Prolonging the Pandemic: A Public Health Expert Faults the Biden Administration

The media was quick to note on July 4 that Pres­i­dent Joe Biden had fall­en short of his goal to vac­ci­nate 70% of Amer­i­can adults by July 4. [On July 10, the Cen­ters for Dis­ease and Pre­ven­tion vac­ci­na­tion dash­board indi­cat­ed that 67.5% of adults had received at least one dose.]  Leana S. Wen,  an emer­gency physi­cian and vis­it­ing pro­fes­sor at the George Wash­ing­ton Uni­ver­si­ty’s Milken School of Pub­lic Health, was less focused on the per­cent­age and more on the admin­is­tra­tion’s strat­e­gy for achiev­ing it.

“Pres­i­dent Biden missed an impor­tant oppor­tu­ni­ty on the Fourth of July by hold­ing an at the White House that did not require its more than 1,000 atten­dees to be vac­ci­nat­ed,” opined Wen, also a Wash­ing­ton Post con­tribut­ing colum­nist and CNN med­ical ana­lyst.

The cel­e­bra­tion could have been a chance to show that vac­ci­na­tion isn’t just an indi­vid­ual deci­sion, but one that affects the health of oth­ers — includ­ing those already vac­ci­nat­ed.

Rather than requir­ing par­tic­i­pants to show a vac­ci­na­tion ver­i­fi­ca­tion,  e.g., their CDC COVID-19 vac­ci­na­tion card, or dig­i­tal ver­i­fi­ca­tion New York’s Excel­sior Pass or Cal­i­for­ni­a’s Dig­i­tal COVID-19 Vac­cine Record or even to “self-attest” to being ful­ly vac­ci­nat­ed, the Biden admin­is­tra­tion opt­ed to con­tin­ue the Trump admin­is­tra­tion’s prac­tice of rely­ing on rapid test­ing to pre­vent viral trans­mis­sion dur­ing the event.

The Wash­ing­ton Post report­ed on July 3:

Biden’s event Sun­day will be the largest to date at the White House dur­ing his tenure. Guests will include essen­tial work­ers along with mil­i­tary fam­i­lies, and every­one will be to take a coro­n­avirus test, accord­ing to White House press sec­re­tary Jen Psa­ki. Those who are ful­ly vac­ci­nat­ed will not be required to wear masks.

The impor­tance of vac­ci­na­tion ver­i­fi­ca­tion

Appear­ing on CNN News­room on July 8, host Jim Sciut­to asked Wen why it’s time for Pres­i­dent Biden to con­sid­er vac­cine man­dates. 

In her col­umn, Wen does not call for the White House to man­date vac­cines but “ with the efforts” of oth­er enti­ties, such as employ­ers, includ­ing hos­pi­tals, and uni­ver­si­ties, to man­date them.

“There is this nar­ra­tive that the Biden admin­is­tra­tion and many oth­ers have been putting out, which is, once you’re vac­ci­nat­ed, you’re fine,” answers Wen (see tran­script). 

And so the nat­ur­al con­clu­sion from that is, why would you care if oth­ers around you are vac­ci­nat­ed or not? If you’re pro­tect­ed, then why not let every­body else just do what­ev­er they want?

In a recent post about new data show­ing a decline in the effec­tive­ness of the Pfiz­er vac­cine,  White House COVID-19 Response Coor­di­na­tor Jeff Zients made this exact point: “If you have been ful­ly vac­ci­nat­ed, you are pro­tect­ed. If you’re not vac­ci­nat­ed, you are not pro­tect­ed,”  Zients told Dana Bash, host of CNN’s State of the Union, in an  on Sun­day, July 4.

Pro­long­ing the pan­dem­ic

Wen con­tin­ued, not­ing how unvac­ci­nat­ed peo­ple in the U.S. will pro­long the pan­dem­ic.

