A Helluva Spot

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Yesterday, Albert Bourla, the CEO of Pfizer, went on CNBC to discuss a new study which suggests that the Pfizer vaccine’s efficacy drops from about 96% against hospitalization to about 84% after six months. Bourla said that these results match with data emerging out of Israel. “We have seen also data from Israel that there is a waning of immunity and that starts impacting what used to be what was 100% against hospitalization. Now, after the six month period, is becoming low 90s and mid-to-high 80s.”

The good news, says Bourla, is that this can be solved with a booster shot. This all sounds plausible and it’s good news inasmuch as people can get booster shots and get back to higher levels of protection. But study is funded by Pfizer and remember that Pfizer is currently in a tussle with the CDC and the FDA over whether booster shots are actually necessary. A few weeks ago Pfizer announced it was moving ahead with seeking authorization for a third shot and the CDC and FDA, quite curtly, issued a joint statement saying, in so many words, not your call.

One way to look at this is that Pfizer has a multi-billion dollar incentive to create a market for third shots. (Here we’re talking about a third dose of the same vaccine.) And that is a pretty good way to look at it. But that doesn’t mean that boosters aren’t a good idea – at least for some people or perhaps at some point. The real issue is we need some impartial arbiter to sort this issue out. We can’t be led around in our COVID control strategies by a private company which stands to make billions or tens of billions of dollars based on the decision being made in a certain way.

My point isn’t that he’s a sheyster. Quite apart from the payday, I’d be pretty stoked if my company had delivered quickly on a vaccine that was saving literally millions of lives around the world. To a great extent, if you’ve made a kick-ass hammer, everything starts to look like a nail. But again, we need someone to sort out the facts here and it can’t be the company that sells the vaccine. Or at least not them alone.

There’s an additional debate about just what drives immunity from the vaccine. I won’t try to summarize it. But the gist is that the level of antibodies in your blood isn’t the only measure of your current immunity. I’m not in a position to evaluate the actual study. But my zero-technical-expertise read was that the study itself seems more equivocal than what Bourla suggests. Here’s one key sentence from the discussion portion fo the study: “Efficacy peaked at 96.2% during the interval from 7 days to <2 months post-dose 2, and declined gradually to 83.7% from 4 months post-dose 2 to the data cut-off, an average decline of ~6% every 2 months. Ongoing follow-up is needed to understand persistence of the vaccine effect over time, the need for booster dosing, and timing of such a dose."

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