COVID Vaccine News!

The Pfizer vaccine is good news, plus some theories about how reporting is broken

On Monday, we got some of the best COVID news we’ve had in a long time: there is a promising vaccine with high efficacy powering its way through Phase 3 trials that may be available as early as January.

We’re going to dish out the good new first and the follow up with the qualifiers.

• The Good News

• A Political Announcement?

• Not A Part of Warp Speed

• Disney Shorts: Thru The Mirror

The Good News

The announcement came from Pfizer, which has been making noise about their progress since September. The efficacy is reportedly over 90%, which is excellent news. This level of effectiveness would have a very serious impact on curbing the curves of future COVID outbreaks.

This is fantastic. The fact that we even have this kind of data on efficacy at this stage in the trial is pretty impressive.

For what it is worth, I will be getting this vaccine when it is made available.

One qualifier that I think is worth noting: Reports of clinical effectiveness are often higher than field reports. For example, the mumps vaccine was reported as over 95% effective in clinical trials, but field evaluations have rated it as 62%-85% effective. That isn’t nothing and we are certainly better off with a mumps vaccine than without one, but there can be large discrepancies between clinical reports and field reports, so my formal recommendation is cautious excitement.

A Political Announcement?

I hate talking about political considerations because over the last 6-8 months, I’ve found they are usually a 3rd or 4th level consideration. Most people are trying to do a job and do the best work they can do and they just aren’t thinking about politics.

Given the timing of this announcement (less than a week after a presidential election), I’ve seen some people suggest that it is political. My default position is “probably not”, but there is an article that goes into how this annoucement got made and here is the most likely timeline.

Having recruited volunteers for their Phase 3 trial, Pfizer did an analysis of 32 of them who had contracted COVID-19. This is known as the “interim analysis”. It takes time to formalize this analysis, to write it up, to report on it. This analysis was mostly likely completed in October, but in the time it took to complete it, 62 more study participants had contracted COVID. If I’m reading the results correctly, they decided (with guidance from the FDA) that they should include these additional cases in their analysis, which pushed the results back a week or so.

Near as I can tell, this additional analysis happened just this last week.

I don’t believe this was an explicitly political decision. At the very least, there are some excellent arguments for including more cases in an interim analysis since you want as sound an analysis as you can have and you don’t want to publish a new one every week.

Never A Part of Warp Speed

This vision of a non-political announcement is somewhat complicated (in my view) by the absolutely inexplicable statement from Pfizer’s head of research, Dr. Kathrin Jansen, that this trial was “never part of the Warp Speed” vaccine acceleration initiative.

But… I say it’s inexplicable but now I’m going to try to explain it. This is why I’m glad I’ve converted to writing long-form; tweets inflame the body’s humors and block the pathways to rational thought.

First, I’m going to allow myself a vent of frustration: What Dr. Jansen said was, on its face, ridiculous. I wrote about Operation Warp Speed with some excitement two months ago. I think it’s the most important program that the Trump administration has initiated. It is being helmed by some brilliant and careful scientists and it has shown real promise and delivered real results.

The core components of OWS are not about money for research and development, but about allowing vaccine trials to run as fast as possible. Is Phase 1 basically safe? Start on Phase 2. Are we getting good early results from Phase 2? Jump right into Phase 3. And we don’t wait for Phase 3 to complete before we start mass-producing the vaccine, the cost of which is being borne by the federal government.

Pfizer's ability to even run this trial makes it a part of Operation Warp Speed. The removal of red tape and the breakneck speed of trial advancement is the core component of this program. It is what makes everything else possible.

So… why would Dr Jansen say this?

It’s taken me a lot of deep breaths and careful thought to propose this: She wasn’t lying. She was most likely talking a corporate speak that was poorly thought out, ill-advised, and horribly reported.

Let me propose a scenario:

Pfizer has its hands on a promising vaccine. The results are starting to come in and they look good, but they are also aware that jumping the gun on any information may be viewed as political. This is the fault of both President Trump, who had been hinting at vaccine news pre-election, and Vice Presidential candidate (elect? I don’t know what to call her) Kamala Harris, who has indicated that she won’t trust vaccine news that comes out pre-election. Pfizer decides to wait for the extended analysis, partly because more info is better than less info and partly because they don’t want to be involved in any crazy election news cycle.

The election is over and they are putting together their slide deck for announcing the vaccine. I’ve build corporate slide decks and one thing you always do is sell your vision. You sell your product. You tell people why you’re way more awesome than everyone else in the product space, even if the differences are barely visible. Someone points out that Pfizer didn’t get government money for R&D for this vaccine, so that is a differentiating factor, so that becomes a bullet point. It comes out in the press conference as something like (this is not a quote, this is my imagining of something that could have happened)

We have been working on this with the vision that people deserve to live healthy lives. Here at Pfizer, we believe that so strongly that we committed our own funding to bring this vaccine to fruition. This research wasn’t even a part of Warp Speed, we have never taken any money from the US government, or from anyone, to bring the best quality health products to the people who need them.

The goal of such a statement is to be technically correct (the government didn’t technically fund the research component of the vaccine) while boosting the company in the public eye. It is (I think) sloppy and self-serving, but welcome to the world of the corporate press release.

But this statement was then dissected and seized on by the press as evidence that the one thing that the Trump administration did right was not actually even helpful. I hate this, but I’ve come to expect it. I feel like I can no longer trust anyone to just tell me the real story, like it is always filtered through some view that hopes to shape my perspective over just giving me clean, usable information. What I’m trying to do here in this newsletter is disentangle the news that isn’t news. I’m trying to look at the quotes in the articles and reverse engineer how someone could be telling the truth when it looks like they are being duplicitous.

My personal position is this: Operation Warp Speed is showing to be a crazy success. We have a dozen vaccines in the pipeline and it seems plausible that by the fall of next year we will be prepared to squash any major COVID surges that will be coming our way.

We should be OK with saying that the Trump administration did a good job with that. Bravo to them. Bravo to the researchers and pharm companies, to the volunteers who risked themselves for this trial. Bravo to everyone who is still in a COVID vaccine trial testing upcoming vaccines.

Despite the news, despite the misinformation, despite the frustrations and anger and mixed signals and politics, we really are getting through this thing. We will get through it and, when we do, let’s remember that we got through it together. The vaccine volunteers are black, white, brown, gay, straight, Republican, and Democrat. We’re all here, getting sick and getting better, testing the cures and risking placebos. The Pfizer vaccine might not even be the one that we use, but it’s a sign that we’re moving forward.

Disney Shorts: Thru The Mirror

Disney was obsessed with Alice’s Adventures in Wonderland and Through the Looking Glass since he was a kid. In face, his first real success came from a short series of shorts he called the “Alice Shorts” which involved a live action actress being transported to a magical cartoon wonderland. It wouldn’t be until 1951 that Alice in Wonderland became a Disney feature film (screenplay by Aldous Huxley? What?!?) but that didn’t stop Walt from experimenting with wonderland in his shorts.

This early Mickey color short has Mickey Mouse falling asleep to Lewis Carroll’s classic and dreaming himself through his bedroom mirror into a wonderland of esoterica where walnuts shrink him and grow him and every word is taken literally.

This short is an endless delight. The animation is glorious, the jokes and gags come at you non-stop. Plus Mickey is totally hitting on the queen of hearts! It’s complex, inventive, adventurous, curious, and just plain fun. I don’t know what it is about Alice that so inspires such an overflowing of imagination (maybe it’s the LSD) but I love it.