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A Vaccine By Any Other Name
It feels like years ago, but it was only Monday that the FDA fully approvedthe Pfizer COVID vaccine. That was a serious milestone. (Moderna also completed its submissionfor full approval this week. J&J is a little farther out since it was the last to get its emergency authorization, but all are expected to be approved before 2022.) So, good news, apparently there's going to be a 2022.
This approval doesn't mean that Pfizer is superior to the others. J&J may still prove best in the long haul. At least, for some people. There was promising news this week about the company's booster effectiveness—in terms of creating a glorious surge in antibodies. What's unknown is whether that's truly necessary to prevent illness, or whether it amounts to antibody-virtue-signaling. TBD.
In any case, now is not the time to worry that you chose poorly. (Unless you chose to use J&J baby powder for 30 years, in which case you may be owed $29.4 million, as a California jury sadly affirmed,because talcum powder can contain asbestos.)
It's an uncertain moment in the world of vaccines. While the FDA is still reviewing approval of initial doses, drug companies have moved on to studying boosters. They're walking a delicate line of attempting to sell additional shots while also selling their initial doses. (This isn't necessarily bad, but it feels sort of like when you buy a computer or phone or car or leaf blower—having chosen it based on definitive promises of superior quality—and then the company suddenly tries to sell you a warranty, or a huge plastic protective case, because, oh, that thing is going to shatter the moment you walk out the door.)
This first FDA approval is, truly, the most consequential. And not just because it changes the game for Pfizer. The company can now charge even more for the vaccine, if it wants to. (Spoiler: It does. It's a publicly traded company, so any CEO who leaves a dollar on the table will be evaporated and replaced by one who won't. To wit, Pfizer has already begun raising prices in Europe.) The approval also gives the company a head start at marketing. Pfizer can now run ads for the vaccine (in the U.S. and New Zealand; all other countries having deemed pharmaceutical advertising manifestly unethical). So those will probably be ... terribly dark.
And they'll be made only weirder by the company using the proprietary name they've given their vaccine: Comirnaty.
If I had an editor here, this is where they'd tell me to move on. But ... this name. It's just so extremely unfortunate. Pfizer's explanation is that it's a portmanteau of four words (COVID-19, immunity, mRNA, and community) ... which is ... too many words. At their best, portmanteaus are ugly—spork, Brangelina, frenemy, mansplaining, infotainment. But those serve their purpose, at least, because they combine two recognizable words into a new, pronounceable word. When you take four words and blend them together, you've lost the plot. I mean, if we want to talk about nucleic acids, I'm a mashup of my four grandparents (Eleanor, Norma, Richard, and James), and I am not named Elnorcharjam. Nor would they want that for me.
And we're not just talking about naming some random baby here. This is important. It's a $33.5 billion product that's supposed to appeal to potential consumers—not disorient or infuriate them. In all seriousness, lots of people who are unsure about getting vaccinated cite concerns that this high-tech mRNA approach is unnatural or "rushed" or "too new" and so ... giving it a name that sounds like either an accidental typo or a fancy new word that's deliberately unpronounceable by the human tongue does not seem likely to assuage such concerns.
To be fair, naming new medications is not straightforward. The FDA has a 42-page document detailing restrictions. Most of it comes down to making sure the name isn't too similar to any other drug's, or implying certain benefits that can't be delivered upon (e.g. PermaViagra is out), while also being only a single word. So ... you basically have to invent words. And that's why drugs so often sound like a really good draw of Scrabble letters as the game is ending, where you just take your Qs and Zs and toss them onto the board.
This might make sense from an intellectual-property-rights perspective, but from a public-health-messaging perspective the inscrutable name is a setback. One more reason we need a totally new system to develop and produce vaccines. (Short of that, personally, I would've named the vaccine Elnorcharjam.)
Okay, now I can move on. We're getting to the horse paste, I promise.
"Don't Vax On Me"
The most consequential thing that this week's FDA approval did was to open up a new world of vaccine mandates. Some came on instantly. More are in the works. These can tread into dicey legal territory when a vaccine isn't fully approved. But now that it is? It's just good business. It's sort of like banning smoking in your office. You may lose a few employees who insist that they can't do serious deals without the sweet taste of tobacco in their respiratory tract. But in most cases, even more employees/customers would prefer not to work in a cubicle where they have to constantly inhale smoke.
Unlike most of my metaphors, this one maybe actually isn't far off. Businesses should offer their employees and customers air that is not laden with virus, just as most now offer air not laden with cigarette smoke. It would be good for the bottom line. (Plus: fewer employee deaths.)
Disney and Walmart already set the tone for such requirements. But when it comes to mandates (not a portmanteau), we're still in a ripping-off-the-BandAid phase. People will complain quite a lot about vaccine and mask mandates—sort of like how they complained that bans on smoking in restaurants were Orwellian big-government overreach. It was once the same with seat belt laws, too, which most states now have, and people comply with without concern that buckling represents a slide into communism. (Although, fun fact, in New Hampshire, the state whose motto is "live free or die," you're still at liberty to choose the latter.)
But usually, eventually—except in New Hampshire—the notion that safety is at odds with freedom fades. As conditions improve, people move on. They do the safe thing, and they live longer lives, using their time to complain about new forms of Orwellian big-government overreach.
