America’s COVID-19 vaccines are driving the nation’s economic and social recovery from the worst of the pandemic. Their development during 2020 was a dramatic triumph for medical science. Programs initiated by the Trump administration and driven to fruition by the Biden team should be seen as bipartisan accomplishments by the public and private sectors working together in the national interest. And yet scarcely a day goes by without controversies, criticisms, and challenges about these life-saving solutions to the pandemic. Instead of celebrating what was achieved, politicians, pundits, and the public cavil and query the science behind the vaccines and how they are being utilized. Why all the angst? Why all the politics? There are no easy answers…
As of Thursday, approximately 48.2% of the country is fully vaccinated, according to the CDC. While the vaccination effort has curbed a nation-wide surge, the pandemic’s trajectory will soon show very starkly how there are now “Two Americas.” In the northeast and on the west coast, the rates of infection, hospitalization, and death will remain low and manageable. Although there will continue to be COVID-19 deaths in these parts of the country, life will continue to be a reasonable facsimile of what it was in early 2020.
In the south and some central states, however, the increasingly rapid spread of the highly contagious and more lethal Delta variant is already causing worrying new surges in hospitalizations and death. That trend is going to accelerate through the summer and will worsen even more in the fall.
Why the differential? It is because immunization rates are high in the north-east and west, but distressingly bad in states such as Missouri, Mississippi, Arkansas and Alabama. Although there are various reasons why vaccine uptake is low in the south, a continued refusal to take the pandemic seriously is one driver. Republican-run states have the most relaxed pandemic restrictions, and polling shows that Republican voters continue to refuse to be vaccinated and reject many basic safety measures such as mask-wearing and targeted restrictions. Ironically, those who are refusing the vaccines are delaying America’s return to the fully normal, restriction-free life that they crave.
Many Republican politicians and their supporters choose to emphasize “personal freedom” and reject the role of the federal or state government in safeguarding its people. Sadly, the “live free or die” mantra all too often becomes “live free and die” – when a lethal virus spreads, every American is vulnerable. In a complex society, we generally accept various restrictions on our freedom to act as we might wish. Americans do not smoke in schools, restaurants, or hospitals. We wear seat belts in cars and some citizens live in states where you are not allowed to open carry a firearm in any place where alcohol is served. And yet, vaccines and masks are rejected for reasons that are generally so bizarre as to be laughable – except that death isn’t funny.
Many baseless claims and conspiracy are being perpetuated by some politicians and media personalities. Allow me to myth-bust some of them: The COVID-19 vaccines do not turn people into human magnets; they do not cause people to transmit rays via 5G networks that mess up women’s menstrual cycles or fertility; they do not modify people’s DNA or contain tracking microchips that control our minds.
The misinformation about vaccines is as pernicious as “The Big Lie” about the 2020 election and is believed by the same sections of American society. Dubious statements by some politicians, Fox News “personalities,” and on other right-wing online news channels are magnified by Facebook, Instagram and YouTube. This misinformation ecosystem is collectively responsible for why so many Republican voters distrust the COVID-19 vaccines.
Conversely, the “mainstream media” that is typically trusted by Democratic party voters has been a rich and valuable source of accurate information and insightful coverage. It is guided by medical and scientific professionals who understand these vaccines, how they work, and what benefits they confer. The difference is stark and tragic.
The polarization in political attitudes and information sources seems to worsen daily. It is shocking to hear Congresswoman Marjorie Taylor Greene describe door-to-door vaccine distributors as “brown shirts” (i.e., Nazis). Congressman Madison Cawthorne has attacked them as people who may “take way your guns and bibles.” The federal government already has employees who visit most American homes daily without confiscating prized possessions – they work for the US Postal Service.
These congressional representatives are not just being foolish, their words are dangerous. In recent years, vaccine distributors in Pakistan, Afghanistan, and Nigeria have been executed for doing their jobs. Who is to say that cannot happen here in today’s America?
While the COVID-19 vaccines are life-saving technologies, there are genuine questions that deserve discussion. Those of us who communicate about vaccines are routinely asked serious questions by friends, members of the public, and medical writers. The public interest in vaccines is substantial – and rightly so.
