POLITICO NIGHTLY: The upside of the vaccine slowdown

 

BY LAUREN MORELLO With help from Myah Ward SAFETY FIRST — AstraZeneca halted its coronavirus vaccine trials this week while it investigates whether a participant’s serious health problem — reportedly spinal cord inflammation — was caused by the shot. The company’s decision to pause the studies while it reviews safety data is encouraging, because it shows the system is working. But it’s a good reminder that developing safe and effective vaccines is a tricky process. And it’s rarely followed so closely by the general public as it has been during this pandemic. Before we get any further, let’s be clear: vaccines are generally safe. In 2014, the CDC estimated that vaccinations would prevent more than 21 million hospitalizations and 732,000 deaths among kids born between 1970 and 2013. And the World Health Organization says that vaccinations prevent 2 million to 3 million deaths worldwide each year. But governments and scientists are walking a tricky tightrope with the coronavirus: trying to compress the normal vaccine development timeline from years to months, without sacrificing safety. Some of today’s safety rules stem from an incident in the 1950s, when a faulty polio vaccine manufactured by Cutter Laboratories infected 40,000 children. Fifty-one were paralyzed and five died. The Cutter vaccine relied on inactivated polio virus — but some 120,000 doses made by the company mistakenly contained live virus that was able to infect children who got the shot. Even with strict safety rules and large clinical trials, it’s not always possible to detect potential problems with a vaccine. Still, the post-Cutter safety rules have worked well. In the late 1990s, the FDA quickly halted the use of a vaccine against rotavirus, a diarrheal disease that is sometimes fatal in children, after reports that it appeared to cause a particular form of bowel obstruction. Later research conclusively linked the shot to the bowel problems, and the vaccine’s manufacturer pulled it from the market. It took eight years for another, safe rotavirus vaccine to be approved. So there are good reasons to be cautious about rushing a vaccine to market. Faced with predictions of a swine flu pandemic in 1976, President Gerald Ford launched a full-court effort to develop a vaccine and distribute it as quickly as possible. But the flu strain that year turned out to be relatively mild, and 450 people who received the vaccine developed Guillain-Barré syndrome, a rare type of paralysis. The risk-reward calculus is slightly different now. We know that the coronavirus is deadly, and can cause debilitating, chronic health problems in survivors. But the reasons for caution remain. A vaccine that causes serious side effects or death violates medicine’s core precept, first do no harm. Yet a vaccine can kill indirectly, too. A vaccine that turns out to be less effective than its initial promise could give people a false sense of protection and prompt them to take greater, and sometimes deadly, risks. And any kind of health problems caused by a coronavirus vaccine, no matter how mild, could undermine confidence in life-saving shots for a wide array of diseases in the decades to come. Welcome to POLITICO Nightly: Coronavirus Special Edition. Where will Rage land in Nightly editor Chris Suellentrop’s Bob Woodward power rankings? Reach out rrayasam@politico.com or on Twitter at @renurayasam. FROM THE HEALTH DESK SEEN BUT NOT HEARD — A Health and Human Services appointee is trying to prevent Anthony Fauci, the government’s top infectious disease expert, from speaking about the risks that coronavirus poses to children. Emails obtained by POLITICO show Paul Alexander — a senior adviser to Michael Caputo, HHS’s assistant secretary for public affairs — instructing press officers and others at the National Institutes of Health about what Fauci should say during news interviews, health care reporter Sarah Owermohle reports. The adviser weighed in on Fauci’s planned responses to outlets including Bloomberg News, BuzzFeed, Huffington Post and the science journal Cell. Alexander’s lengthy messages, some sent as recently as this week, are couched as scientific arguments. But they often contradict mainstream science while promoting political positions taken by the Trump administration on hot-button issues ranging from the use of convalescent plasma to school reopening. The emails add to evidence that the White House, and Trump appointees within HHS, are pushing health agencies to promote a political message instead of a scientific one. Jewish seminary students study behind protective plastic screen cells to prevent the spread of Covid-19 in Sderot, Israel. | Getty Images ASK THE AUDIENCE Is your child heading back to school? If so, Nightly wants to hear from them. Parents and students can send us a short, 1-3 minute voice memo recording to audio@politico.com by Friday, Sept. 11. Please include (1) names, (2) hometown, and (3) the answer to this prompt: Describe the first day of school this year, whether it was remote or in-person. (Anecdotes are encouraged!) Please try to record in a quiet area and hold the phone as if you were talking to someone, but about 1-2 inches from your face. We're accepting submissions from students (and parents of students) from kindergarten through 12th grade. If your student is a minor, parents/guardians, please acknowledge somewhere in the email that you are giving POLITICO permission to use the audio for our podcasts or audio production if we choose to do so. (We can also use the student’s first name only if privacy is a concern.) We’ll use select submissions next week in Nightly. AROUND THE NATION NYC’S ALFRESCO FAREWELL — Indoor dining can resume at 25 percent capacity in New York City on Sept. 30. New York Gov. Andrew Cuomo announced during a briefing in Manhattan that city restaurants can add a fraction of their indoor dining capacity with a host of limitations, including temperature checks at the door, enhanced air filtration requirements in buildings and a strict mask mandate. Patrons must wear face coverings at all times except when seated at their tables, New York reporter Anna Gronewold writes. Tables must be at least six feet apart and one member of each