Over the weekend, Ron Klain, incoming White House chief of staff, underscored a crucial point about vaccines as a solution to the pandemic.
In remarks to NBC, Klain reminded America that vaccines on their own don’t help. “Vaccines don’t save lives. Vaccinations save lives,” Klain said.
His point was simple, but just in case it was lost on anyone, he spelled it out. “That means you’ve got to get that vax out into people’s arms all over this country.” He called it “a giant logistical project.”
It would be challenging in any country, but it’s especially so in America. And I’ve explained why on any number of occasions. Even if you assume the supply side problems will be addressed by the world’s pharmaceutical giants, the demand issue will likely come into play. “Many Americans appear reluctant to be vaccinated, even if a vaccine were FDA-approved and available to them at no cost,” Gallup wrote in August, describing the results of a poll. “Asked if they would get such a COVID-19 vaccine, 65% say they would, but 35% would not.”
The vaccines are coming. We can all debate whether the timeline was too aggressive or whether Pfizer and Moderna are being overzealous, but 2021 will see at least one (and probably several) vaccines approved and distributed.
But compelling people to get vaccinated is another matter. JPMorgan lists four topics around which the bank says there’s “disagreement” when it comes to what happens after vaccines from US and European drugmakers receive regulatory approval. Number three on that list is “the time required to attain herd immunity,” which the bank notes “depends on factors like the share of the population already immune due to prior exposure, public willingness to be vaccinated, government compulsion to vaccinate, and vaccines’ long-term efficacy against this strain or others.”
The right pane (above) is disconcerting. As JPMorgan goes on to write, “willingness to vaccinate is down in almost all countries since the summer but remains above 60% in all major countries surveyed but France and perhaps the US.”
The Pew survey (shown in red in Chart 4 from JPMorgan) reveals a number of issues. The first thing to note is simply that the percentage of all adults in the US who said they would “definitely” or “probably” get the vaccine fell to just 51% in September from 72% in May. That drop could be attributable to any number of factors. Pew explains it mostly in terms of concerns about the speed of the development effort. To wit, from the survey:
There are widespread public concerns about aspects of the vaccine development process. On the heels of a pledge from nine pharmaceutical companies to ensure that a potential vaccine would meet rigorous standards, the Center survey finds three-quarters of Americans (77%) think it’s very or somewhat likely a COVID-19 vaccine will be approved in the United States before its safety and effectiveness are fully understood. And when asked about the pace of the vaccine approval process, 78% say their greater concern is that it will move too fast, without fully establishing safety and effectiveness, compared with just 20% who are more concerned approval will move too slowly, creating unnecessary delays.
That’s backed up by widespread worries among the populace about side effects.
But, the poll also reveals a highly unfortunate, if wholly predictable, breakdown. “Democrats and those who lean to the Democratic Party are 14 percentage points more likely than Republicans and Republican leaners to say they would probably or definitely get a vaccine,” Pew remarked, in September.
There are, of course, other disparities, including findings that indicate African Americans would be less likely to get a shot, but the visual above seems to suggest that a mistrust of science could be a factor among Republicans or, perhaps more aptly, those who identify as such in the Trump era.
Pew writes that although Republicans and Democrats “have differed over many aspects of the coronavirus outbreak… majorities of both groups say their greater concern about the vaccine approval process is that it will move too fast, rather than too slowly.” Specifically, seven-in-ten Republicans “are more concerned about the approval process moving too fast, and an even larger majority of Democrats (86%) share this view.”
I don’t think it’s a stretch to suggest that Democrats’ concerns about the process are at least partially tied to worries about who was in charge of “Operation Warp Speed.” Republicans’ worries about the rapidity with which the development process played out, on the other hand, were likely exacerbated by the extent to which the anti-vax movement became embedded in Republican psychology thanks to the conspiracy-oriented, distorted libertarianism that underpins Trumpism.
That isn’t idle speculation. Indeed, it was already going on prior to the pandemic. Dave Gorski, a Michigan physician who has tracked the anti-vaccine movement for two decades, spoke to Politico about that very dynamic for a May 2019 article called “How the anti-vaccine movement crept into the GOP mainstream.”
“Appeals to freedom are like the gateway drug to pseudoscience,” he said.
“Libertarian demand for medical freedom has displaced the traditional GOP view that it’s a civic responsibility to immunize your kids to prevent the spread of disease,” Politico wrote, in the same linked piece. “As more politicians take an anti-mandate stand, some end up adopting bogus theories about the supposed harms of vaccination – threatening to roll back one of public health’s great achievements.”
That echoes louder than ever this month, with two COVID-19 vaccines poised for regulatory approval.
And so, it turns out that the discourse in America decades ago about motorcycle helmet laws being good public health policy, or a matter of individual liberty to not wear one, was presage to COVID-2020s America.
