Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite.
I live in a wealthy country that is fighting over COVID-19 vaccine mandates.
There is tremendous division around this issue which only grew worse when the administration announced that vaccines would be mandated for all federal workers, federal contractors, and businesses with more than 100 employees. The sweeping mandates even include remote contractors whose only coworker might be a dog, a frog, or a houseplant. Workers who refuse to comply will be fired. In the last couple of weeks, we have heard stories of people leaving their jobs because of the mandates, including qualified healthcare workers. This has led to fear of staff shortages, an ongoing issue made worse by the pandemic, and many have questioned the judgment of letting qualified healthcare workers go when cases could spike again. Imagine HR having to make that phone call? “Hey (insert name here), sorry we kicked you to the curb. We meant what we said at the beginning of the pandemic…that you’re all heroes. Please come back, Hero…, PLEASE?” Good luck with that.
Bus drivers quit or were fired because of vaccine mandates, leaving thousands of kids without rides to school. The Chicago School District started paying parents to find their kids’ a way to school while promising to look into Uber or Lyft as an alternative. For starters, making it more difficult for kids to get to school is probably the least public-health thing one can do. Many kids rely on schools for education, friends, and meals. Also, Uber isn’t making their drivers get vaccinated, so what version of logic is one using when one fires bus drivers for being unvaccinated and plans on replacing them with Uber drivers who are not required to be vaccinated? Is there evidence for unvaccinated Uber drivers being unable to transmit to school kids? If so, that’s some kind of magic.
Some employers, like Louisiana’s largest healthcare system, are not only making their employees get vaccinated, but adding a surcharge if spouses remain unvaccinated. Fortunately, they didn’t add a surcharge for spouses with obesity, the biggest modifiable risk factor for severe COVID disease, hospitalizations, and death, but could you imagine if they did? There would be a lot of punched faces at office parties, and that explosion you just heard? That was the PC police losing their heads.
We aren’t just fighting over vaccine mandates for adults, we are also tearing each other’s hair out over kid mandates. Just recently, the governor of California tweeted that vaccines WILL be mandated for kids in California WHEN the FDA approves it. It was a very confident tweet considering only one vaccine is authorized for emergency use in kids over twelve, and Pfizer just submitted an emergency use application for use of the vaccine in kids between five and eleven. It reminded me of when another politician, the President, told Americans in August that boosters would be available for everyone at the end of September. He did that before the FDA reviewed the evidence. I don’t know, but in a world where drug companies are the most powerful lobbyists in DC and have enormous control over our government, perhaps it’s more prudent for politicians to hold off on announcing mandates before the FDA does its job. People already don’t trust the FDA, CDC…basically any health organization with a three-letter acronym. They believe these organizations have been “captured” by Big Pharma, so maybe don’t do stuff (such as announce mandates in low-risk groups before regulators look at the data) that will only increase their level of distrust. Then again, sometimes the FDA approves a drug even when their statisticians and external advisory committee say the evidence doesn’t justify approval, as was the case with Biogen’s drug for Alzheimer’s, Aduhelm. At the end of the day, science should inform policy. Politics should only inform science if the politicians and government agencies have been captured by companies whose number one interest is making science as profitable as possible. Ahem.
In ‘merica, and other rich spots across the globe, we’re also fighting over vaccine passports. In New York City, people can’t enter a bar, restaurant, gym, or theatre unless they show the guy or gal at the door their vaccine card. The most intriguing thing about NYC’s vaccine passport policy is that it only requires 1 dose of a vaccine, and it doesn’t matter when a person got it. For instance, folks could wake up one day, head to the drug store for their first shot of an mRNA vaccine, and then that same night, head to the bar. Since they have 1 dose, and it’s documented on an official piece of paper, they’d have no problem getting inside. In addition, no one is enforcing any sort of mask rule, even though we know that partially- and fully- vaccinated people can still easily transmit the Delta variant if they get infected. Once in the bar, they can drink their faces off, make out with the bartender, make out with whoever, puke on their way to the bathroom…even sleep on the floor if they want. Our fearless city leaders have made it clear that vaccine passports are about protecting people, but there’s a glaring Catch-22. The CDC has made it clear that someone isn’t considered fully vaccinated until 2 weeks after the 2nd dose of an mRNA vaccine or 2 weeks after 1 dose of the J&J vaccine. One could create a superspreader event with how they are currently enforcing the NYC vaccine passport policy, especially if folks let their guard down and party like it’s pre-COVID times.
