The Russians Are Coming! Peter Hotez's Zany, Evidence-Free Anti-Anti-Vax Rant In Nature

 Peter Hotez, Dean of Baylor College of Medicine's School of Tropical Medicine, has a theory about why there's so much antivax sentiment in the world. It's nice, he says, to offer solid, scientific evidence for vaccine efficacy and safety, but there are too many bad guys out there spewing disinformation.

I have a long-standing disagreement with many of my US public-health colleagues. I admire their commitment to disease prevention, but when I ask for a more direct way to counter anti-vaccine aggression, I’m told, “that’s not our approach; confrontation gives them a platform and oxygen.” In my opinion, this attitude reflects a time when we had dial-up modems. Today, the anti-vaccine empire has hundreds of websites and perhaps 58 million followers on social media. The bad guys are winning, in part because health agencies either underestimate or deny the reach of anti-science forces, and are ill-equipped to counter it.

So who are these shadowy forces?

Investigations by the US State Department and the UK Foreign Office have described how Russian intelligence organizations seek to discredit Western COVID-19 vaccines. One campaign implies that it could turn people into monkeys. This builds on a longer, well-documented history of Russia-sponsored disinformation, presumably to destabilize the United States and other democratic countries. The administration of US President Joe Biden has warned Russian media groups to halt their anti-vaccine aggression, and announced sanctions tied to disinformation and other behaviour, but we need much more.

But wait — has anyone ever claimed they didn't want Moderna because it would make them into a monkey? Who knows! Who cares? He's on a roll. The solution, he's certain, looks like "The United Nations and the highest levels of governments must take direct, even confrontational, approaches with Russia, and move to dismantle anti-vaccine groups in the United States." That is, the federal government should censor antivax groups in the US.

This of course is unconstitutional. Moreover, that it is unlikely to work even if it were implemented does not occur to him, as it does not to all would-be censors; they imagine themselves the beneficiaries and directors of such activity. The lessons learned from the CDC's early flip-flopping on mask-wearing shows no one has a monopoly on Truth. The likely result of such censorship would be more people, not less, asking, "What do they have to hide?"

If anyone were interested in finding out why people didn't want any of the safe, effective vaccines against COVID-19, the place to start is by asking them. The Kaiser Family Foundation has done a series of U.S. polls that are both informative but incomplete, telling us that some people won't get the vaccines, but not why. We need more of this. My (mostly unsubstantiated) belief is that the Johnson & Johnson vaccine pause has proven destructive to overall vaccination efforts. The April 13 pause directly correlates to a daily decline in the number of vaccinations as shown by the graph below (underlying data from Our World In Data):

In Kansas and Arkansas, vaccine distribution has stalled due to lack of demand. I anticipate more stories in the coming days of similar problems, particularly in the south and midwest. This is a serious issue that deserves serious thought and effort. Dr. Hotez provides neither.

The J&J Pause Has Likely Poisoned Acceptance Of All Vaccines

 The FDA and CDC's April 13 pause of the Johnson & Johnson vaccine, which I predicted would cost lives, appears to have done so in the worst way. While we don't have polling data available yet (the KFF poll is probably wrapping up right about now), the last data available indicated Americans were losing their vaccine hesitancy. If this graph of daily vaccinations is any indicator, that hesitancy has come right back up:

 Good job, guys! Explain the risks and don't "pause".

The Big Lie About US COVID Vaccine Exports

 Last month, I expressed disbelief at EU claims the US had installed a vaccine export ban, which mainly was based on Israel's early vaccination program, one I assumed was based in the US, based on the early huzzahs about first doses leaving a plant in Portage, Michigan. But this was flatly contradicted by Charles Michel's claim that "Most of the doses with which Israel embarked on its mass vaccination programme were sent from Belgium."

There I left it, until another Politico EU article came to my attention, this one about AstraZeneca production shortfalls. The relevant grafs (emboldening mine, as usual):

While a Belgian subcontractor making the serum or "drug substance," was fulfilling its contract with AstraZeneca, another plant in the Netherlands wasn't producing enough to be included in the company’s application for approval to European regulators at the end of December, according to EU documents seen by POLITICO and the Belgian magazine Knack.

With so little drug substance coming from the EU, AstraZeneca turned to its U.S. plant in Maryland to make up the difference.

