Pfizer CEO to Public: Just Trust Us on the Covid Booster

Lambert here: Oh. Did anybody at the CDC or the Biden administration think that communicating evolving science during a pandemic would be a problem, and plan for it? They had eight months (nine, if you count the transition period). And it’s not just the a Pharma CEO saying “Just trust us.” That’s the message across the board.

By Sarah Jane Tribble, Kaiser Health News. Originally published at Kaiser Health News.

Pfizer CEO Albert Bourla was confident in June about the ability of his company’s vaccine to protect against the highly contagious delta variant, as it marched across the globe and filled U.S. hospitals with patients.

“I feel quite comfortable that we cover it,” Bourla said.

Just weeks later, Pfizer said it would seek authorization for a booster shot, after early trial results showed a third dose potentially increased protection. At the end of July, Pfizer and BioNTech announced findings that four to six months after a second dose, their vaccine’s efficacy dropped to about 84%.

Bourla was quick to promote a third dose after the discouraging news, saying he was “very, very confident” that a booster would increase immunity levels in the vaccinated.

There’s one hitch: Pfizer has not yet delivered conclusive proof to back up that confidence. The company lacks late-stage clinical trial results to confirm a booster will work against covid variants including delta, which now accounts for 93% of new infections across the U.S.

Pfizer announced its global phase 3 trial on a third dose in mid-July. That trial’s completion date is in 2022. Phase 3 results generally are required before regulatory approval.

“We are confident in this vaccine and the third dose, but you have to remember the vaccine efficacy study is still going on, so we need all the evidence to back up that,” Jerica Pitts, Pfizer’s director of global media relations, said Monday. The financial stakes are enormous: Pfizer announced in July that it expects $33.5 billion in covid-19 vaccine revenue this year.

Meanwhile, Pfizer recently said that if a third dose couldn’t combat the delta or other variants, the drugmaker is poised to come up with a “tailor-made” vaccine within 100 days.

All of this has sown a sense of confusion about what exactly will work, and when. The pharmaceutical industry’s rush to recommend boosters for the public is “a little frustrating,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an adviser to the National Institutes of Health and Food and Drug Administration. Even if a booster is found to be safe, he said, the U.S. effort should focus on “vaccinating people who are unvaccinated.”

In any case, decisions about boosters do not rest with vaccine makers, he said.

“Pharmaceutical companies aren’t public health agencies, it’s really not theirs to determine when or whether there should be booster dosing,” Offit said. “That is the purview of the CDC.”

Indeed, the Centers for Disease Control and Prevention and the FDA ― the federal agencies overseeing the authorization of covid vaccines ― said in July that fully vaccinated Americans do not need a booster shot. Currently authorized vaccines ― from Pfizer, Moderna and Johnson & Johnson ― are working as they should: All three lower the risk of covid severe enough to hospitalize or kill a person.

If hospitalization and death rates increase among the vaccinated, then it would be time to talk about boosters, Offit said, but “we’re not there, yet.”

The White House has added to the mixed messaging: Spokesperson Jen Psaki confirmed that the U.S. will buy an additional 200 million doses of the Pfizer-BioNTech vaccine for inoculating children under 12 and for possible boosters.

Natalie Dean, a biostatistician at Emory University in Atlanta, said the confusion is not necessarily the fault of any one institution but rather “there is genuine scientific uncertainty about how well [existing] vaccines work against the new variant.”

Scientists are piecing together information from observational studies, outbreak investigations and analyses of antibody responses.

For many Americans ― especially those who struggled six months ago to find any dose, frantically hiring vaccine hunters and driving hours-long distances for their first jab ― the confusion has set off a feverish search for an illicit third dose just in case it’s necessary.

“I snuck in a dose of Pfizer last week,” Angie Melton, a 50-year-old mother of four, shared on Facebook. Melton received the one-dose Johnson & Johnson shot at a mass vaccination site in April and feared the highly contagious delta variant could infect her and, then, her unvaccinated 10-year-old son, who has asthma.

After consulting friends and doctors and seeing reports about mix-and-match approaches in Europe, Melton signed onto a local pharmacy site and made an appointment to get a Pfizer shot. She’s scheduled for a second shot as well.

“I’m trying to keep my family safe,” Melton said.

The CDC advisory panel was set to meet Friday to consider updates on whether additional vaccine doses are necessary for immunocompromised people. A presentation about boosters is also on the agenda.

Immunocompromised patients like Sarah Keitt, who has multiple sclerosis and Crohn’s disease, expressed relief that federal regulators planned to recommend a third dose. Keitt, a disability rights activist who lives in Connecticut, said her neurologist told her to get a booster even after she had received two doses of Moderna. On Thursday, she said she was eager to get another dose but still frustrated about a lack of confidence in how much protection it would offer.

