Ron DeSantis’ vaccine complaint uses public health blunders

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Earlier this week, the medical website STATnews reported 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 quibble with the exact number, these vaccines are a huge achievement.

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

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

It is long past time to speak honestly about the shortcomings of Covid-19 vaccines. They don’t do much to prevent people from mild cases of the current variants. They don’t do much to stop transmission in the community. And like all pharmaceuticals, they are not completely safe. Booster duties for young people amount to safety theater (free rapid tests would do a lot more to keep students from infecting their grandparents or professors).

Hiding or ignoring these minor issues undermined public trust and created an opportunity for DeSantis to sow discord and confusion.

While it is fair to say that presidential candidate DeSantis is proving that he is a health hazard with his misleading petition, this move capitalizes on the existing distrust of public health, big pharma and the media by many Americans.

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

But there’s also a false narrative from the left that was parroted in a Politico piece 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 idea that the vaccine prevents people from contracting the virus. “The benefit of a vaccine in the omicron era is not protection against infection, as it was earlier. It’s protection against the most important things: serious illness, hospitalization and death,” said senior scientist and physician at Johns Hopkins University Amesh Adalya.

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

The science behind this problem is not that complicated. The shots trigger what’s called cellular immunity, which can offer months or perhaps years of relatively strong protection against the kind of severe disease that lands people in intensive care. In those who are not elderly or otherwise immune compromised, this protection persists even against the highly mutated omicron progeny now circulating.

But the variants have developed increasingly effective ways to bypass the first line of vaccine-induced defense — antibodies. So vaccine protection against mild disease is porous and transitory. That’s why Offit says it’s better to focus booster campaigns on those who need extra protection against severe disease.

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 percent effective at preventing symptomatic disease. It wasn’t perfect, and as I wrote in this 2020 column, companies needed to collect data on whether the vaccines also prevented asymptomatic infection. But it was a reasonable conclusion that vaccinated people were less likely to contract 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 decline 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 continued to study the vaccine’s effects over the past two years, and it revealed one serious side effect of the mRNA vaccine: a type of heart inflammation called myocarditis.

This is an extremely rare side effect, but it has caused several people to be hospitalized. The risk is concentrated in men in their teens and 20s, Adalya said. If there is an 18-year-old patient who is considering vaccination but is concerned about myocarditis, he can offer Johnson & Johnson’s non-myocarditis vaccine. (This vaccine also has a few risks; it has been linked to rare blood clots, especially 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.”

That’s true—people promoted the vaccine as a way to protect others and end the pandemic—but DeSantis ignores the fact that clinical trials made it seem plausible at the time. The virus and the situation have changed. DeSantis also ignores that vaccines may still have some 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 “is playing definitional ambiguity games,” Sandman said. A good example is this passage, where “prevent” seems to imply perfection rather than reduced chances: “some Florida residents made the choice to get the COVID-19 vaccine because they believed that getting the vaccine would prevent them from spreading COVID-19 among the others.”

But again, DeSantis is capitalizing on mistrust fueled by the mistakes of the public health community and the Biden administration, which sometimes exaggerated what vaccines can do to the point of misleading the public. They may believe that the science is too complex for the public to understand, or they may think that some over-promising is acceptable because vaccines really do save lives. But there are costs to this approach, as we now see.

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

More from Bloomberg Opinion:

• It’s Still Worth Fighting Vaccine Misinformation: Fay Flamm

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

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

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

Faye Flamm is a science columnist for Bloomberg Opinion. She hosts the “Follow the Science” podcast.

More stories like this can be found at bloomberg.com/opinion

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