Love this - the EUA thing is particularly so obvious and frustrating.
Some thoughts that dovetail well with what you've said here:
I just returned from visiting my black, low-income family in Buffalo. Back in April 2020, covid swept through the family (8 older adults and 10ish young adults (18-25) living scattered through 2 houses (4 apartments)). None of my cousins my age had a symptomatic case, though we must assume in the cramped conditions everyone got sick. Of the older adults, 5 had serious cases, 1 was in the ICU for a month, and now has long covid. Another uncle of ours who lived in a nursing home died.
Fast forward to June 2021, all of the older adults are vaccinated but only 1 or 2 of my cousins are. I've tried to approach the subject with them gently, with understanding as a primary goal and persuading on the back burner. For the most part my cousins have been pretty dodgy about it, but I did get one to sit down and talk for a while. And he just had very reasonable questions: what's in it, how does it work, why do some people who get the shot still get sick, etc. "Am I going to have to miss work?" was notably *not* on the list, because he didn't even know enough about the vaccine to know there were side effects.
Now of course, all the information is readily available and he has a smartphone. But blame games are irrelevant to my point, which is that he inhabits a *vastly* different world than all of us, and his information ecosystem is just totally disconnected from ours. He doesn't read the NYT (or any other news source). His engagement with politics is nil. Any information he's getting about any of this is going to come in the form of snapchat or instagram stories, and that information is going to be super sporadic anyways. For the most part no one in his circles is going to be talking about the vaccines at all, they're talking about their annoying coworkers or some girl they're 'messing with' or the NBA playoffs. He does know that Cole Beasley, Josh Allen, and Stephon Diggs all refused to get the shot. (I will say that I do *not* think them publicly endorsing the shot would have registered on his radar at all or made a difference.)
After talking to him and calmly answering his questions, he was like "oh, I guess I'll go get one at rite-aid tomorrow." Note that my uncle had offered to drive him, and I'm not sure he'd have bothered even then if someone wasn't actively trying to give him a ride.
On reflection I think I have three takeaways:
1) One might expect that the family all having covid would provide *more* impetus to get shots, since they've seen how serious it can be. And I think that's true for the older adults. But I think my cousins reasonably think they're immune and also think that if they do get covid again, it won't be so bad. (*I* don't even understand why the vaccines would confer greater/different immunity, especially to variants, than actually having had covid. Why on earth would my cousins, who aren't not actively trying to answer that question?)
2) My cousins are, I think, reasonably representative of the norm among low-income black 20 year olds living in various ghettos. They're basically apolitical and don't engage with any mainstream channels of information or news, except sports. They were exposed to covid early on and were fine. And there just isn't a particularly compelling reason for them to go get vaxxed, nor is there anyone nagging them to do so.
3) I absolutely think they would get vaxxed if *both* a) they were offered a decent amount of money, 50 bucks seems like the right ballpark and b) the shots were *extremely* convenient - I'm talking like, walking distance. The less convenient, the more money it would take to motivate them. Mandates of various kinds might also do it - most likely as a requirement to see a Bills game, or to go to Canada, or for work (in their case, in Amazon warehouses). Only really confident in the last of these, though.
My wife is the controller for a company that operates a warehouse in exurban Atlanta, Georgia. She offered unvaccinated employees $100 to get vaccinated. Two-thirds of those who hadn’t already been vaccinated got the jab. If one employee avoids getting covid because of that, the company has saved money.
In all these discussions about vaccination I never read any mention about people with natural immunity (i.e. people that got sick and recovered). The CDC estimates that some 114 million people have already gotten COVID in the US alone.
This isn't a small slice of the population. There is also very good evidence that natural immunity is as good as or better than vaccination in terms of resistance to reinfection and reduction of severity when reinfected.
When you're interested in knowing how many people are vulnerable to infection by COVID, you have to exclude both the vaccinated population and the people who've had it already. Of course some people are in both groups, so you can't just add up the numbers, but I'm sure there's a sizable group who aren't bothering to get vaccinated because they got the disease already.