“If someone could definitely say there is a 95% chance you are protected” by a booster, Keitt said, “I would love it.”

Despite widespread media reports of “breakthrough cases,” a recent data analysis by KFF found that hospitalizations and deaths are extremely rare among the fully vaccinated ― well below 1%.

Offit points to a recent outbreak in Provincetown, Massachusetts, in which only four of the 346 fully vaccinated people infected with covid were hospitalized, two of whom had underlying medical conditions. And no one died. “This vaccine still does an excellent job in the face of the delta variant at protecting people against severe, critical disease,” he said.

Yet the effectiveness of the Pfizer vaccine against variants is still under debate. This month a new preprint study by the Mayo Clinic found that the product’s effectiveness against infection dropped to 42% from January to July ― as the delta variant’s prevalence markedly increased.

Pfizer and partner BioNTech announced they are developing an updated version of their vaccine in Germany to target the genomic features of the delta variant.

However, the idea that a new formulation could work better is “mostly hypothetical at this point,” said Vaughn Cooper, a professor of microbiology and molecular genetics at the University of Pittsburgh.

Dr. Vincent Rajkumar, a hematologist at the Mayo Clinic who closely studies his patients’ immune responses and antibody levels, said trying both strategies of using the current vaccine and testing a new version sounds reasonable.

There is one hypothesis that if “breakthrough” infections are due to a drop in antibody levels, boosting those levels will be enough, Rajkumar said. But the more worrisome hypothesis is that the delta variant, or any other variant, might respond considerably differently ― and be less threatened ― by the antibodies the current vaccine generates.

“So unless you boost [antibodies] with a vaccine that is specific to delta, it won’t work,” Rajkumar said. Rajkumar said testing both hypotheses is the “right thing to do in the interest of time.”

At the same time, though, the push for giving booster shots to healthy populations is premature, said Dr. Sadiya Khan, an epidemiologist and cardiologist at Northwestern University Feinberg School of Medicine. That’s because even if those already fully vaccinated do get a third dose or booster, the virus is still circulating among millions of unvaccinated people.

“The overwhelming majority of infections and hospitalizations and deaths are occurring among those who are unvaccinated,” Khan said.

“Giving up on that greater strategy of vaccinating the population is going to lead to continued surges,” she said. “The potential for harm is quite large.”

KHN editor Arthur Allen contributed to this report.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

71 comments

  1. Mikel

    Why don’t they just call them “protection levels” instead of “immunity levels”?
    “Protection” is the the more accurate description to what the vaccines provide, not “immunity”.

    1. TimH

      Protection is misused to describe insurance “protect your car from theft” means “reimburse the value after theft”

    2. Karen

      The shots are theraputic, not prophylactic. In that sense, they’re not what we generally consider as vaccines.

      1. Joe Well

        These aren’t the only vaccines like this.

        After the rabies vaccine you still need immunoglobulin in case of an exposure. And then of course there’s the flu shot.

  2. Pookah Harvey

    John Campbell (Youtube 14 min ) compared studies from Israel and the UK concerning vaccine efficacy over time.
    The Israeli study shows efficacy in preventing symptomatic Covid dropping to 41% over several months. The UK study doesn’t show the same drastic decrease, efficacy only drops to 88% over the same time period. Campbell makes the supposition that this might be due to the difference in timing between the primary and secondary injections. In Israel (and the US) the injections are given 3 weeks apart, in the UK it was 8-12 weeks apart. I haven’t heard anyone else talking about this.

    1. mistah charley, ph.d.

      The Canadians also used the longer interval between injections. As I was reading about it at the time I supposed it was due to limitations in vaccine supply. Apparently that was mistaken, or at least not the whole story.

      1. Adam1

        You are correct that the driver was vaccine supplies, but the ability to make that decision (as I recall) was based upon some of the sub study data that indicated at a minimum delaying would not reduce efficacy and possibly would increase efficacy.

    1. lordkoos

      What are people supposed to do? We’re pretty much on our own.

      I for one will never take another vaccine from Pfizer after the bad reaction I had to the second dose, which was a about 20 days after the first. Perhaps if the shots had been spaced farther apart things would have been different, but I’ll opt for another mfg in the future.

      1. urblintz

        a nasal spray vaccine would be critical. seems to have been an afterthought and the development seems too slow, although it is a superior mode of delivery, theoretically, than muscle injection.

        1. montanamaven

          Rancher told me that they have been using nasal spray vaccine for coronavirus in cattle for years.

  3. Lins

    I’m a long time reader/lurker/supporter, but rarely comment.

