Look who showed up in my "In Box" from Politico Pulse! "LOOKING FOR THE WORDS — Public health experts, from CDC officials to leading epidemiologists and doctors, say they need better ways to communicate with the public, citing trust issues and ineffective messaging through the pandemic.
Now, new approaches are emerging, though some experts worry they’re uncommon and not always taken seriously in larger pandemic preparedness discussions.
Still, widespread dissatisfaction over Covid-19 messaging means scattered new initiatives could hold clues to the future of public-facing health communications — particularly a move to more local, accessible, regular interactions with the public.
Starting a conversation
Katelyn Jetelina, epidemiologist and professor at the University of Texas Health Science Center, is among the scientists and doctors who seem to be making breakthroughs.
Since creating a much-read newsletter, Your Local Epidemiologist , during the pandemic to explain public health issues, Jetelina has been part of health communications conversations with government officials in the U.S. and abroad.
The newsletter started as an email to faculty, students and staff to explain the data trickling in early in the pandemic. It eventually moved online and now has a Spanish-language version. She estimates it’s gotten about 300 million hits so far.
Approaches like Your Local Epidemiologist’s — proactive, explanatory and conversational — have been eyed by CDC officials as it considers how to move beyond pandemic messaging missteps .
But Jetelina said messaging changes will likely need to go beyond governments (though she said far more needs to be done on that front) to health systems more broadly, especially at the local level."
Congratulations, while I still think you/she are/is writing just for me, it's nice to read about your impact.
According to the CDC's website, only 15.3% of the population has gotten the bivalent booster (link below).
Is this low uptake because of mis-information and dis-information? Or is it because the American people have concluded - for a variety of reasons based on truths they see with their own eyes - that the current generation of vaccines just aren't living up to their promise? This disillusionment cuts across all age groups, geographies, races, political parties, genders, education, you name it. The vast majority of Americans are DONE with the current generation of vaccines.
From a policy standpoint, if the vast majority of Americans are DONE with the current generation of vaccines, what good is it to blame low uptake on the dis/mis-informationists? Wouldn't it be better for our country for policy makers to focus on the future, taking in to account the reality that the American people have spoken and their minds aren't likely to be changed? We need BETTER vaccines and BETTER therapies for when people do get covid.
Thanks for your comment. I think you read this post with the framing of bivalent boosters. And perhaps some is contributing to that, but I was thinking more of those who never got the vaccine primary series or never one booster.
To answer your question, we actually have data on why people aren't getting the bivalent... they don't know about it or because they can't get access to it. This is true across every age group. There was a survey published on this last Friday, that I was going to include in a research round-up.
PS: if you are doing a research roundup soon, may I respectfully request that you help us understand the implications of the recent Cleveland Clinic study? As far as I know, it’s one of the few studies we have that uses recent data. It has not been peer-reviewed yet it’s based on a very large sample size.
The study shows a correlation (not to be confused with causation) between number of vaccine shots and likelihood of catching covid: the more boosted, the more likely to get covid. My best guess is the true explanation has something to do with behavior and/or natural immunity - that once people drop Covid precautions, they are more apt to catch Covid, especially if they’ve never had it before. I saw this again and again with friends catching covid within weeks of getting the bivalent.
As a person who is interested in science and the truth, can we conclude from this study that the ability of the vaccines to prevent infection has been overstated, especially in the early days when more people took greater precautions?
In addition to mis/dis-information, there is another type of un-truth: ignoring or discrediting valid studies that go against the narrative. My worry is our nation’s policy makers fall in to this category. They seem more fixated on using old data to prove old policy was justified instead of using new data to test the narrative and chart the future.
Here’s the link to the Cleveland Clinic study, you might need to press “full text” to see both charts:
"...valid studies that go against the narrative." This is a concern I have which causes me to have less faith in CDC recommendations, for example. It seems that these non-conforming studies aren't just faint outliers. Some make "Science" their god. But science can get it wrong. How many times have I read, "Well, we NOW know..." And the damage is done.
Thank you for clarifying that mis/dis-information contributed to people never getting their primary series and/or booster. I don’t think there is anything that can be said or done to convince this group to get vaccinated. Even vaccine mandates didn’t help, if anything they probably backfired and sowed the seeds of suspicion for mainstay vaccines like MMR.
So if mis/dis-information has nothing to do with 85% of Americans saying “no thanks” to the bivalent booster, with all due respect, I’m not sure what the applicability of your post is - how does it inform today and the future?
I thought I made a pretty good case why disinformation is bad in the post above, including the ramifications for other public health problems and other vaccines
Thank you for this article. I would just add that one of many reasons people are susceptible to disinformation is that it feeds on well-placed (IMO) distrust of the pharmaceutical industry as out to profit off our health. I myself am critical of Pharma, but that doesn't mean that I think that everything they develop is dangerous. It does mean that I understand people's scepticism about their playbook. If we didn't have a profit-gouging pharmaceutical industry, it would go a long way to establishing trust that the industry isn't just hyping vaccines to make more money. It doesn't help that they are raising the price of COVID vaccines, which has been in the news lately.
This is an excellent point. My college age son got the J&J as his initial vaccine. When he was trying to figure out which vaccine to get as a booster, he came away thinking he shouldn't get a booster at all because he discovered that all the pharmaceutical companies involved had done some horrible things in the past. He eventually did get a booster because his college required it, but, yes, people are not wrong to be skeptical of pharmaceutical companies or even the medical field in general. How to overcome this?