It's reasonable to assume that concentrations of such people are going to be higher in poorer, denser areas where the infection spread fast during the first and second waves (before the vaccines were available) and if those are the areas where vaccination progress is stalled, that's likely one of the reasons.
It's not clear what to do from a policy standpoint about natural immunity. It's difficult to identify and count naturally immune people. But it's clear to me that we're closer to "herd immunity" than the vaccination numbers suggest. And given that we believe COVID is now endemic (it will continue to reinfect both vaccinated and naturally immune people with mild cases forever) I don't think the that either 100% vaccination or 0 new infections are reasonable goals to aim for.
My brother is a researcher in the Bay Area, and he said at one point the reason Berkeley was avoiding a vaccine requirement was that people of color would be less likely to have been vaccinated. So in order to not adversely impact communities of color, Berkeley enabling the spread of COVID which will... adversely impact communities of color.
There is also a progressive politics issue here. I'm a conventional liberal but the pandemic has turned me radically hostile to the FDA and CDC who seem to me to have contributed (unintentionally of course) to tens if not hundreds of thousands of unnecessary deaths. I believe we need a competent regulatory state but it is hard to make the case that we need these particular institutions in their current forms.
Fully vaccinated. Family is fully vaccinated. Not concerned.
Liberals who don’t interact with a single unvaccinated person in their urban suburb obsessing over those not vaccinated 4 state lines away sound an awful lot like conservatives in Florida obsessed with crime waves in Chicago.
I actually find this to be very interesting. I'm related to a person who is, at least nominally, in charge of vaccine encouragement for the company. I was talking to her yesterday and I suggested that what they should do in places where they have low rates, Iowa, Missouri, etc was to offer a straight one hundred dollar bonus for proof of a vaccination.
She told me that that would be unfair to other employees who have gotten vaccinated already like most of R&D and our sales and marketing people who have both hit above 90% vaccinated rates. I said, "are you trying to make people feel good about themselves or are you trying to get people vaccinated so that people can safely go to work?"
I feel like that's where we are with vaccines nationally. We simply aren't willing to outright incentivise people to get vaccinated and we aren't willing to just approve it and mandate it. And the longer we wait to do either of those things the more the culture war battlelines will solidify until it finally goes from being a vaccine to being another signifier of ingroup/outgroup status.
Make version of the vaccine delivered in a sugar cube. You get the people who don't like shots out of the way.
Otherwise, as much as I want to stick mandates to these anti-vax idiots, I can't muster up the energy to spend a lot of time worrying about people who refuse the shot. Fine, get sick then and deal. Something something horse to water.
I'd worry about creating a variant breeding ground, but we're getting variants regardless given the most of the world has far lower vaccination rates than the US. With Moderna and Pfizer having boosters ready to go, we're pretty much in a world where for the vast majority of people, COVID is something you choose to become very sick from or not.
Liberals locking down in liberal cities like SF again would be basically punishing ourselves for the sins of the Q crowd.
That all said, here's an idea: health insurance companies get a waiver from covering covid care expenses in cases where someone was able to get vaccinated but refused to do so. If getting covid as an unvaccinated person means you're covering the entire hospital bill, the incentives change pretty fast.
Let’s stipulate for the moment that “the process” at the FDA has essentially failed and is in desperate need of an overhaul. I’m even reasonably on board with this idea.
But if the goal is to persuade the persuadable, I’m really dubious that changing the rules at this stage to issue formal approval faster will be of any help. The talking point on Fox/OANN/NewsMax will change from “this vaccine is experimental and not fully tested/approved” — which, as you note, is strictly true at the moment — to “they changed the rules to give approval to this vaccine without testing it like they normally would have”. And this, also, would be strictly true and worse yet would end up also being true of any _subsequent_ vaccine approved by the FDA for the rest of our lives.