    Can Yves or Lambert on Yves behalf, state very plainly this blog’s positions regarding vaccination and COVID policy at present/going forward? For example:

    NC does not believe in the vaccines
    NC does not believe we should be unmasked anywhere
    NC does believe we should be shutdown (no mass attended indoor events ?)
    NC does believe non-vaccine treatments should be studied and promoted
    NC does not trust the CDC, FDA, Fauci

    I’m perpetually conflicted by the messaging here, frustrated and anxious (like most). This community is invaluable and one I regard very highly. Thus, to understand NC’s position matters a great deal to me. I truly believe this would be helpful to many.

    All that in mind, I want to convey my deep appreciation and respect for NC, Yves and Lambert.

    1. Reality Bites

      I’m not sure there is a blog position on vaccines. This blog pushes past the hype and actually presents information on vaccines. If anything, I’d say NC says vaccines are a judgment call based on your own risk tolerance. The reason you get mixed messages is because there is way too much boosterism and outright lying by the public health authorities and Big Pharma. The actual data often tells a different story and it isn’t always clear what the conclusion is because things are still ongoing.

      It’s also not as simple as an either/or. I think its quite clear that most of us believe that non-vaccine treatments should be studied and promoted, especially in view of vaccines that do not confer sterilizing immunity. But HCQ and Ivermectin have become political footballs so getting a proper scientific answer is hard. Shutdowns are harder. Shutdowns should be early and short and need to come with social support for those that cannot work during those periods.

      It’s not jus masked/unmasked. Masks indoors are far better but we also need quality masks that are worn correctly. There also needs to be proper building ventilation investments.

      As far as not trusting CDC, Fauci, FDA: I don’t think many do regardless of whether they seem to be complying with the latest directives or not.

    2. Michael McK

      At a time when there is so much uncertainty I would be more worried about messaging that does not reflect the conflicting nature of honest discussion .

    3. Bazarov

      I don’t think “NC” is position, belief, or faith based like many other outlets–rather, it seeks to understand reality in a messy, empirical manner. What occurs on NC is discussion and debate, with a consensus only sometimes forming (and that consensus is subject to radical revision).

      Your position statements are posed around “belief.” Vaccines are not talismans that function according to our faith in them.

      I suggest you revise these statements in such a way that reading for yourself might help you discover useful answers.

      So, let’s take your first statement: “NC does not believe in the vaccines.”

      It would be useful to revise this into questions oriented more empirically and aimed not internally (what does NC think?) but rather externally (what does the evidence presented here suggest about such and such phenomenon?)–

      “To what extent are the vaccines effective in preventing covid infection? Preventing symptomatic infection? Preventing spread? Preventing hospitalization and death?”

      NC provides numerous perspectives on these questions, and because we live in a dynamic reality flush with data, these perspectives are subject to change over time. For example, it’s seems to be the case that vaccine efficacy wanes. Therefore, the answers to the above questions have changed with time.

      I read NC to come to my own conclusions after consulting the evidence and perspectives presented here. I don’t come here because it adheres to some pre-determined line (I read other publications for that species of writing–the World Socialist Website, the Financial Times, etc).

    4. AE90

      I am comforted by the lack of “messaging” and that is why I keep coming back. I continually find info here I would have to search in places I don’t know about to find, and I sincerely appreciate Yves, Lambert and the commentariet for broadening my horizons every day with an opportunity to make up my own mind about what I am reading. There is discussion here. Thanks, I appreciate you all very much.

    5. ChiGal in Carolina

      Is this a joke question? NC doesn’t take categorical positions in the way you describe and if you are a long-time lurker you should know that.

      1. AE90

        Yeah, LOL. What is NC pushing? Something on the internet with no agenda–so confusing! You mean I have to think?

    6. PHLDenizen

      I don’t see how the messaging here is particularly conflicted. You’re asking for absolute, dichotomous answers in a world where absolute and dichotomous is precisely the reason people are so grossly misinformed and wedded to confirmation bias.

      I’ll assume you’re asking in good faith, but it feels like a fishing expedition for ammunition to discredit the hard work people here do, e.g. “NC has taken the position that vaccines are bunk and are therefore right wing skeptics who are trying to kill everyone” or “NC believes we should cripple the economy by shutting everything down”.

      That said, here are my thoughts and I speak for no one but myself:

      1) NC has never said they don’t believe in vaccines. NC is skeptical of twice jabbing experimental, non-FDA approved vaccines in everyone as a “mission accomplished” panacea. NC has never said “do not get vaccinated”. NC has never said “these vaccines do not work at all”. NC HAS said that there’s good evidence breakthrough infections occur, that immunity wanes, that there is some reason to believe longhaul Covid exists, and so on. That amounts to “the vaccines offer some protection, but likely not to the degree the PMC needs for the world to go ‘back to normal’. More study is needed and vaccines are harm reduction, not the annihilation of harm caused by Covid.”

