Letter to the Editor: A primer on vaccine hesitation

Dear Miscellany News,

On Feb. 3, 2022, an article was published in the Opinions section of The Miscellany News regarding vaccine hesitancy. The article’s author attempted to explicate and legitimize the views of anti-vaccination advocates. The publishing of this article by the Miscellany News seemed to be an attempt to open up the column to a wide variety of perspectives. Unfortunately, the article was rife with misinformation and half-truths regarding the COVID-19 pandemic and vaccines. This letter is an attempt to respond to the points made by the author of “A primer on ‘vaccine hesitation’: It’s not so simple” and to correct the misinformation expressed in the article. 

Early in the article, there is an attempt to “address moral and ethical issues” to “help contextualize scientific objections to the COVID-19 vaccine.” The author’s first point surrounding scientific objections begins with the issue of masking. They accuse Dr. Anthony Fauci, one of the nation’s eminent scientific experts, of purposefully misleading the American public regarding the matter of masking as a measure to prevent the spread of COVID-19 and that masks were being stockpiled for healthcare workers instead of the public. As with any novel disease, very little was known about SARS-CoV-2 (the virus that causes COVID-19) in its early days. However, scientists did know about SARS-CoV-2’s cousin SARS. According to the NIH, SARS, while very similar to COVID-19, is much less transmissible than COVID-19 ended up being, partially because transmission of SARS mostly occurred when a person was symptomatic, not before, which is a novel trait of COVID-19. In the early days of the pandemic, Fauci and other doctors did not yet have the data to know this and subsequently shaped guidelines to fit what they already knew about a genetically similar virus. Healthcare workers were in closer contact with those symptomatic with COVID-19, and were at a higher risk of contracting the virus, which is why face masks were needed for them. As our scientific understanding of COVID-19 changed, so too did public health guidelines. Though it may have seemed like a deception, this fact is a basic tenet of the scientific method and not an elaborate scheme to trick citizens; suggesting otherwise erodes trust in public health experts.

Next, the author uses the opioid crisis as an example of the shady dealings of pharmaceutical companies, which is a false equivalence. The opioid crisis was the work of Purdue Pharmaceuticals, not Pfizer. In regard to the 2009 issue with Pfizer promoting Bextra for off-label uses, it occurred over ten years ago, and has little to do with their production of COVID-19 vaccines, which have been repeatedly shown to be safe and effective. 

Furthermore, the FDA is unable to release the full safety data of the Pfizer vaccine because of simple bureaucratic incompetence, not a desire to lie to consumers about side effects. The FOIA (Freedom of Information Act) requests to release all of the safety data is in good faith, and it is important that the public knows about the safety of a widely used product. However, according to Snopes, the FDA’s office which works to review and redact records (many of which contain sensitive personal information) is very small. According to the Washington Post, this office had 3,000 requests of different kinds by the end of 2020, and yet they continue to release 500 pages of safety information regarding the Pfizer vaccine every month. The full safety data is about 392,000 pages. The slow release of the full safety information is not malicious in any way, but rather a testament to the slow nature of many government processes. 

Finally, the author attempts to debunk the efficacy of the vaccines in their article. In doing so, they spread misinformation of the most sinister kind. First is the claim that the Pfizer vaccine is only 1.3% effective based on the use of absolute risk reduction (ARR) instead of relative risk reduction (RRR), the latter of which shows the vaccines to be 95% effective in protecting against COVID-19. This piece of misinformation has made the rounds on social media, and has been subsequently debunked by Reuters. In summary, the RRR shows the reduction in infection risk amongst the test vaccine group compared to a control group that did not receive a vaccine. This is pertinent information when it comes to determining the effectiveness of a vaccine. The ARR, while important, will always be very small, because it is only considering the rate at which infection occurs. Although the chances of catching COVID-19 might be relatively small to begin with, those who are vaccinated have an even smaller chance of catching it and suffering from severe disease. For a disease that is causing hospitalizations and deaths at such a great rate, even a small absolute reduction is important in ensuring that our healthcare system is not overwhelmed and as many lives are saved as possible. As for the citation attributing the National Institutes of Health (NIH) using ARR instead of RRR to determine vaccine efficacy, the link leads to a random textbook found on PubMed. None of the authors of the article work for the NIH; thus, the claim that the NIH “recommends” using ARR instead of RRR is completely unfounded. One of the authors of the textbook is even cited to be a children’s songwriter, which further casts doubt upon the legitimacy or credibility of this claim. 

Then there is the matter of the whistleblower in the British Medical Journal who claimed that poor laboratory practices were employed in the Phase III clinical trials of the COVID-19 vaccine. The whistleblower’s reports come from one company, Ventavia, which was one  out of 153 companies where Phase III trials were conducted. The whistleblower’s reports were of poorly discarded sharps, potentially unblinded participants and other generally poor laboratory practices. While these are not ideal, they definitely do not show that the vaccines are ineffective, especially when this issue was reported in only one site out of 153 by an employee who was at the company for two weeks

The use of Maddie de Garay as an example of the negative effects of the vaccine is completely unacceptable, tragic as her case is. Nowhere has it been found or proven that the COVID-19 vaccine caused her mysterious symptoms. Furthermore, the claims attributing her symptoms to the COVID-19 vaccine are paid for and pushed by the Vaccine Safety Research Foundation, an anti-vaccine group founded by anti-vaxxer Steve Kirsch. Using this example as a way to cast doubt upon the safety of the COVID-19 vaccinations is exploitative of the very serious health conditions this girl faces and legitimizes the arguments often used by anti-vaxxers. 

