By Chris Satullo
Here’s some great news that, for some reason, isn’t breaking through for many Americans:
The Pfizer and Moderna vaccines for COVID-19 are freaking miracles.
They’re at least 94 percent effective at keeping you from catching the original strain of the disease. For a vaccine, that’s as good as it gets. The flu vaccines many of us dutifully get jabbed with every year are sometimes less than half as effective.
In vaccine world, 94 percent is superstar level. It’s LeBron-Brady-JayZ-Streep territory.
Wait, there’s more. Something that really hasn’t sunk in yet with many:
That remaining 6 percent? It’s not, as some seem to think, the risk that you’ll get really sick or die. It’s the risk that you might catch a mild or asymptomatic case of COVID.
In other words, get either of these vaccines and you won’t die from this. You won’t end up with a ventilator jammed down your throat. You won’t get hospitalized and you probably won’t even miss too much work. And, in all probability, you won’t infect anyone else.
The variant strains now cropping up in America are a concern, of course. But news coverage I’ve seen tends unduly to stress the negative – i.e., these two vaccines based on the mRNA method might not be quite as successful against the UK and South Africa variants.
And, no, this young quarterback might never win as many Super Bowls as Tom Brady; this young actress might never get as many Oscar nominations as Meryl Streep. Because no one else has or ever will! But they might be pretty great in their own right.
The other two vaccines waiting to get approved for use in America, Johnson and Johnson’s and AstraZeneca’s, seem to have efficacy rates against the original strain at least in the mid-70s range. Sounds like weak tea compared to 95 percent, you say?
But if you’d told epidemiologists last March that, within a year, they’d have even one vaccine with that kind of success rate against the novel coronavirus, they would have wept in joy and amazement.
So, why are so many people I talk to so…so-so about the vaccines? I’m not even talking about confirmed anti-vaxxers or Blacks with doubts understandably based in dark episodes of American history.
I’m talking about the “I’m going to wait and see before I take the risk” people. And the vaccine-eligible people who, although they’re doing what they can to navigate this mess of a vaccination rollout to get jabbed, still tell me, “Well, I’m not sure it’s really going to change much in the short run.”
Yes, after a year of quarantine, masks, distancing and so much tragedy, people are battered, weary and wary. Yes, the impact of a year of damage done by a bleach-injecting, mask-rejecting, snake-oil-selling, “it’ll vanish like a miracle”-claiming president takes a while to dissipate.
It does seem to me, though, beyond Trump and his crew, some other folks have also failed us. It’s important to review how, because they’re important people whom we have to rely on going forward.
Trust the science.
That’s the mantra, now, isn’t it? And it’s clearly correct, after the wreckage caused by a policy of Ignore and Lie About the Science.
The science, I do trust. It’s the scientists I’m having a problem with. Not with their integrity or grasp of the evidence. All respect for that.
It’s with their grasp of messaging, of the interaction of human psychology, logistical detail and political reality that stands between success in the lab and success in the field.
Many of the experts, even the sainted Dr. Fauci, have pretty much sucked at messaging since Day 1 of the pandemic.
I understand it was brutally hard to operate inside the maelstrom of lies and nonsense generated daily by Donald Trump. In fact, the scientists shouldn’t have had that burden. They shouldn’t have had to take point on something they were not good at –using simple language, vivid analogy, empathetic tone and crisp “here’s five things” advice to convey to a baffled, scared and often resistant public what they needed to do.
But in TrumpWorld, that duty did fall to the scientists – and they kept tripping up.
They started out telling us absolutely not to buy or wear masks, before they told us absolutely to wear masks. Their inept use of professional terms of art such as “flatten the curve” misled millions as to the likely scope and duration of the epidemic. They did a rotten job of explaining – as opposed to just asserting – the importance of contact tracing. Most of all, they kept hesitating to give advice that would have made a difference, because they lacked the kind of certainty they were used to needing before they would publish a scientific paper.
But this was not a peer-reviewed journal. It was a fast-moving pandemic, which requires making tough, life-and-death decisions in the moment based on evidence from a variety of perspectives that is still far sketchier than you’d hope. This is not what we normally ask scientists to do. It’s what we elect presidents to do (e.g. Obama and the bin Laden raid). And the POTUS of the moment was tragically not up to the moment.
The messaging mess, the inability to anticipate how the messiness of psychology and politics would impact recommendations, rose up again to haunt the vaccine rollout.
The CDC’s complicated tier system, compounded by state by state variations, has been a disaster. It’s another example of experts simultaneously overthinking and thinking too narrowly about a problem, not looking beyond the bounds of their expertise to weigh factors that would bear heavily on end results.