      2) NC encourages masking as further harm reduction, as the virus is aerosolized and surface transmission is minimal. There is strong evidence that masking curtails the spread, particularly in enclosed, poorly ventilated spaces. Therefore the wisdom is that, yes, if you want to neither transmit nor receive the virus, then masking lowers the risk of both.

      3) I haven’t see any discussions about full shutdown of the world or if there have been some, I’ve missed them. As a means of harm reduction, one should avoid densely populated events, particularly with delta. If you do attend such things, mask up for the above reason

      4) NC believes that non-vaccine countermeasures warrant study. That’s not a fringe belief or particularly crazy. See IM Doc’s voluminous and knowledgeable posts about his clinical experience, particularly during the early HIV days. Again, the theme is that any and all harm reduction is worthwhile, particular if cheap, effective, and logistically simple. NC believes that privileging ideology and free markets over public health is revolting and exacerbates the pandemic — particularly in 3rd world nations where Bill Gates, et al have refused to relinquish licensing of patents.

      5) Over the years — and prior to the pandemic — there has been much evidence that the FDA, CDC, and their leadership all suffer from regulatory capture. Fauci, in particular, has been angrily denouncing facts that he’s had to concede were later true. This has been a pattern over and over and over. Claims that Covid is not airborne, that the lab leak hypothesis has no basis in fact, shifting goalposts on herd immunity until he said it’s basically impossible, lying about the need to mask, etc. Rather than leading with the well-being of the public in mind, he has consistently acted in ways that are first and foremost political, as well as privileging free markets. Again, lots of material to read here.

      1. CanChemist

        You’ve said it better than I could have :)

        I give both NC and it’s readers credit for not being afraid to wade in along with the science, messy as that can be especially earlier on with so much unknown, and to revise best practices and understanding as necessary.

      2. Karen

        You keep referencing “free markets” as a bad thing, but also acknowledge the pervasiveness of regulatory capture. If markets really were free (i.e., open to real competition, not oligopoly) low cost therapueutic interventions would have ended this pandemic by now.

        1. eg

          “Free markets” is a slogan, not a thing that exists (or ever has existed) since all markets are constructed and maintained by law, and law is a human creation, not some naturally occurring thing. As such any claim about what might have happened already “if markets really were free” is meaningless.

          Please do not construe what I have written as an apologia for any of monopoly, oligopoly nor regulatory capture.

    7. Ben Dalton

      I share PHLDenizen’s skepticism that you are trying to wrangle a fixed opinion from people here so that it NC can be tarred with that brush. But I will answer you anyway, in good faith.

      The commenters above have said what I wanted to say far better than I could. Let me just say that I understand and sympathize with your frustration, anxiety and a state of being conflicted. IMO NC does not advance an agenda/position, something you would have known being a long time lurker. And neither do us readers try to push NC towards one. There is a lot of contradictory information out there in this topic, some being given more prominence in mainstream media than others. I would say NC tries to present all the info and let the readers have a civil discussion. It may/may not result in a consensus. But we are all better off being more informed. That’s all there is to it.

    8. Mikel

      It’s going to take more than the current non-sterilizing vaccines.

      Current shots do not prevent the spread of the virus. They provide protection, with waning effectiveness for all, but with varying degrees based on a person’s health and when they received shots.

      Viral load matters, I believe. It’s like a night out drinking. You go have a drink at one bar, may get a little tipsy. Go barhopping all night long and you could end up pissy drunk.
      So precautions may work like this: rethink going to that concert at the theatre the same weekend someone else in the household could have invited weekend guests that will be traveling back and forth.

    9. marku52

      NC agglomerates data (very well, no one other site is better IMHO). It is up to you to make your own analysis and decisions.

    10. kareninca

      “I’m perpetually conflicted by the messaging here, frustrated and anxious (like most). This community is invaluable and one I regard very highly. Thus, to understand NC’s position matters a great deal to me. I truly believe this would be helpful to many.”

      Unfortunately being an adult means that you have to take what information you can find and use it as well as you can. You can’t expect someone else to take responsibility for that. NC isn’t providing “messaging”; they are providing links to sources of information, and pointing out that not all of the available information is reliable.

      If you want someone to tell you the Truth, you will have to accept that most people who are eager to perform that service are stupid or venal or both.

      Part of the problem with the current situation is that many people in authority think that Americans would rather be told something firmly, even if there are not good data for it. It sounds like that is what you want, so maybe they are right.

