The Washington PostDemocracy Dies in Darkness

The Health 202: Americans worry a coronavirus vaccine will be rushed. Trump's rhetoric isn't helping.

with Alexandra Ellerbeck

President Trump has made the race for a coronavirus vaccine front-and-center in his reelection effort: He's suggested one could be available by Election Day – and now a brand new ad proclaims “the finish line is approaching" a vaccine that will help bring the economy back to life. 

But this strategy could undermine the confidence of Americans when a vaccine eventually is approved, as more worry the whole process is being rushed – possibly for political reasons. 

The share of American voters saying they would readily get vaccinated this year has declined since July. 

According to a CBS News poll conducted last week, 21 percent said they would get a coronavirus vaccine immediately if it were free, compared with 32 percent who gave that answer in late July. The poll also found:

  • Fifty-eight percent said they’d consider getting vaccinated but would wait first to see how doing so affects others.
  • Twenty-one percent said they would never get a coronavirus vaccine.

Trump escalated the political stakes by telling a crowd in Winston-Salem that Democratic presidential nominee Joe Biden and his running mate Kamala Harris are questioning the safety of a potential vaccine solely to make him look bad.

"Joe Biden and Kamala Harris are undermining science and risking countless lives with their reckless anti-vaccine rhetoric," Trump said. "They're trying to disparage it. They're trying to make it politics."

But polling finds there’s broad perception that drug developers are pushing forward too quickly on a coronavirus vaccine, perhaps to the detriment of safety measures. 

  • When asked how they would respond were a vaccine to be announced in 2020, 65 percent said their first thought would be: “It was probably rushed without enough testing.”
  • Thirty-five percent said their first thought would be: “It’s a scientific achievement to find a vaccine that fast.”
Americans' lack of confidence in a vaccine is discouraging but not surprising to health experts.

The share of people who actively oppose vaccines is still very small in the United States. But the number of people who feel unsure about them is on the rise — leading the World Health Organization to declare vaccine hesitancy among its top 10 priorities for 2019.

And experts fear Trump’s rhetoric is feeding the perception that the Food and Drug Administration is rushing the whole process to get a vaccine before Election Day. He has said one could be ready “before a very special date” and has pressured his health secretary, Alex Azar, to speed up the process. 

Biden and his running mate Kamala Harris have conficting messages on a vaccine created under the Trump administration.

Biden has said he's worried people will be reluctant to take a “really good vacccine” because Trump has said so many untrue things about the pandemic. 

“If I could get a vaccine tomorrow I’d do it, if it would cost me the election I’d do it," Biden said on Labor Day. "We need a vaccine and we need it now.”

Yet Harris seemed to feed into that very perception by saying she wouldn't trust Trump's word that a vaccine was safe and suggesting scientists are “muzzled” because the president is focused on getting reelected.

Experts tell me there’s no evidence yet that the FDA is diverging from long-established procedures for analyzing and approving new vaccines.

We explained the process more fully in yesterday’s Health 202. FDA leaders are strictly adhering to previously set standards for moving through the approval process and assuring staff members that political noise won’t influence the agency’s decisions, Bloomberg News reported.

Daniel Salmon, director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health, stressed that there is a long-standing pathway for approving vaccines — and as long as the FDA sticks to that pathway, the public can have confidence in the process.

“It’s all about the process,” Salmon said. “Don’t love or hate the product based on your politics. Base it on science and a process.”

The pharmaceutical industry is also promising adherence to protocol.

The chief executives of nine drug companies pledged not to seek regulatory approval for coronavirus vaccines before safety and efficacy have been established in Phase 3 clinical trials, Christopher Rowland reported.

It’s “an extraordinary effort to bolster public faith in a vaccine amid President Trump’s rush to introduce one before Election Day,” Christopher writes.

“We believe this pledge will help ensure public confidence in the rigorous scientific and regulatory process by which covid-19 vaccines are evaluated and may ultimately be approved,” the executives wrote in their joint statement. 

The signers include leaders of Moderna and Pfizer, who are both carrying out final-stage trials, along with AstraZeneca, Johnson & Johnson, Merck, Novavax, BioNTech, Sanofi and GlaxoSmithKline.

