Is it safe? Misinformation, experts, hesitancy, public understanding, and patient groups.

Perhaps we need to greater public understanding of how things work?

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I think I reached my limit on Zoom teaching on Friday. Six hours of it led to my brain imploding. Here’s a few things that may be of interest…

Misinformation and low quality academia

Stuart Ritchie on some of the poor practice that has been endemic in academia and highlighting the flaws in research. Well worth reading.

As so often in academia, a well-meaning idea—the fast-tracking of reviews to improve the pace of scientific progress in a pandemic—worked poorly in practice. That’s because it collided with the toxic academic publish-or-perish culture, where longer CVs mean greater prizes – in the form of tenure, promotion, and other career rewards. Academics had a lot to gain by taking advantage of the rapid reviews, even if their actual scientific contribution was questionable. Combine that with a genuine desire to help out—as well as the fact that many scientists whose labs were closed by lockdowns were otherwise twiddling their thumbs, so tried their hand ineptly at some COVID research—and you have a recipe for an epidemic of tossed-off, low-quality papers.

Another piece to read alongside this is Renée DiResta is in The Atlantic: ‘Virus Experts Aren’t Getting the Message Out’

In the case of the coronavirus, the worst-case predictions of some of those early prescient voices on social media were borne out, even as some city leaders were telling the public—in March—to keep going out to theaters and the CDC was still insisting that only a very narrow group of Americans needed to be tested. Frontline doctors and scientists emerged in droves as the pandemic spread, posting on Twitter, Medium, and Reddit to tell the public about the number and severity of cases they were seeing in their hospitals; their stories further contradicted earlier reassurance from institutions that the flu posed a more serious risk to the United States. And so a meta-debate began: Why were social-media companies elevating the WHO and the CDC when some of their information turned out to be incorrect? And if agencies like these were wrong about COVID-19, what else were the so-called experts wrong about?

Vaccine hesitancy

There’s a couple of interest UK sources on vaccine hesitancy. First a pre-print (I know!) looking at uptake in healthcare professionals of the COVID-19 vaccine, which has some perhaps surprising results, and some that tally with prior concerns. Younger healthcare professionals had worse uptake, but surprisingly doctors had lower uptake than other healthcare professionals, even after multivariate analysis taking into account ethnicity (itself linked to uptake as other studies have found). So, a lot of things to potentially think about, and it is only from one hospital site.

On the other hand…. Some good news on overall refusal rates.

The ONS social survey found that, overall, only one person in 100 offered vaccination had declined, but with variation between age groups. The figure for those aged 30-49 was 5 per cent; for the 50-69s it was 2 per cent, and for the over-70s it was less than 1 per cent.

Good news. Good vaccines. Good uptake. Fingers crossed, a good year.

There is clearly work to do on vaccine hesitancy in some groups, and a need to address individual recipient’s concerns, but I can’t help thinking the length of the pandemic’s effects on our society. and high case rates. give vaccine hesitancy a slightly different flavour. The test will be as we see cases fall, and younger age groups less likely to see a personal benefit from the vaccine.

For that reason, despite my support for not prematurely lifting lockdowns, I find some of the signalling that vaccines won’t lead to changes in how we can operate socially a little concerning. Some might think, why bother getting vaccinated if it isn’t going to improve matters?

The Oxford Vaccine

A good profile of the Oxford vaccine’s Sarah Gilbert and Andrew Pollard in The Guardian. This bit stuck out for me.

“just as researchers have made rapid changes in their work practices to produce vaccines, so has the public understanding of that work altered, said Pollard. “It is only when you go outside the office, you realise the whole world knows about clinical trials and safety reporting and regulators in a way that they never did before. It seems everyone is watching what we’re doing – which is not an experience I have ever had before. Indeed it’s always been quite difficult to persuade people to take an interest in my work!”

I do think a better public understanding of regulation and clinical trials would allay the fears of those who think COVID-19 vaccines were rushed…

Patient groups and drug safety

An interesting paper by Chincilla et al in Drug Safety around patient groups in pharmacovigilance.

Patient organizations also present some ideological limitations regarding their involvement in drug safety activities; they are more likely to participate actively when they have been affected by ADRs in the group, and some organizations consider they would only engage if there is a problem among their members. This situation exposes the lack of systematic integration of patient organizations into the PV community.

There are clearly issues with patient organisations, especially industry funding, but getting them involved in pharmacovigilance is essential.

That’s all for this week and stay safe.

Anthony

Don’t forget to report your suspected adverse effects from medicines and vaccines. In the UK, this means using the Yellow Card Scheme.