Analysis | Ron DeSantis Vaccine Complaint Exploits Public Health Gaffes – The Washington Post

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Earlier this week, medical website STATnews reported on data that showed Covid vaccines have saved 3 million lives in the US. That’s about three times as many Americans as have died from the virus. Even if you quibble with the exact figure, these vaccines have been a momentous achievement. 
But the same day, Florida Governor Ron DeSantis petitioned the state Supreme Court to start a grand jury investigation into the safety and efficacy claims behind mRNA vaccines — the dominant kind used in this country. 
Despite the success of these vaccines, misleading messaging from public health experts and from the White House has created confusion that’s left fertile ground for DeSantis’s disingenuous and self-serving maneuvers.
It’s well past time to talk honestly about the downsides of the Covid-19 vaccines. They don’t do much to prevent people from getting mild cases of the current variants. They don’t do much to stem community transmission. And like all pharmaceuticals, they’re not perfectly safe. Booster mandates for young people amount to safety theater (free rapid tests would do a lot more to keep college students from infecting their grandparents or professors).
Papering over or ignoring those minor problems has eroded public trust and created an opening for DeSantis to sow discord and confusion. 
While it’s fair to say that presidential hopeful DeSantis is proving himself a health hazard with his misleading petition, the move capitalizes on pre-existing distrust of public health, big pharma and the media on the part of many Americans. 
In parts of his petition dealing with safety problems, DeSantis is playing into a common misconception: That anecdotes count as data. If you followed hundreds of millions of people for a period of time, some would die or suffer complications unexpectedly, by chance — and so when you give hundreds of millions of people a vaccine, the same thing will happen for reasons that have nothing to do with the vaccine. (That was brought home by the sudden death of sports journalist Grant Wahl , 49, during the World Cup — attributed to an aneurism by an autopsy but used by vaccine skeptics to drum up fear.) 
But there’s a false narrative from the left as well, which was parroted in a Politico piece about the DeSantis grand jury stunt: “Most of the medical community, including the Centers for Disease Control and Prevention, the FDA and Johns Hopkins, have emphasized that the Covid vaccine is safe and effective in preventing the virus and protecting against serious symptoms.”
Science no longer backs the notion that the vaccine prevents the virus from infecting people. “The benefit of the vaccine in the omicron era isn’t protection against infection the way it was earlier. It’s protection against what matters most: severe disease, hospitalization and death,” said Johns Hopkins University senior scholar and physician Amesh Adalja. 
Pediatrician and FDA vaccine advisor Paul Offit said the same thing to me earlier this month — the vaccines and boosters in 2022 and beyond are good for saving lives and preventing severe disease. At this point, most vaccinated people have been sick with Covid. They know firsthand the vaccine didn’t “prevent the virus” for them. 
The science behind this issue isn’t that complicated. The shots induce so-called cellular immunity, which can offer months or perhaps years of reasonably strong protection against the kind of severe disease that lands people in the ICU. In those who aren’t elderly or otherwise immune compromised, this protection persists even against the much-mutated descendants of omicron now circulating. 
But variants have evolved increasingly efficient ways to get around the first line of vaccine-induced defense — antibodies. So the protection from vaccines against mild disease is porous and transient. That’s why Offit says it’s better to focus the booster campaigns on those who need extra protection against severe disease.
There’s a reason scientists initially said the vaccines would prevent transmission of the virus: Clinical trials done in 2020 showed that the Pfizer and Moderna vaccines were around 95% effective at preventing symptomatic disease. It wasn’t perfect, and as I wrote in this 2020 column, the companies should have gathered data on whether the vaccines prevented asymptomatic infection as well. But it was a reasonable inference that vaccinated people were less likely to get infected and spread the virus.
The trials had other limitations — the Pfizer trial, for example, followed about 50,000 people from late July to mid-November. So they couldn’t detect the way antibodies wane over longer periods of time, nor could they detect side effects that might crop up in one in a hundred thousand or million people.
Scientists have continued to study the effects of the vaccine over the last two years, and that uncovered one serious side effect from mRNA vaccine: a kind of heart inflammation called myocarditis. 
It’s an extremely rare side effect but has caused a few people to be hospitalized. The risk is concentrated in males in their teens and 20s, said Adalja. If he had an 18-year-old patient who was considering vaccination but worried about myocarditis, he might suggest the Johnson & Johnson vaccine, which isn’t associated with myocarditis. (That vaccine has a few risks too; it has been associated with rare blood clots, mostly in pre-menopausal women.) 
Independent risk communication consultant Peter Sandman points to some of the deceptions DeSantis uses in the petition, in which the governor claims: “The federal government, medical associations, and other experts have created an expectation that receiving a COVID-19 vaccine is an ethical or civic duty and that choosing not to get vaccinated against COVID-19 is selfish and harmful to others.”
That’s true — people did promote the vaccine as a way to protect others and end the pandemic — but DeSantis ignores the fact that the clinical trials made this look plausible at the time. The virus and the situation changed. DeSantis also ignores that the vaccines may still have some protective effect against infection and that, by reducing the risk of severe illness, they reduce the risk that hospitals will be overwhelmed with Covid patients.
And DeSantis “plays games with definitional ambiguities,” said Sandman. A good example is this passage, where “prevent” seems to imply  perfection rather than reduced odds: “some Floridians made the choice to receive the COVID-19 vaccine because they believed that receiving the vaccine would prevent them from spreading COVID-19 to others.”
But, again, DeSantis is capitalizing on a distrust enhanced by the mistakes of the public health community and the Biden administration, who have at times oversold what the vaccines can do to the point of misleading the public. They may believe that the science is too complicated for the public to understand, or tell themselves some overpromising is acceptable because the vaccines do save lives. But there are costs to that approach, as we’re now seeing. 
I asked Adalja what can be done to prevent him seeing more of his patients getting severely ill or dying. His answer: more-targeted use of the booster shots and Paxlovid for the elderly and other high-risk people. Some blame for neglecting our elderly and high-risk citizens can be placed on misdirected public health efforts and some on loss of public trust. What DeSantis is doing is unconscionable, but he’s filling a trust vacuum created by his enemies. 
More From Bloomberg Opinion:
• It’s Still Worth Fighting Anti-Vaccine Misinformation: Faye Flam
• Why Anthony Fauci Is Still Optimistic About Science: Lisa Jarvis
• Abortion Clinics Shouldn’t Have to Stand Alone: Sarah Green Carmichael
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Faye Flam is a Bloomberg Opinion columnist covering science. She is host of the “Follow the Science” podcast.
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