      If I were cynical I would say that it sounds like you are trying to get the website’s hosts into trouble. Or that you are working on a “project” to document the “positions” of various websites and are too lazy to do the work to see that NC doesn’t have “positions”. But I’ll be charitable and assume you are sincere, oblivious, presumptuous and potentially destructive..

    11. TalkingCargo

      Thank you Lins for expressing my own feelings perfectly. I too would like to “convey my deep appreciation and respect for NC, Yves and Lambert.” However, I have found NC’s coverage to be disappointing. And while I get it that a lot of the “NC Opinion” is driven by the commenters, it’s still the case that the people at NC select the articles they highlight every day (with some input from respected commenters) and these selections drive the comments.

      For me, nothing about this response to the virus has passed the smell test since day one. Maybe someone can point me to the epi or pan-demic where we’ve waited for the development of vaccines without actually trying existing off-patent drugs to find out if they could be effective treatments. And the thing is, I can’t find any convincing data that it’s even possible to develop a vaccine for this virus. So the authorities have made the decision to pin all our hopes on untested vaccines. I’ve often wondered how that decision was made. Maybe it went something like this:

      POTUS (sweating profusely); This pandemic is a major disaster! We’ve got to do something!!!
      ECONOMIC ADVISER (adjusting bowtie): Pandemic? No problem sir. We’ll just assume a vaccine.

      I’d argue that there is nothing “scientific” about this response. In fact, it seems fair to describe it as faith-based epidemiology.

      Also I see a lot of commenters criticizing the decisions of the CDC. I think this is based on the apparently inaccurate assumption that their goal is to protect the public by reducing the number of infections, hospitalizations, and deaths. However, if you instead assume that the CDC’s goal is to instill fear in the populace in order to get as many shots in arms as possible regardless of the consequences, many if not most of the CDC’s decisions look quite “logical.”

      Now I’m still waiting for more data to come in and I’m trying not to prematurely judge anything, but that’s becoming increasingly difficult. Lately, I’ve been considering the possibility that the virus itself is less concerning than the response to the virus which is all about generating fear and confusion. Many of the people on this website will be familiar with the phrase “Fear is the mind-killer,” which I consider to be one of the truest things Herbert ever wrote. When someone tries to scare you with frightening stories, I think the best response is to face the fear, analyze it, and determine the appropriate actions. But many people let their fear control their actions and that causes them to do hurtful things that they wouldn’t ordinarily even consider. My feeling is that we should try to tamp down the fear factor because there are enough people out there trying to amplify that fear.

      In conclusion I will say that I plan to continue my monthly donations to NC and WC because I still find them very valuable. However, I am going to another website for Covid news because I don’t feel that the coverage here is skeptical enough.

      1. ChiGal in Carolina

        Thanks for your courage in speaking up and what other sources do you find valuable for covid info?

        I do think there is some hyperbole or scare-mongering but not sure about not being skeptical enough.

        1. TalkingCargo

          I’ve been going to The Automatic Earth mostly. Raul and the commenters there have often led me to links that give another side of the “story”. I’ve found UTube videos (some have been de-platformed but can still be accessed by other means) by Bret Weinstein, an Irish guy named Ivor Cummins (not so much from him lately), Dr. Pierre Kory and the FLCCC website, and Dr. Peter McCullough. I tend to give Kory and McCullough a bit more credence because they actually treat Covid patients.

          Of course I should mention IMDoc’s invaluable posts here – he’s another who actually treats patients. Also many of the names I noted above have been mentioned here. The British doctor John whatshisname (maybe I’m suffering from brain fog myself) seems to be one of the few who is actually trying to follow the science. So many others seem to want to lead it instead.

          I think in true scientific endeavor, there is always a danger of (to paraphrase Lily Tomlin) never being skeptical enough.

          1. Lambert Strether Post author

            At a high level, and without triggering a discussion of any of these sources individually, my skepticism takes the form of document analysis. There’s a lot that can be gleaned from looking at About pages (funding; institutional affiliations), biographies (exaggerated, self-important claims or off-point expertise), and footnotes. (For example, if a paper makes a claim and cites to a footnote, and I go to the footnote and find that the cited source does not support the paper’s claim, then I can toss the paper, probably the author, and possibly the source. And yes, this skeptical method goes all the way up to sources as “authoritative” as, say, the NEJM). Many oft-cited “skeptical” sources don’t pass my particular method of analytical skepticism. I’m trying to sort thing for readers, so I want to set a high bar.

            It’s a tricky balance to strike. We’re in the midst of a pandemic, and since RCTs take too long against a virus that multiplies geometrically, we have to rely on observational evidence. Hence the great importance of clinicians (see, e.g., the treatment protocols at FLCCC). Hence my willingness to consider the off-label or repurposed drugs, with which I am sure readers are familiar.

