Trump’s awful turn against mRNA vaccine research

Operation Warp Speed, we hardly knew ye

Donald Trump made a lot of mistakes in his handling of the Covid-19 pandemic, but he did champion rapid development of mRNA vaccines in a way that likely saved millions of lives.

Due to both the limited efficacy of the vaccine and limited uptake, hundreds of thousands of Americans died of Covid-19 after the great post-vaccine reopening. But the non-pharmaceutical interventions that kept the pandemic at bay for months were based on studies of their efficacy as short-term measures — compliance was breaking down even before vaccines became widely available, and it’s pretty clear that even in a no-vaccine world, they would not have been broadly sustained for much longer. In a counterfactual world in which the vaccines were developed 12 or 18 months later, the death toll would have been much higher.

And I think that Trump deserves real credit for helping to avert this.

It’s not so much that Operation Warp Speed involved staggering levels of policy innovation. Mostly, the private-sector pharmaceutical companies just did the work.

What the Trump administration did was put a lot of money into it without many strings attached, even adjusting regulations to be more favorable to the companies making the vaccines. I think Democrats mostly approved of OWS at the time and continued to approve of it in retrospect, so they feel confident that had they been in charge, they would have done the same thing. And they certainly might have.

But I think we know that Democrats tend to be uncomfortable with broad, no-strings-attached giveaways to corporate America. Would a Democratic OWS have become an “everything bagel” that collapsed under its own weight or a kind of appropriately seasoned onion bagel? I’m not sure. But I doubt it would have been a totally plain bagel that said to the pharmaceutical industry, “Go forth and profit by innovating!”

But by the time Joe Biden took office, things were going in a very particular direction. Democrats really wanted people to get Covid-19 shots, but the right was not only critical of vaccine mandates, they were increasingly paranoid, latching on to conspiracy theories about the mRNA vaccine. By 2024, skepticism of mRNA vaccines had fully merged with the longstanding movement against the measles vaccine and childhood vaccinations more broadly. Next thing we know, RFK Jr. is secretary of health and human services, and the Trump administration is doing less than nothing to protect us from harmful chemicals in drinking water and toxic metals in the air and soil, instead focusing on efforts to “Make America Healthy Again” by sabotaging vaccination.

The latest blow is that BARDA, the Biomedical Advanced Research and Development Authority, which is supposed to serve as a kind of DARPA for biology, is canceling its contracts for mRNA vaccine research. This is a total disaster for American science, American biosecurity, and American public health.

mRNA vaccine technology is broadly promising

In a traditional vaccine, the patient is injected with a weakened version of the virus, along with other components, to train the immune system against it. But with an mRNA vaccine, the patient receives bits of mRNA that instruct their body to make the viral proteins that trigger an immune response to a particular virus.

One incredibly useful upside of this technology is that it’s fast — you can go from design to creation much faster if you don’t need to grow live cultures. Because it’s fast, you can also make changes to the vaccine relatively quickly.

But the technology isn’t just useful against viruses. Another promising application is cancer treatment. One individual’s cancer is genetically distinct from another person’s, and mRNA allows doctors to craft personalized immunotherapies that attack a patient’s specific cancer. There have been some especially good results combining mRNA with something called checkpoint inhibitors, and a number of clinical trials for this class of treatments are under way. There’s also at least one early trial in mouse models, suggesting we might be able to create a universal anti-cancer immune booster as an mRNA vaccine.

Of course, as ever with new technology, some things that look promising early on won’t pan out.

And yet, it’s an exciting set of technologies. For a while, we were seeing frequent celebrations of the mRNA breakthrough in right-of-center publications such as American Affairs and The Wall Street Journal opinion section. Conservative think tanks like the American Enterprise Institute were gushing. Personally, I find the prospect of biomedical breakthroughs to be a refreshing respite from an era in which “technology” has mostly meant, in practice, “computer stuff.”

And there is some good computer stuff out there — I’m a big fan of ride-sharing apps, for example — but a huge share of what people have gotten rich off of in the “computer stuff” space is things like ever-better streaming video and compulsive social media scrolling, neither of which seem to be making society better. Nobody was sitting around 25 years ago saying, “It would be great if television and video games became so much more convenient and compelling that everyone started spending less time socializing, sleeping, exercising, and reading!” By contrast, lots of people have said, throughout human history, that it would be great if our ability to prevent and treat disease improved.

GLP-1 agonists are already transforming American public health by getting people to adopt healthier eating habits, and if mRNA can enhance and extend our immune systems, that would be another huge step toward a much better world. If you want a deeper dive on the specifics of mRNA and cancer, I recommend Noah Smith’s post, which is full of righteous indignation.

The counterpoint to Smith’s argument that RFK Jr. kneecapped promising cancer treatments is that all he really did here is cut BARDA funding for mRNA vaccine research on respiratory ailments. There’s no formal implication for cancer research. Smith’s counter to the counter, which I think is persuasive, is that if HHS is going to start canceling contracts due to conspiratorial paranoia about mRNA vaccines, this has systemic implications for all mRNA vaccine research, regardless of the source of funding or the details of the vaccine. Can we expect any treatment based on mRNA vaccine technology to be approved by Trump’s FDA?

