The NYT has an article about two vaccine scientists recently resigned from the FDA and wrote a paper in their personal capacities opposing COVID vaccine booster shots for the general public.
Some of the reasons for opposition outlined by the Times:
- Available data showing waning immunity has been only recently available and may not hold
- Current vaccines show “robust” protection against severe disease, hospitalization, and death.
- The rest of the world has not yet been vaccinated.
As a disclaimer, I am interested in booster shots partly because, being concerned about my own future, I have been watching for vaccine effectiveness data before adjusting my behavior. I am not necessarily impressed by what I’ve seen. The Mayo clinic study that was published late last month very closely agrees with Israeli data showing that the Pfizer vaccine, which I received, is effective against symptomatic infection about 46% – which is not that good. Also, data on hospitalized COVID patients who have been fully vaccinated here in the US is concerning.
My COVID personal risk calculus has never been weighted on data and odds, however. I look at the situation and wonder why some people get so ill and others do not. Because we do not yet know why some get very ill or die, data showing how many people out of a million who receive the vaccine and get infected, then later go on to die, or worse, get long COVID and suffer irreparable organ tissue damage is hardly a consolation. We know it will happen. It must be somebody. Why would it not be me?
Feelings aside, there are logical and practical reasons to not find the arguments of the opponents of booster doses persuasive.
- Data Freshness: So, the data is new or at least some is new. The Israeli data isn’t so new. It came out at the end of June. We shall never know if the Israeli data will hold up because they started boosters in July. Perhaps CDC data is stale given that more than half of it contain data that covers the period through approximately June before the Delta variant was an issue in the US. I am aware that the Mayo Clinic study did as well. These opponents admit that they have seen waning immunity in available data. What is the game plan if it DOES hold, and who is going to be the test case? They do not say. I’d prefer it not be me – we are people, not lab mice.
- “Robust protection” against severe disease: This is sort of a zinger for me. It seems like they are saying that it’s just fine if vaccinated patients end up sick and miserable. My answer is that perhaps, because of the “odds” (that appear to be changing in the wrong direction every week), I may end up just fine. Perhaps I will not. It all depends on what the shifting odds look like for the “when” of getting infected considering that the driver for boosters is waning immunity. Not to mention that it is strongly believed that I could spread COVID if I get infected.
- But there’s another reason that higher and higher chances for symptomatic breakthrough infections should not be waved off regardless of the odds of severe disease. Classic Darwinian theory says that the chances are higher for a vaccine resistant variant to come from a vaccinated person than an unvaccinated person. Do we want to end up back at beginning?
- Global vaccination status: This argument reminds me of beauty pageant speeches about solving world hunger because of the impracticality of the expectation that the rest of the world can be vaccinated before these vaccines become obsolete, even if we did no boosters. Thus far, enough vaccine doses have been administered to vaccinate about 2.5 billion people while the world population is ~ 8 billion. These 2.5 B people that have been vaccinated in the last 8 months are what seems to me as the low-hanging fruit who live where social institutions and infrastructure support rapid distribution. The rest of the world, perhaps not so much. And the global equality argument says nothing about who or where the rest of them are, how many of them are there, how the vaccines would get to them, what hurdles there are to be mowed down, or how long it would take. I honestly believe its proponents do not know. The “where” they are is important too, because I honestly do not believe that the US is responsible for vaccinating people in India or China, two huge chunks of unvaccinated global population, before we can take adequate care of our own. We can neither manage a vaccination program for these countries nor can we guarantee it would be appropriately managed; and it’s the same anywhere else.
- I believe it was proper for these two former FDA scientists to resign. When one works for the Federal government, one is working for the American people not the globe. It was not their job to resist approving boosters in the US in the face of compounding data on waning immunity for the sake of unattainable global vaccine equity. If they wish to decline a booster for themselves, that choice is up to them. They do not have the right and should not have the authority to do so for the whole nation based on political policy preferences. Elected officials should be making the policy, and they should do what is necessary to carry it out or resign if they cannot. I applaud their choice to resign.