            However, clinicians (at least the older ones) have been trained with iron discipline in patient care, including patient advocacy. They have not been trained in advocacy at the population level, which is not the same as the patient level, in the same way that political economy is not the same as “the social determinants of health” (laudable though the latter endeavor is). So, if I were to see, on such an advocacy site, an article with co-authors like, say, “Dr. X and Susan Sarandon,” I would really worry that the all-too-human tendency to confuse conviction with correctness, and patient advocacy — no matter how justified — with science, had kicked in (along with the rationalization that overly connected dots are “good for patients” and “we’re just getting the word out”). And I would probably cross a site like that off my mental list, because I would not be able to sort it for readers. And of course social media makes all this much, much worse.

            So tell me: Who is the skeptic?

          2. ChiGal in Carolina

            As Lambert states is his practice as well, I always look at the About or Mission Statement for news sources. Automatic Earth doesn’t have one but I noticed Ilargi also writes for Zero Hedge which I have never looked at so I checked it too. Nope, no About or Mission Statement. Nor is there any background information on the various authors and editors.

            Hmm…yeah, I’m skeptical alright! NC is my kind of source: transparent, no hidden agenda. Sorry you’re hooked on that stuff, dude.

      2. Ian Perkins

        Many existing off-patent drugs, such as hydroxychloroquine, dexamethasone, and ivermectin have been tried as treatments for COVID, and continue to be used, though none seem as effective as vaccines in preventing hospitalisation, severe illness and death (no doubt someone will disagree with that). Some have undergone randomised control trials too, and many others have been investigated in labs and computers for possible use.

        1. TalkingCargo

          One of the reasons I’m waiting for more data is because I don’t think it’s been shown yet that the vaccines are more effective, especially considering the number of adverse reactions. From what I can tell, the off-patent drugs can be very effective, especially in the early stages.

          BTW, I’m not a doctor but I do know something about science and math. So take this with a grain of salt. I’m only saying what I’ve noted in the discussions.

      3. Lambert Strether Post author

        > skeptical enough

        Paradoxically, I think that many of the “skeptics” are far too ready to “connect the dots,” which at the edges of the skeptical “community,” if I may so denote it, is just the same as projecting patterns into clouds (“very like a whale”). To be skeptical of a narrative is not the same as to be skeptical of one’s own methods. If you want to see real skepticism in action, follow Yves’ reporting on CalPERS, which makes the “connect the dots” crowd look like little children. As method, a hermeneutic of suspicion is not the same as reporting; it is one of the tools of reporting. The mental “click” one gets when all the pieces of a pattern fit together is not the same as evidence.

        For me, the most revelatory quote in Dune comes not from the nostrums of the Bene Gesserit’s religious manuals, but from the final irony of Liet Kynes, an actual scientist:

        “Then, as his planet killed him, it occurred to Kynes that his father and all the other scientists were wrong, that the most persistent principles of the universe were accident and error.”

        1. Basil Pesto

          If you want to see real skepticism in action, follow Yves’ reporting on CalPERS, which makes the “connect the dots” crowd look like little children.

          Superbly put.

    12. Cocomaan

      I’m perpetually conflicted by the messaging here, frustrated and anxious (like most).

      This might not be the blog for you if you’re looking for:

      1. Messaging and binary position statements

      2. Content that doesn’t produce anxiety, frustration, etc

      1. Lambert Strether Post author

        > anxiety, frustration

        I am the sort of person who defends/copes with anxiety and frustration by asking Why? Hence on Covid my rather public quest for a daily practice that will protect me (and others). But it is in the process of investigation that I find balance and reassurance, not in answers per se, because for very large and complicated systems, only partial answers are to be found. It is enough for me to have done everything possible, even if the possible is not the same as the necessary.

        1. Cocomaan

          indeed, that’s why this blog is part of my daily routine, just like coffee!

          If I wanted absolute certainty and for my blogs to calm my anxieties, I’d subscribe to get the WhiteHouse.Gov newsletter, or Pfizer’s press releases.

  4. Halsey Taylor

    Since when did good science ever get in the way of marketing? How many years did big tobacco trot out data to support their businesses.

    Not much has changed. ‘Space Merchants’ is as relevant as ever.

