Not a winning message for a populist era, but that would be neither here nor there if she were correct on the merits. I don’t think she is. Watch, then read on.
With all due respect to @NateSilver538, he is not an expert on the psychology of vaccine confidence. He is a poll aggregator and political pundit. He is not an infectious disease specialist, epidemiologist, vaccinologist, virologist, immunologist, or behavioral scientist. pic.twitter.com/HBrI6zj9aa
— Céline Gounder, MD, ScM, FIDSA (@celinegounder) April 14, 2021
One obvious problem with “trust the experts” is: Which experts? Opinion about the pause isn’t uniform within Gounder’s profession.
The “listen to experts/science” crowd needs to see the problem: well-credentialed experts IN YOUR FIELD have confident, contradictory assertions all over the place. So it turns into “which experts” which turns into “ones I like”—not really a manageable process for ordinary folks.
— zeynep tufekci (@zeynep) April 14, 2021
“We are concerned about heightened reservations about the J&J vaccine, but in addition to that, those reservations could spill over into public concerns about other vaccines,” said the chief science officer for LA County’s department of health to the NYT. An expert in “public health communications” told the same paper that the pause was a “messaging nightmare,” although she believes it was the only ethical option available. Medical pros, people who do this stuff for a living, are worried about vaccine hesitancy spiking in the wake of the FDA’s decision, not just data nerds like Nate Silver. In fact, a panel of experts is meeting today to advise the FDA on the way forward. What conclusion should we draw about the pause if their verdict isn’t unanimous?
The fact that the media’s coverage of the clotting issue has been poor and sensationalistic makes matters worse. “[O]f the 20 most-engaged stories on social media about the Johnson & Johnson pause, just two headlines included the context that the blood clots were rare occurrences, according to data from NewsWhip,” Axios reported this morning. And that sensationalism is happening in a culture where there’s already plenty of dry tinder to ignite irrational fears about side effects. A Cornell professor who’s studied vaccine hesitancy told WaPo that four percent of respondents in one survey he’s aware of listed death as a common side effect of COVID vaccination. Imagine what the number will be after the FDA’s J&J pause.
The other problem with “trust the experts” is that a major part of the calculus in deciding whether the pause was justified are the implications it has for public opinion — and guys like Silver are experts in that. “This is devastating,” pollster Frank Luntz told WaPo about the FDA’s order. “At the very moment that conservatives were starting to reconsider their hesitancy, they are told that their fears are real and justified. Right now, there are thousands of people saying, ‘See, I told you so.’” If Luntz could show that the pause is apt to move, say, a million people from the “undecided” column on getting to vaccinated to “opposed,” would the pause still be a good idea? What if it were five million?
I’m not an expert but I can read a farking graph about what happened to acceptance of the AstraZeneca vaccine in Europe after that was paused:
Meanwhile, what about all the people who were scheduled to get their J&J shots this week and had the rug pulled out from under them? How many of them will reschedule if and when the vaccine returns to the market?
In California, mobile vaccine clinics in rural areas were canceled. In Chicago, vaccination events for restaurant employees and aviation workers were postponed indefinitely. And at colleges in Ohio, New York and Tennessee, where the one-dose vaccine offered a chance to quickly inoculate students before they left campus for the summer, appointments were called off en masse…
In Aurora, Ill., a mass vaccination clinic planned for Tuesday was called off, leaving 1,000 patients without appointments. In Riverside County, Calif., mobile clinics that had planned to vaccinate about 400 people in less populous areas on Tuesday were canceled. And in rural Jefferson County, in southeast Iowa, a Johnson & Johnson clinic targeting manufacturing workers was scrapped at the last minute.
“It was so heartbreaking to me,” said Christine Estle, the county’s public health nurse administrator, who said she and her colleagues had encouraged the roughly 140 people scheduled to attend to make appointments at local pharmacies or hospitals.
J&J had been cracked up to be the COVID vaccine for people who are wary of COVID vaccines because it was one dose and had fewer side effects than the mRNA vaccines. That, plus the fact that it’s easier to store, made it ideal for those who are vaccine-hesitant and/or live in rural areas. All they need to do is agree to be jabbed once and they’re done. Some may now resist all attempts at vaccination, in J&J’s case because they don’t trust that product anymore and in Pfizer’s and Moderna’s cases because they don’t want the hassle of two separate appointments.
Like I said last night, I don’t understand why the FDA didn’t take an “informed consent” approach to the blood clot issue by announcing it publicly but giving people with upcoming J&J appointments the option of receiving their dose as scheduled while the feds study the issue. Most men and plenty of women would have gone ahead with it. Now they’re in limbo, especially if they’re reluctant to get an mRNA vaccine instead. Give the public the most up-to-date information about risk and let them make their own decision. If the FDA investigation turns up an alarming number of other clotting cases then a decision about a pause can be made.
An interesting detail in lieu of an exit question: TV’s late-night hosts, who are normally lockstep with the Biden administration and, ahem, “science,” seemed skeptical of the decision to pause last night with several stressing how low the risk of a clot was. They’re not medical experts but they are experts of a sort in communications. And they seem to sense the danger of the pause.