Letter From The Editor: Leadership & vaccination resistance

Opinion

Here’s a spoiler alert. I like vaccinations.

Two of my friends growing up, one with mean leg braces and the other confined to a wheelchair, were polio victims. I’ll be celebrating World Polio Day on Oct . 24, and I was happy to learn that we’ve achieved a 99.9 percent worldwide reduction in polio cases over the past three decades. The area preventing total eradication of polio — the wild poliovirus areas of Afghanistan and Pakistan.

Then there is sub-Saharan Africa where a half million people, mostly children, die each year from Malaria where the new RTS S Malaria vaccine is a “game-changer” and the “the most exciting news in years.” Vaccinations are important to food safety for everything from protecting food servers from hepatitis A to preventing animal diseases.

And if  I did not know better, I’d say we are doing just great with vaccinations. Take the last normal school year, for example. That would be the 2019-20  school year.   Our vaccination rate for all those childhood diseases — diphtheria, measles, mumps, rubella, polio, tetanus, and whooping cough (pertussis) was 95 percent.

By contrast, the situation we’re in with the COVID-19 vaccinations in the United States is embarrassing. Something that should have been easy and straightforward is all twisted up. We are coming up on December anniversary dates when the COVID-19 vaccinations became available. Yet about 117 million Americans have yet to get their first shot.

About 216 million or 65.3 percent received at least one vaccination and  187 million Americans are “fully vaccinated.” Another 7 million of us have gone in for the “booster” shot. We are not looking good in comparison with any number of European countries and “mandate mania” has  people digging  in their heels

If public attitudes toward vaccinations are changing in some permanent way, we are going to be in trouble. Where is this mandate approach going to step? No SNAP benefits without vaccinations? No child credits? I think vaccination resistance may be a symptom, not a disease.

Who’s to blame is not important, but the need to accept that FDA’s Gold Standard and CDC’s Papal infallibility both took hits during the pandemic, many of which were self-inflicted. There’s been a crisis communications failure of epic proportions.

If federal public health agencies do not understand how they’ve been weakened by the pandemic, there’s probably not much we can say that will be helpful to the sorry state in which they find themselves. We’ve been left with no one in public health with the credibility needed to talk doubters into getting vaccinations.

I’ve wondered whether this shaky leadership might have been avoided if former FDA Commissioner Scott Gottlieb had not quit ahead of the pandemic. He left government on April 5, 2019, well  before the bad news involving the Wuhan Institute of Virology, 

With his book and smooth comments on television, it’s reasonable to wonder if we’d ever would have heard of Tony Fauci if Scott Gottlieb was running FDA.

Dr. Stephen Hahn, who took over as Commissioner on Dec. 17, 2019, is a cancer doctor. He was adept at running big organizations, but viruses were not his thing.  COVID-19 did put Hahn on television, but he did not look comfortable.

The CDC’s problem was falling right out of the box when our confidence in its ability to perform remained high. It never really recovered from the early distribution of flawed coronavirus test kits that were distributed early in the pandemic to public health laboratories. Poor quality control was blamed, and the faulty test kits put the U.S. behind other counties testing millions before we recovered,  

It damaged Director Robert R. Redfield and some questioned CDC’s actual past performance in light of the fairly recent — 2014 — breach of Ebola in one of its Atlanta laboratories. The investigation found the deadly virus was incorrectly marked and moved within the facility. The reason people went over that ground again, which was pre-Redfield, is because a lab breach at the Wuhan is a possible cause of the pandemic.

In the new administration, Dr. Rochelle P. Walensky is CDC director and Janet Woodcock is Acting Commissioner of FDA. Dr. Walensky, who is rarely upbeat, has made several important announcements so far, but critics have found her erratic and questioned the influence she gives the teacher’s union to CDC’s guidance.

Woodcock, a veteran FDA executive, has been told the president wants to put someone else in the job. And the White House has not named an Under Secretary for Food Safety at USDA, which means the administration is running out of the pandemic without two of the top public health positions in the government being filled.

One has to wonder if America’s historically pro-vaccination culture is changing for lack of this credible leadership.  

 So for reasons that we are told involve their fears, religious beliefs, or unique medical issues, for some of the 117 million Americans who still have not obtained COVID vaccinations that have been available for free for the past year.   

We are going to have to wait and see if beliefs about vaccinations in the United States have really changed or if the hesitancy is just more pandemic fear and paranoia.   

 It’s beginning to look like about one-third of the country has either changed its beliefs or has serious second thoughts. Opinion experts say that while attitudes are moveable, beliefs like these are hard to change. The pandemic was more of a dramatic event for some than others.

Our herd has not received sufficient vaccines yet for our population to enjoy immunity from COVID-19. That’s too damn bad, but let’s not shoot anyone over it.   There are other ways of persuasion.

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