What to believe about Covid vaccinations? Here’s some common sense (with authoritative links) to avoid senseless politicizing and help you make an informed decision.
— Was the development of the coronavirus vaccines rushed? If by rushed, do you mean they cut corners, then the answer is no. They did take a process that usually happens sequentially and ran it in parallel, which accounts for the unprecedented speed of completion. Vaccines are usually produced in small test batches, then tested for safety (side effects?). After a vaccine passes that test, another small batch is produced and tested for efficacy (does it work?) Then the results are sent to the federal government for review, and the government also reviews and approves the production process. In the case of the coronavirus vaccines, the full human trials were done simultaneously, and the government insured the pharmaceutical companies from liability. It also immediately reviewed the initial production process, approved and authorized full-scale production, and guaranteed to reimburse the companies by either buying the vaccine (if it worked) or paying their costs (if it failed). It was potentially an expensive proposition for the government, but a worthwhile bet nonetheless.
— Some of the vaccines (Pfizer & Moderna) use messenger RNA (mRNA). Is this an unproven technology? Health professionals have been working on mRNA vaccines for almost thirty years, doing clinical trials and injecting this technology into people, so the technology is not new. The problem has been that they hadn’t developed a single successful vaccine, as either other treatments looked more promising (for HIV/AIDS, for example) or the disease threat disappeared (as in MERS and SARS) before they could complete the vaccine development process. The exciting thing this time is it worked and in time! Why is that important? Up to this point, vaccines used either a live virus, a dead virus, or an attenuated virus. The common word: virus. One of the bugaboos of the anti-vaxxer movement was the (true-but-irrelevant) claim they were injecting the disease into you! With mRNA, there is no form of the virus injected into you. This could prove to be a promising new treatment for a variety of diseases.
— What about the claim an mRNA vaccine could affect my DNA? As soon as people hear RNA or DNA, they get concerned, as we all learned DNA is the “building block of life” and messing with it can be tragic. I heard a great explanation of why you shouldn’t worry from Natasha Loder, the health policy editor at The Economist, and it goes like this: the whole purpose of DNA is to create proteins that in turn make life possible (make blood cells, repair neurons, reproduce, everything). DNA does this by generating messenger RNA, little temporary messages that tell cells what proteins to make. So DNA is like a record album on your old phonograph, and mRNA is like the musical notes coming our of the speaker. The notes play and then they are gone. When your immune systems “hears” the notes from the mRNA, it “remembers the tune” and learns how to protect from the virus. Can the song you hear “change” the record playing it? Nope. An mRNA vaccine is also potentially a great response to virus mutation, since the mRNA in the vaccine can be more easily changed to deal with mutations.
—Why is the United States failing at its vaccination program? Define failing. Here’s the most recent data on vaccinations:
The US is currently in 5th place worldwide, and the only large country ahead of the US is the UK. Our vaccination rate is three times higher than the EU or Canada, and six times higher than China. The world leader is Israel, which has advantages in small population, small geographic size, and a national health system set up for imminent emergency (i.e. wartime) function. That, and they don’t count Palestinians in territory under Israeli control. Still lessons to be learned, for sure, but the numbers don’t lie.
The Biden administration has announced plans to give one-hundred million inoculations in its first one-hundred days. Since we achieved the ability to inoculate one million a day before the inauguration, we should easily meet and surpass this goal.
—Did the Trump administration have a vaccine plan or not? At one point, President-elect Biden said “There is no detailed plan that we’ve seen, anyway, as to how you get the vaccine out of a container, into an injection syringe, into somebody’s arm.” An unidentified senior Biden administration official said “There is nothing for us to rework. We are going to have to build everything from scratch.” In response, Dr. Anthony Fauci said “We’re certainly not starting from scratch, because there is activity going on in the distribution.” So the plan did exist, and involved the complex distribution of difficult-to-transport vaccines across the country to medical providers for injection. The task of putting needles in arms was left for the States and health professionals. Who would you prefer do it?
