Wednesday, February 1, 2023

Ron DeSantis Vaccine Complaint Exploits Public Health Gaffes

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Earlier this week, the medical website STATnews reported on data showing that Covid vaccines have saved 3 million lives in the US. That’s about three times as many Americans as have died from the virus. Even if you argue with the exact figure, these vaccines have been a significant achievement.

But on the same day, Florida Governor Ron DeSantis petitioned the state Supreme Court to begin a grand jury investigation into the safety and efficacy claims behind mRNA vaccines — the dominant type used in this country.

Despite the success of these vaccines, misleading messages from public health experts and the White House have created confusion that has left fertile ground for DeSantis’ disingenuous and self-serving maneuvers.

It’s time to talk honestly about the downsides of Covid-19 vaccines. They don’t do much to prevent people from getting mild cases of the actual variants. They don’t do much to curb community transmission. And like all pharmaceuticals, they are not completely safe. Booster mandates for youth constitute security theater (free rapid tests would do much more to keep college students from infecting their grandparents or professors).

Writing off or ignoring these minor problems has eroded public trust and created an opening for DeSantis to sow discord and confusion.

While it’s fair to say that presidential hopeful DeSantis is proving himself to be a health risk with his fraudulent petition, the move capitalizes on the pre-existing distrust of public health, big pharma and the media on the part of many Americans.

In the parts of his petition dealing with safety concerns, DeSantis is playing on a common misconception: that anecdotes count as data. If you followed hundreds of millions of people over a period of time, some would die or have complications suddenly, by chance – and so when you give hundreds of millions of people a vaccine, the same thing will happen for reasons that have nothing to do with the vaccine. (This was brought home by the sudden death of sports journalist Grant Wahl, 49, during the World Cup — attributed to an aneurysm by an autopsy but used by vaccine skeptics to stoke fear.)

But there is also a false narrative from the left, which was parroted in a Politico article about the DeSantis grand jury stunt: “Most of the medical community, including the Centers for Disease Control and Prevention, the FDA and Johns Hopkins, have emphasized that the Covid vaccine is safe and effective in preventing the virus and protecting against serious symptoms.”

Science no longer supports the notion that the vaccine prevents the virus from infecting people. “The benefit of vaccination in the omicron era is not the protection against infection that it once was. It’s protection against what matters most: serious illness, hospitalization and death,” said Johns Hopkins University researcher and senior physician Amesh Adalja.

Pediatrician and FDA vaccine advisor Paul Offit told me the same thing earlier this month — vaccines and boosters in 2022 and beyond are good for saving lives and preventing serious disease. At this point, most of the vaccinated people have been sick with Covid. They know the vaccine did not “prevent the virus” for them.

The science behind this issue is not that complicated. The shots trigger so-called cellular immunity, which can provide months or perhaps years of strong enough protection against the kind of severe illness that lands people in the ICU. In those who are not elderly or immunocompromised, this protection persists even against the highly mutated progeny of omicron now circulating.

But variants have evolved increasingly efficient ways to overcome the first line of vaccine-induced defense – antibodies. So vaccine protection against minor illnesses is porous and transient. That’s why Offit says it’s best to focus booster campaigns on those who need extra protection against serious illnesses.

There’s a reason scientists initially said the vaccines would prevent transmission of the virus: Clinical trials conducted in 2020 showed that the Pfizer and Moderna vaccines were about 95% effective at preventing symptomatic disease. It wasn’t perfect, and as I wrote in this 2020 column, companies should have collected data on whether vaccines also prevented asymptomatic infection. But it was a reasonable conclusion that vaccinated people were less likely to become infected and spread the virus.

The trials had other limitations—the Pfizer trial, for example, followed about 50,000 people from late July to mid-November. So they couldn’t detect how the antibodies faded over longer periods of time, nor could they detect side effects that might occur in one in a hundred thousand or a million people.

Scientists have continued to study the effects of the vaccine over the past two years, and they discovered a serious side effect from the mRNA vaccine: a type of inflammation of the heart called myocarditis.

It is an extremely rare side effect, but it has caused some people to be hospitalized. The risk is concentrated among men in their teens and 20s, Adalja said. If he had an 18-year-old patient who was considering vaccination but was concerned about myocarditis, he might suggest Johnson & Johnson’s vaccine, which is not linked to myocarditis. (That vaccine also has some risks; it has been associated with rare blood clots, mostly in premenopausal women.)

Independent risk communication consultant Peter Sandman points out some of the deception DeSantis uses in the petition, in which the governor claims: “The federal government, medical associations and other experts have created an expectation that getting a COVID-19 vaccine is an ethical or civic duty and that choosing not to get vaccinated against COVID-19 is selfish and harmful to others.”

This is true—people promoted the vaccine as a way to protect others and end the pandemic—but DeSantis ignores the fact that clinical trials made this seem plausible at the time. The virus and the situation changed. DeSantis also ignores that vaccines may still have a protective effect against infection and that, by reducing the risk of severe disease, they reduce the risk of hospitals being overwhelmed with Covid patients.

And DeSantis “plays games with vague definitions,” Sandman said. A good example is this passage, where “prevention” seems to imply perfection rather than lessening the likelihood: “some Floridians made the choice to get the COVID-19 vaccine because they believed that getting the vaccine would prevent them from spreading COVID- 19 to others.

But, again, DeSantis is benefiting from mistrust fueled by the missteps of the public health community and the Biden administration, who have at times overstated what vaccines can do to the point of misleading the public. They may believe that the science is too complicated for the public to understand, or they may tell themselves that something too promising is acceptable because vaccines save lives. But this approach has costs, as we are now seeing.

I asked Adalje what can be done to prevent him from seeing more of his patients become seriously ill or die. His answer: more targeted use of booster shots and Paxlovid for the elderly and other high-risk people. Some of the blame for the neglect of our elderly and high-risk citizens can be placed on misdirected public health efforts and some on a loss of public trust. What DeSantis is doing is unconscionable, but he is filling a trust vacuum created by his enemies.

More from Bloomberg Opinion:

• It’s Still Worth Fighting Vaccine Misinformation: Faye Flam

• Why Anthony Fauci is still optimistic about science: Lisa Jarvis

• Abortion clinics should not stand alone: ​​Sarah Green Carmichael

This column does not necessarily reflect the opinion of the editorial board or of Bloomberg LP and its owners.

Faye Flam is a Bloomberg Opinion columnist covering science. She is the host of the Follow the Science podcast.

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