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The most pernicious anti-vaccine talking point

Florida Surgeon General Joseph Ladapo gestures as speaks alongside Gov. Ron DeSantis (R) last week. (Chris O'Meara/AP)
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Politics is a business that rewards saying things that are technically true — or at least not provably false — in the service of promoting one’s viewpoint.

Such is the case with the most ascendant and pernicious talking point among anti-vaccine activists, mandate critics and even just conservatives who are playing to the vaccine-skeptic crowd: that the coronavirus vaccines don’t prevent infections or the transmission of the virus.

The talking point is everywhere these days, including among those who say that they are pro-vaccine. It’s also utterly misleading, even in the cases in which it’s not presented in an utterly false manner.

Florida Gov. Ron DeSantis (R), a potential 2024 presidential contender whose comments and actions have trended in a more vaccine-skeptical direction, said last week, “We know — and the data is very clear at this point — covid vaxxes are not preventing infection.”

The same day, Fox News host Tucker Carlson welcomed anti-vaccine activist Alex Berenson on his show yet again.

“The vaccinated can spread the virus as efficiently as anybody else,” Carlson claimed. “So what is the justification for these mandates at this point?”

Berenson responded that “there’s just no evidence that the vaccines halt infection or transmission in any way.”

A couple of days earlier on the same network, host Shannon Bream cited a new study on the transmission of the virus among vaccinated people. A legal expert responded that this undercut the case for vaccine mandates.

“If this product is not doing that, if it’s not preventing infection and transmission, if those who are vaccinated can still become infected and transmit the virus,” Aaron Siri said, “the legal underpinning for mandating these products goes away.”

The same week, former Fox host Jedediah Bila appeared on her old show “The View” and caused a stir by making a similar argument. She said that “the vaccine does not prevent you from getting covid and does not prevent you from transmitting covid.”

As we noted at the time, you can make an argument that what Bila said was technically true (even as others above like Berenson’s are demonstrably false). The vaccines do not prevent you from getting the coronavirus in 100 percent of cases — or transmitting it if you get it.

But this is also something we’ve essentially known from the start. The earliest studies of the coronavirus vaccine showed efficacy rates against infection in the 90th percentile and higher. That meant some vaccinated people were still going to become infected and potentially transmit the virus to others.

Since then, we’ve seen the efficacy of the vaccines wane, particularly as people have gotten further away from their shots and as the virus has mutated and the delta variant wave took hold. The boosters have been shown to significantly increase protection.

But the talking point is a prime example of misleading with perhaps-justifiable comments. While it’s true that the vaccines don’t completely stop infections and transmissions, they certainly reduce the spread by a large amount. And there is evidence — albeit preliminary and with some counterpoints — that they also stop transmissions in the fewer vaccinated people who become infected.

In other words, if the goal is not just to prevent the most serious cases — which the vaccines clearly do — but also to stomp out the virus more broadly, the vaccines unquestionably help. But these folks focus almost exclusively on the limits of the vaccine in a way that betrays their agenda and provides people with a slanted view of the vaccines’ effectiveness.

It provides a window into why unvaccinated Republicans, in particular, wrongly perceive no real benefit from vaccination.

The source for much of such claims is a study published in the Lancet a month ago. It showed that 38 percent of unvaccinated people who were exposed to a household member who was infected also got infected themselves. The number was significantly lower — 25 percent — for those who were vaccinated.

But when it came to whether those household members were exposed to a vaccinated person or an unvaccinated person, the difference was not significant — 25 percent exposed to a fully vaccinated person became infected themselves, versus 23 percent who were exposed to an unvaccinated person.

The study reinforced what we’ve seen over and over again: that vaccinated people are significantly less likely to contract the virus in the first place, thus diminishing the possibility that they pass the virus on to others. Vaccination works. Some studies continue to show it prevents more than 50 percent of infections. And that’s even if you set aside the much larger efficacy in preventing hospitalizations and deaths, which remains at 90 percent or above in most studies.

The talking point, though, not only often sets aside the huge reduction in severe cases; it also sets aside that reduction in infections. It does so by focusing narrowly on the smaller universe of vaccinated people who become infected in the first place.

But even the study above allows that transmission among vaccinated people might also be lower. It says that “peak viral loads showed a faster decline in vaccinated compared with unvaccinated people, although peak viral loads were similar for unvaccinated and vaccinated people.”