The fact, though, is that the unvac­ci­nat­ed also affect the vac­ci­nat­ed. If you are a vac­ci­nat­ed , but you’re liv­ing among a lot of unvac­ci­nat­ed indi­vid­u­als, as [CNN health reporter] Eliz­a­beth Cohen was just show­ing in these clus­ters, your chance of hav­ing a break­through infec­tion increas­es.

Your chance to infect­ing oth­ers around you who are unvac­ci­nat­ed also increas­es. And, by the way, the more unvac­ci­nat­ed peo­ple there are, the longer this pan­dem­ic is going to be. 

Wen end­ed her col­umn (source arti­cle) by writ­ing that the admin­is­tra­tion’s new­ly announced strat­e­gy of door-to-door out­reach to increase vac­ci­na­tions, which has received push­back from some Repub­li­can gov­er­nors in -hit states, is “not near­ly enough.”

Biden needs to get behind proof of vac­ci­na­tion, start­ing with his own White House events. A gath­er­ing tout­ing the Unit­ed States’ progress toward inde­pen­dence from the virus should have been the ide­al oppor­tu­ni­ty to make the case for vac­cine . It mat­ters for every­one, includ­ing the vac­ci­nat­ed.

Oth­er experts con­cur

Wen is cer­tain­ly not alone in fault­ing the admin­is­tra­tion for not going fur­ther to get Amer­i­cans vac­ci­nat­ed, as The New York Times report­ed on July 6.

“Dr. Ezekiel J. Emanuel, a pro­fes­sor of bioethics and health pol­i­cy at the Uni­ver­si­ty of Penn­syl­va­nia, said the Unit­ed States was unlike­ly to make sig­nif­i­cant strides in its vac­ci­na­tion cam­paign with­out man­dates,” wrote Michael D. Shear and Noah Wei­land.

“I like to say a man­date is legal, eth­i­cal and effi­ca­cious,” he said. “Ulti­mate­ly, work­places are prob­a­bly going to have to.”

How­ev­er, Reuters report­ed that the Biden admin­is­tra­tion instruct­ed fed­er­al gov­ern­ment agen­cies on June 10 not to require work­er vac­ci­nates. Wei­land and Shear add that the “Biden admin­is­tra­tion con­sid­ered and reject­ed calls to require a fed­er­al vac­cine pass­port, a move that some experts said would help con­tain the spread of the virus by allow­ing peo­ple to prove that they had been inoc­u­lat­ed.”

FDA approval vs. autho­riza­tion

“There’s one thing that could make an imme­di­ate impact on vac­cine uptake: Grant­i­ng full FDA approval to Pfiz­er’s shot,” writes Wash­ing­ton Post researcher Alexan­dra Eller­beck on July 6.

It’s been eight weeks since Pfiz­er and BioN­Tech applied to the Food and Drug Admin­is­tra­tion for full approval of their coro­n­avirus vac­cine, but the agency has yet to act. Pres­sure is grow­ing for the FDA to move faster to license the vac­cine.

The lack of full autho­riza­tion has been a core part of the mes­sag­ing and lit­i­ga­tion strat­e­gy of anti-vac­cine groups. And while a fed­er­al judge upheld at least one Texas hos­pi­tal’s man­date for its employ­ees, many employ­ers are cau­tious about invit­ing lit­i­ga­tion.

101 mil­lion eli­gi­ble Amer­i­cans yet to be vac­ci­nat­ed

The CDC rec­om­mends every­one 12 years and old­er should get a COVID-19 vac­ci­na­tion to help pro­tect against COVID-19

As of  July 10, 183,836,917 Amer­i­cans had received at least one shot of an autho­rized COVID-19 vac­cine. Sub­tract­ing that num­ber from 333,007,229 equals 149,170,312  unvac­ci­nat­ed Amer­i­cans, includ­ing 48 mil­lion chil­dren in Amer­i­ca aged 0–11 who are inel­i­gi­ble to be vac­ci­nat­ed at this time.

That leaves 101 mil­lion Amer­i­cans who have cho­sen (or their par­ents have cho­sen for them) to not be vac­ci­nat­ed against COVID-19.

Relat­ed posts:

Hat tip to Jim Sciut­to.

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