- Some public health voices are underestimating the benefits of the COVID vaccine.
- Vaccines are extremely effective and will pave the way for life to return to normal.
- We must emphasize these benefits instead of hedging.
- This is an opinion column. The thoughts expressed are those of the author.
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David Leonhardt writes for the New York Times that some public health voices are “selling less than the vaccine”, and he is right. Many of the messages we hear about COVID-19 vaccines – even from sources who want us to get them as soon as possible – drown out the vaccines. Some public health officials and media sources continued to emphasize that vaccines are not entirely effective; we do not yet know how much they act to prevent transmission; and that getting vaccinated doesn’t mean you can get back to normal life.
At the same time, these same authorities and sources express concerns that there are not enough people interested in receiving the vaccine. This hesitation is partly motivated by excessive (if understandable) fears about the risks of obtaining the vaccine. But isn’t it logical that people would also hesitate to get the vaccine if most of the messages about the vaccine are about its benefits being limited and qualified?
As Leonhardt notes, there are many good reasons to believe that the vaccine is better than you may have heard – and experts will say so if you ask the right questions. The Pfizer and Moderna vaccines are about 95% effective in preventing COVID-19 and probably even more effective than preventing severe cases of COVID. And there are good reasons to believe that they will also be effective, at the population level, in reducing the spread of the virus.
And some of the warnings you hear about the vaccine are a repeat of a logical error that we suffered last year: treating the absence of evidence as evidence of absence.
Likely benefits of under-selling
We do not yet have a study that proves that vaccination significantly reduces a person’s risk of contracting and spreading the coronavirus, because studies of Pfizer and Moderna vaccines have examined the effectiveness of vaccines in preventing symptomatic diseases, not asymptomatic infections. Likewise, the lack of studies to prove the effectiveness of simple masks delayed their adoption last spring. But randomized clinical trials are not the only source of scientific knowledge.
As experts describe Leonhardt, based on our experience with other vaccines, it would be unusual for one that is so effective in preventing disease to be effective in preventing transmission as well, although we have not proven it to be in a study. In addition, as Dr. Paul Sax notes in the New England Journal of Medicine, participants in the Moderna study were tested for asymptomatic infection one month after their first dose, and even with just one dose, participants who received the vaccine were significantly less likely to be infected than those who received a placebo.
It is true that a vaccine injected in the arm does not mean that you can immediately go back to normal. Vaccines are not designed to be fully effective until two weeks after the second dose (although there is evidence of significant partial efficacy two weeks after the first dose). And a system where vaccinated people roam in public spaces without a mask, while the unvaccinated continue to mask can be logistically unsustainable, even before considering the risk of asymptomatic spread.
There is an ideal time to convey this message about the need for caution and patience after the vaccine is injected: when people take the injections. At that point, they are sold with the vaccine and become a captive audience for medical professionals.
But for the general public, these messages must be tempered with messages about the great personal benefit of vaccination. The vaccine greatly reduces the personal risk of getting diseases. And, as Leonhardt notes, people who get the vaccine will be reasonably able to choose to resume certain activities that they might have previously avoided, such as intergenerational family gatherings involving close contact, even before society in general returns to normal. Rather than being stifled, this observation should be used as a selling point for the vaccine.
We need to start accepting a more positive vaccine message
An apparent concern that motivates cautious vaccine messages is that if we tell people a very positive story about the vaccine, they will go crazy with the risks of transmission as soon as they are injected. There is a problem with this concern: people have already gone crazy with the risks of transmission. Look around you. In most parts of the country, COVID is spreading like wildfire.
Instead of taking this opportunity to scold the public, I think it’s worth thinking about why we ended up with an uncontrolled spread. We are seeing that the social changes needed to control the spread of COVID without a vaccine are unsustainable in our society. You can say “this is not difficult” as much as you like on Twitter, but asking people to give up normal social contact, family activities, religious practice and commerce for almost a year is a big question. Many people are saying no.
This pandemic has extended to cover a significant part of their lives, and older Americans at greater risk of severe COVID also have the greatest reason to ask themselves what fraction of their remaining life should they spend in isolation. You can argue whether it is reasonable, in some cases, for people to have looked at this situation and decided that it is worth taking significant COVID risks to get back to a more normal life, but more importantly, it is inevitable that some people will decide that way. .
There are three reasons why this situation requires more positive messages about the personal benefits of the vaccine.
One is that if people are not extremely careful with other measures to prevent spread, it is especially important to vaccinate them to reduce the risks to themselves and others.
The second is that a message about being able to safely change behavior soon – instead of happily telling people that pandemic conditions are here to stay – gives people more reason to comply with restrictions in the short term.
And a third is that the exhaustion of society with COVID preventive measures reflects the extent to which this crisis has exhausted people’s empathy. Since there is a real and convincing message about the individual, personal benefits of being vaccinated, it is better to rely on that than on more messages about how important it is to be vaccinated for the good of others.
Vaccines are great – great for society and great for the people who receive them. We should not be ashamed to tell people that the vaccine will change their lives. This gives them a good reason to want to be vaccinated and even gives them a good motivation to maintain responsible behavior for the brief period before they are protected by vaccination.