Wednesday, July 21, 2021

What if we were still researching polio vaccines, 50 years later?

The FDA is still studying the Covid vaccines, leaving them in the "emergency" category that provides a handy excuse for deniers and fence-sitters.

So we find ourselves in the awkward position of one government agency in full-throated advocacy of getting "shots in arms" -- namely the CDC and the administration -- while another agency, the FDA, sending a somewhat mixed message which basically is that "no one is quite certain of the vaccine's value, efficiency, etc."

FDA officials have defended their "go slow" approach by saying that their approval of such drugs have always proceeded this way and that to go faster could damage the agency's credibility in the future.

A useful exercise is always to imagine "the worst" that could happen. After all, if the worst is bad enough, that might be useful in making decisions.

Here's today's thought experiment: imagine that the FDA tomorrow announced that the vaccine is completely safe and now moves from emergency status to "fully approved." Now imagine that in six months it is found that being vaccinated produces unexpected cancers or heart disease or whatever in a significant percentage of those vaccinated.

Would most people's first thought be to blame the FDA, saying the agency SHOULD have been more cautious? How many Americans know or care much about the FDA's history or traditions or much of anything about how the agency fully approves anything?

How many would then say they will never trust the FDA (or the CDC) again? 

Here's a guess: most Americans would have about as much trouble with a quicker decision, even if it proves to be wrong, as they have with a government that seems to be sending very different messages.

And that amount is approximately zero.

I would guess that social media influences more decisions. I would guess that what your family or neighbor or doctor tells you influences more decisions. 

We want our government to keep us safe -- well, by "we" I mean those not firmly in the Trump cult of ignorance mixed with nationalism -- but most of us prefer this to be done quietly, behind-the-scenes, without any requirement to examine the data or weigh up benefits and risks.

As writers, we need to pay attention to the effects of an unfocused argument. The federal government is not sending a clear message about vaccines, and this includes most Republicans in Congress, and therefore a casual citizen can't be blamed too much for being both confused and cautious. 

We WANT to blame them, of course, but there is value in strong arguments, well-supported and clear.

The "fog of war" aspects of vaccine approval and dissemination will lengthen the plague, at least among those in some areas of each state. I feel bad in a vague way for the health professionals whose lives continue to be at risk and whose energy and dedication have been put to extreme tests over the past 18 months. I say a "vague way" because there are all sorts of jobs I feel vaguely bad about, from stressed and under-supported teachers to sanitation workers to Uber drivers.

One part of me silently repeats: "Life sucks, and then you die." Laughing in the face of disaster is sometimes the only possible response to life.

But as for those who willfully choose ignorance and pride over common sense and science, maybe we just need to find the right "nudge" to get them to even momentarily modify their views.

A vaccinated Republican senator or representative may not be helping anyone with their constant questioning of science and stout defense of people's right to be wrong, but most of them ARE vaccinated.

Removing that "emergency" notification right now would remove an important barrier to people feeling a bit more trust in government.

Until then, the FDA going so slowly seems like a choice that will lead to more suffering and death. 


Two quick updates today: First, there is a report that the Pfizer vaccine, at least, may get formal approval in September. And, as I predicted on Monday, the market rebounded almost back to where it was last week on Tuesday. Yay me.

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