One way would be to put some controls on how much pharmaceutical companies are allowed to profit from their products, especially those that are developed out of research that was publicly funded.
I too am a physician, however I have no formal training in epidemiology. I have learned a great deal about this field over the last two years in my own investigation into the vaccine trials and observational studies from around the world. This does not make me an expert. I am an anesthesiologist with a background in mathematics and physical systems modeling (I had a career as an engineer prior to medical school).
Although I agree that mis/dis/malinformation abounds, I have a different take on our approach and the validity of information that supports the thesis that the Covid vaccines are safe and effective.
In this article you have cited a number of misinformation spreaders, including Children's Health Defense. In full disclosure, I am affiliated with that organization. In fact, I have been serving as the Senior Science Editor for The Defender, our online publication. I do not take this position lightly and have endeavored to ensure that what we publish is reasonable, factual and defensible. Moreover, I often discuss our material with experts who are affiliated with our organization before taking the step to publish anything.
I have found that our separate camps have become echo chambers. That is why I have chosen to subscribe to your substack. My intention is not to discredit you in any way but to encourage an open exchange of ideas. I believe you are earnestly explaining your position in good faith. I just happen to disagree with some of your opinions/interpretations.
As a physician, I take my role in this very seriously. CHD pays me only a fraction of what I could earn as a clinical anesthesiologist. I have children and aging parents to support. In other words, I have nothing to gain by speaking up and spreading what you are labeling "misinformation".
I have offered some commentary and what I believe are very reasonable questions on your last two substack articles, specifically around the UK Health Surveillance Data set and the estimates of "lives saved" by the Covid-19 vaccination campaign.
I am hoping that you will address them to perhaps uncover where our disagreements originate and in doing so, find more productive ways for all of us to learn from one another.
Given the fact that we both agree that misinformation is a huge problem, wouldn't the most effective solution be to have an open dialogue about where the misconceptions are on both sides?
I have recently launched my own substack, "An Insult to Intuition", where I have explained how I initially came to a different position with regard to the Covid-19 vaccines. You don't need to be a paid subscriber to comment.
I personally think you're much more likely to be just trying to put links out to increase your influence and ability than "taking your role seriously". Your org. got outed as a disinformation machine and you think pushback might win you a few more viewers.
Dandarc, I understand how you could mistrust someone with an opposing point of view on this heavily divided topic. Ack, I get it!
Did you read through Setty’s article? If so, can you address something (aside from his affiliation) that specifically registers as untrue?
Something that we can openly debate, or ask Katelyn to address?!
I wonder if you (and we all) can come to the table to discuss these important issues with a sense of curiosity rather than contempt.
Listening to people soundly argue the other side of an issue can challenge and expand our thinking, and thus help strengthen our own arguments at the very least.
And, comments like his give us a golden opportunity to use this space to debate and dismantle false information in real time!
I read a credible source that just about 1/4 of all anti-covid-19 vaccine tweets came from this one source. Therefore no need to give them any clicks.
The problem with your approach is that disinformation is so incredibly easy to create. For example, I'll make something up that I hope is disinformation right now - "Chevalisa Bruzzone is a Russion Bot." Prove me wrong.
Half-Italian Bot, I suppose. :-) Again, can you let us know a specific thing you read in Setty's response that you would like to challenge? Let's talk about it. I would also be curious to learn more about the credible source you reference just above. If you can put some specific data on the table, I'd love folks—Katelyn included—to be able to respond.
And you say "I have nothing to gain by speaking up and spreading what you are labeling "misinformation", while also saying you are "serving as the Senior Science Editor for The Defender, our online publication."
You reek of lies. You're scared that the truth will wreck your precious bottom line.
I regard everything that does not promote your lie-platform to also be a lie.
You should be ashamed of yourself. An anesthesiologist as the senior science editor for a publication purportedly about children's health and vaccines? Is that the best they could find? I hope that money you're making buys you some good sleep aids because it sure as heck isn't buying you any moral compass.
Can you please explain the VAERS data more fully? Also, when you talk specifically about profiting from disinformation, don't forget the HUGE profits being made by the pharmaceutical companies. If only we could do something about that it would take a bite out of the disinformation folks' complaints.
If Katelyn has a chance to explain it, she’d explain it better than I ever could, but I took a stab at it in a recent post “Information Can Be Both Factually True and Very Misleading.” https://t.co/NYNKmzjjI1
Here’s a snippet.
“If you waved a toy magic wand over [millions of] random people’s heads, and gathered every negative health outcome that happened to them after that, you’d see the whole gamut of bad health outcomes in that database: you’d find people who had cancer, pancreatitis, strokes, heart attacks, epilepsy, gonorrhea, AIDS, gout, migraines, appendicitis, kidney failure — and yes, people who died.
“None of it, presumably, was caused by the waving of the toy magic wand.
“Most of these databases are noise.”
I go into a lot more detail but that’s basically the reason 18,000 could be dead after taking a vaccine, just as 18,000 would be dead shortly after waving a magic wand, if you waved a toy magic wand over a big enough group of people.
VAERS does not ask people to make judgments and report things that happened “because of” the vaccine. They are trying to gather every single bit of data they can, to see if they can find a signal among all that noise.