Legitimate concerns have arisen about rare but troubling vaccine side effects. The Johnson & Johnson and AstraZeneca (in Europe) adenovirus-based vaccines have triggered blood clotting disorders that can be fatal, particularly in younger women. The same vaccines were recently linked to rare and seemingly less serious neurological side effects, most often in men over the age of 50. The Pfizer and Moderna mRNA vaccines are associated with generally mild heart muscle inflammations in a small number of young men.
However, a sense of perspective needs to be applied when considering these troubling, real but sporadic outcomes. First and foremost, these adverse events occur in between 1 in 100,000 and 1 in a few million recipients. Secondly, no health intervention is perfectly safe when applied to hundreds of millions of people – each with their own unique genetic makeup and medical history. We have learned to accept some risks to incur the benefits. The COVID-19 vaccines are no different – harm caused to hundreds of people, however tragic, must be balanced against the many millions of lives they will save. In short, the risks of death and long-term severe illness are far greater after contracting COVID-19 than when taking the vaccines that protect us against those terrible outcomes.
Will the COVID-19 vaccines continue to be effective in the face of the rapidly spreading Delta variant? So far, the answer seems to be yes. The mRNA vaccines, in particular, raise such a high level of antibodies that there’s enough “spare capacity” left over to deal with Delta and its kin. There may be more mild infections in vaccine recipients than we are used to seeing, but protection against severe disease and death is still preserved. Last month, even with Delta infections on the rise, over 99% of American COVID-19 deaths were in non-vaccinated people.
The latest question concerns the need for a booster shot. Public confidence in vaccine efficacy may have been harmed recently when Pfizer renewed its call for a third, booster shot of its mRNA vaccine. There was a rapid push-back from the CDC and FDA, preceded and then supported by public comments from many medical science professionals. The vaccines may indeed lose some potency over time, but immunity does not suddenly fall off a cliff.
While it is reasonable for Pfizer, and other companies, to plan for any future booster doses, the company’s recent actions raised additional issues. The American political left does not trust Big Pharma, and what Pfizer did was seen in some circles as an attempt to boost profits more than immunity. There was also the perception that a company was treading into decision-taking areas that are the responsibility of federal agencies. The CDC, FDA and NIH monitor vaccine performance and will determine if and when a booster dose is needed. That process will surely involve close liaison with the vaccine companies that have worked with the government since the pandemic began.
At some point, a booster immunization may be needed, but that time is not now. The current priority in the USA is to maximize the number the number of people taking their first and second doses. And it’s in America’s best interests to help provide vaccine doses to the rest of world – as well as the moral issues involved, the global economy will remain depressed while the virus continues to circulate and generate new variants.
The national vaccine development and rollout program is something all Americans should take pride in. Its success has transformed the nation’s health and financial welfare. Without the vaccines, our current death toll of 607,000 would easily be in the millions. But instead of a universal celebration of science’s success, party politics promotes farcical myths that compromise confidence in the vaccines and slows our recovery from a horrible pandemic. To say this is tragic is an understatement.
John P. Moore
Dr. John P. Moore is a tenured Professor of Microbiology and Immunology at Weill Cornell Medical College in New York. He received his B.A., M.A., M.Phil. and Ph.D. degrees from Cambridge University, UK. He moved to the USA in 1992, joining the Medical College in 2000.
Moore was an Elizabeth Glaser Scientist of the Pediatric AIDS Foundation and held a Merit Award from NIAID. He is an Editorial Board member for several journals, and has served on multiple study sections and review committees for NIH and charities.
Moore’s research for many years has focussed on understanding how HIV-1 enters cells and how to inhibit virus entry with specific drug candidates and antibodies. He presently directs intra- and multi-laboratory projects involving the design of HIV-1 envelope glycoprotein trimers for neutralizing antibody induction and structural studies. Some of these immunogens are now in Phase 1 clinical trials. Since March 2020, a significant proportion of Moore’s time has been spent on virology and vaccine topics related to SARS-CoV-2 and the COVID-19 pandemic, particularly to provide guidance to reporters and members of the public.