party must provide their personal information in case contact tracers need to investigate a cluster of infections. Bar service will not be allowed. Cuomo said a ramped-up State Liquor Authority and a State Police task force have monitored 36,000 establishments across the state and helped to bump social distancing compliance at outdoor dining and bars to 99.2 percent. Positive coronavirus tests also remain low across the state: Today, New York had a 0.9 percent infection rate, he said, the latest in more than a monthlong string of positive rates under 1 percent. CASES UP ON THE FARM — Cramped living quarters. No time off. A lack of protective gear. Advocates warned at the start of the pandemic that farms were ripe for outbreaks. In the latest POLITICO Dispatch , agriculture and trade policy intern Ximena Bustillo explains how decades of workplace issues created a coronavirus disaster among farmworkers. Listen to the latest POLITICO Dispatch podcast THE GLOBAL FIGHT DICKENSIAN CHRISTMAS PERIL — Boris Johnson wants to save Christmas through mass testing — but his advisers are bracing for a long winter. The U.K. prime minister said today that new “simple, quick and scalable” tests that involve saliva swabs and turn out results in just 20 minutes should become available “soon” and could allow those testing negative not to socially distance, Cristina Gallardo writes. The government aims to pilot this approach in indoor and outdoor venues in northwest England next month, he said, adding that this could allow the U.K. “to have life much closer to normal by Christmas.” England’s top doctor, Chief Medical Officer Chris Whitty, struck a more somber tone at a joint press conference with the prime minister. “The period between now and spring is going to be difficult because this is a respiratory virus,” Whitty said. ON THE HILL THE DEAL WITH THE DEAL — The prospect of Congress and the White House providing coronavirus relief to millions of Americans is getting worse by the day, despite leaders in both parties saying they’re open to a deal, Marianne LeVine and John Bresnahan write. The Senate is set to vote Thursday on the GOP’s narrow relief proposal, which even Republicans acknowledge will not pass. Meanwhile, Treasury Secretary Steven Mnuchin, the Trump administration’s lead negotiator, is tamping down expectations that an agreement can be reached. Mnuchin said today that his main focus is making sure Congress passes a stopgap measure to keep federal agencies open beyond Sept. 30. As for a coronavirus relief package, Mnuchin said he was unsure if a compromise is possible. NIGHTLY NUMBER 15 The maximum number of people identified as having Covid-19 of the 675,000 passengers screened at 15 designated airports, according to a government document obtained by Reuters. The U.S. government is set to remove limitations on where international flights can land in the U.S. and end enhanced medical screening of international passengers starting next week. PARTING WORDS ALL THE RAGE — Chief Washington correspondent Ryan Lizza emails us: Washington is entering a Bob Woodward book news cycle, a semi-regular media storm that like a hurricane is different each time but has some distinctive characteristics. We saw it approaching when President Donald Trump attacked Woodward in a pair of August tweets, calling the book he hadn’t read “FAKE,” and its author a “social pretender.” It reached shore today, when the book, Rage, which is partly based on 18 interviews with Trump and is scheduled to drop next Tuesday, Sept. 15, was obtained by CNN and The Washington Post. Pick your scoop: Trump knew more about the coronavirus threat in January and February than previously revealed, and he told Woodward that he “played it down” because he didn’t want “to create a panic.” Dan Coats, the former director of national intelligence, believed “that Putin had something on Trump” and that Trump “doesn't know the difference between the truth and a lie." James Mattis, the former Defense secretary, says Trump is “dangerous,” “unfit" to be president, has “no moral compass,” and is providing a blueprint to foreign adversaries on “how to destroy America.” Anthony Fauci, according to CNN, is “quoted telling others Trump’s leadership was ‘rudderless’ and that his ‘attention span is like a minus number.’“ Rod Rosenstein, the former deputy attorney general, saw in Trump evidence of “a disturbed mind.” If history is any guide, next up will be a long excerpt in The Washington Post, Woodward’s longtime home. This Sunday he will appear on “60 Minutes,” his preferred stop for the first big network TV interview before a book launch. If he’s lucky, Trump will continue to attack him on Twitter, driving sales to record numbers the way the president did for Woodward’s last Trump book, 2018’s Fear. If Woodward is really lucky, Trump will sue him the way he sued John Bolton and Mary Trump, two recent authors of books about the president that also had explosive sales. Once the book is out, media scolds will debate Woodward’s sourcing methods (too much reliance on deep background!), critics will re-litigate Woodward’s unbalanced treatment of sources (those who cooperate get off too easy!), and his alleged flaws as a writer (his books are notebook dumps!). Though it’s now a crowded space, Woodward essentially invented the modern nonfiction book that straddles the gap between news reporting and a definitive historical account. If journalism is “ the first rough draft of history,“ a Woodward book is supposed to be the second or third draft: lots of familiar material but that is more refined, digs deeper, and has a more authoritative take on recent events. On that last point Woodward has sometimes been known to do a heroic job of unearthing lots of new facts but a poor job of adding the necessary context and framing to help readers make sense of the events he’s covering. But this time Woodward reportedly does not refrain from making it clear precisely what he believes his reporting reveals. According to CNN, it’s right there in the final line of the book: “Trump is the wrong man for the job.” Did someone forward this email to you? Sign up here.   Follow us on Twitter Renuka Rayasam @renurayasam   FOLLOW US

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