Gathering all possible data is how people determined that the J&J vaccine was associated with blood clots and they removed it promptly. The system really does work. I often ask vaccine-hesitant people, if J&J was removed so quickly (and they are part of influential, profitable “big Pharma” for sure), then if the mRNA vaccines were a problem wouldn’t they have been removed, too? Instead many billions of doses have been given and they’ve been determined to be safe and life-saving.
I would love an additional column just on this point, expanding and clarifying:
"Kernel of truth. Almost all vaccine rumors have a kernel of truth–something that is true but then distorted, taken out of context, or exaggerated. For example, VAERS does say that more than 18,000 people have died after the vaccine. However, this is taken out of context given the surveillance system and post hoc fallacy.
I'm a new reader to your blog and grateful to my friends who recommended you. As a lay person I am bewildered by the extremely different positions intelligent and informed people take on Covid and these vaccines. One thing I would love to see is intelligent, open fair discussion of alternative views. Propaganda, misinformation, profiteering, exploitative sensationalistic fear mongering are certainly huge problems in this society. The term 'conspiracy theory' is brandished as a weapon, when in fact, there are intelligent conspiracy theories and there are stupid, baseless ones. I know Robert Kennedy and have respected his work for decades as a defender of our environment. His heroic, successful lawsuit against Monsanto is something everyone (but Monsanto) is, or ought to be, grateful for. I'm making this comment to express my wish that you would engage Dr. Setty, RFK's Science Editor whose writing for The Defender is exemplary, science based, though his perspective is often different from yours. What is not different is that you each have educated yourselves and are devoted to our society's health. All of us will benefit from your civil dialogue.
So there's a lot of material here at this blog. Why not read it first and then decide whether you think there's any value to a dialogue with an org that has been pretty much the #1 source of anti-covid-vaccine bullshit and therefore has a well earned poor reputation.
I read a lot of material on both sides of this increasing schism. My background is in social science and history, not medicine. I have both a healthy trust and mistrust of institutions. For example, I respect and trust our local epidemiologist and Robert Kennedy and Madhava Setty because they've all graduated with distinctions from our finest schools, proving their expertise in their fields of science, medicine, statistics, and law. I don't trust our media so much. So when you say RFK is the #1 source of disinfo, where do you get that from? Have you ever critically evaluated those hit pieces? They don't seem honest to me. Which is why I'd love to see a real dialogue between qualified experts, not an argument.
I am a big fan of this column, but find one aspect of this column needing clarification. It states, “Disinformation campaigns, like COVID-19 vaccines, turns out to be incredibly lucrative”, then lists 2 examples, the first provides the income gained ($100M), but the Kennedy example just states how his website traffic increased, not how that is lucrative? If the traffic didn’t generate revenue, then this should not be included as an example of a lucrative motivation. Can this be explained further or corrected? Otherwise it seems it may be an example of misinformation (yikes!).
I read this column for its evidence-based perspective and have found it exceptionally helpful in my de ion-making to get all COVID vaccinations and have used it to convince others, but I am concerned about this one Kennedy example, especially b/c I know he does have a huge following.
If you're selling something, increasing traffic to the website selling it will inevitably result in increased sales. That's the entire point of sales campaigns. It's also in synch with this extremist crackpot political agenda, so there's that.
Your post is priceless and should be read by everyone in Congress. Disinformation, because, it has deadly consequences, shoukd have extremely strong legal consequences. This will require Congress to act. The Executive simply doesn't have the power. If it were up to me I'd remove disinformation from under First Amendment free speech protection, shut down those main purveyors, lock up the malefactors and throw away the key! Social media must also be brought under control so we don't have to be constantly fighting Brandolini's Law.
I am concerned about physicians who are considered credible who use their large influence to spread their opinions which are sometimes not supported by evidence. There's rampant disinformation and there's also "fact free" information such as The Washington Post/CNN correspondent about overcounting of Covid deaths which has been carefully addressed by Jeremy Faust. When people who are considered credible spread misinformation, that is quite serious too. There is a notable pediatrician who feels the bivalent booster is not indicated for most people.
This is great stuff. The question is, how do you convince those who are passing along the nonsense that it's nonsense. They've now bought in, and they see articles like yours as more of the "deep state" or "big pharma" or whoever trying to suppress the "truth." We can attempt to inoculate the not-yet-affected against falling for future nonsense, but that isn't going to fix the ones who are already there. (This is more a rhetorical question; I don't think there's a good answer).
The only part where the logic is wobbly is around the motive. Stating the motive is profit by highlighting how, after growing to fame, some outlets have made profits, ticks every box of the bad epistemics checklist.
Motives behind these accounts most likely come from all sorts of places (from political and monetary gain to full on belief, and belief in associated dogma) and we need to do a better job at understanding those if we are to counter this phenomenon.
THANKS. This is a great neutral, competent, complete review of the topic. It really leaves unexplored the problem of why good public health information has no punch or power in the public square. Are we all intellectual weenies in white coats?
One tact that could be useful is saying that IF there were good evidence about the vaccines having widespread adverse effects, you would want the truth to come out too. And surely at least one country with advanced health surveillance would ring the alarm bell (esp. since most countries have no financial interest in Pfizer/Moderna). But there isn't.
Sometimes covid vaccine defenders come off as blindly pro-vax imo. But what do I know I guess...
