Pandemic prescriptions

Gregory Poland still carries a postcard he received in 2020 from a 9-year-old girl. The large handwriting in purple marker reads, “Hi there Did you find a vacsen yet Do you think coved will Be over sonne.”

Poland holds it up during our Zoom interview, covering the girl’s name to protect her privacy.

“This little girl took it upon herself to write to me,” said Poland, a professor of medicine and infectious disease at the Mayo Clinic in Rochester, Minn. “She’s had a liver transplant and she’s scared.” Poland and his wife met the girl and her family during the COVID-19 lockdown. He says they got so close to the family they became like her unofficial grandparents. Eventually the girl did get COVID, and he helped her through it. Today, she’s fully recovered.

“This is why I do what I do,” Poland said, tears welling in his eyes.

Poland is the founder and director of the Mayo Vaccine Research Group and the editor-in-chief of the journal Vaccine. He gives consultative advice to nearly every Western vaccine manufacturer, including Pfizer and Moderna, and is a vaccine adviser to the Biden White House.

Those positions cross-pollinate well, but Poland also has a surprising line on his résumé. He graduated from Westminster Theological Seminary in Philadelphia and serves as assistant pastor of a Presbyterian church in Florida, where he lives. “It’s only a modern concept that there’s any sort of divide between ministry and medicine,” he told me. “I’ve been a believer as long as I’ve been a physician, which is over 40 years, and regularly pray with my patients.”

In March 2020, the COVID-19 pandemic swept into America like a flash flood into a canyon. In those early days, the level of fear and isolation was nearly unbearable for many. Millions of Americans looked forward to the release of vaccines as to the coming of a savior—their only protection against death or severe sickness.

Hospitals braced for impact. Staffers at the Johns Hopkins Hospital in Baltimore set up a special COVID in-patient ward to prepare for an influx of patients. Stuart Ray, a professor of medicine in the division of infectious diseases, volunteered to be the attending physician on the first shift.

“I thought, ‘This is not that different from what we had at the height of AIDS,’” Ray said. Plus, younger medical staff members were nervous, “so I just suited up. I’ve been at Hopkins for 32 years and wearing PPE is part of the job as an infectious-­disease doctor,” he said, referring to the acronym for personal protective equipment. Ray stands out in a crowd, not only because he’s 6'5" with blond hair and blue eyes, but because he still wears a mask. He credits masking for the fact that he’s never been infected with COVID.

This month marks three years since those ­terrifying early days of the pandemic, and unlike Ray, most Americans have thrown their masks in the trash. But many questions linger, particularly about the efficacy and risks of the COVID-19 vaccines. Eighteen months ago, such questions prompted condescension from public health officials and medical community leaders. Now, though, doctors and researchers have begun openly debating what went wrong during the pandemic response—and trying to tally the fallout.

But Gregory Poland isn’t debating. He says plainly that America now needs a COVID “truth commission”: “We had people sworn to protect the public health who politicized this and said something publicly different than what they did privately. And it cost people’s lives.”

IN LATE 2020, the FDA issued emergency use authorizations (EUA) for two COVID-19 vaccines made by Pfizer and Moderna. Both relied on a newer technology that uses mRNA—or messenger RNA—created in a lab. A single-­stranded molecule of ribonucleic acid, mRNA works in the COVID vaccines by teaching healthy cells how to make a full or partial protein that triggers an immune response.

In Februrary 2021, the FDA issued an EUA for a vaccine produced by Johnson & Johnson (J&J). The J&J vaccine worked using a modified version of a vector virus—not the COVID-19 virus—to trigger the immune response. Some Americans preferred that more traditional technology. However, in May 2022, the FDA restricted use of the J&J vaccine due to a risk of blood clots.

MRNA technology had not been used in the vaccines Americans normally get, but it didn’t come out of nowhere, says John Moore, an immunologist at Weill Cornell Medical College in New York City. “MRNA vaccines were under development for the best part of a decade.” When President Donald Trump announced Operation Warp Speed in May 2020 to accelerate vaccine development and production, the mRNA options won out.

“It was a logistics issue because of the urgent need to get as many people vaccinated as possible,” Moore said. “It was whatever could be made as quickly as possible in bulk because you’re making billions of doses in the end. You don’t do that by snapping your fingers.”