I know that our host prefers to avoid double-bank-shot GAME THEORY approaches to public health and I’m largely sympathetic, but at the same time I think we need to be honest with ourselves about the depth of the abyss that we are currently on the edge of. In 2016 Trump played footsie with the anti-vaccine fringe (there were even rumors of him appointing RFK Jr as surgeon general!) but whether out of personal unpredictability or at the behest of saner voices behind the scenes ended up not paying the issue much attention as President. And for now, Rupert Murdoch seems to be trying to thread the needle on this issue. But there is no guarantee that will hold true in 2022/2024 and if the Trumpists decide that demagoguery on the topic of vaccines is their path back to power, they will absolutely do that and there are worse actors than SARS-CoV-2 waiting in the wings.
Hi, Matt. You’ve pointed out in the past the ways in which the public health community has gotten us all into trouble with what you’ve called “bank shots” but which you might also call “saying things that aren’t true.” The classic example was the early advice on masking. Instead of saying, “We need to save our small supply of quality masks for the medical community so please don’t hoard them,” they said, “Masks don’t work, so please don’t hoard them.” I think most of us agree now that this was a mistake.
There are other examples, pretty much none of which worked as intended. The lesson seems to be that we should tell the truth and trust the public to be grown-ups who can handle the truth. And that trying to manipulate people through misinformation – or even just false confidence in the face of uncertainty – is very likely to backfire.
I worry, though, that you are sort of advocating another bank shot here in terms of vaccine approval. If someone were to say, “These COVID-19 vaccines are based on brand new medical technology that none of us had ever heard of 18 months ago and haven’t gone through the same level of rigorous testing and observation of our typical vaccines,” that’s just true. I got the vaccine anyway – as soon as I possibly could – but not because I thought it was just as safe as a measles shot. I got it because I thought it was the right thing to do despite the obvious risk.
Of course it would be great if we knew more about the long-term safety and efficacy of these vaccines. But the FDA can’t just waive away the current situation by pretending to know more than it does. The Emergency Use Authorization seems to reflect that reality: These vaccines have not gone through all the testing we’d typically expect, but under the circumstances we think they are safe enough to use anyway.
And under these circumstances, what would it even mean for the FDA to give full approval to the vaccines? It doesn’t change the actual current level of medical/scientific knowledge about them; it just sort of moves the goal posts in terms of what full approval requires. So isn’t it just another bank shot?
One thing that some of the past bank shots seem to have in common is a reluctance to ask individuals to make sacrifices for others. That’s true of the original mask debacle, but also of some of the later stay-at-home and pro-masking advice. Because we haven’t wanted to tell people that they have to make significant personal sacrifices primarily to help others, we’ve instead fudged the data a bit to make it look like it’s actually an act of self-interest rather than self-sacrifice.
Instead, as you’ve recommended elsewhere, why not just go full bore (sorry) on the truth here: Yes, these vaccines are a bit scary. Yes, they are based on brand new technology that hasn’t been tested as much as we’d like. Yes, just like with ordinary vaccines, there is certainly some risk of complications. But your country needs you to get vaccinated anyway. Not just – or even primarily – to protect yourself, but to protect more vulnerable people around you.
I love your idea of a massive marketing campaign, far more aggressive than what we have now. But rather than pretending to know that the vaccine is perfectly safe and that vaccination is in everyone’s narrow self-interest, why not send the message that getting vaccinated is an act of patriotic bravery? And refusing it is an act of selfish cowardice.
This is beside your point, but it is salient to me that LeBron James specifically does not seem to be vaccinated based on his public comments and also broader trends among athletes.
I am not privy to any inside information, but I think that sports leagues *should* be one of the things where employees are required to be vaccinated, except that the most prominent employees (the athletes) have collectively bargained contracts and I’m not sure how those deal with vaccine requirements whether or not the vaccines are formally approved.
I bring this up because
a) I’ve heard almost nothing about the issue of vaccine requirements for unionized workers, teachers or athletes or auto workers or otherwise
b) the specific case of athletes (wealthy individuals with access to lots of information with lots of exposure risk and who depend on being healthy for work) broadly not getting vaccinated (as seems to be the case based on public health data) seems like a bemusing problem to me that doesn’t affect a large number of people (there aren’t that many pro athletes) but might be a prominent indicator of other less visible trends
My bias is showing here, but I think there's a significant contingent of Dems/libs that want the unvaccinated to "bend the knee" and admit that vaccines are good and they work. When instead they shouldn't give a flying fuck and just get as many people vaccinated as possible, through whatever means are legal.
