In day-to-day life, we accept that everything we do has risks. Each year thousands of people drown in their bathtubs. Thousands more are seriously injured or killed by falling from ladders. Many others precipitate a fatal heart attack by shoveling snow. We deem such risks acceptable in light of the alternative — not bathing, not climbing up things, not leaving home for weeks waiting for snow to melt.
Nowhere is this risk-benefit trade-off more explicit than in medicine. Pharmaceutical commercials remind us: You will frolic on the beach at sunset psoriasis-free, with a golden retriever, smiling into the distance. You also may experience sudden loss of cardiac function, seizures of the arms or intermittent explosive ear discharge. Talk to your doctor. We are able to hold in our heads the idea of drugs being simultaneously good and possibly harmful.
Yet for one specific class of medicine, vaccines, this discussion is deliberately being made impossible.
When researchers report an apparent side effect or adverse outcome, they can be near certain that bad actors will twist their words to undermine their meaning. Some of those bad actors will argue that side effects mean vaccines are bad for everyone. Others will say that past assurances of safety are malicious deceptions. The playbook is ageless, but only recently has such messaging come from federal officials and media figures with millions of followers. What began as an anti-establishment sentiment is now deeply established.
It’s more important than ever that accurate and nuanced discussions about vaccines can happen in the open, especially as measles and other vaccine-preventable diseases spread among communities in the United States, and the probability of future pandemics is projected to double in coming decades. But it has become difficult to do.
Take an example from last month. Researchers at Yale and Mount Sinai Medical Center released a draft of a study — which is to say, not peer-reviewed and not published — describing subtle changes in the immune system among 42 people who had experienced various symptoms after getting the Covid-19 vaccine. These symptoms included fatigue, tingling and numbness, muscle aches, brain fog and others similar to those seen in long Covid patients. The paper was clear that its findings were preliminary and should serve only to “inform future research.” It concluded modestly: “This study is early-stage and requires replication and validation.” It was the equivalent of saying to the scientific community, “Hey, I think I’m maybe seeing something? Is anyone else seeing this?”
In another era (before the pandemic), a study of this nature would have been passed around among scientists who do similar research, and probably landed in a pile in their office. It would not have received serious attention until it was vetted and published in a journal, at which point it would potentially inspire more definitive studies. If those bore out, the findings might eventually influence patients and doctors’ decisions or inform updated guidelines, vaccines and treatments.
Now it has become common practice to post studies online in preliminary form — so other researchers don’t have to wait months or years to see and critique them, and so curious or skeptical members of the public might witness the scientific process unfold in real time. Some scientists have already offered criticism of the study, arguing that the methodology cannot adequately assess whether the symptoms are, in fact, related to the vaccine, that the study is too small to be significant and other concerns. Theoretically this transparency would engender trust. But it’s difficult to know what to make of early findings, especially in small studies with results that are certainly not clear. Especially when not everyone interprets such work in good faith.
This includes some of the loudest voices in media and government. Elon Musk reshared a post on X about the Covid vaccine study: “They are finally admitting ‘Long COVID’ is just vaccine injury,” the post said, which is not what the study said at all. Multiple studies have shown that vaccines decrease the risk of long Covid and are estimated to have prevented over a million deaths.
A right-wing influencer with 3.6 million followers on X wrote: “Studies are beginning to prove that the COVID jab is far worse than COVID — and may in fact be a deadly poison for your immune system.” Another with one million followers said the study proved that the vaccine causes AIDS, calling for the F.B.I. to “hunt down” and imprison “every person involved in this crime against humanity.”
There is no way to read the study — or most coverage of it — with honest intentions and come away thinking the above claims are true. In the past I would have worried that sharing these sorts of posts amplifies misinformation. But those bizarre falsehoods are going out via megaphone, and it’s important to be aware of their unifying message. Rhetoric on vaccine safety has escalated from misstated facts to disinformation that serves to broadly discredit scientists and call for them to be punished by the state.
This is happening amid cuts to funding for biomedical research of all sorts, including on vaccines, and amid escalating threats to academic free speech. To the extent that this deters further study and conversation, everyone is made less safe. Researchers pursuing complex questions about vaccines shouldn’t have to fear that their work will be weaponized against them.
There are reasonable questions to be debated on the future of Covid-19 vaccination. As it stands, people are already not convinced of the utility of regular boosters. Though boosters are recommended for all adults, only 23 percent of that population is up-to-date in the United States. (Harlan Krumholz, a lead author of the study, said he continued to get them.)
Today the rates of hospitalization and death from Covid are nowhere near what they were in 2020, despite our overall low use of boosters. The Covid vaccines also do not prevent widespread transmission — as, say, the measles vaccine does. As such, vaccinating everyone against measles is a clear imperative. But the future guidance around the Covid vaccine will need to be approached with more nuance, with guidelines and vaccine formulations evolving as researchers learn more about the virus and the benefits of repeated vaccination.
The existence of even inconclusive studies on vaccines should reassure the public that scientists are continually re-evaluating current practices, constantly checking and rechecking for ways that treatments might be improved upon, communicating all along the way.
We should take heart that despite attempts to artificially polarize and divide the public, most people still search for truth so they can make the best medical decisions possible. The task remains to pursue the truth wherever it leads, and speak to the quiet majority who remain open to the same. Whether on ladder safety, vaccination or anything else.
The post The Vaccine Discourse Is Broken appeared first on New York Times.
