Following-up on yesterday's post, here are a few notes on objections to Covid-19 vaccinations, skipping over the most irrational, silly, and dishonest of the lot. (Damn, social media can be a sewer!):
- Some people protest that the vaccines are not well-tested, or even more dramatically that we are all being used as guinea pigs. This is nonsense on the precipice of insanity. In early 2020, ‘expert’ skeptics predicted at least a year-and-a-half and as much as three years before a vaccine would be ready, but they didn't account for modern technology or the willingness of the federal government to streamline the process and throw money at the problem.
The Moderna trials had 30,420 subjects (participants), and the Phase 3 Pfizer trial had 46,331 (I've seen ‘43,000+’ elsewhere, but that may account for drop-outs), to the usual standards, before the FDA issued the Emergency-Use Authorizations. Operation Warp-Speed streamlined the development process by throwing money at it, allowing manufacturers to (as Pfizer puts it) ‘[work] closely with regulatory agencies, providing near real-time data [Well this is the twenty-first century! – M.] and receiving review and advice more quickly than ever before’, and permitting some parts of the trials to run in parallel. The EUAs short-circuited the FDA's usual bureaucratic overkill for the simple reason that people were dying by the hundreds of thousands, but the data were made public before the EUAs were approved and were very convincing (skeptics turned giddy!), and the decision to issue each EUA was made at a public meeting. I haven't heard of any serious medical or public-health professional who thinks, after reviewing the data, that the pre-EUA testing wasn't adequate. For what it's worth – a lot, I think – Pfizer and Moderna have both now applied for standard FDA approval for their vaccines, which means that they have their voluminous ducks in a row even by the FDA's tightest standards. The FDA, as per SOP, intends to re-interrogate every damned duck, so no one expects them to move on final authorization before fall (this October, it appears), but the fact that the paperwork is in and accepted should put a bloody end to the ‘experimental’ and ‘untested’ myths. [Update 8/4 – The FDA has moved Pfizer's expected approval forward to ‘by September’, which appears to mean before the end of this month. My guess is that someone applied a cattleprod to the plodding FDA bureaucracy. – M.] - A certain type of clotting (thrombotic thrombocytopenia – you're sorry that you asked) is associated with the J&J and Astrazeneca (not mRNA) vaccines, but the rate is only 2 or 3 in 1,000,000 while the pre-pandemic baseline (incidence) is 5 in 1,000,000, so the risk is actually lower for vaccine recipients than for the general population. (I imagine that the margin of error for the post-vaccine figure is rather large.) But the incidence of these clots is about 25% among victims of moderate Covid-19, and 50% (!) in severe cases. (I take the 50% figure from Chinese and Dutch reports. I don't trust Chinese government candor right now, nor the ability of mainland Chinese scientists to be candid without disappearing, but the Dutch seem reasonably independent.) For people with known clotting issues, especially women under age 50 (perhaps pre-menopause?), advice is to get one of the mRNA shots (Pfizer or Moderna), since there is no evidence of clotting related to those vaccines.
- Another objection regards potential heart inflammation (myocarditis and pericarditis) in men and boys under age 30. As of two days ago, the rate of verified cases after vaccination was 20 in 1,000,000, which, as with clotting, is no greater than the pre-Covid ‘background’, i.e. these cases are no more common or severe than they were pre-pandemic. In almost all cases the issue is easily treated, usually without hospitalization. But again as with clotting, this inflammation is very common in Covid-19 patients, so if you're really worried about myopericarditis, you and your children should get the vaccine. As of this writing, the Pfizer vaccine is available to everyone age 12 and over, but if you're really worried about post-vaccine heart inflammation (for no good reason, but all the same), no cases have been reported following the J&J vaccine, so there you are. Go ahead and get vaccinated. That J&J vaccine is, so far, limited to ages 18+.
- mRNA doesn't ‘recombine’ with DNA, but viruses do, so as with myopericarditis and clotting, if recombination is weighing heavily on your mind, getting the vaccine is your best protection. But there's some good news here, even if you get the disease: In the case of SARS-Cov-2 (the Covid-19 virus), recombination with a temporary problem, lasting only the six to twelve somewhat-unpleasant months it takes for your body to replace the relatively few affected cells. The mean time might be quite unpleasant (Get the shot!), but every cell in the human body is replaced in time. Unfortunately, time doesn't heal many of the other Covid injuries; you'll just have to live with the brain damage and lung-scarring.
- I mentioned that the Delta variant affects children more than did previous strains. A note on the scale of the problem so far, while Delta is young: The CDC reports that, in the U.S. so far (2020 and 2021, I think, as of 1:06pm Eastern today), there have been just over 3.5 million juvenile cases of Covid-19 resulting in 529 juvenile deaths. But the new Delta variant has proven significantly more dangerous to children, and in any case children can pass-on the virus – the original strain and all known variants, but Delta is significantly more transmissible – and incubate new variants, asymptomatically, same as everyone else.
One further note: The Biden administration has purchased some five hundred million doses of the Pfizer vaccine, and is redirecting a large number previously purchased from J&J/Janssen and Astrazeneca, to ship worldwide, primarily to poor countries with negligible vaccine supplies and little prospect in their treasuries. I hope that logistical help is included, because those countries also have very poor health and security infrastructures. I would normally take such a giveaway as an improper imposition on the American taxpayer (charity is the proper usual solution) and it pains me to praise the Biden administration, but this is a matter of public safety for Americans. Inoculating the world is necessary to protect ourselves. I would hope, in this case, that the rest of the first world would see the same advantage in public generosity. We might not completely eradicate Covid-19 (or, fingers crossed, we might), but even if we were to bring it down to sub-flu incidence, the cost of five hundred million (plus) doses – some of which we aren't using anyway – and some logistical help, possibly including a show of force to discourage warlords, will have been cheap in comparison to what relatively uncontained Covid can do and has done.
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