I said a year ago that the biggest motivator for the reluctant would be Disneyland requiring a vaccine, and I'm sticking to it.
Has anyone seen a poll with something like this question. “Have you had a close friend or family member die of COVID-19?” My answer is yes, but my informal queries show nearly everyone I know would answer no. We all see the economic impact, but I wonder who among the unvaccinated just don’t seem worried. For me personally, until I actually SAW polio in Africa, I didn’t really REALLY get the importance of vaccinations. As a young man, I wasn’t anti vax, but seeing certainly made me pro vax.
I’ve been critical of some of your vaccine process takes in the past (you can’t “just” rapidly spin up more manufacturing of a therapeutic like this; it’s not like making plastic widgets or whatever), but I’m on board with this one. One mechanism I could imagine is something covered by EUA could automatically trigger a data review for full authorization once you’ve treated, say, 10 million people, or some significant fraction of the treatable population. I guess the counterpoint is that it’s not large numbers of patients matters that really matters to prove safety, giving the treatment enough time in the field to make any longer term side effects known. Maybe that’s what the FDA is waiting for.
I also don’t understand why kids under 12 aren’t allowed to access vaccines on a right-to-try basis. I understand that this case isn’t contemplated under existing right to try legislation, but in terms of increasing population vaccination rates, letting parents desperate to give their kids the vaccine actually do so sure seems like low hanging fruit.
I think that school reopening is an underrated risk for Democrats going into the midterms. All of the real progress made on recovery from the pandemic will be undermined if parents still need to manage child care every single day and feel, not wrongly, that their kids are missing another year of education.
Whether or not it is fair, I suspect Ds will take the hit for that. Seems like an unforced error, especially when not medically necessary at all.
Love this - the EUA thing is particularly so obvious and frustrating.
Some thoughts that dovetail well with what you've said here:
I just returned from visiting my black, low-income family in Buffalo. Back in April 2020, covid swept through the family (8 older adults and 10ish young adults (18-25) living scattered through 2 houses (4 apartments)). None of my cousins my age had a symptomatic case, though we must assume in the cramped conditions everyone got sick. Of the older adults, 5 had serious cases, 1 was in the ICU for a month, and now has long covid. Another uncle of ours who lived in a nursing home died.
Fast forward to June 2021, all of the older adults are vaccinated but only 1 or 2 of my cousins are. I've tried to approach the subject with them gently, with understanding as a primary goal and persuading on the back burner. For the most part my cousins have been pretty dodgy about it, but I did get one to sit down and talk for a while. And he just had very reasonable questions: what's in it, how does it work, why do some people who get the shot still get sick, etc. "Am I going to have to miss work?" was notably *not* on the list, because he didn't even know enough about the vaccine to know there were side effects.
Now of course, all the information is readily available and he has a smartphone. But blame games are irrelevant to my point, which is that he inhabits a *vastly* different world than all of us, and his information ecosystem is just totally disconnected from ours. He doesn't read the NYT (or any other news source). His engagement with politics is nil. Any information he's getting about any of this is going to come in the form of snapchat or instagram stories, and that information is going to be super sporadic anyways. For the most part no one in his circles is going to be talking about the vaccines at all, they're talking about their annoying coworkers or some girl they're 'messing with' or the NBA playoffs. He does know that Cole Beasley, Josh Allen, and Stephon Diggs all refused to get the shot. (I will say that I do *not* think them publicly endorsing the shot would have registered on his radar at all or made a difference.)
After talking to him and calmly answering his questions, he was like "oh, I guess I'll go get one at rite-aid tomorrow." Note that my uncle had offered to drive him, and I'm not sure he'd have bothered even then if someone wasn't actively trying to give him a ride.