I would hardly call it "blindly" pro-vax. Personally, I grew up in a politically conservative area, and while my childhood friends have gone their own way politically, they are split along the liberal-conservative political spectrum, and apparently along with that, a pro-vax/anti-vax spectrum. One childhood friend of mine got COVID during the delta wave. This guy is almost exactly like me physically: Not old, not young (literally he was in my same class so he's the same age as me, 50 years old), physically fit (he was an avid runner, I'm an avid cyclist) and not obese (particularly compared to other American males of the same age), and no other health issues. Politically he leans more conservative, but hardly a Trumper, and not anti-vax or pro-vax. Likely he just didn't know who to believe, hesitated and never got vaccinated. He spent five weeks in an ICU, had several very close calls, but eventually did make it, but his life will never be the same again. A year and a half later, he's still unable to return to work and physical therapy meant he had to start all over again.
According to many antivaxxers, the simple fact that he did not die means he never needed to get the vaccine. The guy nearly died. His life will never be the same again. You cannot possibly tell me if his immune system had a head start if he was vaccinated that the results would have been exactly the same. It defies every single scientific convention and absolutely zero data supports it.
This pisses me off to no end. This is not some ideological point scoring for me. This literally almost killed him, and forever changed his life, and not getting vaccinated, I have to believe the outcome would be better. This is not ideological. This is just facts and science.
To many, this is an ideological point. The data portends a particular political point. To them, the idea that vaccines work portends that vaccine mandates are a good idea. If you are opposed to all government intervention, then the idea of vaccine mandates are a bad idea, so you need to attack the reason for them, which is the fact that vaccines work. We've seen this so many times, with mask mandates, with climate change proposals, if these problems portend government intervention, and you have no other proposal to combat these problems, then you have to attack the facts that portend that solution.
This is not political to me. This is personal. I don't care who you voted for, and I have every belief that my friend and I disagree on almost everything politically. Unfortunately, that damn near killed him, and given the fact that we almost identical in our demographics, there's little doubt that could have happened to me. For me, I've been vaccinated, I've been twice boosted, I've had zero problems, and I did eventually get COVID (albeit omicron) and it was like bad allergies, not over a month in the ICU. I didn't even miss a single day of work (remotely) and my life has not changed, as it clearly did with him.
I am not "blindly" "pro-vax". I'm blindly "pro-friend", regardless who they voted for.
@Joe Carlin: It's refreshing to hear that some folks can really agree to disagree. Life is too short. Let's accept that some people can remain friends if only they will accept the other's viewpoint but that viewpoint doesn't have to be adopted/swallowed entirely. Maybe certain points he makes are more valid than others. Why would you hate or reject someone that might educate you with alternative views? We tend to demonize alternative opinions. I can still consider my viewpoint more correct without actually hating my friend who "doesn't get it" (according to my experiences, education, and biases).
Dear Katelyn, PLEASE do not cross that line and try to support the present administration, CDC, NIH or any other governmental or political entity= red or blue. Your value, and I have sent your reviews to many, is in dealing ONLY with data. As a retired pediatric infectious disease physician who worked in Academia (tenured at 2 Universities) until going to the FDA and working there for almost 20 years, there is only one thing that should convincingly persuade anyone about an intervention and that is data that is collected in randomized controlled trials. Unfortunately, we do not always have such and MUST use other data. At that point, all any of us are doing is bringing our own data set to the discussion. Your value is the data that you bring to the discussion, please do not veer into justifications or vilifications or assumptions about why people behave the way they do. Please stick to the data. Thank you for your contributions and I would only suggest reading Siddhartha Mukherjee's "The Gene" for an additional perspective on why people behave the way they do sometimes. D. Murphy, MD, FAAP
"Please stick to the data." Odd statement, considering that this is what the article in question does. Data do not exist in a vacuum, BTW. They must be interpreted. And the interpretation must be done in a way the evaluates the validity of said data.
Examining the motivations of those pushing misinformation is actually valuable data. So is differentiating facts from fabrications. Why would anyone want to oppose that?
I also see no issue with supporting "the present administration, CDC, NIH or any other governmental or political entity" IF said entity is dealing with facts and doing so honestly and with a goal of improving public health. Which, based on the available data, appears to generally be the case.
Disagree on 'restricting' the valuation. Social and/or profit-seeking aspects very obviously pertain to the field of epidemiology.
It is epidemiology, not a controlled drug or treatment evaluation. It deals with people's fears, irrational responses, and very much so when they are exacerbated by profiteering or malevolence.
Look who showed up in my "In Box" from Politico Pulse! "LOOKING FOR THE WORDS — Public health experts, from CDC officials to leading epidemiologists and doctors, say they need better ways to communicate with the public, citing trust issues and ineffective messaging through the pandemic.
Now, new approaches are emerging, though some experts worry they’re uncommon and not always taken seriously in larger pandemic preparedness discussions.
Still, widespread dissatisfaction over Covid-19 messaging means scattered new initiatives could hold clues to the future of public-facing health communications — particularly a move to more local, accessible, regular interactions with the public.
Starting a conversation
Katelyn Jetelina, epidemiologist and professor at the University of Texas Health Science Center, is among the scientists and doctors who seem to be making breakthroughs.
Since creating a much-read newsletter, Your Local Epidemiologist , during the pandemic to explain public health issues, Jetelina has been part of health communications conversations with government officials in the U.S. and abroad.