(Speaking of which, George Orwell died at 46 of tuberculosis, which is now preventable with a vaccine. Which you'd know if you followed Bustle on Instagram.)
I also wish we didn't need mandates. We wouldn't if people did their part. But even if I were totally ambivalent about continuing to exist, I'd still get vaccinated, because I want this pandemic to end. It's very old, and needs to end.
Still the message of looking out for one another and ending this pandemic together is clearly not resonating with millions of people. American adults have now had ample opportunity to do their part. Yet still more than 1,000 Americans are dying of COVID every day, while vaccine doses fly headlong into the trash. As of August 1, more than a million doses had been wasted in just 10 states.
We're treading in a domain of belief that defies politics. Part of it draws on rugged individualism. Many still-unvaccinated American adults are operating under the false assumption that the disease just somehow isn't going to affect them. Or, if it does, they won't get too sick, because they're not elderly, and they have a membership to Planet Fitness. Concern about transmitting the virus to other people isn't evidently on their cost-benefit map. That's a you problem.
(If I can come back to the vaccine-name issue just once more: This is why the incorporation of "Community" into the vaccine name so misses the point. People who truly care about their community are already vaccinated. At this point, a better word to allude to might be "Freedom." So .... CofreedimRNAnty? You're welcome.)
Hence the need to put the cost-benefit into immediate, individual terms, in order to safely open schools and businesses and all else. I support all kinds of industry-specific and location-specific nudges, like Juliette Kayyem's proposal that vaccination should be required in order to fly on commercial airlines. Not because I'm especially worried about transmission happening on planes themselves (where ventilation is great), but because it's a nudge that will get people to decide to do their part. And then, when they fly home for Thanksgiving, instead of seeding the dinner table with a new Upsilon Strain (or wherever we're at then), things will just be okay. Everyone will eat and argue and eat, and things will just be okay.
Barring that, if these rates of viral transmission keep up—also barring some ultra-effective nasal vaccine coming to market (maybe call it Navramit9fqzy?)—we all should expect to get infected in coming years. Yes, even if you already had COVID. The choice is really just whether you'd prefer to face these infections with a vaccine-trained immune system, or without.
So the bottom line that's failing to be communicated: Mandates do not come at the expense of freedom. Suppressing a highly contagious, deadly respiratory virus creates freedom.
The Horse Paste Is a Grift
If you're still reading this, you've probably not been eating horse-deworming paste. Even if someone on a forum referring to him/herself as "a horse" has been telling you to. Time's Vera Bergengruen has an excellent story this week on how a small group of "doctors" is running the grift convincing people to forego vaccination and, instead, pay them to prescribe an old anti-parasite medication called ivermectin.
Preliminary studies like this one of 19 people in search of an emergency, low-cost aid for countries yet without access to vaccines suggested that the medication may potentially slightly decrease viral load in people with COVID-19. But clinical trials have not borne this suggestion out. Nonetheless, prescriptions in the U.S. have increased 10-20 fold since last year. (The medication has legitimate uses in treating roundworm infections. Though COVID-19 is, of course, a virus, not a worm.)
People who can't get prescriptions—or who can't get appointments with charlatans who are writing such prescriptions—have been buying and hoarding a livestock analog paste. Tractor Supply Co sells it in "apple flavor that horses love!" when it's not sold out.
Reports to poison control have tripled, and people have been hospitalized. The tragedy is that people are clearly afraid of COVID-19, and they are trying to protect themselves and/or people they love. They've fallen victim to people who don't care if they live or die. Some veer this bizarre direction because they're rightly skeptical of pharma's profit motives, and the healthcare system's motives. These industries have spent decades driving people who trusted them into bankruptcy and chronic illness, while Trump et al worked to defund and undermine the FDA—the ostensible beacon of what's actually worthwhile, and which everyone is now begging to move more efficiently. And now we're all asked to trust this agency and the industry that has failed us so repeatedly and profoundly. Skepticism is genuinely warranted.
I'm clearly skeptical of the drug industry. Pharma has incentives to develop drugs that we barely need, and to have us take them often, and possibly in higher doses than would be ideal. The maximizing of profit comes at the cost of prioritizing solutions that would help you stop needing to take the drug. This is a serious problem. But in that skepticism it's also possible to fall blindly into someone else's malicious pitch. The pharma industry is, despite its myriad failings, at least still held to a minimum standard. It can only sell things that are deemed safe and effective, and those products are subject to ongoing scrutiny. If your baby powder harms a single person, for example, you could lose $29.4 million. This could jeopardize your quarterly earnings, and your position as CEO. You could be evaporated. So there is, at least, some degree of accountability.
By contrast, the people who tell your family to take horse paste are more like a circus that sets up camp one day and vanishes the next. You're on your own. As the FDA tweeted, "You are not a horse. You are not a cow. Seriously, y'all. Stop it." But of course the calls to stop it are probably themselves further incentive to double down. Defiance is the goal. Yelling louder is not a solution; it only makes things worse. But we keep doing it, and not learning.
I don't blame vaccine-hesitant people who are uncertain. I doblame people who profit from misleading and misinforming them. I blame the drug and health-care systems that have alienated people to such a degree that they readily do the opposite of any official recommendation. At this point, the only way to get people to stop eating horse paste might be for Dr. Fauci to recommend it.
I mean, I hope he doesn't. Though it'd be a hell of a way to sign off.
Take care, have a good weekend.
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