One of many regrettable features of the Trump era is the way that the president’s lies and conspiracy theories have seemed to vindicate some of his opponents’ most fatuous slogans. I have in mind, in particular, the claim that has echoed through the liberal side of coronavirus-era debates — that the key to sound leadership in a pandemic is just to follow the science, to trust science and scientists, to do what experts suggest instead of letting mere grubby politics determine your response.
Trump made this slogan powerful by conspicuously disdaining expertise and indulging marginal experts who told him what he desired to hear — that the virus isn’t so bad, that life should just go back to normal, usually with dubious statistical analysis to back up that conclusion. And to the extent that trust the science just means that Dr. Anthony Fauci is a better guide to epidemiological trends than someone the president liked on cable news, then it’s a sound and unobjectionable idea.
But for many crucial decisions of the last year, that unobjectionable version of trust the science didn’t get you very far. And when it had more sweeping implications, what the slogan implied was often much more dubious: a deference to the science bureaucracy during a crisis when bureaucratic norms needed to give way; an attempt by para-scientific enterprises to trade on (or trade away) science’s credibility for the sake of political agendas; and an abdication by elected officials of responsibility for decisions that are fundamentally political in nature.
The progress of coronavirus vaccines offers good examples of all these issues. That the vaccines exist at all is an example of science at its purest — a challenge posed, a problem solved, with all the accumulated knowledge of the modern era harnessed to figure out how to defeat a novel pathogen.
But the further you get from the laboratory work, the more complicated and less clearly scientific the key issues become. The timeline on which vaccines have become available, for instance, reflects an attempt to balance the rules of bureaucratic science, their priority on safety and certainty of knowledge, with the urgency of trying something to halt a disease that’s killing thousands of Americans every day. Many scientific factors weigh in that balance, but so do all kinds of extra-scientific variables: moral assumptions about what kinds of vaccine testing we should pursue (one reason we didn’t get the “challenge trials” that might have delivered a vaccine much earlier); legal assumptions about who should be allowed to experiment with unproven treatments; political assumptions about how much bureaucratic hoop-jumping it takes to persuade Americans that a vaccine is safe.
And the closer you get to the finish line, the more notable the bureaucratic and political element becomes. The United States approved its first vaccine after Britain but before the European Union, not because Science says something different in D.C. versus London or Berlin but because the timing was fundamentally political — reflecting different choices by different governing entities on how much to disturb their normal processes, a different calculus about lives lost to delay versus credibility lost if anything goes wrong.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Then there’s the now-pressing question of who actually gets the vaccine first, which has been taken up at the Centers for Disease Control and Prevention in a way that throws the limits of science-trusting into even sharper relief. Last month their Advisory Committee on Immunization Practices produced a working document that’s a masterpiece of para-scientific effort, in which questions that are legitimately medical and scientific (who will the vaccine help the most), questions that are more logistical and sociological (which pattern of distribution will be easier to put in place) and moral questions about who deserves a vaccine are all jumbled up, assessed with a form of pseudo-rigor that resembles someone bluffing the way through a McKinsey job interview and then used to justify the conclusion that we should vaccinate essential workers before seniors … because seniors are more likely to be privileged and white.
As Matthew Yglesias noted, this (provisional, it should be stressed) recommendation is a remarkable example of how a certain kind of progressive moral thinking ignores the actual needs of racial minorities. Because if you vaccinate working-age people before you vaccinate older people, you will actually end up not vaccinating the most vulnerable minority population, African-American seniors — so more minorities might die for the sake of a racial balance in overall vaccination rates.
But even if the recommendation didn’t have that kind of perverse implication, even if all things being equal you were just choosing between more minority deaths and more white deaths in two different vaccination plans, it’s still not the kind of question that the C.D.C.’s Advisory Committee on Immunization Practices has any particular competency to address. If policy X leads to racially disparate death rates but policy Y requires overt racial discrimination, then the choice between the two is moral and political, not medical or scientific — as are other important questions like, “Who is actually an essential worker?” or “Should we focus more on slowing the spread or reducing the death rate?” (Or even, “Should we vaccinate men before women given that men are more likely to die of the disease?”)
These are the kind of questions, in other words, that our elected leaders should be willing to answer without recourse to a self-protective “just following the science” default. But that default is deeply inscribed into our political culture, and especially the culture of liberalism, where even something as obviously moral-political as the decision to let Black Lives Matter protests go forward amid a pandemic was justified by redescribing their motor, antiracism, as a push for better public health.
When we look back over the pandemic era, one of the signal failures will be the inability to acknowledge that many key decisions — from our vaccine policy to our lockdown strategy to our approach to businesses and schools — are fundamentally questions of statesmanship, involving not just the right principles or the right technical understanding of the problem but the prudential balancing of many competing goods.
On the libertarian and populist right, that failure usually involved a recourse to “freedom” as a conversation-stopper, a way to deny that even a deadly disease required any compromises with normal life at all.
But for liberals, especially blue-state politicians and officials, the failure has more often involved invoking capital-S Science to evade their own responsibilities: pretending that a certain kind of scientific knowledge, ideally backed by impeccable credentials, can substitute for prudential and moral judgments that we are all qualified to argue over, and that our elected leaders, not our scientists, have the final responsibility to make.