"The most important quantity" of drug substance came from the American plant, owned by Catalent, before being put into vials in Italy in a process known as "fill and finish," the documents said, detailing inspections in January and early February of three AstraZeneca plants in Belgium, Italy and the Netherlands that produced vaccines for the EU.

 So, perhaps they mean arm-ready shots? Either way, there is, as I suspected, a lot less there than meets the eye. The US has not, in fact, stopped exports of vaccines.

mRNA's Cherry On Top: The EU Buys Another 100M Pfizer Vaccines

The EU exercised its option to buy another 100 million doses of Pfizer/BioNTech COVID-19 vaccine, bringing the total to 600 million. Combining that with the 1.8 billion dose order drafted earlier in the month, this means the EU has essentially gone all-in on mRNA. Reviewing my post on the situation back in February, this means the EU has 3.365 billion mRNA vaccine doses either delivered or deliverable. Presumably CureVac's doses are still on order as part of that sum.

The buy makes it appear that the EU has lost faith in Sanofi's protein subunit vaccine, which had trouble with efficacy in the key older group. Sanofi has since shifted gears, and on March 12 announced with partner Translate Bio, that they, too, would have an mRNA vaccine candidate, with phase 1/2 trials commencing soon (?), but these are not expected to conclude until Q3, 2021.

COVID Vaccine Bullets

•  The European Union is negotiating a 1.8 billion-dose order with Pfizer to be delivered in 2022 and 2023 (!!!) and will not renew contracts with AstraZeneca or Johnson & Johnson. The doses will be manufactured in the EU.
• For all that mRNA manufacturing has generally scaled well, we finally have a story of missed shipments from Moderna, who has announced they will cut vaccine deliveries to Canada and the UK due to manufacturing problems.

  While the company didn’t specify how many doses would be cut and where, Canada’s Procurement Minister Anita Anand said Friday that its shipments will contain 650,000 doses this month instead of the expected 1.2 million. 

  Moderna also warned up to 2 million of a planned 12.3 million shots scheduled for delivery in the second quarter would be delayed until the following quarter, according to a report from Reuters. However, a company spokesperson also told the news agency that its deliveries to the European Union and Switzerland remain on track.

• Pfizer's CEO now says there will likely be a need for COVID booster shots, possibly annually.
• CureVac plans on releasing trial data of its mRNA vaccine in the coming weeks.
• Moderna is putting its mRNA influenza and HIV vaccines into phase I trials this year.
  

  Current flu vaccines in the market have efficacy rates in the regoin [sic] of 40-60%: which Moderna believes its mRNA technology can improve on. It also says that its technology has several advantages over egg-based vaccine production: not only in terms of production advances but in accurately targetting vaccines against strains (egg-based production has the potential to cause unintended antigenic change to the vaccine virus).

  They also released phase I trial data for a respiratory syncytial virus (RSV) vaccine, and a cytomegalovirus (CMV) vaccine.
  

The Bogus Story About Vaccine Racism

The woke crowd has unsurprisingly turned to its favorite hobgoblin of "structural racism" (i.e. this piece in Journal of the American Medical Association) as explanatory for differing rates of COVID-19 vaccine uptake. Per recent polling by the Kaiser Family Foundation, Hispanics (61%) and blacks (55%) say they have either already gotten a COVID vaccine or plan to do so as soon as possible. The big problem the "structural racism" argument has is this reticence is more or less mirrored in historical data for influenza vaccines. Blacks (by about 15%) and Hispanics (~13%) lag white vaccination rates considerably for the most vulnerable age group (69.9% for ≥ 65 years). Otherwise there is a lag, sometimes quite noticeable, other times not so much, but the idea that COVID vaccine reticence is somehow driven by systemic racism fails to heed the historic story.

The Trouble With Labels And Facebook's Censorship

 The New York Post has a story about BLM co-founder Patrisse Khan-Cullors buying four million-dollar-plus homes in the New York area, scoping out property in the Bahamas, and last month buying a $1.4M home in Malibu. This is in addition to homes in the Atlanta and Los Angeles areas.