The newsletter started as an email to faculty, students and staff to explain the data trickling in early in the pandemic. It eventually moved online and now has a Spanish-language version. She estimates it’s gotten about 300 million hits so far.
Approaches like Your Local Epidemiologist’s — proactive, explanatory and conversational — have been eyed by CDC officials as it considers how to move beyond pandemic messaging missteps .
But Jetelina said messaging changes will likely need to go beyond governments (though she said far more needs to be done on that front) to health systems more broadly, especially at the local level."
Congratulations, while I still think you/she are/is writing just for me, it's nice to read about your impact.
According to the CDC's website, only 15.3% of the population has gotten the bivalent booster (link below).
Is this low uptake because of mis-information and dis-information? Or is it because the American people have concluded - for a variety of reasons based on truths they see with their own eyes - that the current generation of vaccines just aren't living up to their promise? This disillusionment cuts across all age groups, geographies, races, political parties, genders, education, you name it. The vast majority of Americans are DONE with the current generation of vaccines.
From a policy standpoint, if the vast majority of Americans are DONE with the current generation of vaccines, what good is it to blame low uptake on the dis/mis-informationists? Wouldn't it be better for our country for policy makers to focus on the future, taking in to account the reality that the American people have spoken and their minds aren't likely to be changed? We need BETTER vaccines and BETTER therapies for when people do get covid.
https://covid.cdc.gov/covid-data-tracker/#datatracker-home
Thanks for your comment. I think you read this post with the framing of bivalent boosters. And perhaps some is contributing to that, but I was thinking more of those who never got the vaccine primary series or never one booster.
To answer your question, we actually have data on why people aren't getting the bivalent... they don't know about it or because they can't get access to it. This is true across every age group. There was a survey published on this last Friday, that I was going to include in a research round-up.
PS: if you are doing a research roundup soon, may I respectfully request that you help us understand the implications of the recent Cleveland Clinic study? As far as I know, it’s one of the few studies we have that uses recent data. It has not been peer-reviewed yet it’s based on a very large sample size.
The study shows a correlation (not to be confused with causation) between number of vaccine shots and likelihood of catching covid: the more boosted, the more likely to get covid. My best guess is the true explanation has something to do with behavior and/or natural immunity - that once people drop Covid precautions, they are more apt to catch Covid, especially if they’ve never had it before. I saw this again and again with friends catching covid within weeks of getting the bivalent.
As a person who is interested in science and the truth, can we conclude from this study that the ability of the vaccines to prevent infection has been overstated, especially in the early days when more people took greater precautions?
In addition to mis/dis-information, there is another type of un-truth: ignoring or discrediting valid studies that go against the narrative. My worry is our nation’s policy makers fall in to this category. They seem more fixated on using old data to prove old policy was justified instead of using new data to test the narrative and chart the future.
Here’s the link to the Cleveland Clinic study, you might need to press “full text” to see both charts:
https://www.medrxiv.org/content/10.1101/2022.12.17.22283625v1
"...valid studies that go against the narrative." This is a concern I have which causes me to have less faith in CDC recommendations, for example. It seems that these non-conforming studies aren't just faint outliers. Some make "Science" their god. But science can get it wrong. How many times have I read, "Well, we NOW know..." And the damage is done.
Thank you for clarifying that mis/dis-information contributed to people never getting their primary series and/or booster. I don’t think there is anything that can be said or done to convince this group to get vaccinated. Even vaccine mandates didn’t help, if anything they probably backfired and sowed the seeds of suspicion for mainstay vaccines like MMR.
So if mis/dis-information has nothing to do with 85% of Americans saying “no thanks” to the bivalent booster, with all due respect, I’m not sure what the applicability of your post is - how does it inform today and the future?
I thought I made a pretty good case why disinformation is bad in the post above, including the ramifications for other public health problems and other vaccines
It was also useful to have all that information in one place.
Yes, you did! Thank you!
The article isn't just about the bivalent vaccine. I thought that would have been obvious from reading it.
Thank you for this article. I would just add that one of many reasons people are susceptible to disinformation is that it feeds on well-placed (IMO) distrust of the pharmaceutical industry as out to profit off our health. I myself am critical of Pharma, but that doesn't mean that I think that everything they develop is dangerous. It does mean that I understand people's scepticism about their playbook. If we didn't have a profit-gouging pharmaceutical industry, it would go a long way to establishing trust that the industry isn't just hyping vaccines to make more money. It doesn't help that they are raising the price of COVID vaccines, which has been in the news lately.
This is an excellent point. My college age son got the J&J as his initial vaccine. When he was trying to figure out which vaccine to get as a booster, he came away thinking he shouldn't get a booster at all because he discovered that all the pharmaceutical companies involved had done some horrible things in the past. He eventually did get a booster because his college required it, but, yes, people are not wrong to be skeptical of pharmaceutical companies or even the medical field in general. How to overcome this?
One way would be to put some controls on how much pharmaceutical companies are allowed to profit from their products, especially those that are developed out of research that was publicly funded.
Hi Dr. Jetelina,
I too am a physician, however I have no formal training in epidemiology. I have learned a great deal about this field over the last two years in my own investigation into the vaccine trials and observational studies from around the world. This does not make me an expert. I am an anesthesiologist with a background in mathematics and physical systems modeling (I had a career as an engineer prior to medical school).