That latter fact, though, is what the vaccine and mandate skeptics have focused upon.

“Fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts,” Bream said while questioning Siri.

Again, this is true! They can efficiently transmit the virus. But that doesn’t mean they transmit it as easily, which is a weird thing to leave out. The talking point is always that vaccinated people can transmit and that it’s not 100 percent preventive; it rarely mentions that fewer become infected and that transmission might also be lower.

Which is what multiple studies have now shown. As the Atlantic wrote earlier this month:

Vaccinated people spread the virus less overall because they are significantly less likely to get infected in the first place. In early September, the CDC found that six unvaccinated people were testing COVID-positive for every one vaccinated person. But there are plenty of reasons to be optimistic beyond that. Some recent research shows that even once they’ve been infected, the vaccinated are less likely to spread the coronavirus than the unvaccinated. “We’re back in this category of Yeah, it can happen, but it seems to be a very rare event,” Ross Kedl, an immunology professor at the University of Colorado School of Medicine, told me.
He pointed me to two studies, neither of which has been peer-reviewed, to make his point. One shows that although transmission did occur among the vaccinated in Provincetown [Mass.], those cases represent what Kedl calls a “very limited” proportion out of the total number of infections that occurred as part of that outbreak. In the other study, researchers in the United Kingdom found that the Pfizer and AstraZeneca vaccines consistently reduced transmission downstream of breakthrough cases. Much of the original Delta concern was based on something called “viral load” — the amount of virus a person carries while infected. But the researchers concluded that viral load is just one of many factors correlated to transmission reduction. In other words, even if vaccinated and unvaccinated people have the same viral load, it may not necessarily mean they are just as likely to spread the virus.

Other data also show the “viral load” numbers can be misleading, as the Atlantic noted:

“The data are very clear that vaccinated individuals are less likely to spread the virus to others than unvaccinated individuals,” Christopher Byron Brooke, an assistant professor at the University of Illinois at Urbana-Champaign, told me in an email. A recent paper Brooke co-wrote showed that vaccinated people shed less virus, stop shedding virus sooner than the unvaccinated, and shed particles that are less infectious — supporting the notion that they’re less likely to transmit disease. One study from the Netherlands found a 63 percent reduction in household transmission among the vaccinated. That’s a testament to our vaccines: Homes are a “setting where the deck is heavily stacked towards transmission since members of a household are in extremely close contact for long stretches of time,” Brooke said.

It’s at this point that the Atlantic piece mentioned the study published in the Lancet mentioned above. What’s clear is that this is something that’s still being studied, and we don’t have a full picture of how vaccinated people transmit the virus. But medical experts are increasingly convinced the evidence points in one direction.

Amesh Adalja of the Johns Hopkins Center for Health Security said that the vaccines “don’t work like bug zappers,” but that breakthrough infections among vaccinated people “are of a different caliber than an infection in a nonimmune person.”

“First, it is much less likely a vaccinated person contracts the virus,” Adalja said. He added that while “viral loads, which aren’t fully a marker for contagiousness, may be similar early on in the vaccinated and nonimmune, they rapidly decline in someone who is vaccinated curtailing the period of contagiousness. There is also data that the virus isolated from breakthrough infections is often unable to infect cells as it is damaged and/or coated with antibodies.”

Adalja concluded: “Breakthrough infections are significantly less contagious than infections in nonimmune persons.”

There is certainly a valid debate to be had on vaccine mandates. This talking point, though, makes it sound as if the vaccines have virtually no function beyond preventing severe cases when it comes to reducing the spread, which is clearly not the case.

It’s pernicious in that it’s not facially anti-vaccine. It’s often presented as a counterpoint to the idea that the vaccines should be mandated. If they aren’t stopping the spread, the logic goes, what’s the benefit?

But “stopping” is a relative term, and the very evident benefit of vaccines in stopping infections is there; it’s just ignored in the service of the red herring that they are supposed to have eliminated the spread altogether. It harks back to how some like former Trump White House chief of staff Mark Meadows talked about masks — that if they weren’t a 100 percent solution, why bother? The obvious answer is that reducing risks and substantially reducing the spread is a good thing, given the stakes.

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