Strategic Ambiguity, Preventable Misery
RFK Jr. has Trump Administration officials cosplaying "pro-science" while staying true to his anti-vax roots. The result will be more disease.
As Brian promised (threatened?) I’m taking over the Off Message nerve center while he’s away on a well-earned vacation. We’re friends, and Brian is an inveterate jokester, so know at the outset that I’m exercising considerable discipline in not turning his platform into an open-source clearinghouse for the Internet’s new and disturbing AI-generated comics trend. Imagine his surprise when he logs back on!
Instead, let’s talk vaccines. These days I devote most of my time to talking about authoritarianism and democracy in print and on NPR. But I spent my early career covering science, medicine and health at FDA, CDC, HHS, and at medical research institutions across America. Now, even while the Trump Administration sets about gutting medical research at NIH and diseases surveillance programs at CDC, I’ve kept a close eye on its vaccine policies. You’re already thinking of the reason why: Donald Trump elevated America’s leading anti-vaccine propagandist to direct the fate of its public health infrastructure as HHS Secretary. This merits a check-in.
First: unless you’re over 65 or have a serious co-morbid condition, it’s going to be a lot harder, if not impossible, for you to get a Covid booster this year. One point two million American deaths into the Covid era, Trump’s leaders at the FDA are abandoning universal vaccination by narrowing the shot’s approval to the elderly and high-risk. The two officials who wrote the policy say they want to require more data on whether repeat vaccinations actually boost immunity in younger, healthier people who’ve already had vaccines or have gained natural antibodies through infection. That will make it clearer if all those shots are worth the risk.
In principle more evidence is a good thing, surely. But as many experts have pointed out, we already have millions and millions of reasons to know available Covid vaccines are safe. Millions of people have gotten them! Side effects are rare, and serious side effects are far rarer. And even if younger, healthier people are at lower risk of Covid hospitalization and death, they’re still carriers. Coronavirus is communicable to grandparents, teachers with diabetes, and people who work in places full of sick people. As of now, a healthy 40-year-old ICU nurse can’t get a booster if she wants one. And parents who want to make sure their kid doesn’t bring an infection home from school can’t either.
But signaling “we just don’t know” to the public, when we actually know a great deal, comes with its own cost. Public health experts spend huge parts of their professional time figuring out how to effectively message pro-health policies in terms people of different incomes, educations and communities will accept. Even hand-washing can’t work to slow the spread of germs if people don’t think its a good idea. That’s why big public moves like restricting well-known vaccines are usually only done with a lot of deliberation before needlessly signaling uncertainty or lurking risk. Not here.