Opinion | Extending the Johnson & Johnson vaccine pause for a week was a deadly mistake

From The Washington Post:

At its meeting, ACIP analyzed vaccine side effects with admirable transparency. But there was no rigorous analysis of the risks of not being vaccinated. Rather, ACIP insisted that because “alternative covid-19 vaccines (mRNA vaccines) are available,” the tradeoffs are inconsequential. This shows a profound disconnect with the reality many Americans face.

When the pause began, millions of Americans were still ineligible for vaccines. And universal eligibility on April 19 will not mean immediate access; obstacles to vaccination will remain, especially for people who can’t travel long distances. This undermines the blithe assertion that unbounded supply of other vaccines makes pausing one irrelevant. Plus, the J&J vaccine requires only one appointment instead of two and can be delivered in settings where others can’t. The pause has stymied essential efforts, such as outreach to homebound D.C. seniors at far higher risk from covid-19 than from vaccination.

Looking at ACIP’s roster helps diagnose its mistake. Its voting members are almost all doctors far more familiar with rare vaccine side effects than with marshaling scarce public health capacity to respond to a surge of infections. The committee lacks comparative effectiveness experts or health economists familiar with weighing inevitable tradeoffs at a population-wide scale.

Took me a bit to put into words my thoughts on this. I think this is where I’ve landed:

  • Making a decision quickly which is not 100% obvious and includes the reasoning that “this might hurt some people, but it will benefit more people” feels wrong.
  • Making that same decision slowly, over time, with plenty of open debate feels fine.

There’s something to the process of debating and discussing, prior to endorsing, an idea which carries with it the chance of harm for some subset of people who are impacted. Perhaps it’s just the rationalization that the debate itself will hopefully inform those who stand to be harmed that “hey, this is happening, think about it!” and if by the end of talking it through the decision is still made then some duty has been met to properly inform the folks the decision is being made against.