The J&J Disaster and the “science” of Epidemiology

When the CDC put a pause on the administration of doses of the J&J vaccine, I suggested here that this didn’t make a whole lot of sense. They claimed that pausing vaccinations would promote confidence in it and contribute to the overall distribution of this vaccine. So, although the six deaths from blood clots were minuscule in comparison to its overall efficacy, the CDC claimed that the “science” dictated a pause. This struck me at the time and still strikes me as too clever by half.

Yesterday’s announcement that millions of J&J vaccines are at risk of expiring in June suggests that I may have been right in my concerns. The pause caused the cancellation of vaccine appointments throughout the country. Although most of these cancellations could be rescheduled, they caused a real delay in administration that seems to have had profound and disturbing consequences. The expiration of millions of vaccines in June is being described as an “unintended consequence” of the pause. Although I am very confident that the CDC didn’t intend this consequence, I’m not sure why it didn’t foresee it. As a “science” that claims to be able to judge the best way to deliver vaccines to the public, why wouldn’t epidemiology have anticipated the effects of this pause on the infrastructure of vaccine delivery? If it did and judged that the pause in delivery would have greater benefits as compared to the inevitable expiration of millions of vaccines, then we should be able to judge whether this is the right calculation. If it didn’t, then I have even more profound doubts about epidemiology as a “science.” If we really are pursuing science, we must attempt to judge this question.

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