Politics. Cue the orchestral music, the gauzy video of happy, healthy Americans, and the sonorous voice-over of the 21st century’s version of Hal Riney.
The White House has convinced the 17 members of the FDA’s Vaccine and Biological Products Advisory Committee, the FDA, the 15 members of the CDC’s Advisory Committee on Immunization Practices and the CDC, that children aged 6 months to 4 years should be immunized against COVID.
As a result, this weekend the United States became the first nation in the world to have a vaccine available to virtually everyone one in the country.
Forget for a minute that most countries, especially those in Europe, have determined that vaccinating the young is a waste of resources and potentially dangerous. The narrative at the White House is that it has battled and triumphed.
All for an enemy that doesn’t exist
The “political people,” as they are known around government, are calling the shots.
The bureaucracy, where much of government’s expertise and institutional memory resides, has departed to parts unknown. Downtown is more like the days of my youth as it struggled decades later to overcome the depopulation brought on by the riots of 1968. The federal government, as a family member put it, is running in 2nd gear.
Political people, much like sell-side analysts, prefer storytelling to the hard work of understanding. Without the ballast of subject matter experts (the real ones, not the ones on cable news) that keep the storytelling tethered to reality, the tales being told get taller every day.
Policy. The White House’s preferred vehicle for COVID storytelling is, sadly, the CDC’s Morbidity and Mortality Weekly Review. A few weeks ago, they published a lame study on “long COVID” whose methods and conclusions are impossible to defend. Last week we get, just ahead of consideration of COVID shots for infants and toddlers, COVID-is-the-leading-cause-of-death-in-children storyline.
On its face, it is preposterous. Children rarely die. When they do it is almost always from non-natural causes like accidents, suicide or homicide. According to the CDC’s own data, 1,086 children died of COVID from January 2020 through the week ending May 28, 2022. During the same period there were 81k all cause deaths for children 0-17 years of age, all of them tragic.
The MMWR had to resort to data crimes detailed here that, because it is an official government publication, were repeated through all the dependable outlets seeking to preserve their access. Members of the FDA and CDC advisory committees reliably repeated the talking point at their respective meetings.
Additionally, the exaggerated risk to children helped panel members and leadership at the FDA and CDC rationalize their way to approval of the vaccine with low quality evidence presented by both companies.
Years into this pandemic, both PFE and MRNA are designing vaccines based on the Wuhan strain sequence, evaluating efficacy based on anti-body titers, ignoring prior immunity and using small numbers of trial participants that lead to confidence intervals on efficacy that are laughable.
The risks remain largely unknown.
None of these things matter to political people. Their math skills are usually confined to counting votes and the risk/reward analyses are limited to what happens in November 2022.
Power. To a scientist or a physician, the FDA’s and CDC’s behavior seems irrational, perhaps corrupt. To a political person it is a necessary part of overcoming the inevitable and probably unflattering comparisons to Governor Ron DeSantis of Florida.
(Let us note that many of DeSantis’ policies were deployed by Democratic governors, like Colorado’s Jared Polis, but none of them are likely to run for president.)
DeSantis and others adopted policies of “focused protection.” It has been clear from early 2020 that COVID has a devastating impact on the elderly and the immunocompromised.
The White House, in contrast, has advocated for population-wide measures that frequently ignore the risk/reward on various age cohorts. Making matters worse is a lot of those measures, like school closures, have had deleterious effects on an order unknown in the modern era.
Refusing to grant an EUA to PFE or MRNA for childhood vaccinations would amount to but one conclusion by the administration.
“We were wrong.”
Have a great rest of your long weekend.
Emily Evans
Managing Director – Health Policy
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