On reflection I think I have three takeaways:
1) One might expect that the family all having covid would provide *more* impetus to get shots, since they've seen how serious it can be. And I think that's true for the older adults. But I think my cousins reasonably think they're immune and also think that if they do get covid again, it won't be so bad. (*I* don't even understand why the vaccines would confer greater/different immunity, especially to variants, than actually having had covid. Why on earth would my cousins, who aren't not actively trying to answer that question?)
2) My cousins are, I think, reasonably representative of the norm among low-income black 20 year olds living in various ghettos. They're basically apolitical and don't engage with any mainstream channels of information or news, except sports. They were exposed to covid early on and were fine. And there just isn't a particularly compelling reason for them to go get vaxxed, nor is there anyone nagging them to do so.
3) I absolutely think they would get vaxxed if *both* a) they were offered a decent amount of money, 50 bucks seems like the right ballpark and b) the shots were *extremely* convenient - I'm talking like, walking distance. The less convenient, the more money it would take to motivate them. Mandates of various kinds might also do it - most likely as a requirement to see a Bills game, or to go to Canada, or for work (in their case, in Amazon warehouses). Only really confident in the last of these, though.
My wife is the controller for a company that operates a warehouse in exurban Atlanta, Georgia. She offered unvaccinated employees $100 to get vaccinated. Two-thirds of those who hadn’t already been vaccinated got the jab. If one employee avoids getting covid because of that, the company has saved money.
In all these discussions about vaccination I never read any mention about people with natural immunity (i.e. people that got sick and recovered). The CDC estimates that some 114 million people have already gotten COVID in the US alone.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html
This isn't a small slice of the population. There is also very good evidence that natural immunity is as good as or better than vaccination in terms of resistance to reinfection and reduction of severity when reinfected.
https://www.nature.com/articles/s41586-021-03647-4
https://www.medrxiv.org/content/10.1101/2021.04.20.21255670v1
When you're interested in knowing how many people are vulnerable to infection by COVID, you have to exclude both the vaccinated population and the people who've had it already. Of course some people are in both groups, so you can't just add up the numbers, but I'm sure there's a sizable group who aren't bothering to get vaccinated because they got the disease already.
It's reasonable to assume that concentrations of such people are going to be higher in poorer, denser areas where the infection spread fast during the first and second waves (before the vaccines were available) and if those are the areas where vaccination progress is stalled, that's likely one of the reasons.
It's not clear what to do from a policy standpoint about natural immunity. It's difficult to identify and count naturally immune people. But it's clear to me that we're closer to "herd immunity" than the vaccination numbers suggest. And given that we believe COVID is now endemic (it will continue to reinfect both vaccinated and naturally immune people with mild cases forever) I don't think the that either 100% vaccination or 0 new infections are reasonable goals to aim for.
My brother is a researcher in the Bay Area, and he said at one point the reason Berkeley was avoiding a vaccine requirement was that people of color would be less likely to have been vaccinated. So in order to not adversely impact communities of color, Berkeley enabling the spread of COVID which will... adversely impact communities of color.
There is also a progressive politics issue here. I'm a conventional liberal but the pandemic has turned me radically hostile to the FDA and CDC who seem to me to have contributed (unintentionally of course) to tens if not hundreds of thousands of unnecessary deaths. I believe we need a competent regulatory state but it is hard to make the case that we need these particular institutions in their current forms.
Fully vaccinated. Family is fully vaccinated. Not concerned.
Liberals who don’t interact with a single unvaccinated person in their urban suburb obsessing over those not vaccinated 4 state lines away sound an awful lot like conservatives in Florida obsessed with crime waves in Chicago.
I actually find this to be very interesting. I'm related to a person who is, at least nominally, in charge of vaccine encouragement for the company. I was talking to her yesterday and I suggested that what they should do in places where they have low rates, Iowa, Missouri, etc was to offer a straight one hundred dollar bonus for proof of a vaccination.
She told me that that would be unfair to other employees who have gotten vaccinated already like most of R&D and our sales and marketing people who have both hit above 90% vaccinated rates. I said, "are you trying to make people feel good about themselves or are you trying to get people vaccinated so that people can safely go to work?"