One of those companies, AstraZeneca, announced yesterday it is putting a hold on its late-stage trials worldwide, as it investigates a serious side-effect in a trial participant in the United Kingdom. The company is testing a vaccine developed by Oxford University.

"We are working to expedite the review of the single event to minimize any potential impact on the trial timeline," AstraZeneca said in a statement. "This is a routine action which has to happen whenever there is a potentially unexplained illness in one of the trials, while it is investigated, ensuring we maintain the integrity of the trials."

Naming the initiative “Operation Warp Speed” might not have been the best messaging approach.

The administration announced its effort in the spring to accelerate the development, manufacturing and distribution of coronavirus vaccines and treatments. Operation Warp Speed is a catchy-sounding name, but Salmon said he worries it could worsen vaccine hesitancy.

“Operation Warp Speed might be the worst name ever because it implies we’re cutting corners,” Salmon told me.

“By naming it in a way that emphasizes speed, it gives the impression that corners are being cut, and so far that hasn’t been the case,” he added.

Ahh, oof and ouch

AHH: Senate Majority Leader Mitch McConnell (R-Ky.) unveiled a slimmed-down coronavirus relief bill on Tuesday.

“A month after bipartisan talks collapsed on Capitol Hill, McConnell is aiming to pressure Pelosi and Senate Minority Leader Charles E. Schumer (D-N.Y.) by presenting a GOP package that would spend around $500 billion on some key priorities including small businesses, enhanced unemployment insurance, child care, the post office, coronavirus testing and schools, Erica Werner reports

McConnell announced plans for a vote later this week, but the bill, which lacks support from Democrats, is almost certain to fail. House Speaker Nancy Pelosi (D-Calif.) called the measure “pathetic,” and McConnell may even see some defections from his own party.

“This emaciated bill is only intended to help vulnerable Republican Senators by giving them a ‘check-the-box’ vote to maintain the appearance that they’re not held hostage by their extreme right-wing that doesn’t want to spend a nickel to help people,” Pelosi and Schumer said in a joint statement.

The bill represents significantly less investment than what Republicans were discussing with Democrats before talks broke down a month ago. It would also create a liability shield that would protect some companies from coronavirus-related lawsuits. As of Tuesday, there were no signs of negotiations restarting. In addition to pressure over a targeted coronavirus relief bill, lawmakers face a rapidly approaching deadline to agree on a federal budget by October to avoid a government shutdown. 

Former labor secretary Robert Reich tweeted:

McConnell blamed the Democrats for the lack of a relief bill:

OOF: USAID will shut down its coronavirus task force on Wednesday.

The decision is being met with concerns by some who fear it will lead to greater dysfunction at USAID, which already faces personnel and structural turmoil,” Politicos Nahal Toosi reports. “Others, however, say the task force was poorly managed and that its functions can be delegated.”

USAID was central to global aid during the pandemic, including sending ventilators to other countries, but the agency also faced backlash over reports that aid was not coordinated with U.S. requests for protective equipment. Recent reports suggest internal turmoil at the agency over restructuring and tensions between career officials and political appointees.

While officials pointed out that the task force was meant to be temporary, its shutdown comes as the global death toll for the virus nears 900,000. A new “Readiness Unit” is meant to help transition some of the task forces functions to other agencies and departments, including a new temporary planning cell within USAID called “Over the Horizon.”

“The decision to end the task force also comes as President Donald Trump and his aides downplay the pandemic in the run-up to November’s elections,” Nahal writes. The White House has ended its regular coronavirus briefings, and during the Republican National Convention, economic adviser Larry Kudlow spoke of the pandemic in the past tense.

OUCH: Farmworkers are among those hardest hit by the coronavirus.

“For several weeks, many of the places that grow the nation’s fruits and vegetables have seen disproportionately high rates of coronavirus cases — a national trend that, as harvest season advances in many states, threatens already vulnerable farmworkers, their communities and the places they work,” Politicos Helena Bottemiller Evich, Ximena Bustillo and Liz Crampton report.

While theres no official count of the number of farmworkers who have been infected with or died of the virus, a Politico analysis shows that counties with some of the highest rates of coronavirus infection are also top agricultural producers. These rural counties may also have less health-care and public health infrastructure to combat the virus. Many farmworkers are also undocumented and may fear reporting virus symptoms to employers or state health workers.

Meanwhile, most states and the federal government have declined to implement safety standards for agricultural workers during the pandemic.