As for this author’s claims that natural immunity is just as effective in protecting against COVID-19, and that this pandemic is not “a pandemic of the unvaccinated,” the evidence clearly displays the opposite. The vaccines were never touted as a panacea to the pandemic; they were created to help prevent the spread of COVID-19 and lower risk of infection and hospitalization. They do this brilliantly, and denying this fact is a lie by omission. According to the CDC, “During October-November [of 2021], unvaccinated persons had 13.9 and 53.2 times the risks for infection and COVID-19 associated death, respectively, compared with fully vaccinated persons who received booster doses. While it is certainly true that vaccinated people are getting infected with COVID-19, they are not the ones who are overwhelmingly dying from the disease. The author’s failure to address this simple fact is a mistruth, and allowing this misinformation to spread is extremely irresponsible. Furthermore, about one-third of people who catch COVID-19 have “no apparent natural immunity” according to Johns Hopkins Medicine. Claiming that natural immunity is better than vaccination in every way is equally as irresponsible, especially when we know the destruction that COVID-19 has caused, particularly amongst immunocompromised individuals.

Finally, the author’s use of the CDC’s Vaccine Adverse Event Reporting System (VAERS) is irresponsible. While there are definitely negative risks associated with COVID-19 vaccines, the chances of these risks are miniscule compared to the risks of negative effects from the virus itself. Firstly, the report from Harvard Pilgrim Healthcare is over 10 years old, which is enough to question whether this report can still be applied to the current state of VAERS. Then there is the matter of the VAERS disclaimer. The VAERS website states, “VAERS reports alone cannot be used to determine if a vaccine caused or contributed to an adverse event or illness. The reports may contain information that is incomplete, inaccurate, coincidental, or unverifiable.” Believing this data to be completely accurate when it comes to determining negative effects of the COVID-19 vaccines is irresponsible and highly dangerous. While these negative effects must certainly be explored, blindly attributing them to COVID-19 vaccinations is completely unfounded. Additionally, the author’s use of the Cutter Incident is a complete false equivalence. The Cutter Incident occurred because the poliovirus was not properly inactivated in a batch of vaccines. The American healthcare system learned from this incident, and vaccine practices have improved greatly since 1955. But even disregarding this simple fact, the technology of the polio vaccine and the COVID-19 vaccines is completely different. Most of the COVID-19 vaccines rely on mRNA technology, which makes it scientifically impossible for people to catch the disease from the vaccine. Comparing it to the polio vaccine, which used a weakened form of the virus, is fear-mongering and completely irrelevant to the question at hand.

Although the author states in the first paragraph that they are not supporting “anti-vaxxers,” the paragraphs that follow utilize the same arguments and misinformation spread by that very group. The author then concludes by claiming that the vaccines are a “miraculous accomplishment,” which they just spent the past 1,600 words trying their hardest to disprove. If they are truly ineffective, as stated earlier in the article, why is the author then doubling back and claiming that the vaccines are miraculous? The publishing of this article, with all of its flawed logic and misinformation, was a grave mistake, for it promotes misinformation on the platform. The vaccines have been proven again and again to be safe and effective, and to mislead the public into thinking otherwise is dangerous and irresponsible. While I respect The Miscellany News’ efforts to broaden perspectives in the Opinions column, allowing misinformation to be published is unacceptable.

4 Comments

  1. It seems that in the original opinion article, Maddie De Gray was not brought up as an example of potential vaccine effects, but rather as an example of Pfizer’s sloppy handling of its trial data, as she was listed as merely experiencing “abdominal pain”

  2. The contribution by Joseph Cocozza (2-2-22) addressed topics of current high interest and discussion in public health. He developed ideas on these issues and in follow-up, he responded thoughtfully and with self-awareness, civility and humility to comments and criticisms.
    I hope he will look into further study in bioethics, public health, medicine and law.
    Ms. Noorwez also is to be commended for her interest in public health and study of the issues. However, she begins her response with a statement falsely assigning her classmate an intention to promote an anti-vaccine position, which he clearly excluded at the start of his opinion.
    It is interesting also how she defends the handling of the public messages on masks. It was known at the immediate start of the epidemic that the viral transmission was respiratory. The first reports were of a cluster of patients in
    Wuhan with pneumonia and subsequent area outbreaks of respiratory illnesses.
    If masks were not useful, then why did health professionals wear them? It was obvious that the initial public health message not to wear masks was to prevent hoarding and a lack of supply for medical people. It would have been the right thing to say that the supply was limited at that time. Rationing if necessary would have been an option and would have been understood and accepted by the public, but not wrong information.
    But what this erroneous message did along with future versions was to create doubt and mistrust. This was followed by a terrible politicization of the
    situation by the vice-presidential candidate who pronounced that she would not accept a vaccine developed by Donald Trump. It would be hard to find a more damaging statement by a public official at any other point during the pandemic.
    Vaccine hesitancy is a major serious public health concern, particularly in relation to sociaI disparities. Is consent dead? I hope not.

    Janet Cary Stiles, M.D.

    • “However, she begins her response with a statement falsely assigning her classmate an intention to promote an anti-vaccine position, which he clearly excluded at the start of his opinion.”

      I’m glad that saying “I’m not anti-vax” before sharing any opinion automatically excludes it from being anti-vax. This is some sound logic and you seem like a completely unbiased person.

  3. Addendum: Suggest viewing 6-12-20
    video interview of Dr. Fauci by internet journalist Katherine Ross on her internet you-tube presentation “The Street: Why we weren’t wearing masks from the beginning.”
    The official handling of the inexplicable flip-flopping mask advice would be
    a great case study in dissembling for Political Science 101.

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