Miscellany Central: A collective shift on vaccinations

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A collective shift on vaccinations

When President Joe Biden announced new federal vaccine mandates, he voiced a frustration that many vaccinated Americans feel toward those who are unvaccinated: “We’ve been patient. But our patience is wearing thin. And your refusal has cost all of us.”

But beyond speaking to people’s frustrations, Biden’s comments are his attempt to shift discussions about vaccines away from the individualist framing that’s dominated public discussions to one that’s more collective — making it clear that a few people can cause pain for many others.

Early this year, it was easier to portray vaccines as a largely individual choice. Before the delta variant, and when initial vaccine trial data came out, the evidence suggested that the shots would protect people from even mild disease, on top of nearly perfectly shielding vaccinated people against serious illness, hospitalization, and death.

This made it easy to believe the vaccines could be an individual choice: If getting the shot means you’re totally protected, then you had nothing to worry about from unvaccinated people — they only hurt themselves.

When the Centers for Disease Control and Prevention in May declared that vaccinated people no longer need to wear masks, the agency’s director, Rochelle Walensky, tapped into the individualist framing: “The science demonstrates that if you are fully vaccinated, you are protected. It is the people who are not fully vaccinated in those settings who are not protected.”

Experts, including Walensky, always cautioned that there was a nuance to this: If new variants emerged or vaccine efficacy waned, then even people who got their shots could be at risk once again. And some people still can’t get vaccinated at all (kids) or may not get the full benefit from the vaccines (some who are immunocompromised).

Delta and recent studies suggesting vaccine efficacy may be waning have put that nuance in a very bright spotlight, as Covid-19 cases, hospitalizations, and deaths have risen across the country.

A new study from the CDC, for example, found that the vaccines still provide strong protection: People who are unvaccinated are five times as likely as vaccinated people to be infected by the coronavirus, 10 times as likely to be hospitalized, and 11 times as likely to die.

But that same study also found some protection — particularly against risk of infection — had decreased, likely due to delta, waning vaccine effectiveness, or both.

Along with other recent data, this suggests that vaccinated people are still at some risk of contracting the coronavirus, even as they are still very protected from that infection leading to their hospitalization or death.

Crucially, those who are vaccinated also still seem to spread the coronavirus to some degree, although still at much lower levels than the unvaccinated.

And the more the virus spreads, the more likely it is to mutate into a new, dangerous variant — potentially one that can evade the vaccines and subsequently undo months of progress.

Put all that together and you get a less individualist story about Covid-19: Despite the strong protection from the vaccines, allowing the virus to continue to spread presents a significant risk even to those who got their shots. And that has, justifiably, led to less patience among vaccinated people, including Biden.

So Biden and other officials are pushing for a more collectivist perspective. It’s now very clear that it would be better for everyone — the vaccinated and unvaccinated alike — if as many people as possible get their shots to minimize illness and the spread of it.

But America has already massively improved access, tried to persuade the hesitant, and offered incentives. So Biden is now using what many experts previously considered a “last resort”: mandates.

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PAPER OF THE WEEK

Air pollution is a big killer worldwide

A new study by the Energy Policy Institute at the University of Chicago shows just how bad air pollution is for public health around the world.

Researchers Ken Lee and Michael Greenstone used data from their organization’s Air Quality Life Index, which makes estimates based on studies in the field, to put the effect of air pollution on life expectancy into context.

One conclusion: Globally, “the impact of particulate pollution on life expectancy is comparable to that of smoking, almost three times that of alcohol and drug use and unsafe water, five times that of HIV/AIDS, and 114 times that of conflict and terrorism.”

The majority of the life expectancy loss is in four developing nations in South Asia (Bangladesh, India, Nepal, and Pakistan), where average life expectancy is nearly six years shorter than it would be if pollution levels met the World Health Organization’s guidelines.

But developed countries are affected, too. In the US, about 10 percent of people live in a region with levels of air pollution that surpass the WHO guidelines. Those in California’s Central Valley, for example, “stand to gain up to 5 months of life expectancy if air quality were kept below the WHO guideline rather than at the 2018 level — a year when California saw intense wildfires that contributed to the pollution,” the report concluded.

A big risk is that global warming and the changes it will bring, including potentially more wildfires, will make things worse.

But there’s good news: Various governments, ranging from the US to European nations to China to Japan, have done a lot of work to reduce air pollution, with Americans on average now “exposed to 62 percent less particulate pollution than they would have been in 1970.” That’s a sign the world can make progress on this issue — if it chooses to.

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On Tuesday’s episode, Matt, Dara, Jerusalem, and I spoke about what’s gone wrong with life expectancy in the US, especially compared to our developed peers in Europe. Listen here.

Miscellany Central

Saturday, September 18, 2021

A collective shift on vaccinations

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