Although I agree that mis/dis/malinformation abounds, I have a different take on our approach and the validity of information that supports the thesis that the Covid vaccines are safe and effective.
In this article you have cited a number of misinformation spreaders, including Children's Health Defense. In full disclosure, I am affiliated with that organization. In fact, I have been serving as the Senior Science Editor for The Defender, our online publication. I do not take this position lightly and have endeavored to ensure that what we publish is reasonable, factual and defensible. Moreover, I often discuss our material with experts who are affiliated with our organization before taking the step to publish anything.
I have found that our separate camps have become echo chambers. That is why I have chosen to subscribe to your substack. My intention is not to discredit you in any way but to encourage an open exchange of ideas. I believe you are earnestly explaining your position in good faith. I just happen to disagree with some of your opinions/interpretations.
As a physician, I take my role in this very seriously. CHD pays me only a fraction of what I could earn as a clinical anesthesiologist. I have children and aging parents to support. In other words, I have nothing to gain by speaking up and spreading what you are labeling "misinformation".
I have offered some commentary and what I believe are very reasonable questions on your last two substack articles, specifically around the UK Health Surveillance Data set and the estimates of "lives saved" by the Covid-19 vaccination campaign.
I am hoping that you will address them to perhaps uncover where our disagreements originate and in doing so, find more productive ways for all of us to learn from one another.
Given the fact that we both agree that misinformation is a huge problem, wouldn't the most effective solution be to have an open dialogue about where the misconceptions are on both sides?
I have recently launched my own substack, "An Insult to Intuition", where I have explained how I initially came to a different position with regard to the Covid-19 vaccines. You don't need to be a paid subscriber to comment.
This is part I of a three part analysis:
https://madhavasetty.substack.com/p/safe-and-effective
I welcome anyone here to drop your thoughts on my own critique of the situation. Thank you for considering this.
I personally think you're much more likely to be just trying to put links out to increase your influence and ability than "taking your role seriously". Your org. got outed as a disinformation machine and you think pushback might win you a few more viewers.
Dandarc, I understand how you could mistrust someone with an opposing point of view on this heavily divided topic. Ack, I get it!
Did you read through Setty’s article? If so, can you address something (aside from his affiliation) that specifically registers as untrue?
Something that we can openly debate, or ask Katelyn to address?!
I wonder if you (and we all) can come to the table to discuss these important issues with a sense of curiosity rather than contempt.
Listening to people soundly argue the other side of an issue can challenge and expand our thinking, and thus help strengthen our own arguments at the very least.
And, comments like his give us a golden opportunity to use this space to debate and dismantle false information in real time!
No normalization of disinformation. Even the presentation of it normalizes it. This is how your evil game works.
You're astroturfing and gaslighting.
I read a credible source that just about 1/4 of all anti-covid-19 vaccine tweets came from this one source. Therefore no need to give them any clicks.
The problem with your approach is that disinformation is so incredibly easy to create. For example, I'll make something up that I hope is disinformation right now - "Chevalisa Bruzzone is a Russion Bot." Prove me wrong.
Half-Italian Bot, I suppose. :-) Again, can you let us know a specific thing you read in Setty's response that you would like to challenge? Let's talk about it. I would also be curious to learn more about the credible source you reference just above. If you can put some specific data on the table, I'd love folks—Katelyn included—to be able to respond.
Precisely. It is exactly like the BBC example above. Gaining viewership of their lies is the entire point.
And you say "I have nothing to gain by speaking up and spreading what you are labeling "misinformation", while also saying you are "serving as the Senior Science Editor for The Defender, our online publication."
You reek of lies. You're scared that the truth will wreck your precious bottom line.
I regard everything that does not promote your lie-platform to also be a lie.
And everyone else should do the same.
You should be ashamed of yourself. An anesthesiologist as the senior science editor for a publication purportedly about children's health and vaccines? Is that the best they could find? I hope that money you're making buys you some good sleep aids because it sure as heck isn't buying you any moral compass.
How many bots did you use to like your own post?
You paid $5/month to peddle this tripe in order to continue your organization's normalization of disinformation.
That is the entire point of our supposed Doctor Setty's post.
We do not normalize your disinformation. We see it for what it is.
"it's easier to fool people than to convince them that they have been fooled"
Can you please explain the VAERS data more fully? Also, when you talk specifically about profiting from disinformation, don't forget the HUGE profits being made by the pharmaceutical companies. If only we could do something about that it would take a bite out of the disinformation folks' complaints.
The huge profit from pharma isn’t lost on me. I think they need to be continually monitored with checks and balances
If Katelyn has a chance to explain it, she’d explain it better than I ever could, but I took a stab at it in a recent post “Information Can Be Both Factually True and Very Misleading.” https://t.co/NYNKmzjjI1
Here’s a snippet.
“If you waved a toy magic wand over [millions of] random people’s heads, and gathered every negative health outcome that happened to them after that, you’d see the whole gamut of bad health outcomes in that database: you’d find people who had cancer, pancreatitis, strokes, heart attacks, epilepsy, gonorrhea, AIDS, gout, migraines, appendicitis, kidney failure — and yes, people who died.
“None of it, presumably, was caused by the waving of the toy magic wand.
“Most of these databases are noise.”
I go into a lot more detail but that’s basically the reason 18,000 could be dead after taking a vaccine, just as 18,000 would be dead shortly after waving a magic wand, if you waved a toy magic wand over a big enough group of people.