There’s also a problem with fake vaccine cards, which I’ve come to learn are easy to get. While they are illegal, my feeling is that there are a lot of them out there. But is that really shocking? I mean, the printing press was invented in the 1400s, the art of forgery has come a long way, baby, and a lot of people don’t want to get vaccinated. The most amusing thing I’ve seen is people purchasing fake vaccine cards from someone who can’t spell. The forger spelled “Moderna” as “Maderna” and as a result, people are getting caught and possibly facing jail time. Where are those annoying Spelling Police when you need them?
We’re fighting over mandates…vaccine passports…but the epitome of our privilege is the fight over boosters. We’re arguing over who should get boosters and who shouldn’t. While experts agree that the over-65 crowd should get boosters because of waning vaccine-induced immunity, the vaccine’s reduced effectiveness against Delta and their high-risk age group, there’s an argument over who in the younger age groups should get them. At the end of the day, the CDC and FDA said that younger people with underlying health conditions and those who have jobs that put them at increased risk MAY get a booster, at least from Pfizer. I love that word MAY. It’s very different from SHOULD, you know. MAY leaves it up to the people, so in many cases, someone is mandated to get the vaccine but MAY get a booster. MAY also gives our regulators some wiggle room if something turns out to be unsafe with the boosters. “I said MAY, not SHOULD. It’s your fault, Jim!”
But seriously, while I applaud our regulators for at least valuing personal choice when it comes to boosters, how is the average person supposed to know what to do? I was talking to Gary, a fully vaccinated, young guy who works as a bartender, someone exposed to lots of saliva, sweat, breakup tears, and Irish blood, and he wasn’t sure if he was going to get a booster. He was concerned about its safety. He asked me what the regulators said to do, and I said, “They said you MAY get it, Gary. And the usual, please.” Gary’s a guy who is always hammered and barely washes his socks, but we’re going to let him decide if the booster shot is safe for him. Okay then.
Despite the confusion from the top, a lot of people across ‘merica are getting boosters. I saw a report that the pace of booster shots is outpacing folks getting their first or second dose. I wonder who is going to be afraid of who in that situation. The unvaccinated are always “chill” but how many boosters will it take for the vaccinated to stop being terrified of the unvaccinated? And will the boosted be afraid of the un-boosted?
The thing that kills me the most about our fight over boosters is that less than 1% of people in low-income countries are vaccinated. That means their highest-risk populations, elderly people and people with obesity, aren’t vaccinated for COVID-19. They don’t even have access to the vaccines. Meanwhile, Americans are busy defending their mandate positions with memes on Instagram and Twitter. We’re busy labeling each other as “Antivaxxer” or “Corporate Shill” because there is obviously nothing in between. We’re fighting over vaccine passports that don’t make scientific sense and arguing over whether kids at a private school should wear masks, get vaccinated, and put protective covers on their trumpets and flutes during their private music lessons. We’re behaving like rabid hyenas towards each other, but do you know what we’re not doing? We’re not calling out Big Pharma.
Big Pharma loves that we are fighting with each other because it is distracting us from the bigger picture. It’s causing us to lose sight of the forest for the trees. C’mon, people! COVID-19 is a global virus. If it gets inside someone in South America, India, Africa, etc., who then decides to hop on a plane or a boat to America, COVID comes with that person. Ironically, COVID doesn’t need a passport to cross oceans, it just does, and it can do it fast. If low-income or low-to-middle income countries can’t get ahead of COVID-19 and their people continue to get infected and sick, the global spread will continue, and new variants will form. It’s trendy to blame the unvaccinated in America for the vaccine’s reduced effectiveness, but that’s silly. Big Pharma, doctors paid by Big Pharma, and certain politicians want you to blame the Redneck devouring disinfectant behind his double-wide, but it’s not his fault. Liberals won’t like this, but he didn’t create the Delta variant. Delta came from India. Mu? Lambda? They came from South America. My point is that rich countries can’t get ahead of COVID-19 unless they help poor countries get ahead of it. And while we should want to help them because it’s the right thing to do, lots of people don’t think that way. Lots of people are narcissists and only care about themselves, so that’s why you must show them how helping poor countries helps them.