When you have a pandemic and a vaccine, the number one goal is to get as many shots into as many arms as quickly as you can.
The Holy Grail is “herd immunity,” the level of immunity in a society that begins to deny a pandemic – which is best imagined as a wildfire (not a wave) – the fuel it needs to keep burning. For this virus, the best guess is we need about 70-80 percent of Americans vaccinated to achieve “herd immunity” and tame the pandemic. We’re talking 230 million to 265 million people.
That’s the target, in a country where, in a January poll, only 56 percent said they’d get the vaccine. (The same polls showed pessimism about the pandemic growing 7 percent since approval of the mRNA vaccines! Oh, boy.)
What’s more, the rise of more contagious variants only ratchets up the need for speed.
For the CDC panel, warring with a sense of urgency was the plain fact that supply was going to be limited in the early going. Some sort of triage plan was needed.
In coming up with theirs, the panel members were appropriately concerned about racial equity. Feeding on embedded injustices in our health system and work culture, the virus was killing people of color at a higher rate.
I don’t fault them at all for weaving in equity. I fault how they did it. They made two mistakes. One was assuming the Trump administration had a clue what it was doing, that it had a plan for supply and logistics that would give these overwrought tiers a prayer of working. Instead, the Trumpers stonewalled even the panel, some of whose members have said they were as shocked as the rest of us at the logistical fiasco that ensued.
A related error may have been even more damaging: In light of slim supply early on, the panel thought about priorities mostly in terms of eligibility. But the issues of willingness and practical access were just as crucial; without them, all those carefully nuanced tiers were just words on paper.
It’s swell to say you’re putting at-risk Black workers at the head of the line. But you have to be aware than many of those people you’re inviting to go first are going to hear that as another trick by the white establishment to use them as guinea pigs. An enormous investment in smart messaging delivered by trusted leaders and celebrities would have been needed to make real a priority list favoring people of color. Didn’t happen.
Then, as the noted medical ethicist Dr. Arthur Caplan told me at a recent event where I interviewed him, it doesn’t work to tell people in poor urban neighborhoods, Come and get it, if the clinics you set up are in areas foreign to them. To ask folks from North Philly, say, to come to a Center City convention center, he said, “you might as well tell them they have to go to Hershey Park to get a shot. And 75 year olds – who, no offense, can be a little tech-phobic – you tell them, ‘Sure, you go first, but you have to fight your way through this clunky website that might crash two times before it lets you finish’…that’s just not going to work.”
In the last presidency’s dying days, the kind of smart thinking about messaging, incentives, access and logistics that Caplan advised was in short supply. The rollout of the tiers seems to have driven home two counterproductive messages:
- Don’t ever jump the line. Shame on you for even thinking about it.
- Don’t get cocky. Getting vaccinated doesn’t change anything.
The first message has led to the tragedy of Pfizer vaccines (which, once thawed, must be used the same day) being thrown out, and doctors who try to avoid such stupid waste actually being charged, briefly, with a crime – simply for vaccinating people in the middle of a pandemic.
And, at this moment when shots in arms should be our great societal goal, it’s led even some people eligible for the vaccine to turn down chances to get one, thinking what they’re doing is socially righteous, rather than epidemiologically unwise. (Caplan: “The shot you turn down may be as likely to get wasted as to go to someone more worthy.”)
The “don’t get cocky” message must be part of what’s behind this strange malaise of people getting more pessimistic post-vaccine and the rash of news stories primly warning people that even after they have two doses, nothing in their lives should change.
This bad advice is annoying the heck out of some eminent doctors who really know what they are talking about:
- Dr. Aaron Richterman, Penn Medicine: “We’re underselling the vaccine.”
- Dr. Ashish Jha, Brown School of Public Health: “The negativity is driving me a little bit crazy.”
- Dr. Monica Gandhi, University of California, San Francisco: “Two vaccinated people can be as close as two spoons in a drawer.”
So, if someone’s willing to give you the vaccine, get it. Once you do, go ahead: Have dinner with vaccinated friends. Hug your grandkids. See that distant friend you’ve missed. Show those around you that the vaccine is safe and transforming. Still wear masks in public, out of solidarity and concern for others. And, by all means, support with dollars, if you have them, the groups trying to get the vaccines to underserved populations.
Remember: The goal is herd immunity, not hewing to fussy guidelines that have been overtaken by events.
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Chris Satullo, a civic engagement consultant, is a former editorial page editor/columnist at The Philadelphia Inquirer, and a former vice president/news at WHYY public media in Philadelphia