Vaccines usually require five to 10 years or even longer to reach patients. Compared with that, COVID-19 shots did arrive in a finger-snap. Johns Hopkins’ Stuart Ray called the vaccines “almost miraculous.” Moore called them a “game changer.”

“I think a lot of the fear went out of our society; at least people who chose to be vaccinated could get back on with their lives,” Moore said.

Public health officials trumpeted the vaccines’ arrival with a massive public relations campaign, but many Americans’ attitude was, “Not so fast.” For months, health officials had seemingly contradicted themselves about important aspects of the pandemic response, eroding public trust.

Poland believes that mistrust, and not conspiracy theories or scientific ignorance, drove vaccine resistance. He notes that the country of Denmark had one of the highest rates of vaccine uptake. “When [researchers] ask people why they got vaccinated, they say: ‘It’s because our government leaders in public health told us to, so we did it.’ They trust their government.”

Epidemiologist Jay Bhattacharya challenged the public health response from the beginning. A ­professor of medicine at Stanford University and a committed Christian, Bhattacharya found the official approach alarming.

“Public health panicked and ­misread the evidence,” he said. “Instead of sticking to normal standards for very high-quality evidence for making decisions, they decided because this was such a crisis, even low-quality evidence would suffice to make very broad decisions that damaged the lives and livelihoods of the poor, the vulnerable working class, and children.”

Bhattacharya chooses his words carefully, often qualifying his statements. He looks every inch the professor with his salt-and-pepper hair, glasses, and sweater. But his mild demeanor belies the boldness it took to defy the apparent consensus of public health officials not only in America but in most of the world.

In October 2020, Bhattacharya joined with epidemiologists from Harvard and Oxford to write an open letter, the Great Barrington Declaration. The document called for “focused protection” of those at risk for COVID and letting everyone else go about their lives. “There’s nothing really new in it,” Bhattacharya told me. “It’s basically the old ­pandemic plan that worked for a century for respiratory virus pandemics. You protect vulnerable people and develop therapeutics and vaccines as quickly as you can. And then for the rest of the world, you don’t disrupt society because it hurts people more than it helps them.”

Preeminent public health officials, such as famed geneticist Francis Collins, met the Great Barrington Declaration with fierce criticism, claiming the approach it advocated would cause mass fatalities. Collins, who is also a Christian and once led the Human Genome Project, by 2020 headed the National Institutes of Health. He fired off an email to Anthony Fauci, then director of the National Institute of Allergy and Infectious Diseases. Collins called for a “quick and devastating published takedown” of the Great Barrington Declaration. In the same email, which came to light through a Freedom of Information Act request, Collins called Bhattacharya and his co-authors “three fringe epidemiologists.”

Bhattacharya’s faith helped him cope with those attacks. “For me, my identity is in Christ,” he said. He now carries around business cards a friend made for him that say “Fringe Epidemiologist.”

Still, the email’s implications were no joke. “Tony Fauci and Francis Collins sit on top of almost $45 billion of money that funds the work of every biomedical scientist of note in the United States,” Bhattacharya said. “You can’t get tenure at a top medical school unless you have an NIH grant. So when they say ‘fringe epidemiologists,’ it’s an implied threat: If you cross us, it’s not just that you won’t be able to get funding for your research. It also determines social status within science.”

Bhattacharya believes that’s why there appeared to be broad medical consensus about COVID policies when many medical professionals did not in fact agree. Today, more of those professionals feel free to speak their minds. The central idea of the Great Barrington Declaration, that mass shutdowns caused more harm than they averted, is becoming mainstream opinion.

IN 2021, COLLEGIAL EFFORTS to raise vaccine uptake turned into mandates. That September, President Joe Biden issued executive orders requiring vaccination for federal government employees and companies with 100 or more employees. The Supreme Court eventually struck down the mandate for private employers, but many companies imposed their own. A survey in late 2022 found that over one-third of businesses still required employees to be vaccinated.

According to the Centers for Disease Control and Prevention (CDC), 81 percent of eligible Americans got at least one dose of a COVID-19 vaccine. Meanwhile, Christians and other religious objectors across many ­occupations scrambled to file exemptions. Many objected to vaccines based on the use of aborted fetal tissue cells in testing or production.