Pandemics are a big deal and will keep happening

Beyond the speculative cancer treatments, though, I want to defend the original core proposition that it’s a good idea to be researching mRNA vaccines for respiratory viruses.

The Covid-19 pandemic killed many millions of people, cost the world trillions in economic output, and wreaked all kinds of havoc across society.

Conservatives have talked themselves into a weird corner in which, because they think non-pharmaceutical interventions (NPIs) went too far, they’ve also decided that all the harms of the pandemic are attributable not to the spread of the virus, but to the NPIs themselves. This is just not true. Lots of people really did die. A larger number of people who did not die got seriously ill. Lots of other people got not-so-seriously ill, but even not-so-serious illness is bad and worth avoiding if possible. And many more people would have gotten sick and died without a broad behavioral response before vaccines were available. Conservatives often muddy the waters between research showing that a lot of formal state NPI policy mandates were ineffective and the conclusion that behavioral response had no impact on the pandemic.

But when I visited Texas in 2020 and there were no mask mandates and few mandatory closures in place, there were still plenty of people wearing masks. There were no NBA games being played. There were no blockbuster movies out in theaters, and Taylor Swift wasn’t playing huge stadium shows. Behavior was very different in November 2020 from November 2019, separate from formal policy.

Lots of individual people in red states were taking Covid-related precautions and lots of individual people in blue states were blowing off the guidelines. The policy impacts, as a result, were low. But the behavioral response to a scary new pandemic isn’t something you can just hand-wave away by not doing policy. Alternatively, if you had convinced everyone to behave as if they somehow didn’t notice that a novel respiratory virus was circulating, you would have had much more rapid spread of disease and a much higher death toll — as we saw in the early days of the pandemic in New York City, when people in fact were not aware that a novel respiratory virus was circulating.

The point is, just because the policy response to the pandemic was imperfect doesn’t mean you can chalk all the harms up to the imperfections of the policy response. The virus itself was an actual Bad Thing that had Bad Consequences, and even if policy is better next time around, the consequences of a novel pandemic will still be Bad.

In fact, it’s totally plausible that the next pandemic will be much worse.

It could involve a virus that is deadlier than Covid-19. Or one whose burden falls harder on young kids, which I think regardless of policy would generate a bottom-up level of social freakout that would far exceed anything we saw during this pandemic.

There are basically two leading theories about Covid-19’s origins: that it came from a wild animal or that it came from laboratory virus research. There is every reason to believe that both of these scenarios, each with the potential to spark new pandemics, are becoming more likely. Population growth is pushing more humans into new habitats. Climate change is pushing more animals out of their existing habitats. Dense, efficient farming is pushing more animals closer together (and closer to humans), where zoonosis can occur. Artificial intelligence and other advances are making it easier to engineer new viruses.

There will be more — and potentially deadlier — pandemics in the future.

The Biden administration developed a good proposal for pandemic prevention that they sadly half-assed their advocacy for, because it had to play second fiddle to the groups’ spending priorities.

What we got was this very modest BARDA program. BARDA is an incredibly successful agency that, per this great Institute for Progress report, deserves more funding. And walking away from its quest to help safeguard against future respiratory pandemics is very bad on its own terms, even in the unlikely event that this doesn’t impact cancer research at all.

The perils of crank conservatism

I think you could put the turn against mRNA technology in the same bucket with several red states banning cultured meat or the Trump administration not only removing subsidies from solar and wind energy (fair enough), but also raising every possible regulatory roadblock to their deployment.

The MAGA-fied version of the Republican Party seems to have broadly turned against classic themes of free markets, innovation, and technological progress in favor of a vibes-based assessment of technologies. The Biden administration undertook a somewhat ham-fisted regulatory crackdown on cryptocurrency, and crypto then became a red-coded technology, so Trump has become a relentless booster of crypto, even as it looks more and more like a niche technology rather than something transformative. By contrast, people who care about animal welfare are excited about cultured meat, so it’s liberal and bad and we’re going to make it illegal. Similarly, if environmentalists make exaggerated claims about the virtues of wind, solar, and batteries, MAGA will respond by making exaggerated claims about their defects and trying to make it illegal to use them. Excitement about artificial intelligence is currently driving the stock market valuations of the S&P 500’s biggest companies, so the Trump administration is gung-ho about AI, while doing nothing to address its labor market impacts.

And, of course, since caring about Covid is lib-coded, vaccination has become lib-coded, and now mRNA vaccines are bad.

Trump is so flagrantly corrupt in so many ways that it can feel absurd to write takes like, “This Trump administration policy decision is bad and wrong.” But canceling this BARDA research is really bad and wrong! The larger attack on scientific research is bad, and this in particular is especially bad. The broader implications for cancer and other diseases are bad, and so is the decision to abandon critical biodefense programs.

Hopefully, we’ll be lucky enough to avoid paying the price in the short term and will be able to change course in the medium term. But gambling with the country’s future is irresponsible and morally indefensible.