But what is Big Pharma’s role in all of this? Why should we take a break from bashing each other and start calling out the vaccine makers? Because they are putting profit before people and as a result, will prolong the pandemic.
As I said before, less than 1% of people in poor nations are vaccinated. Less than 10% of people are vaccinated in low-to-middle income countries. According to a report by Amnesty International, companies have sent less than .3% of their total vaccine supply to poor countries. Meanwhile, Pfizer and BioNTech are predicted to bring in 86 billion in revenue from COVID vaccines and Moderna is predicted to bring in 47 billion. Pfizer and BioNTech are predicted to bring in 26 billion from boosters alone in the next year, while Moderna will likely bring in 14 billion. The WHO has begged rich countries to slow down with the boosters until other countries get a chance at first doses for their most vulnerable, but the rich countries aren’t listening. There have been calls for the drug companies to share their intellectual property and allow for other countries to manufacture the vaccines, but so far, they’ve resisted. They’ve resisted, even though our current leaders initially said they support intellectual property waivers. But does it even matter what our elected officials say? In 2021, drug companies already spent 171 million on lobbying in DC. They spent 309 million in 2020…, so it’s not like they don’t control our government like a puppet.
Speaking of lobbyists, one of the largest drug company lobbying firms, Pharmaceutical Research and Manufacturers (PhRMA) posted results of a survey that concluded that most Americans were against intellectual property waivers. The trick here is to look at the questions they asked. For example, they asked Americans if poor countries should be allowed to manufacture vaccines if the vaccines would be less safe and of poorer quality. Of course, Americans answered NO to those questions. It’s like asking people if they’d support a new pizza shop coming to town if there was a chance that some slices of pizza could contain cyanide. The survey might have looked differently if they asked questions like, “would you support vaccines being made in other countries if you knew that it would help vaccinate the most vulnerable people in the world?” or “would you support poor countries making vaccines if it would help end the pandemic for all of us?” Methods, my dears, methods. The methods are the most important part of any survey or any study, not the conclusion.
One might laugh over Big Pharma’s sudden and great concern over safety and quality issues when it comes to offshore drug manufacturers. Seventy-five to eighty percent of the active pharmaceutical ingredients in FDA-approved drugs are sourced in 150 countries. That’s right, just like our clothes, socks, phones, gadgets (okay, everything) are made in some other country, our drugs are too. Do the drug companies expect us to believe that the FDA can monitor all those manufacturers in all those countries? You might remember that there have been some big recalls over drugs made in China and India that were contaminated with cancer-causing agents, NDMA and NDEA. Valsartan and irbesartan, two popular FDA-approved blood pressure medications, were recalled in 2018. Zantac and Nizatidine, heartburn medications, were recalled in 2019, and several companies had to recall Metformin, a popular drug for Type-2 Diabetes, in 2020. With all these recalls and issues with quality control, why do drug companies prefer off-shore manufacturing? It’s to save money. It’s cheap. So this idea that they all of a sudden have grave concerns over quality control when it comes to other countries making vaccines is as bogus as their claim that lowering drug prices will hurt innovation when we know all about their patent thickets and how much they spend on lobbying and marketing. Also, India is already a dynamite vaccine maker. Its Serum Institute is the largest vaccine producer by volume, and India provides most of the vaccines to the developing world. The notion that America and a handful of other wealthy nations are the only countries that can do science is snobbery. The idea that there are no smart people in poor countries who can figure out how to make vaccines is as ludicrous as saying that there are no dumb people in rich countries. It’s, again, a way to distract us from pointing out that Big Pharma is interested in one thing: big profits. Even Russia, though its vaccine has not been authorized by the WHO, has licensed its vaccine to 34 manufacturers in India and Brazil. That’s more than the US companies can say! US companies and their spokesmodels are more focused on fueling our vaccine fights, so we don’t notice how they are prolonging the pandemic. They are more concerned with getting boosters to rich countries so they can stick them in the arms of people who MAY need them. Meanwhile, nothing substantial will get to the most vulnerable in poor countries, and Big Pharma will laugh all the way to the bank.
Big Pharma has us. It has us good. It has our privileged selves between its teeth and… I’m not sure if we’re aware enough or wise enough to figure out how to break free.