“The Trump administration has repeatedly declined to impose mandatory safety requirements for agricultural workplaces,” Politico reports. “No federal assistance has been designated to help farmers obtain personal protective gear for their laborers, like it has for other essential workers like nurses and police officers.”

Coronavirus numbers

Coronavirus cases and deaths are down slightly over the past week but may be plateauing.

“The coronavirus pandemic appears to be leveling off in most of the United States, with new cases, deaths and hospitalizations all down over the past week, but the plateau leaves the country with high and persistent infection numbers and worries of a post-Labor Day surge in some areas,” Anne Gearan and Rachel Weiner report.

The number of new cases reported each day has remained steady at about 40,000 over the past week, down from a peak of more than 70,000 in July. That could mean the pandemic is leveling off, but at a rate that is twice as high as the beginning of the summer.

With flu season starting and colder weather driving people to socialize indoors, experts say it will be difficult to drive cases down any further without restrictive health measures that are politically unlikely. Some areas could also see a surge tied to the Labor Day holiday.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told The Washington Post that it made sense to think of coronavirus cases not as waves but as spikes followed by plateaus. 

“This is just one big forest fire of coronavirus, and it will burn hot wherever there is human wood to burn,” he said. “If you don’t put the fire out completely, and then you walk away from it, it’s going to start burning again in days.”

Coronavirus latest

  • Scientists are getting a clearer sense of why older people are so much more likely to die of the virus. It’s not only the fact that they are more likely to have other underlying conditions, but also that the aging immune system is more easily overwhelmed and sometimes overreactive, the New York Times’s Veronique Greenwood writes.
  • The coronavirus hit tribes hard — more than 20 percent of confirmed coronavirus cases in Montana are among Native Americans — leading to shutdowns and curfews, which in turn are hampering efforts by tribes to conduct the 2020 Census. As the Trump administration pushes officials to speed up the timeline for the census, tribal leaders worry that if they don’t get accurate numbers for the once-in-a-decade count, they could lose federal money flows for housing, schools and health care, the Associated Press’s Matthew Brown, Iris Samuels and Lindsay Whitehurst report.
  • Ground Zero workers with health problems developed as a result of exposure to toxic materials at the site of the Sept. 11, 2001, terrorist attacks are now finding that those chronic conditions lead to more severe cases of covid-19, the Wall Street Journal reports.
  • A study from a California research group says 260,000 coronavirus cases could be tied to a motorcycle rally in Sturgis, S.D. The study, which has not been peer-reviewed, looked at cellphone data to track changes in case rates in areas that sent the most bikers to the rally, arriving at estimates orders of magnitude higher than the 129 cases identified by the South Dakota Department of Health through contact tracing. The report has faced pushback from Gov. Kristi L. Noem (R), the Sioux Falls Argus Leader’s Megan Raposa reports.
  • New York is mandating that K-12 schools report their number of positive coronavirus cases to the state’s health department. Colleges are also required to report positive cases and may be forced to switch to all remote classes if that number goes above 100, Reuters’s Nathan Layne reports.
  • Workers with underlying health conditions that put them at higher risk of contracting the virus are increasingly looking for protections under the Americans With Disabilities Act, which requires workplaces to offer reasonable accommodations for those with disabilities, Alexandra Ellerbeck reports for the Center for Public Integrity.

Elsewhere in healthcare

Voters in red states will decide whether to legalize medical or recreational marijuana in November.

“Five of the six states with ballot questions lean conservative and are largely rural, and the results may signal how far America’s heartland has come toward accepting the use of a substance that federal law still considers an illegal and dangerous drug,” Kaiser Health News’s Justin Franz reports.

Mississippi and Nebraska will vote on measures to allow medical marijuana, while South Dakota voters will vote on ballot measures related to both medical and recreational marijuana. Three states — Montana, Arizona and New Jersey — already allow medical marijuana but will vote on whether to legalize recreational sales of the drug.

Changing demographics, examples of legalization in neighboring states and the presence of an established medical marijuana program in those states that allow it may all contribute to changing attitudes around a legalization push that would have been hard to imagine even a few years ago.  

Sugar rush

National arts reporter Geoff Edgers went live on Instagram with musician Yo-Yo Ma on July 31. (Video: The Washington Post)