Let’s get the important part out of the way first: Vaccines are the most successful healthcare intervention ever conceived by humankind. Period.

More lives have been saved and prolonged due to vaccines than any other medical intervention. For example, when Dr. Paul Offit co-developed the RotaTeq vaccine for pediatric rotavirus, that pathogen was leading to severe illness and death in 200,000 children annually. Now in developed countries, most people don’t even know what rotaviruses are—let alone worrying about their spread in children.

And so it is with measles, mumps, rubella (German Measles), varicella (Chicken Pox), hepatitis A and B, meningitis, tetanus (a huge ancient killer of humans), pertussis, diphtheria, polio, papillomavirus and many other scourges of humanity. To live in these times is to not even understand what it was like to endure these infections and watch the morbidity and mortality toll on huge numbers of people.

First-world problems
We find ourselves in contemporary times, armed with the ultimate in information bias in the form of internet search algorithms and social media—so that each of us can be spoon-fed only those stories that fit the narratives we subscribe to. Want to think that vaccines are causing autism and killing scores of people (which they aren’t)? Just begin to look for those posts on social media and Google, and the confirmation bias begins. Due to the ‘learning’ nature of search algorithms, you’ll soon have a veritable cornucopia of stories and links sent to you about fictitious anecdotes and shocking misreads of clinical data—enough to think that healthcare practitioners exist specifically to cause harm.

Of course, nothing could be further from the truth, and healthcare workers have been in the trenches for the past two years combatting an endless parade of COVID-19 cases entering hospitals and clinics. If the pandemic is fake news, what of the disability and (excess) death tolls nationally and globally as a result of these infections? There’s a strange and surreal disconnect between what the laypublic considers to be true, and what healthcare workers are seeing and contending with on a daily basis. And unfortunately, this is further made complex by partisan lines and their respective echo chambers. It all comes down to funneling and information bias.

Science supports vaccination
When the FDA needs to make a determination as to the efficacy and safety of a new vaccine, they call upon their Vaccine and Related Biological Products Advisory Committee (VRBP). This is a group of virology and vaccinology experts who are independent of the FDA, and go through a multi-hour review of the clinical data with the sponsor company(ies) who submit their vaccine(s) for authorization or approval. Questions are asked.
Challenges are made. The group includes physicians, scientists and pediatricians. When the VRBP committee renders a judgment, it is done so by a vote of all the participating members, and in the case of the COVID-19 vaccines, the voting has virtually been unanimous in favor of authorization (Janssen, Pfizer-BioNTech, Moderna).

The holdouts from the current vaccine campaign underway worldwide have frequently invoked pseudoscientific jargon that they read from FDA’s own website that the vaccines (especially the mRNA-based vaccines) are ‘experimental’ treatments and ‘gene therapies’; they are neither experimental, nor gene therapies, and have now garnered full approval—not ‘just’ authorization—by the FDA.

Literal billions of doses have been administered globally of these vaccines, and by the way, when the VRBP committee was convened to review some of these vaccines, they had way more data about their efficacy and safety in-hand than they had for other vaccines in the past which were then fully-approved by the FDA. In addition, Janssen’s vaccine technology was excellent, as was that of both Pfizer-BioNTech and Moderna; mRNA vaccine technology has been around for decades—and while it was the first time that the public had heard about it (about a year ago), in healthcare, we’ve known about it for decades.

In general, those who are resistant to vaccines shouldn’t be in the healthcare industry or be able to call themselves ‘scientific’ in any manner, because they clearly have trouble interpreting very real clinical data from very real scientific studies.

Everybody’s an armchair epidemiologist
It’s been humorous to some degree to be out in public almost anywhere, and hear people bantering or complaining about their opinions of aerosol particulate transmission physics or virology and epidemiology. When confronted by such a life-changing scenario (pandemic) as we’ve all endured for more than two years now, it’s natural for people to absorb information and try to synthesize opinions. But without proper training, they’re mostly wrong.

For example, I’ve heard more times than I can count out in public that ‘masks don’t do anything.’ Fiction. If this is your line of belief, I’d invite you to undergo an open cardiothoracic surgery and ask your surgeon to forego wearing a mask during your procedure. We know of universal precautions and what works, ever since the inception of early surgical theaters and tying back to Pasteur’s Germ Theory of Disease. So, with literally billions of opinions circulating online, it’s more likely than not that the Facebook (or Twitter, Instagram, Google, etc.) opinion people have read is incorrect, rather than correct.

Should kids be vaccinated?
Cynicism knows no boundaries. Let’s be clear: Scientific skepticism is a great thing, and that means looking for good evidence. Cynicism is maintaining a bias even in the face of reliable evidence. For these people, no amount of evidence will change their minds. And sometimes, that’s ok. If someone believes that the moon is actually made of cheese, that doesn’t affect anyone else. But if someone eschews masks or vaccines, citing fiction from their social media feed, that DOES objectively affect and potentially harm others.