I feel like that's where we are with vaccines nationally. We simply aren't willing to outright incentivise people to get vaccinated and we aren't willing to just approve it and mandate it. And the longer we wait to do either of those things the more the culture war battlelines will solidify until it finally goes from being a vaccine to being another signifier of ingroup/outgroup status.
Make version of the vaccine delivered in a sugar cube. You get the people who don't like shots out of the way.
Otherwise, as much as I want to stick mandates to these anti-vax idiots, I can't muster up the energy to spend a lot of time worrying about people who refuse the shot. Fine, get sick then and deal. Something something horse to water.
I'd worry about creating a variant breeding ground, but we're getting variants regardless given the most of the world has far lower vaccination rates than the US. With Moderna and Pfizer having boosters ready to go, we're pretty much in a world where for the vast majority of people, COVID is something you choose to become very sick from or not.
Liberals locking down in liberal cities like SF again would be basically punishing ourselves for the sins of the Q crowd.
That all said, here's an idea: health insurance companies get a waiver from covering covid care expenses in cases where someone was able to get vaccinated but refused to do so. If getting covid as an unvaccinated person means you're covering the entire hospital bill, the incentives change pretty fast.
Let’s stipulate for the moment that “the process” at the FDA has essentially failed and is in desperate need of an overhaul. I’m even reasonably on board with this idea.
But if the goal is to persuade the persuadable, I’m really dubious that changing the rules at this stage to issue formal approval faster will be of any help. The talking point on Fox/OANN/NewsMax will change from “this vaccine is experimental and not fully tested/approved” — which, as you note, is strictly true at the moment — to “they changed the rules to give approval to this vaccine without testing it like they normally would have”. And this, also, would be strictly true and worse yet would end up also being true of any _subsequent_ vaccine approved by the FDA for the rest of our lives.
I know that our host prefers to avoid double-bank-shot GAME THEORY approaches to public health and I’m largely sympathetic, but at the same time I think we need to be honest with ourselves about the depth of the abyss that we are currently on the edge of. In 2016 Trump played footsie with the anti-vaccine fringe (there were even rumors of him appointing RFK Jr as surgeon general!) but whether out of personal unpredictability or at the behest of saner voices behind the scenes ended up not paying the issue much attention as President. And for now, Rupert Murdoch seems to be trying to thread the needle on this issue. But there is no guarantee that will hold true in 2022/2024 and if the Trumpists decide that demagoguery on the topic of vaccines is their path back to power, they will absolutely do that and there are worse actors than SARS-CoV-2 waiting in the wings.
Hi, Matt. You’ve pointed out in the past the ways in which the public health community has gotten us all into trouble with what you’ve called “bank shots” but which you might also call “saying things that aren’t true.” The classic example was the early advice on masking. Instead of saying, “We need to save our small supply of quality masks for the medical community so please don’t hoard them,” they said, “Masks don’t work, so please don’t hoard them.” I think most of us agree now that this was a mistake.
There are other examples, pretty much none of which worked as intended. The lesson seems to be that we should tell the truth and trust the public to be grown-ups who can handle the truth. And that trying to manipulate people through misinformation – or even just false confidence in the face of uncertainty – is very likely to backfire.
I worry, though, that you are sort of advocating another bank shot here in terms of vaccine approval. If someone were to say, “These COVID-19 vaccines are based on brand new medical technology that none of us had ever heard of 18 months ago and haven’t gone through the same level of rigorous testing and observation of our typical vaccines,” that’s just true. I got the vaccine anyway – as soon as I possibly could – but not because I thought it was just as safe as a measles shot. I got it because I thought it was the right thing to do despite the obvious risk.
Of course it would be great if we knew more about the long-term safety and efficacy of these vaccines. But the FDA can’t just waive away the current situation by pretending to know more than it does. The Emergency Use Authorization seems to reflect that reality: These vaccines have not gone through all the testing we’d typically expect, but under the circumstances we think they are safe enough to use anyway.