Why? First, the initial vaccines approved have these unique transport requirements; when Johnson & Johnson’s one-shot vaccine is soon approved, it can be easily shipped, making large-scale movement and storage possible. Second, no country is undertaking mass, indiscriminant inoculation. For example, the US CDC recommended sending the limited vaccines to healthcare workers and the elderly. Setting up even a hundred large inoculation sites would not have addressed this target population, which is all over the country and not easily moved to such sites. Medical staff can’t take time off to wait in line, the elderly aren’t mobile. So a slower start was inevitable, but remember, our overall numbers are still strong. Third, there is no federal health infrastructure to help with this problem: no doctors, no nurses, no lists of same. The federal government did help speed the vaccine, and is distributing it. They could have provided more resources to States and medical providers, but that would not have changed the results much. Why not?
— What are the factors slowing the vaccination program? First and foremost, the pandemic! Hospitals and staffs are overwhelmed just when we need them to conduct the vaccinations. State governments are experiencing the same problems they attribute to the federal government, as inspectors aren’t available, employees are remote, resources are strapped. If this was all on the federal response, we would expect to see almost all delivered vaccines to be injected by States. States are averaging using less than fifty percent of their received inoculations! Second, the combination of the difficult storage and transport requirements bouncing up against vaccine resistance. Even medical professionals are reporting between fifteen and fifty percent of their ranks refusing the vaccine, so only about sixteen percent of the initial target population has been vaccinated. Medical staffs include doctors, nurses and a large cadre of less-skilled professionals, many of whom are people of color. These latter groups are especially skeptical of government safety claims and were also affected by irresponsible pre-election claims about “Trump’s vaccine.” If someone says no, there isn’t always someone else eligible for that shot right away. At best, vaccinations are delayed; at worst, vaccines spoil. Third, there are no magic wands to increase production or distribution. As I explained before when discussing Covid testing, these processes are not ones you can ramp up easily using the Defense Production act. The pharmaceutical companies can’t outsource their controlled vaccine production to, oh, say, beer bottlers, and even if they could, would you want them to? The Biden administration has directed the mass production of a syringe which permits more Pfizer doses per syringe than the current one, but take note: Pfizer has agreed to provide the US a set number of doses, so they will send less vaccine if we are using these syringes!
The US state leading the vaccination charge? West Virginia. Yes, a state with lousy health care, poor infrastructure, and an older/sicker/widely dispersed population is succeeding. Why? They skipped participating in the big federal program, worked with local independent pharmacies/doctors/hospitals (whom they know), and used their National Guard (under State, not federal direction) to manage the process. Instead of whining and pointing the finger of blame, they are getting the job done. Their only complaint? They would like more vaccine, please.
There is a role for large federally-run vaccination sites as the number of vaccines and doses increases and the eligibility pool does too. It will be interesting to watch how the federal government runs this effort. Vaccinations are not rocket science, but they do require some training and some medical staff on hand; from where will they come? Stay tuned!
—Should you get a Covid vaccine? This of course is the sixty-four million dollar question. In general, yes. All the vaccines out there (even the Russian and Chinese ones) appear to be safe, although some (the Russian and Chinese ones) have limited efficacy (may not work so well). Even then, some immunity is better than nothing. The more vulnerable you are to serious illness or death from the coronavirus, the greater your need to get vaccinated. Of course consult your doctor, especially if you have a history of severe allergic reactions. We still don’t know whether the vaccine prevents you from being infectious (as opposed to being sick), so even once vaccinated you may still face requirements for masking, social distancing, and testing for public activities. Scientists are gathering data establishing protection from infectivity, so those precautions may be temporary for the inoculated.
Like everything else during this pandemic, getting inoculated is a personal call assessing risk versus gain. Take it seriously, get expert medical advice, and don’t judge others who decide otherwise.
To quote Montgomery Burns, “Excellent!”
Thank you. Clear explanations.