Along these lines, I’ve been asked by a lot of media outlets over the last few months about whether or not children should be vaccinated against COVID-19. This is again a line of inquiry that the FDA and CDC have been deeply involved in, and specific age groups have had vaccines authorized for their use.

What we do know to be true is that COVID-19 infections have been endured far better by younger age groups in our population than older age groups. We can easily view and cite those data. Whether one individual should have their child immunized for COVID-19 is another question entirely. It depends on factors like: Their family and genetic history, immunocompromization, other diseases and comorbidities, and frankly, the risk tolerance of that parent or guardian. There isn’t ONE answer to this, and it depends upon looking at the statistics across different age groups, who have markedly differential responses and outcomes to COVID-19 infections—and taking that into context with the risk associated with vaccination.

Which brings up an important point, and that is:

Science’s Greatest Strength Is Also Its Greatest PR Weakness
‘Science’ doesn’t know everything. In fact, let me let you in on a little secret: Science itself doesn’t know anything! The pursuit of science is one of mental rigor and objective discipline. Science is a process of collecting measurements, falsifying hypotheses and drawing conclusions based on the data. Scientific studies report all the time on conflicting results—and that’s not only okay, it’s how science prevails. We get closer and closer to approximations of actual truth by undergoing the rigor of scientific study.

So, you may have heard something like this from someone in the public: ‘One day they say wear masks, another they say masks don’t do anything; The same with vaccines: ‘Do they save lives, are they harmful? They don’t know anything.’ This is because ‘they’ refers to scientific consensus, and science is built on the foundation of challenging results and refining studies.

In proper science, there isn’t “AN” answer to general questions (Is it raining today? That depends on where and what time). But I think that sometimes we do ourselves a disservice in science by giving equivocal answers with uncertainty included. The public (and many scientists!) are ill-equipped to assess probabilities and uncertainty (including p-values, confidence intervals, effect sizes, etc.). So sure, one study may suggest that masks are ‘58% effective,’ and another that they ‘prevent 82% of transmissions,’ but those numbers are ephemeral; they include natural variation that exists in-reality, in the study design and in how the different studies were designed and conducted differently. But it sounds very much like a waffling answer, and one that erodes and undermines the credibility of real scientists who are trying to get the right information out there. By comparison, the very unscientific social media posts are very precise in their language: They suggest things like ‘masks don’t work’ or ‘COVID-19 vaccines are killing more people than they’re saving.’ Very confident statements, regardless of their level of fiction.

VAERS isn’t what the public thinks it is
The Vaccine Adverse Event Reporting System (VAERS) is the central clearinghouse of all vaccine adverse events reported by the public, solicited and unsolicited. For this reason, it’s VERY messy data. Anybody can claim anything, and it is listed as an adverse event (AE). Of course, we do this very thing in clinical trials through pharmacovigilance (PV), but that is very much more controlled. And even then, it requires careful scrutiny to know what events were actually associated with the use of the drug under study (adverse drug reaction) and which weren’t.

So, in the VAERS system exists a pantheon of every imaginable condition and complaint. None have been adjudicated by medical experts, but simply exist in their raw form in the database. The problem is that these data are viewable by the untrained public. So, people have tried to surmise that any deaths reported in the system are ‘obviously’ caused by the vaccines, even though causality is NOT assessed in VAERS. Example: If you have a 92-year-old patient who is immunized for COVID-19 and later passes away (natural causes, auto accident, other infection unrelated, etc.), this could be recorded as an adverse event associated with the vaccine. Those who choose to draw their own conclusions use these data for nefarious purposes, without truly understanding what the data are or how they should be appraised. Having VAERS raw data viewable by the public is a liability—not an asset—to science in the public’s interest.

Conclusion
It’s up to all of us to be our own medical advocates, to strive for what is right. Unfortunately, it’s become harder and harder for the general public to know what ‘right’ is. We’re long past the era when we look to various ‘experts’ for their input, because fake expertise exists a mouse click away, biased in whatever direction you’d like.

We never really considered that we’d get to a point like this in humanity’s arc, where access to exabytes of data would cause more problems than it solves, but here we are. And I think a lot of the problem is rooted in scientific communication trying to be too precise for its own good. People want ‘an’ answer, not a spectrum of answers inclusive of various sources of risk with an uncertainty figure tied to it. But we can all help by educating those members of the public who we know or associate with who may truly not understand, but are literally thirsting for a better answer than what exists on the interweb. 

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Ben Locwin
Contributing Editor, Healthcare Executive

Ben Locwin is a healthcare executive and dispeller of scientific misinformation. Frequently shining a bright light down dark alleys of ignorance, it’s become clear during the two years of global pandemic that it’s a very real thing for people to choose and prefer ignorance. But that doesn’t mean that scientists shouldn’t still strive to do what is right. And that’s to keep on ‘science-ing’ the sh!t out of our world’s problems. We’ve gotten nowhere in this world were it not for what science has elucidated for our eyes.