The failure to balance risk abated by a preventive measure with risk from the measure is a good reason for the backlash against the COVID vaccines. Looking at risk from the disease compared to vaccine side effects, it is clear that no net benefit exists for those under age 25 (thanks to negligible risk from the disease) and even an incre…
The failure to balance risk abated by a preventive measure with risk from the measure is a good reason for the backlash against the COVID vaccines. Looking at risk from the disease compared to vaccine side effects, it is clear that no net benefit exists for those under age 25 (thanks to negligible risk from the disease) and even an increased risk for males in the cohort less than 25 years old. In contrast, there is a net reduction in overall risk of morbidity for mortality with a vaccination for those over age 25, increasing significantly after age 60. Because public health leaders chose to downplay or ignore treatment-induced risks, they adopted a strategy that came back to bite them in the ass when the risks became known to the general public. This is not a condemnation of the vaccine - ALL vaccines carry some risk - but rather the strategy of public health leaders to pursue a universal vaccination goal and not ignore, but actively downplay the tradeoffs.
It is not the first time we have seen this in the Public Health community. Neustadt and Fineberg documented the same pattern in the 1975-76 Swine Flu incident in an evaluation commissioned by former Secretary of Health, Education, and Welfare Joseph Caliafano. I documented problems with framing the need to improve the public health system's ability to deal with infectious diseases by tying it to the fear of bioterrorism in a 2004 article in the journal Public Administration Review, and made similar criticisms of WHO and CDC communications over the 2009 Influenza epidemic in an interview I gave CBS.
The problems with much of the leadership in public health are a monotechnic focus on a single solution without consideration of opportunity and transaction costs as well as an unwillingness and inability to communicate issues of risk to the public. With the latter, there are structural incentives that exist in the fact that communicating fear increases agency power and improves budgetary position.
The failure to balance risk abated by a preventive measure with risk from the measure is a good reason for the backlash against the COVID vaccines. Looking at risk from the disease compared to vaccine side effects, it is clear that no net benefit exists for those under age 25 (thanks to negligible risk from the disease) and even an increased risk for males in the cohort less than 25 years old. In contrast, there is a net reduction in overall risk of morbidity for mortality with a vaccination for those over age 25, increasing significantly after age 60. Because public health leaders chose to downplay or ignore treatment-induced risks, they adopted a strategy that came back to bite them in the ass when the risks became known to the general public. This is not a condemnation of the vaccine - ALL vaccines carry some risk - but rather the strategy of public health leaders to pursue a universal vaccination goal and not ignore, but actively downplay the tradeoffs.
It is not the first time we have seen this in the Public Health community. Neustadt and Fineberg documented the same pattern in the 1975-76 Swine Flu incident in an evaluation commissioned by former Secretary of Health, Education, and Welfare Joseph Caliafano. I documented problems with framing the need to improve the public health system's ability to deal with infectious diseases by tying it to the fear of bioterrorism in a 2004 article in the journal Public Administration Review, and made similar criticisms of WHO and CDC communications over the 2009 Influenza epidemic in an interview I gave CBS.
The problems with much of the leadership in public health are a monotechnic focus on a single solution without consideration of opportunity and transaction costs as well as an unwillingness and inability to communicate issues of risk to the public. With the latter, there are structural incentives that exist in the fact that communicating fear increases agency power and improves budgetary position.