Somewhere in my third, fourth, fifth, and sixth, grade civics classes, I remember whole four week sections of the semesters being devoted to something called personal responsibility. What the hell happened to us?
Just speculation on my part, but a second- or third-order effect that is plenty conceivable is the continued accerleration of the wealth of cities vis-a-vis the lesser affluent, mostly low-density regions of the country.
What few young kids there are in these lower-density regions will keep moving to the major urban centers, suburbs, and the second-tier cities. They are not going to move back to the towns they are from. Towns will de-incorporate, die, and only a small number of hangers on will remain. Already so many examples from decades past; the process never stopped.
Cities will re-generate. Rents will go down, attract a new generation of hipsters, and the cycle starts anew.
All the while, South Dakota, with all of 0.25% of the nation’s population, will continue to have two senators…or, maybe not.
Well, there may be a happier ending – eventually these depopulated states become targets for affluent migration as money and education are attracted to idle mismanaged resources, both natural and human. Eventually the demographic and economic change can shift the political winds as these states are re-introduced to modern civilization. I can’t claim to have seen this process run to completion anywhere, yet, but I have hope for both Texas and (someday) Idaho, speaking from personal observation.
Apologies if this has been covered somewhere, but the question I have about the vaccines from Pfizer and Moderna is related to the durability of it, meaning how long does a vaccine immunize you from contracting covid? I recall seeing early data which suggested it was a 3-6 month timeframe when antibodies are present following infection (or early stage vaccination trials), and I haven’t seen any mention of this in either release regarding the vaccines this week or last.
Good question. Just one of many
I suspect there is no real solid way to estimate but a best guess supported moderately from observation is that infection immunity seems to last roughly 3-6 months and that a vaccine would provide similar results, potentially better for the dual inoculation, so let’s be generous and estimate 12-18 months. If 35% of the country refuses vaccination then this will be an annual thing like the flu and eventually a mutation will outbreak again defeating the existing vaccine.
This is all based on the idea that the approval sample sizes and subject populations are significantly representative of the overall population to give weight to the 90-95% effectiveness. We’ll know that after it is widely available.
I have hopes the vaccine gets the case load down far enough that hospitals can again cope with ICU levels it generates but I am very dubious that this is anything but COVID’s world for the next few years, especially in the US. If we can just make it through this winter without everything falling apart.
Antibodies might fade after a period of a few months, but that is not unusual for viral infections. The issue is how much long term memory your immune system retains via “T-Cells”. It is possible for your immune system to remain primed for future infections for years. That doesn’t mean you won’t be re-infected, just that you might be better at fighting off the infection in future.
Very true, there is a lot we will not know for sure for years.
The Pfizer and Moderna genetic vaccines utilize mRNA technology which has never been used on humans before the current Covid 19 trials. Absolutely nothing is known about the potential long term risks associated with this technology, which for me is cause for great concern. Do you, Mr Heisenberg, or anyone else share this concern?
There is no approved mRNA vaccine, but Moderna had at least one mRNA vaccine in trials before COVID. Any new drug or vaccine carries some risk, and long-term risks are not necessarily apparent from short term trials. But for a variety of reasons, an mRNA vaccine isn’t as scary as it might sound. It’s not an entire viral genome, just a modified version of mRNA for one of the viral proteins, the spike protein. For most observers, the risk of an mRNA vaccine is that it might not work, due to the difficulty with formulating and delivering mRNA, not that it would have unforeseen safety issues.
I’m no virologist, but I have to think that training the immune system to recognize spike protein attacks w these mRNA vaccines will help overall in the long run against this virus and perhaps mutations of it, even if antibodies wane over time, probably via T-Cell memory. This virus is so devastating precisely because it is novel to human evolution. It kills before the body knows what has happened.
Does anyone remember “flipper babies” or DES for nausea? The side effects of new medications are not always immediately known. Fast-tracking is political, not science.
The problem with polls is they typically don’t allow for nuanced answers. I am the farthest thing from an anti-vaxxer, yet if you had polled me in September about whether I would take a vaccine, I would have been counted as one of the doubters. But the situation is very different with two vaccines, looking 90%+ efficacious (yes, preliminary results), with no strong negative safety signals so far. Vaccines are not compulsory, but–if you want to go to school, if you want to go to college, you need to get vaccinated. I would not be surprised to see compulsory or pseudo-compulsory vaccination at many workplaces. And I would not be surprised to start seeing waiver forms. Do you want to go to Disneyland? OK, sign this form stating that you have either tested negative for coronavirus in the preceding 24 hours, or stating that you have been vaccinated. When the unvaccinated start to feel they’ve been left behind by society, they might come around. And as I’ve stated before, the beauty of a 90+% efficacious vaccine (if that holds up as more data is gathered) is that if I get vaccinated, I get protected. Yes, it would be better for many reasons if everybody is vaccinated, but at least I can protect myself in this scenario.