COVID-19 is barreling toward its 200,000th victim in the United States because our public health apparatus has been stymied by a Trump administration that has put politics ahead of public health at every turn. Federal agencies like the Centers for Disease Control and Prevention are sidelined, and state and local health departments lack the federal leadership they’ve needed. Even eight months into the crisis, testing continues to drag. Contact-tracing has been underfunded, understaffed and haphazard. And President Donald Trump continues to politicize masks, casting them as a referendum on personal liberty, rather than public health.
All of this has ratcheted up the pressure on the advent of a vaccine. The federal government has already spent over $10 billion on Operation Warp Speed—a program designed to parallel process the usual steps of vaccine development, conducting clinical trials and manufacturing millions of doses of several candidate vaccines at the same time.
There’s no doubt that a vaccine could be a shot in the arm for America’s struggle against the pandemic. But Trump thinks it could also be a shot in the arm for his laggard re-election campaign—he’s all but promised a vaccine before Election Day. And that’s the danger: The vaccine can either be one or the other, but not both.
On Monday, Trump said, “We’re going to have a vaccine very soon, maybe even before a very special date. You know what date I’m talking about.” Given his utter incompetence in responding to the pandemic, Trump and his team must realize that the “October surprise” of a vaccine before Election Day is the Hail Mary his campaign needs to save any face on his handling of the pandemic. But by using the vaccine as a political tool, Trump is threatening the trust people have in it—and therefore its very value. After all, the mere existence of a vaccine does nothing against the pandemic: It has to be taken to be effective.
Vaccines work in two ways. First, they directly protect people who take them from the disease. Second, and perhaps more importantly, when enough people take them, they generate a population-level “herd immunity,” which is the protection afforded to people who aren’t even vaccinated because so many people around them are. Epidemiologists differ on how much immunity we would need to achieve herd immunity from COVID-19, but estimates range from as low as 70 percent to as high as 90 percent.
But poll after poll shows that Americans are skeptical of the vaccine. According to one poll, less than half of Americans say they would get a vaccine. Another poll found that only 21 percent of Americans would get one as soon as possible—down from 32 percent in July. Fifty-eight percent say they would wait to see what happened. The same poll found that 65 percent of respondents feel that if a vaccine were to be announced this year, it would have been “rushed through.”
Already, polls suggest that vaccination rates would be too low to achieve herd immunity through the vaccine, and the continued politicization of the vaccine threatens to drive vaccine rates down further.
Trump’s politicization of the vaccine is in line with his politicization of the entire pandemic. Whether it’s pressuring the Food and Drug Administration to prematurely authorize hydroxychloroquine or convalescent plasma, or sidelining the CDC or Dr. Anthony Fauci, he has shown no regard for the scientific process or medical expertise, even from his own infectious disease advisers. The results show.
But in shaking public trust of the vaccine, Trump may do damage that extends well beyond his time in office. The doubt he has cast on the process may not only prolong the pandemic but also the threat of COVID-19 for years to come.
Scientific consensus is that COVID-19 is here to stay. Though, at some point, it will no longer be the pandemic we know of today, it will remain present, infecting thousands of people a year, like the flu. And though we have a flu vaccine, it still kills tens of thousands of Americans annually. Why? In part because people don’t take the flu vaccine. According to the CDC, only about 45 percent of Americans over 18 got a flu vaccine in 2018-19. Trump’s politicization of the coronavirus vaccine may doom it to the same fate—and thousands of Americans to suffer the consequences.
Abdul El-Sayed, M.D., D.Phil., is an epidemiologist and former health director for the City of Detroit. He is the author of Healing Politics: A Doctor’s Journey into the Heart of Our Political Epidemic and host of the podcast America Dissected. / Newsweek