And under these circumstances, what would it even mean for the FDA to give full approval to the vaccines? It doesn’t change the actual current level of medical/scientific knowledge about them; it just sort of moves the goal posts in terms of what full approval requires. So isn’t it just another bank shot?
One thing that some of the past bank shots seem to have in common is a reluctance to ask individuals to make sacrifices for others. That’s true of the original mask debacle, but also of some of the later stay-at-home and pro-masking advice. Because we haven’t wanted to tell people that they have to make significant personal sacrifices primarily to help others, we’ve instead fudged the data a bit to make it look like it’s actually an act of self-interest rather than self-sacrifice.
Instead, as you’ve recommended elsewhere, why not just go full bore (sorry) on the truth here: Yes, these vaccines are a bit scary. Yes, they are based on brand new technology that hasn’t been tested as much as we’d like. Yes, just like with ordinary vaccines, there is certainly some risk of complications. But your country needs you to get vaccinated anyway. Not just – or even primarily – to protect yourself, but to protect more vulnerable people around you.
I love your idea of a massive marketing campaign, far more aggressive than what we have now. But rather than pretending to know that the vaccine is perfectly safe and that vaccination is in everyone’s narrow self-interest, why not send the message that getting vaccinated is an act of patriotic bravery? And refusing it is an act of selfish cowardice.
This is beside your point, but it is salient to me that LeBron James specifically does not seem to be vaccinated based on his public comments and also broader trends among athletes.
I am not privy to any inside information, but I think that sports leagues *should* be one of the things where employees are required to be vaccinated, except that the most prominent employees (the athletes) have collectively bargained contracts and I’m not sure how those deal with vaccine requirements whether or not the vaccines are formally approved.
I bring this up because
a) I’ve heard almost nothing about the issue of vaccine requirements for unionized workers, teachers or athletes or auto workers or otherwise
b) the specific case of athletes (wealthy individuals with access to lots of information with lots of exposure risk and who depend on being healthy for work) broadly not getting vaccinated (as seems to be the case based on public health data) seems like a bemusing problem to me that doesn’t affect a large number of people (there aren’t that many pro athletes) but might be a prominent indicator of other less visible trends
My bias is showing here, but I think there's a significant contingent of Dems/libs that want the unvaccinated to "bend the knee" and admit that vaccines are good and they work. When instead they shouldn't give a flying fuck and just get as many people vaccinated as possible, through whatever means are legal.
I said a year ago that the biggest motivator for the reluctant would be Disneyland requiring a vaccine, and I'm sticking to it.
Has anyone seen a poll with something like this question. “Have you had a close friend or family member die of COVID-19?” My answer is yes, but my informal queries show nearly everyone I know would answer no. We all see the economic impact, but I wonder who among the unvaccinated just don’t seem worried. For me personally, until I actually SAW polio in Africa, I didn’t really REALLY get the importance of vaccinations. As a young man, I wasn’t anti vax, but seeing certainly made me pro vax.
I’ve been critical of some of your vaccine process takes in the past (you can’t “just” rapidly spin up more manufacturing of a therapeutic like this; it’s not like making plastic widgets or whatever), but I’m on board with this one. One mechanism I could imagine is something covered by EUA could automatically trigger a data review for full authorization once you’ve treated, say, 10 million people, or some significant fraction of the treatable population. I guess the counterpoint is that it’s not large numbers of patients matters that really matters to prove safety, giving the treatment enough time in the field to make any longer term side effects known. Maybe that’s what the FDA is waiting for.
I also don’t understand why kids under 12 aren’t allowed to access vaccines on a right-to-try basis. I understand that this case isn’t contemplated under existing right to try legislation, but in terms of increasing population vaccination rates, letting parents desperate to give their kids the vaccine actually do so sure seems like low hanging fruit.
I think that school reopening is an underrated risk for Democrats going into the midterms. All of the real progress made on recovery from the pandemic will be undermined if parents still need to manage child care every single day and feel, not wrongly, that their kids are missing another year of education.
Whether or not it is fair, I suspect Ds will take the hit for that. Seems like an unforced error, especially when not medically necessary at all.