Biden Pledges to Follow Science. But Sometimes It Gets Ahead


WASHINGTON — As he announced Friday that booster vaccines will be available to some Americans, President Biden made a prediction: His administration is likely to soon provide a third dose of the vaccine “anywhere” to anyone who wants it.

“In the near term, we’ll probably open this up,” he told reporters from the State Dining Room at the White House.

But this politically popular assessment in a country where most people vaccinated against the coronavirus say they’re eager for a supplement is the latest example of how Mr. Biden and some of his team are ahead of the nation’s top public health scientists. , stressing that in recent days there is not enough evidence to suggest that boosters are necessary for the entire American population.

In fact, two panels of scientists, one for the Food and Drug Administration and the other for the Centers for Disease Control and Prevention, voted against recommending boosters to everyone in recent days, following fierce public debate posted online.

The president’s remarks on Friday were when he suggested that for the second time in two months the boosters would be open to all. CDC director and one of the president’s political appointees, Dr. They were published the day Rochelle P. Walensky was fired. allowing boosters for a larger group of people more than the agency’s own vaccine panel recommends.

Taken together, Mr. Biden and Dr. Walensky’s statements didn’t quite fit all of the scientists who advised them, raising questions about the president’s commitment to always “follow the science” while battling the pandemic. While some trusted the CDC director for charting a course in uncertain waters, others warned that politics interfered with scientific decisions—something Mr. Biden promised to avoid after the war. The obvious pressures seen during the Trump administration.

“Everyone uses this ‘follow the science’ phrase very openly, and I don’t think the science here guarantees that you can pick a group of people and say you have a higher risk of getting an infection,” said Dr. Sarah S. Long, a member of the CDC’s advisory committee, referred to groups of workers made available for reinforcement firing.

A professor of pediatrics at the Drexel University School of Medicine, Dr. Long said that telegraphing a president’s opinion before the official public health process undermined expert advisers, calling it a violation of “balances and balances” in the system. . Also, Dr. He criticized Walensky for increasing the number of people available for boosters.

If this reversal pattern were to go beyond boosters, “it would be the end of the vaccine program as you know it,” he said.

But a number of other committee members, including those who resisted broad expansion of the reinforcement program, said Dr. He defended Walensky’s decision, adding that federal regulators allowed additional withdrawals less than 24 hours before CDC advisors were asked for guidance. This is to them, like staffing needs in hospitals or schools, Dr. He left less time to discuss Walensky’s weighty issues and little time to articulate the language of his proposals.

D., clinical director of organ transplantation and immunocompromised host infectious diseases at Massachusetts General Hospital. “At a time when more than 2,000 Americans are dying a day, we are not in a position to sit and wait,” said Camille Kotton. . “We have to act as quickly and thoughtfully as possible.”

Still, the CDC’s medical advisers said Friday largely because new attempts by the White House to block parts of the support campaign are thwarting the public’s desperately needed clarity.

Chair of the immunization committee and professor of pediatrics at Stanford, Dr. “Even though the pandemic is a public health emergency, I hope we will have enough space and grace to continue using our process,” said Grace Lee. University Faculty of Medicine.

The president’s exposure to such criticism is precisely where he promised he would never be.

As a candidate, Mr. Biden has repeatedly denounced President Donald J. Trump for putting pressure on scientists at the CDC and FDA. CDC’s headquarters in Atlanta.

“A whole generation is coming who learns from what they do,” he told those working there that day. “I’m not just talking about learning how to deal with a virus. Learning it, telling the truth, following the science and wherever it takes you and being honest about it makes a difference.”

White House officials insist the president did just that, and dismiss criticism that his comments about the additional doses put undue pressure on the government’s public health experts. They say the discussion about promoters was initiated by the government’s top doctors, and the administration made it clear from the start that any decision would be subject to independent review and approval.

And Mr. Biden has deferred much more to public health professionals than Mr. Trump, who is pushing FDA and CDC officials to act faster and privately to approve vaccines. actively promoted unproven treatments for coronavirus like hydroxychloroquine. The former president also clashed with scientists many times. Wearing mask and decisions about when will schools open, churches and other events.

But the public embrace of Mr. Biden’s booster vaccines has ranked many in the public health sector, including those working within the government, and he says it could have the effect of putting undue pressure on scientists. evidence.

Some public health officials and doctors say they fear Mr Biden, who has dedicated his presidency to successfully managing the pandemic, will push for supplements because they are politically popular. A Reuters/Ipsos national survey A study conducted Aug. 27-30 found that 76 percent of Americans who had at least one shot of the vaccine wanted a booster. Only 6 percent are absent, according to the survey.

In mid-August, the president told the nation that his administration plans to provide booster vaccines to everyone starting the week of September 20, pending decisions from the FDA and CDC.

“As a simple rule of thumb, take a booster shot eight months after your second shot,” he said in a speech at the White House.

It turned out to be premature. Only one vaccine manufacturer, Pfizer, has gained authorization to administer supplemental doses, and only for some of its recipients.

On Wednesday, the FDA authorized boosters, but only for older adults, people with underlying health conditions, and some frontline workers who are frequently exposed to the virus.

The agency’s decision was the exact opposite of Mr. Biden’s earlier comments.

Doctors also called Dr. They were divided over Walensky’s decision to override his own panel of immunization experts.

On Thursday, the panel voted to recommend boosters for older adults and those with underlying health conditions. However, it recommended that frontline workers such as teachers and nurses who have already been vaccinated should not be allowed to receive booster vaccinations.

In a decision announced early Friday morning, Dr. Walensky rejected this latest recommendation and said the CDC would allow frontline workers to receive support. In a briefing to reporters later on Friday, he defended the move, noting that the delegation was sharply divided on the issue.

Dr. “Our teachers face uncertainty as they enter the classroom, and I must do my best to protect the health of our nation,” Walensky said, describing it as “the first step” and adding that “we will continue to review.” new data on efficacy and experience with the third shot, as it becomes available.

Professor of medical ethics and health policy at the University of Pennsylvania, Dr. Steven Joffe, with such a close vote at the CDC meeting, that Dr. He said it was reasonable for Walensky to manage it differently. However, he suggested that he and management may have been impressed by the earlier support he had shown for a wider distribution of the booster.

“To what extent did he feel compelled to follow this line of decision-making?” said. “I can’t get inside his head and answer that question. The fact that the final decision makers had predetermined their final positions put the advisory boards in a very difficult position.”

Jason L. Schwartz, associate professor of health policy at the Yale School of Public Health, Dr. He said Walensky’s intervention “reflects how closely and directly engaged senior political appointees have been in shaping this support programme.”

He anticipated that his participation would “color” the future work of the expert committee.

Michael D. Scissors reported from Washington and Benjamin Mueller from New York. Noah Weiland Contributed to reports from Washington.



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