VAERS does not ask people to make judgments and report things that happened “because of” the vaccine. They are trying to gather every single bit of data they can, to see if they can find a signal among all that noise.
Gathering all possible data is how people determined that the J&J vaccine was associated with blood clots and they removed it promptly. The system really does work. I often ask vaccine-hesitant people, if J&J was removed so quickly (and they are part of influential, profitable “big Pharma” for sure), then if the mRNA vaccines were a problem wouldn’t they have been removed, too? Instead many billions of doses have been given and they’ve been determined to be safe and life-saving.
I would love an additional column just on this point, expanding and clarifying:
"Kernel of truth. Almost all vaccine rumors have a kernel of truth–something that is true but then distorted, taken out of context, or exaggerated. For example, VAERS does say that more than 18,000 people have died after the vaccine. However, this is taken out of context given the surveillance system and post hoc fallacy.
Sure! I have a whole lecture on it. Happy to put it in a post
I'm a new reader to your blog and grateful to my friends who recommended you. As a lay person I am bewildered by the extremely different positions intelligent and informed people take on Covid and these vaccines. One thing I would love to see is intelligent, open fair discussion of alternative views. Propaganda, misinformation, profiteering, exploitative sensationalistic fear mongering are certainly huge problems in this society. The term 'conspiracy theory' is brandished as a weapon, when in fact, there are intelligent conspiracy theories and there are stupid, baseless ones. I know Robert Kennedy and have respected his work for decades as a defender of our environment. His heroic, successful lawsuit against Monsanto is something everyone (but Monsanto) is, or ought to be, grateful for. I'm making this comment to express my wish that you would engage Dr. Setty, RFK's Science Editor whose writing for The Defender is exemplary, science based, though his perspective is often different from yours. What is not different is that you each have educated yourselves and are devoted to our society's health. All of us will benefit from your civil dialogue.
So there's a lot of material here at this blog. Why not read it first and then decide whether you think there's any value to a dialogue with an org that has been pretty much the #1 source of anti-covid-vaccine bullshit and therefore has a well earned poor reputation.
I read a lot of material on both sides of this increasing schism. My background is in social science and history, not medicine. I have both a healthy trust and mistrust of institutions. For example, I respect and trust our local epidemiologist and Robert Kennedy and Madhava Setty because they've all graduated with distinctions from our finest schools, proving their expertise in their fields of science, medicine, statistics, and law. I don't trust our media so much. So when you say RFK is the #1 source of disinfo, where do you get that from? Have you ever critically evaluated those hit pieces? They don't seem honest to me. Which is why I'd love to see a real dialogue between qualified experts, not an argument.
Also--really?
Why do you peddle evil?
Yawn.
LOL. You're just Setty with a different account, or Setty's disinformation buddy. Betting on the former as you also sound the same.
More normalization cowardice.
I am a big fan of this column, but find one aspect of this column needing clarification. It states, “Disinformation campaigns, like COVID-19 vaccines, turns out to be incredibly lucrative”, then lists 2 examples, the first provides the income gained ($100M), but the Kennedy example just states how his website traffic increased, not how that is lucrative? If the traffic didn’t generate revenue, then this should not be included as an example of a lucrative motivation. Can this be explained further or corrected? Otherwise it seems it may be an example of misinformation (yikes!).
I read this column for its evidence-based perspective and have found it exceptionally helpful in my de ion-making to get all COVID vaccinations and have used it to convince others, but I am concerned about this one Kennedy example, especially b/c I know he does have a huge following.
Katelyn, please address this. Maybe I’m misreading it, but, regardless, it needs clarification.
If you're selling something, increasing traffic to the website selling it will inevitably result in increased sales. That's the entire point of sales campaigns. It's also in synch with this extremist crackpot political agenda, so there's that.
Also: https://nypost.com/2022/02/02/robert-f-kennedy-jr-anti-vax-crusade-is-making-him-millions/ and https://www.vanityfair.com/news/2021/05/how-robert-f-kennedy-jr-became-anti-vaxxer-icon-nightmare
Your post is priceless and should be read by everyone in Congress. Disinformation, because, it has deadly consequences, shoukd have extremely strong legal consequences. This will require Congress to act. The Executive simply doesn't have the power. If it were up to me I'd remove disinformation from under First Amendment free speech protection, shut down those main purveyors, lock up the malefactors and throw away the key! Social media must also be brought under control so we don't have to be constantly fighting Brandolini's Law.
I am concerned about physicians who are considered credible who use their large influence to spread their opinions which are sometimes not supported by evidence. There's rampant disinformation and there's also "fact free" information such as The Washington Post/CNN correspondent about overcounting of Covid deaths which has been carefully addressed by Jeremy Faust. When people who are considered credible spread misinformation, that is quite serious too. There is a notable pediatrician who feels the bivalent booster is not indicated for most people.
This is great stuff. The question is, how do you convince those who are passing along the nonsense that it's nonsense. They've now bought in, and they see articles like yours as more of the "deep state" or "big pharma" or whoever trying to suppress the "truth." We can attempt to inoculate the not-yet-affected against falling for future nonsense, but that isn't going to fix the ones who are already there. (This is more a rhetorical question; I don't think there's a good answer).
A really good analysis!!
The only part where the logic is wobbly is around the motive. Stating the motive is profit by highlighting how, after growing to fame, some outlets have made profits, ticks every box of the bad epistemics checklist.