Brandon Scroggins pastors Reformation Baptist Church in Wetumpka, Ala. He wrote eight to 10 exemptions for people faced with getting fired if they didn’t get the shot. “I thought it’s the least we could do to help our people who stand to lose everything,” he said.

That was especially true for members of the military. All service branches required COVID-19 vaccination. Scroggins wrote an exemption for a church member who was approaching retirement after 19½ years in the Air Force. The exemption review dragged on long enough that he reached 20 years. He was able to retire unvaccinated with his full pension. His case was unusual, though. About 8,400 service members were discharged for refusing the vaccine.

Some doctors spoke out against universal vaccination. Martin Kulldorff, professor of medicine at Harvard University (on leave) and co-author of the Great Barrington Declaration, tweeted in March 2021, “Thinking that everyone must be vaccinated is as scientifically flawed as thinking that nobody should. COVID vaccines are important for older high-risk people, and their care-takers. Those with prior natural infection do not need it. Nor children.”

However, Twitter censored Kulldorff’s opinion and similar ones by other doctors, a fact revealed by the “Twitter files,” a trove of documents Elon Musk released after he purchased the company. Two vaccine reviewers resigned from their positions at the Food and Drug Administration, openly declaring their disagreement with the agency’s recommendation that everyone get boosted.

Bhattacharya notes that vaccine trials tested only whether the shots prevented symptomatic infection for three months. Not a very useful benchmark, he said: “What you want to know is, does this vaccine prevent disease transmission?”

But those shortcomings did not stop people from drawing excessively optimistic conclusions—that, for example, the vaccine would make the disease go away. “That was never possible,” Bhattacharya said.

Along with mandates, vilification and even demonization of unvaccinated Americans became widespread. President Biden got in on the act in December 2021. “We are looking at a winter of severe illness and death for the unvaccinated—for themselves, their families, and the ­hospitals they’ll soon overwhelm,” he said.

Though hospitalizations and deaths among older Americans spiked that January, no wave of mass deaths materialized. But the share of deaths among those who received a vaccine did climb throughout 2022, according to a Kaiser Family Foundation analysis. Amid these statistics, official hyperbole about vaccine efficacy seemed to harden the resolve of Americans already hesitant about getting the shot. Bhattacharya believes it’s unlikely the vaccines would have been as contentious as they were—and still are—had people not felt government pressure to take them.

THE GOVERNMENT’S controversial vaccine messaging is largely over, but investigations into the harm caused by the vaccines themselves is only now ramping up. A study by the Commonwealth Fund in December found the ­vaccines had prevented over 18 million hospitalizations and 3 million deaths. The study used a computer model of disease transmission to come up with its estimates. But it’s impossible to put a precise number on something that didn’t happen. And despite the vaccines, the CDC says over 1 million Americans have died of COVID.

A January 2023 Rasmussen poll found nearly half of Americans think COVID-19 vaccines are to blame for many unexplained deaths, and more than a quarter think they know someone who might have been a victim.

Sandy Regler, 61, believes she suffered an adverse ­reaction. On a cold Baltimore morning in January 2022, she woke up with a strange throbbing in her head. “It was this persistent headache, 24 hours a day,” she said. Regler is a retired police officer who had always enjoyed good health and had no history of headaches. She first went to her ­doctor, then began milling through an endless cycle of tests and appointments with specialists.

She also went to her dentist to see if the headaches might stem from some kind of jaw issue. The dentist asked a question that startled her: “How soon after your booster did the headache start?” Regler replied that she had gotten the first series of vaccines in April 2021 followed by a booster in December. The headache, she said, started ­several weeks later. Even now when she asks doctors about a connection with the vaccine, they get “very, very uncomfortable,” she says. At this point, Regler manages the pain with prescription medications but still has many questions.

She’s not alone. During a congressional hearing in February, Rep. Nancy Mace, R-S.C., said she suddenly developed chronic asthma after her second shot. “I have tremors in my left hand, and I have the occasional heart pain no doctor can explain.”