  5. Susan the other

    Something I don’t understand is: it seems to me that a vaccine gives you an initial level of immunity at around 80 – 90% and then over 7 months it wanes, down to about 40%. So my reading is that even 40% protects you against severe Covid, hospitalization and death. One question is how long does the 40% last? Another is, if you have only 40% left, but it is functioning to keep you from dying, would a full-strength booster screw that up in any way? Does the immune system take the vaccine and then improve on it in its own way, maintaining a critical 40% protection level which can be overwhelmed or dissolved, by a new booster? And etc. This, based on the accidental discovery that waiting a longer interval for the second Pfizer shot caused a better immune response – which has not been completely explained. The answer could go either way I guess. And one answer could be that 40% is good enough, even with Delta being twice as virulent. Just don’t quit wearing good masks to keep the initial load down.

    1. HotFlash

      A big question for me is how do the vaccines compare to ‘naturally acquired’ immunity, as in, you got covid and fought it off,. I have seen conflicting statements but no studies. Did Pfizer or any of the crowd test for antibodies in their test subjects before the trials? Did any of them test for asymptomatic cases during the (short) trials? Pfizer did not, not sure about the others.

      1. Erelis

        This might be of interest. I would recommend on Youtube the video blog called “TWiV 779: Evolving boosterism”. TWiV stands for This Week in Virology. The virologists look at studies measuring the immune systems of people who fought off Covid and how their immune systems react if they are then given the Pfizer vaccine (one dose at least). In general, the immune system of people who developed a natural response is enhanced by getting the vaccine. It seems that people with natural developed immunity can have weak points like the lack of enough memory cells. A subsequent vaccine dose can overcome that issue (if memory serves this late in the evening).

    2. Skip Intro

      I believe we can now state with near certainty that the mRNA vaccines do not prevent infection and transmission, i.e. virtually no immunity. The initial ~90% stats were about the reduction in hospitalization, and that resistance against symptoms fades. It is hard to tell how much, since the virus itself is a moving target, and pre-delta studies may be dated. I find it likely that reduced symptoms in the vaccinated may be the result of reduced viral loads, and reduce transmission somewhat.
      A real problem is that normal vaccines don’t just treat symptoms, and people were led to believe that these were vaccines that would stop the virus, not just the strain on the hospitals. It is hard to get people to adapt to the new reality, as they are barely caught up with aerosol transmission yet. We still have a society-wide hand-sanitizing OCD epidemic too. And everyone is just getting the propaganda geared up for vaccine passports, which would no nothing to prevent covid transmission, but give people a false sense of security.
      Boosters of the same vaccine may give diminishing returns with increased risks.

  6. CanChemist

    I’d be curious from some opinions from the other scientists / MDs on NC about this recent publication on Pfizer (and AZ) antibody decay.

    Lancet: “Spike-antibody waning after second dose of BNT162b2 or ChAdOx1”
    https://doi.org/10.1016/S0140-6736(21)01642-1

    It seems like a decent study and when I plot their data, I get a nice fit to an exponential curve that does indeed starting approaching zero as it gets to the 6 month mark post 2nd dose. The median interval between first and second doses was also 77 days. Further evidence that at least for spike antibodies, the clock is ticking? the AZ responses weren’t great either compared to mRNA.

    And related to that, in Nature,
    “A correlate of protection for SARS-CoV-2 vaccines is urgently needed”
    https://doi.org/10.1038/s41591-021-01432-4
    “Recent studies suggest that neutralizing antibodies could serve as a correlate of protection for vaccines against SARS-CoV-2 in humans.”

    1. marku52

      I my admittedly feeble understanding, the immune response to the virus or the vaccine comes from 2 major systems. Antibodies constitute the body’s rapid reaction force. First on the scene. But they have a half life of about 6 months. As time goes on, you are as prone to infection as the unvaccinated person.

      The other response is the Humoral system. It consists of cells that remember infections that live in the bone marrow. The are slower to respond, but perhaps longer lived? This may explain why many vaccinated folks get the infection, but do not proceed to severe disease.

      The antibodies aren’t there to stop the initial infection, but the Memory T and B cells arrive later to prevent severe disease.

      If you know better, please correct me.

      1. Lambert Strether Post author

        This is what Monica Ghandi says below, and — subject to correction by people actually qualified to speak — the concept of two major systems is correct.

  7. BCD

    Offit points to a recent outbreak in Provincetown, Massachusetts, in which only four of the 346 fully vaccinated people infected with covid were hospitalized, two of whom had underlying medical conditions. And no one died.

    Apparently Offit didn’t read the CDC report or attempt to understand its full context regarding what the hospitalizations numbers from Ptown actually mean. From the CDC report:
    “Among five COVID-19 patients who were hospitalized, four were fully vaccinated; no deaths were reported.”
    https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm

    Now the fact that having 80% of hospitalization in Ptown be vaccinated is just 1 data point but one has to acknowledge this particular data point does NOT convey evidence of significant protections being offered by vaccines in regard to hospitalizations. Imagine if the headlines about Ptown all stated 80% of hospitalized were vaccinated rather than 74% infected being vaccinated?