 BLM, of course, is a label, which means anyone can use it. There really is no unified formal organization, which has led to grifters capitalizing on the brand's goodwill. BLM Global Network Foundation, Khan-Cullors' particular instance, is one among many:

Founded by Khan-Cullors and another activist, Kailee Scales, the nonprofit Oakland, Calif.-based BLM Global Network Foundation was incorporated in 2017 and claims to have chapters throughout the US, the UK and Canada, and a mission “to eradicate White supremacy and build power to intervene in violence inflicted on Black communities.” The group does not have a federal tax exemption and donations are filtered through ActBlue Charities and Thousand Currents, two nonprofits that manage the cash.

This, of course, sounds awfully familiar; the whole point of ActBlue is to hide the operations of political scam artists. What makes this worse is Facebook censoring attempts to share the story, something mainly reported by News Corp. outlets. (Twitter has not, so far, attempted to step on this.) What good can come from this? The fact that the BLM name is being openly used by grifters is bad enough; that Big Tech covers for them is appalling.

The Insane, Reckless "Pause" Of The Johnson & Johnson Vaccine Will Cost Lives

 The FDA and CDC have called for a "pause" of deliveries of the Johnson & Johnson (Janssen) COVID-19 vaccine. This is absolutely insane based on relative risk alone: one woman died among the six women affected (all 18-49 years old), versus over seven million vaccinated. Meantime, the CDC's own best-guess infection fatality ratio shows twenty deaths per million infected among the 0-17 years age group. So the FDA and CDC are stopping vaccinations that could save the lives of twenty times the number of people even in the best case scenario. The most likely case, the 18-49 age bracket, sees an IFR of 500, which means you are looking at two orders of magnitude more risk of death than without vaccination. The FDA has a history of safetyism overriding sense, and this will kill people, especially as it means fewer vaccines will be available.

 In a sense, the pause may not matter, because the vaccines wouldn't be available even if these thrombotic events hadn't happened. Johnson & Johnson took over production at contract manufacturer Emergent BioSolutions following production errors there that mixed up their vaccine with AstraZeneca's, and this caused the destruction of up to "15 million doses". Accordingly, the CDC announced it expects J&J to cut supply by 80%, putting the overall annual goals of 100 million doses in the US and one billion worldwide in jeopardy.

Lastly, for anyone who wants to get into the weeds on this subject, Derek Lowe has a good explainer on the subject. This seems to be a problem shared with the AstraZeneca ChAdOx1 vaccine as well, and while I recommend the whole post, I wanted to highlight this one section in particular:

Is this blood clotting happening with the mRNA vaccines, too?

No. That seems quite clear – to the best of my knowledge, there have been no reports like this at all with either the Moderna or the Pfizer/BioNTech vaccine. That’s good news, and it tells us a lot. For one thing, this blood clotting problem is not a general feature of trying to vaccinate people against the coronavirus. It also means that it apparently has nothing to do with inducing the coronavirus Spike protein in people, since that’s what both the adenovirus vectors and the mRNA vaccines are doing, in the end.

The version of that protein brought on by the AZ/Oxford vaccine is slightly different from the others (it doesn’t have a key set of protein-stabilizing mutations), and when the clotting problems showed up in Europe some people were wondering if that had anything to do with it. But the appearance of such side effects with the J&J vaccine would seem to rule that out. Instead, what those two have in common is that they’re both adenovirus vector vaccines [emboldening mine — RLM]. Oxford used a chimpanzee adenovirus, and J&J picked a less-common human one. Which means that if this is a side effect shared by adenovirus vectors, it’s shared at a pretty basic level, isn’t it? I’m not enough of an adenovirus jock to tell you in detail about the similarities between the proteins in the ChAdOx vector versus Ad26, and at any rate it’s probably more about the antibody response to these things (and why, in a small number of people, that goes awry with the PF4 protein).

It's becoming increasingly obvious that the vectored virus vaccines are a technological dead end: harder to manufacture at scale, more likely to generate weird side effects, and less effective than mRNA vaccines. But any of them are still better than getting COVID.

Update 2021-04-15: Alex Tabarrok has a useful thread detailing post-vaccination thrombotic events in the UK. The mRNA vaccines maybe have dodged a bullet on this?

Pfizer, All UK spontaneous reports received between 9/12/20 and 28/02/21

Deep vein thrombosis 8
Pulmonary embolism 15
Thrombocytopenia 13

AZ, All UK spontaneous reports received between 4/01/21and 28/02/21

Deep vein thrombosis 14
Pulmonary embolism 13
Thrombocytopenia 12

— Alex Tabarrok (@ATabarrok) March 15, 2021