Much of the speculation about adverse reactions ­centers on the Vaccine Adverse Event Reporting System (VAERS), a database co-managed by the CDC and FDA. Private individuals and medical professionals can use VAERS to report post-vaccination health events.

Stuart Ray warns VAERS alone cannot be used to draw conclusions. “VAERS only asks the question: Have you had any health event, and did you receive the vaccine?” To date, over 19,000 deaths after COVID-19 vaccination have been reported to VAERS, but the CDC has only confirmed nine as causally linked to the vaccines. All events require further study to evaluate a causal relationship.

You would be hard-pressed to find a person more pro-­vaccine than the Mayo Clinic’s Gregory Poland, but he also acknowledges suffering an adverse reaction. “After my second dose of the mRNA vaccine, I developed tinnitus, which is a persistent ringing in the ears, and I decided to go ahead and get my third dose and it got dramatically worse,” he said. “Once I was ­sitting in a hot tub by myself at night, looking up at the stars and tears came to my eyes, realizing I will never hear quiet or silence again.”

Poland still strongly believes the benefits of COVID-19 vaccines outweigh the risks. He recently encouraged vaccination for his daughter-in-law, who is pregnant, and also for his 18-month-old grandson. He speaks openly about his ­tinnitus in hopes of provoking honest discussion about the vaccine and to encourage doctors not to dismiss patients who complain of adverse reactions. He recently addressed an online gathering of vaccine-injured people: “I realize as I’m looking at the sea of faces on the screen, people are crying. And so I stopped to inquire about this. The bottom line was, they told me, ‘Nobody has taken us seriously.’”

COVID-19 vaccines have proven highly lucrative. Pfizer brought in around $36 billion from global sales of its vaccine in 2021, making it one of the most profitable pharmaceutical products in history. This led some to charge that vaccine mandates represented a form of corporate welfare. COVID vaccine makers are exempted from legal liability under the Public Readiness and Emergency Preparedness Act of 2005. Still, victims of vaccine injuries can seek ­compensation under a federal program called the Countermeasures Injury Compensation Program. It pays a maximum of $50,000 per year for lost wages and covers medical bills. The maximum payout for a death is $370,376. The program has received 11,252 claims related to COVID-19 ­vaccines and treatments. So far, it has awarded compensation for only 21 claims.

The FDA and CDC currently acknowledge some adverse events, including myocarditis (an inflammation of the heart muscle), blood clots, disruptions to women’s menstrual cycles, and Guillain-Barré syndrome, a neurological disorder. Poland is working to get tinnitus added to the list. “When I’m in rooms with them, I pound my fist on the table,” he said, recalling meetings with public health officials. “I’m pushing CDC, who doesn’t want to recognize tinnitus as a side effect, even though other countries have.”

Bhattacharya believes the focus on vaccine injuries is, at least partly, a manifestation of resentment. “The idea the ­vaccine created harm is very salient if you feel forced to take it, as opposed to something you chose to take because it was right for you from a medical point of view.”

VACCINE UPTAKE HAS WANED drastically over time. According to the CDC, only 16 percent of the eligible population has received the latest boosters. Poland says public health officials have done a poor job of communicating their benefits. They are presented as a matter of life or death, he said, when they should be framed in nuanced terms regarding the protection they offer against serious infection and its side effects. “You can’t capture that in a public health recommendation,” he said. “And so they end up saying very black-and-white things. I always kind of grit my teeth.”

Stuart Ray hopes doctors will eventually be able to make booster recommendations based on a patient’s risk profile, as determined by tests and medical history. Poland is tracking promising research on redeveloping boosters as a nasal spray, transcutaneous patch, or oral tablet.

In his role as a White House vaccine adviser, Poland fields questions about the best way to communicate with the public. He always repeats the same advice: “radical, transparent honesty.”

Public health officials should acknowledge the risks of the vaccines but weigh those against the greater risks posed by the virus, he said. But they should also admit there are still many unknowns. After that, Poland said, officials should strive to answer every last question anybody asks.

“I think when you approach people that way, you build trust with them,” he said. “It takes a long time to build trust. It takes one minute for the government to destroy trust.”

Vaccine concerns

A January Rasmussen poll asked 1,000 Americans …

The margin of sampling error is +/- 3 percentage points with a 95% level of confidence.