-CoV-2 infection?
- Does serologic test positivity wane over time? Does serologic test positivity confer protection against future COVID-19 infection? Does serologic test positivity prevent future asymptomatic transmission of SARS-CoV-2?
- How much protection does the Pfizer or Moderna vaccine provide, compared to asymptomatic vs. symptomatic COVID-19 infection?
I would much rather overestimate the dangers of COVID-19, and be extra cautious (social distancing, masking, vaccination), than underestimate the dangers of COVID-19 and put myself and others at risk.
For radiation oncologists and anyone with face-to-face contact with cancer patients, my opinion is that vaccination should be mandated (assuming an infinite supply of vaccine), unless you have uncontrolled HIV, or you're an organ transplant recipient, or you were otherwise excluded from the phase 3 vaccine trials. For young healthcare workers (ages 20's-40's), the primary rationale is protection of patients, maintenance of the healthcare workforce (i.e. absenteeism due to quarantine), and public health messaging.
Since vaccine supplies aren't infinite, and if a fraction of healthcare workers are vaccine hesitant, it may be equally beneficial to just quickly move on to vaccinating older adults and medically high-risk people, like radiation oncology clinic patients.