The Bad-Faith “Rationale” for Halting NIH Support for mRNA Vaccine Research
Despite HHS leadership claims, mRNA vaccines are safe, effective, and scalable. More federal investment is needed to improve them to confront disease threats.
In an OpEd to the Washington Post on August 12th, Jay Bhattacharya, the NIH Director, explained the purported rationale for halting federal support for mRNA based vaccines: “[A]s a vaccine intended for broad public use, especially during a public health emergency, the platform has failed a crucial test: earning public trust." In doing so, the NIH Director failed to acknowledge the role of HHS leadership and anti-vaccine influencers in undermining the public trust, just days after a fatal attack on CDC’s main headquarters in Decatur, Georgia.
Instead, Bhattacharya continues to sow doubt by questioning the extent to which mRNA vaccines were effective in saving lives. In his words: “Still, I do not believe the mRNA vaccines caused either mass harm on the one hand or saved 14 million lives on the other. Those estimates swing wildly based on speculative modeling, not concrete evidence. A recent modeling study concluded that the global coronavirus vaccination campaign saved 2.5 million lives from 2020 to 2024, mainly among the elderly.”
It is notable that even the low range of estimates implies that vaccines developed in 2020 against a novel coronavirus saved 2.5M lives. This level of impact in the US and globally should be the basis of expanded research rather than less. It also notable that the cited study claiming lower levels of impacts was led by John Ioannidis, a Stanford University faculty member. Bhattacharya and Ioannidis co-led a flawed serological survey of COVID infections conducted in April 2020 in Santa Clara, California that significantly under-estimated the infection fatality rate of COVID.
Bhattacharya got it badly wrong, then.
He keeps getting it wrong, now.
The Santa Clara serological survey is a central element addressed in my long-form effort in Asymptomatic to unpack how the silent transmission of COVID represents a double-edged sword. Diseases that cause less harm to individuals can cause catastrophic harm to populations. Precisely so, it is essential to be cautious in inferring how often infections are asymptomatic – the work of Bhattacharya and Ioannidis badly overestimated the number of missed (silent or subclinical) infections and helped drive an alternative narrative: COVID was no worse than the flu. The accelerating advocacy for COVID revisionism driven by grievance comes with a cost, from degradation of public health to the undoing of mRNA vaccines. We will have to pay this back, with interest.
The ability of COVID to spread presymptomatically (before symptoms) or from those who never developed symptoms meant that many would be infected unwittingly. For the vast majority of individuals, COVID was unlikely to lead to hospitalization or worse. So, if COVID could be mild or even asymptomatic for many, then why did it cause such catastrophic effects?
The threat posed by diseases reflect the product of the number of people infected and the fraction of severe outcomes, when accounting for risk stratified by age and other factors. COVID’s ability to spread silently meant there were more infections, some of which were severe. Per-individual, COVID was far less dangerous than SARS-1 or Ebola for that matter. Yet COVID caused far more fatalities. After an initial phase, estimates of the infection fatality rate varied between 0.5% to 1% (depending on demographics, decreasing for younger and increasing for older populations).
This was why those of us working on COVID response were so concerned.
A disease that could spread to ~3 new individuals for each infected individual could potentially infect 80% of the population. If COVID caused fatalities in 1 in 200 individuals then the pandemic was likely to cause more than 1M fatalities in the US. If COVID caused fatalities in 1 in 100 individuals then the pandemic was likely to cause more than 2M fatalities in the US. Analysis of excess mortality suggests that ~1.2M Americans died in the first two years of the pandemic. Of course, there are important questions to ask regarding the scope and efficacy of interventions. But, ongoing efforts to diminish COVID’s impact seem unwilling to confront the massive number of cases, hospitalizations, and lives lost. The impact would have been even worse if not for the rapid development and deployment of safe and effective vaccines.
Precisely so, Bhattacharya’s OpEd is equally problematic given what it omits. The decision to distribute mRNA vaccines at scale was based on a randomized study of >40,000 participants that evaluated the efficacy of vaccines in stopping symptomatic disease compared to a placebo. As described in a landmark, late 2020 publication in the New England Journal of Medicine, the mRNA COVID vaccines were found to be both safe and effective, reducing symptomatic illness by approximately 95%. This is not a question, as the NIH Director claims in his OpEd, of stepping back from a 'promising' technology.
The record is clear: the mRNA vaccine technology proved successful in record time.
Precisely because the vaccines were effective, the risks surrounding COVID infections have dropped tremendously. There are legitimate and interesting questions to ask on the frequency, design, and recommendations surrounding COVID vaccines. The virus continues to evolve, new variants will emerge, but people who were vaccinated were and are far less likely to have a severe outcome given a breakthrough infection. Moreover, COVID is not the only present or future disease threat.
Yes, public health groups should have been clearer that vaccines were meant to reduce symptomatic infections – and that a mild breakthrough infection should be viewed as a positive outcome relative to the alternative. But instead of reaching 80% levels of vaccine coverage in 2021, attitudes towards COVID vaccines shifted. Vaccine hesitancy – driven in part by Sec. Kennedy and anti-vaccine influencers – led to tragedy. Consensus estimates suggest that >200,000 lives could have been saved in the US between Spring 2021 and Fall 2022 with timely vaccination. But one would never know this from reading the OpEd.
As described in a trio of letters in response to Bhattacharya’s OpEd, both HHS and NIH are going in the wrong direction. Multiple scientists – myself included – have spoken out on the record against the NIH decision to step away from mRNA vaccine technologies. There are multiple, long-form pieces available that critique the bad-faith rationale – including via Rasmussen Retorts – and short pieces that focus on the growing nexus of misinformation and violence – including from Ben Lopman.
Rather than accelerating the dismantling of American leadership in science, the NIH should recommit to supporting mRNA vaccine development as part of a portfolio of technologies while restoring grant funds to researchers whose federally funded awards on vaccine hesitancy and misinformation have been terminated.
Our health and economy are at stake.
Simply shortsighted not to research mRNA further!
It’s mind boggling to me how the severity of this pandemic can be downplayed by this administration and so many citizens. Anyone who knew anyone in the health field particularly in ERs at the time. has the recall of how awful things were. How is it so easy for others to say “no big deal”. Crazy.