Rushing the Release of a Vaccine Could Be the Worst Part of Trump's COVID-19 Disaster
September 3, 2020
President Donald J. Trump listens as Secretary of Health and Human Services Alex Azar delivers remarks during a press conference (The White House)
By Mark Sumner
Over the last week, alarms have been getting louder and louder over the possibility that Donald Trump may try to rush out a vaccine as a kind of ultimate “October surprise” in advance of the election. The Palm Beach Post reported that Phase 3 testing of the Oxford vaccine had been paused because the Food and Drug Administration was considering issuing a Emergency Use Authorization that would allow manufacturer AstraZeneca to begin distribution without waiting for the results of an extended trial. Then the Financial Times backed up the idea that Trump was hoping to hurry this vaccine forward before the election. And despite repeated claims from FDA commissioner Stephen Hahn that the agency “would not cut corners,” these statements are hard to take seriously just days after the FDA overruled the concerns of experts to expand use of convalescent plasma despite the lack of trial results.
On Wednesday morning, McClatchy is reporting that on August 27, the Centers for Disease Control and Prevention director Robert Redfield issued a letter to the governors of all fifty states telling them that Trump wants them to “do everything in their power to eliminate hurdles for vaccine distribution sites to be fully operational by Nov. 1.” The signals that Trump is planning to announce the availability of a vaccine before the election are not subtle—and they’re everywhere.
If Trump does this, if he rushes a vaccine into distribution without the completion of trials and without the full support of healthcare experts, the result could be more illness, more economic cost, and more deaths than no vaccine at all.
The risks of rushing a vaccine forward without completing Phase 3 testing are more than the threat of releasing an unsafe or ineffective vaccine, but obviously, those are threats. The 6.2 million proven cases of COVID-19 in the United States is less than 2% of the population. To effectively end the pandemic, at least 70% of the population needs to be immunized. If hundreds of millions of doses of vaccines were administered, even a low rate of safety issues could generate thousands of serious problems. And if a vaccine is less than 70% effective, even administering it to everyone in the nation might not achieve the level of immunity necessary to reduce the rate of transmission below the point where the COVID-19 epidemic would be sustained.
That’s only part of the risk. Even if the vaccine turned out to be almost perfectly safe and almost perfectly effective, pushing it forward without adequate testing will absolutely generate a problem with public trust that could be at least as bad as a vaccine that simply didn’t work.
As Stat News reports, the latest Harris poll shows that 78% of Americans believe vaccine approval is being driven more by politics than by science. An amazing 83% of Americans worry that any vaccine that appears in the next few weeks could be unsafe. As a result of these concerns, only half of Americans have said they would consider getting a COVID-19 vaccine. These results are only to be expected after Trump has repeatedly pushed an ineffective “cure” for COVID-19 and made exaggerated claims about other treatments.
By attempting to deliver a “miracle” in advance of the election, Trump risks creating a whole new—and much more justified—anti-vax movement specifically aimed at the COVID-19 vaccine. This movement would not be out of conspiracy theories about microchips from Bill Gates, or the false threat of autism, but out of the very real and fully justified concern that the vaccine was adequately tested for safety and efficacy. As a result, the use of the vaccine would almost certainly be greatly reduced. It is not hard to imagine a level of concern such that getting most Americans to consider taking the COVID-19 vaccine takes years. Hurrying now could mean that the vaccine may never achieve broad levels of acceptance.
Whether the U.S. moves forward with an ineffective vaccine, or rolls out a vaccine that works but which 83% of the population doesn’t trust, the effect is the same: An insufficient level of immunity to halt the spread of COVID-19. That kind of result would make it much more likely that COVID-19 moves from being epidemic to endemic—to becoming a disease that is always present, and always ready to flare up again in the population. It also increases the chance that a large pool of COVID-19 virus continues to exist in the population, creating a very real risk that mutations could occur to make the virus more contagious, or more deadly, or unphased by current vaccines.
Donald Trump has deliberately screwed the handling of the COVID-19 crisis with the intention of causing more deaths in Democratic states to gain a perceived political advantage. If Trump fumbles the vaccine roll-out, it would be a sorry finish to the greatest tragedy in a century. At this moment, the number of dead Americans from COVID-19 is approaching 190,000 and the economy is in deep recession, but even those results could be trivial compared to the long-term damage that would result if COVID-19 becomes a recurring plague.
Posted with permission