After President Trump’s chief of staff told the head of the U.S. Food and Drug Administration he’d be fired Friday if the agency didn’t approve the first COVID-19 vaccine for distribution that very day, it appears that the distorted political process of developing immunizations for the virus is running its course.
First up appears to be a Pfizer vaccine to be followed within days by a vaccine from Moderna. The Pfizer product has already encountered a few problems with adverse drug reactions in England, but the desperation about COVID, combined with the unrelenting politicization of the U.S. pandemic response, makes clear that this and other vaccines will soon be introduced.
What this all means for Kaua‘i is a still an unfolding story, but the Kaua‘i District Health Office has done a good job separating our island’s COVID response from the Washington politics that have damaged the credibility of the process there.
On a Thursday conference call, Dr. Janet Berreman, Kaua‘i’s district health officer, described two major developments that bear attention, especially because she has devoted more-than-considerable effort trying to ensure that our island gets its COVID responses — from quarantines to testing and vaccinations — right.
The first is that while the FDA has said 2.9 million doses could be shipped around the country in the next few days, with 81,000 coming to Hawai‘i, our island expects to receive about 4,000 doses between now and the end of December.
Those doses will go almost exclusively to front-line medical and health-care workers, from hospital staff to firefighters and ambulance crews. Vaccinations for the public on Kaua‘i won’t begin until sometime in the first quarter of next year — assuming the process goes smoothly. While nothing about the country’s COVID response has gone smoothly so far, we can at least continue to expect the response here locally to be well-coordinated.
The coming of the vaccine overshadows another major Kaua‘i COVID development. Until now, test samples collected on-island have had to be sent to O‘ahu for processing. That has sometimes meant a delay in getting results. Delay means people who are positive for the virus aren’t identified in a timely manner and may spread the disease between when they take the test and when they receive the results.
But starting in the next few weeks, Berreman said, two, new, high-speed processing machines are due to arrive on Kaua‘i. The faster of the two, which can handle 500 samples per eight-hour shift — or as many as 1,500 a day — will go to Wilcox Medical Center. The second machine will go to Kaua‘i Veterans Memorial Hospital. It is not quite as fast, but will strengthen our testing capabilities and cut the time it takes to get critical results.
This all leaves a looming unanswered question: Will people on Kaua‘i accept the vaccine and show up to get their series of two shots? Berreman said candidly that she doesn’t know.
However, for planning purposes, her office is projecting that about 70% of Kaua‘i residents will accept it.
It’s important to remember that none of the five vaccines in various stages of trials has fully completed all of the testing steps required under non-pandemic, normal circumstances. The rush to develop and approve them has been tainted by politics, and what regular people know about them is primarily from manufacturer news releases. That is a departure from the scientific norm of peer-reviewed studies published in medical journals so their methods and results can be replicated by independent researchers who have no financial ax to grind.
The situation led to an unprecedented editorial in the British medical journal The Lancet in late November that observed: “Unfortunately, the trials’ results were announced by press releases, leaving many scientific uncertainties that will dictate how the vaccines will affect the course of the pandemic.
“Little safety data are available. How well the vaccines work in older people and those with underlying conditions and their efficacy in preventing severe disease are still unclear. The duration of protection is unknown.”
For us here on Kaua‘i, this is made more worrisome by the fact that we have the highest rate of so-called vaccine-hesitancy of any county in the state. The routine vaccines in question are those used to save lives by preventing the usual childhood illnesses — measles, mumps, rubella and the like.
According to state Department of Health data released last year, about 2% of school students statewide were un-vaccinated. But on Kaua‘i, the rate was almost triple that — 5.7%. The unvaccinated rate was even worse for Kaua‘i charter schools — 8%.
Many of the un-vaccinated children were subject to so-called religious-exemption claims by their parents, though there is no statutory definition. On Kaua‘i, six of 27 schools reported exemption rates of 15% or more.
Various national polls over the last few months have shown that anti-vaccine prejudices are so deeply ingrained and the politics of the COVID vaccine have been so dangerous that about 35% of all Americans don’t intend to be inoculated. Among Republicans, only about 47% have said they will get the shots.
Trump politics clearly plays a role. Here on Kaua‘i, the November election results showed he got more than 11,500 votes — or 34% of the total. That’s about 11% more than Republicans get in typical Kaua‘i presidential voting. It seems safe to speculate that the proportion of Trump voters who won’t accept the vaccine will be substantial.
Without what may be the Trump anti-vaccination bump, we already have some of the worst and most-entrenched, irrational, anti-vaccine behavior anywhere in the country right here at home.
Dr. Berreman’s 70% projection — while modest — seems likely to be overly optimistic. All that said, even with the unknowns about these vaccines, there is still an argument to be made that getting the shots is a prudent personal decision, COVID being the menace it is.
We also know that even once vaccinations begin, it will take months for the entire island to be covered, and any immunity rates the vaccines produce will phase in gradually. Virtually nothing is known about how long immunity will last or what unexpected severe side effects may materialize.
We will all still need to wear masks, maintain safe social distance and keep up strict hygienic practices well into 2021, and probably well into 2022.
Life will not be back to normal any time soon.
Allan Parachini is a Kilauea resident, furniture-maker, journalist and retired public-relations executive who writes periodically for The Garden Island.