    The KFF report sited for “well below 1%” of hospitalized being vaccinated is using data starting on January 1st 2021. The Ptown data looks like evidence the KFF study is not relevant for the Delta variant.

    1. Anonymous 2

      A sample size of five is too small by a factor of thousands. Kahnemann is good on the absurdity of even trained statisticians jumping to conclusions on the basis of small samples.

      1. BCD

        Indeed its absurd for a medical expert (Dr Paul Offitt) to cite a small study that doesn’t backup his claim or support his general argument.

        There is not much good for vaccines in the Ptown study, there is no logical argument for using that study to promote vaccinations. We are swimming thru oceans of damage control regarding Ptown.

        Other valid studies show vaccines in a better light. Plenty of legitimate debate as well as vigorously promoted back and forth around the efficacy of these vaccines. All things being equal I tend to be more convinced when people cite information that backs up what they say.

        Totally agree with Dr Offit on his first point, its too early for people to be experimenting with mixing vaccines as boosters. My popcorn is ready for the part of this horror story where overzealous Dad rage attacks a school board member about how to decide which 5yo had a potent enough unapproved mixed vaccine cocktail (get one with an umbrella Timmy!). Let’s all agree, no need to track data here its just more stuff to go to war over in Idiocracy Cov-pocalypse. /s

    1. Lambert Strether Post author

      Monica Ghandi is from UCSF. A cursory Google search shows headlines with bad calls, but she’s not a loon.

      I like Ghandi’s reminder that our immune system has memory (“we can’t keep all those antibodies in our system- too much protein”). Although AFAIK, the immune system as an entire system is simply not understood, any more than consciousness or sleep or other important bodily functions are understood, either.

  8. Joe Well

    Why don’t we have better answers to the question of degrading immunity from the thousands of people who got the shots a year ago in the original Moderna and Pfizer trials?

    Yes, I know that the control groups got vaccinated by now and so the data won’t be as good, but…come on.

    1. Jeff

      Perhaps the reason is because the data is inconclusive and Pfizer, along with their government partners fear that panic would ensue.

      It’s a great time to be a skeptic.

      1. Joe Well

        I suspect that, too, but why aren’t more people who are concerned about degrading immunity asking this question?

    2. Karen

      Once the control group is vaccinated, the trial is over. Period. That’s the one (only?) aspect of this nuanced discussion that IS binary.

      1. Joe Well

        It just occurred to me, the control group could still be the control group now that they got vaccinated, comparing the effect of one year of vaccination to 6 months, and it is infuriating the trial wasn’t designed this way in the first place.

        Yes, it would no longer be double-blind, but I think the people who didn’t get any side effects could have figured that out for themselves in the first trial.

  9. The Rev Kev

    I know that it is not the same but how these vaccines are being used is so much reminding me of a sub-plot of the book “World War Z.” In it, a pharmaceutical hustler comes up with a drug called “Phalanx” that is supposed to protect you against this new virus which it doesn’t but it keeps people calmed down in spite of its high cost. That is, until people realize that it is not what it is supposed to be. Here are two posts talking about this and some aspects sound very familiar with these vaccines that we are deploying-

    https://zombie.fandom.com/wiki/Phalanx

    https://blogs.brown.edu/intl-1802g-s01-fall-2015/2015/12/01/world-war-z-the-morality-of-phalanx/

  10. JTMcPhee

    Am I missing something here?

    I don’t see anything about long-Covid/long-hauler morbidities. Just talk about percentages of people that either have no symptoms or only “mild” disease, or are by the magic of mRNA, spared completely from infection. Does that “mild” incorporate the horrible long-term effects of this virus? https://health.ucdavis.edu/health-news/newsroom/studies-show-long-haul-covid-19-afflicts-1-in-4-covid-19-patients-regardless-of-severity/2021/03

    There’s going to be a boatload of people disabled and vulnerable as a result of this disease and the half-a$$ed response by the Neoliberal Consensus…

    1. eg

      I see a metric crap-tonne of motivated reasoning that focuses solely upon deaths and ignores other deleterious health outcomes associated with COVID.

      Govern yourself accordingly.

  11. Erelis

    Something to note about Pfizer making modifications to the current vaccine within a 100 days to handle the Delta variant. I believe mRNA based vaccines can do the quick turn around. Problem is, doesn’t this result in a NEW vaccine. And shouldn’t it go through the entire process that any new vaccines go through to ensure that the new vaccine is safe and effective? Is Pfizer trying to sell what could be a very dangerous outcome if we come to believe that some tweaks were made, and no worries, no need for full round of trials? And oh, would the new vaccine also need two doses?

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