— It fails to promote safety or fight misinformation

by Vinay Prasad, MD, MPH 

The development of the mRNA vaccines during the COVID-19 pandemic has been the single greatest scientific advance of the pandemic, and will lead to a Nobel prize. At the same time, there are many legitimate questions and concerns about the dose, the number of shots, the interval between shots, order of vaccination, and the line between individual benefit, collective benefit, and no benefit at all. What is the best vaccination program for someone who has recovered from COVID-19? Does it vary by age? What is the optimal dosing and schedule of mRNA vaccine for adolescents? Does it vary from boys to girls — given the massive difference in rates of myocarditis? What evidence is needed to support boosters? And finally, as pediatric trials become available, what evidence is needed for regulators to decide if the risk/benefit profile is favorable?

As I look across social media, I am concerned. Clearly there is a small, but vocal minority of people who are critical — often irrationally so — of vaccination. They are wrong. But, what I see more and more, among the ranks of physicians and other professionals, is a growing minority on the other end of the spectrum. These are people who are quick to label legitimate scientific dialog as “anti-vax” or “dangerous misinformation.” In many cases, the speakers have little knowledge of the issues themselves. They couple this condemnation with a strong sense that they are “morally” correct, working to purge the world of dangerous anti-vax thinking. Ironically, they are further polarizing an already polarized debate, and worse, they are simply wrong. These are real and live issues. Intelligent scientists have to discuss these policy implications openly. The stakes could not be higher.

As we continue to investigate unanswered questions during this unprecedented pandemic, the tribalism and polarization must end. Simply raising questions about the vaccines isn’t anti-vax, so let’s not label it as such. Instead, we need to welcome new questions and invite ongoing, open discussions from medical professionals. If not, we risk poisoning progress.

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