Motives behind these accounts most likely come from all sorts of places (from political and monetary gain to full on belief, and belief in associated dogma) and we need to do a better job at understanding those if we are to counter this phenomenon.
THANKS. This is a great neutral, competent, complete review of the topic. It really leaves unexplored the problem of why good public health information has no punch or power in the public square. Are we all intellectual weenies in white coats?
One tact that could be useful is saying that IF there were good evidence about the vaccines having widespread adverse effects, you would want the truth to come out too. And surely at least one country with advanced health surveillance would ring the alarm bell (esp. since most countries have no financial interest in Pfizer/Moderna). But there isn't.
Sometimes covid vaccine defenders come off as blindly pro-vax imo. But what do I know I guess...
I would hardly call it "blindly" pro-vax. Personally, I grew up in a politically conservative area, and while my childhood friends have gone their own way politically, they are split along the liberal-conservative political spectrum, and apparently along with that, a pro-vax/anti-vax spectrum. One childhood friend of mine got COVID during the delta wave. This guy is almost exactly like me physically: Not old, not young (literally he was in my same class so he's the same age as me, 50 years old), physically fit (he was an avid runner, I'm an avid cyclist) and not obese (particularly compared to other American males of the same age), and no other health issues. Politically he leans more conservative, but hardly a Trumper, and not anti-vax or pro-vax. Likely he just didn't know who to believe, hesitated and never got vaccinated. He spent five weeks in an ICU, had several very close calls, but eventually did make it, but his life will never be the same again. A year and a half later, he's still unable to return to work and physical therapy meant he had to start all over again.
According to many antivaxxers, the simple fact that he did not die means he never needed to get the vaccine. The guy nearly died. His life will never be the same again. You cannot possibly tell me if his immune system had a head start if he was vaccinated that the results would have been exactly the same. It defies every single scientific convention and absolutely zero data supports it.
This pisses me off to no end. This is not some ideological point scoring for me. This literally almost killed him, and forever changed his life, and not getting vaccinated, I have to believe the outcome would be better. This is not ideological. This is just facts and science.
To many, this is an ideological point. The data portends a particular political point. To them, the idea that vaccines work portends that vaccine mandates are a good idea. If you are opposed to all government intervention, then the idea of vaccine mandates are a bad idea, so you need to attack the reason for them, which is the fact that vaccines work. We've seen this so many times, with mask mandates, with climate change proposals, if these problems portend government intervention, and you have no other proposal to combat these problems, then you have to attack the facts that portend that solution.
This is not political to me. This is personal. I don't care who you voted for, and I have every belief that my friend and I disagree on almost everything politically. Unfortunately, that damn near killed him, and given the fact that we almost identical in our demographics, there's little doubt that could have happened to me. For me, I've been vaccinated, I've been twice boosted, I've had zero problems, and I did eventually get COVID (albeit omicron) and it was like bad allergies, not over a month in the ICU. I didn't even miss a single day of work (remotely) and my life has not changed, as it clearly did with him.
I am not "blindly" "pro-vax". I'm blindly "pro-friend", regardless who they voted for.
@Joe Carlin: It's refreshing to hear that some folks can really agree to disagree. Life is too short. Let's accept that some people can remain friends if only they will accept the other's viewpoint but that viewpoint doesn't have to be adopted/swallowed entirely. Maybe certain points he makes are more valid than others. Why would you hate or reject someone that might educate you with alternative views? We tend to demonize alternative opinions. I can still consider my viewpoint more correct without actually hating my friend who "doesn't get it" (according to my experiences, education, and biases).
No country has financial interest in Pfizer, as Pfizer funded all of their own work.
Dear Katelyn, PLEASE do not cross that line and try to support the present administration, CDC, NIH or any other governmental or political entity= red or blue. Your value, and I have sent your reviews to many, is in dealing ONLY with data. As a retired pediatric infectious disease physician who worked in Academia (tenured at 2 Universities) until going to the FDA and working there for almost 20 years, there is only one thing that should convincingly persuade anyone about an intervention and that is data that is collected in randomized controlled trials. Unfortunately, we do not always have such and MUST use other data. At that point, all any of us are doing is bringing our own data set to the discussion. Your value is the data that you bring to the discussion, please do not veer into justifications or vilifications or assumptions about why people behave the way they do. Please stick to the data. Thank you for your contributions and I would only suggest reading Siddhartha Mukherjee's "The Gene" for an additional perspective on why people behave the way they do sometimes. D. Murphy, MD, FAAP
"Please stick to the data." Odd statement, considering that this is what the article in question does. Data do not exist in a vacuum, BTW. They must be interpreted. And the interpretation must be done in a way the evaluates the validity of said data.
Examining the motivations of those pushing misinformation is actually valuable data. So is differentiating facts from fabrications. Why would anyone want to oppose that?
I also see no issue with supporting "the present administration, CDC, NIH or any other governmental or political entity" IF said entity is dealing with facts and doing so honestly and with a goal of improving public health. Which, based on the available data, appears to generally be the case.
As an amateur here -
Disagree on 'restricting' the valuation. Social and/or profit-seeking aspects very obviously pertain to the field of epidemiology.
It is epidemiology, not a controlled drug or treatment evaluation. It deals with people's fears, irrational responses, and very much so when they are exacerbated by profiteering or malevolence.