Thread by @maggiekb1

So this is probably going to get me yelled at, but I want to talk a little about a sci com issue around the J&J vaccine and how well it works.

The official take in sci com and public health seems to be that it's just as good as Pfizer and Moderna ... which is correct, sorta ...

Pfizer, Moderna and J&J all prevent hospitalization and death -- severe illness -- at a damn near 100% rate. That is great. And, to that extent, folks are ABSOLUTELY correct to take the "getting vaccinated with whatever is best, brand doesn't matter" approach.

BUT

There's other stuff at play here. Because we've also been telling people that Pfizer/Moderna are 95% effective at preventing symptomatic illness and that J&J is about 70% effective at that.

And to that extent, telling people J&J is just as good ... looks like lying.

Now this gets all messy as hell, because those 95%/70% efficacy numbers are comparing very different clinical trials, where J&J was up against some of the newer variants and Pfizer/Moderna were not. We don't actually know how they compare to one another NOW.

But I have some big problems with the idea that we (speaking about journalists here) have to tell people that J&J is just as good as Moderna/Pfizer. It could well be, but I don't know that. And you can't tell people 70% efficacy and 95% efficacy are the same and expect trust.

Are all three vaccines equally good at preventing hospitalization and death? Yup. But you don't get to assume what individual patient's goals are. If their goal is to not get sick at all ... well, based on the data that now exists (which could be wrong) the vaccines aren't equal.

The goals of the patient and the goals of the public health system may not be the same, basically.

And I am not 100% convinced that, as a reporter, it's my job to decide the goals of the public health system are the only ones that matter?

So I bring this all up because of the news that the mayor of Detroit has turned down at shipment of J&J because he says the Moderna/Pfizer (that the city has enough of to meet demand) is better.

cnn.com/2021/03/04/hea…

I'm seeing comments on this news that present that decision as dumb or insane. And I'm not sure it is.

Because this week I have also seen at least two of my black friends (TM) on Facebook talking about black communities getting stuck with J&J vaccines through various programs.

We've set up information so people can clearly see, in some ways at least, that Moderna/Pfizer is better. (Again, yes, I know the studies aren't comparable.) Then we've told them all the vaccines are equal. Then we're putting J&J in community vax clinics?

My point here is not that J&J is bad or that there is a conspiracy afoot. But ... can you not see how it would feel like one?

And at the same time we are also having these big conversations about How Do We Build Up Vaccine Trust In Minority Communities.

Well, friends ...

Insisting that we must describe Pfizer/Moderna and J&J as equal is probably not gonna help that trust thing. And maybe the mayor Detroit had that on his mind when he made this decision?

Anyway. I'd get the J&J, Pfizer OR Moderna and I don't really care which I get. Because I'm unlikely to get ill even if I catch COVID and, well, I'm privileged enough to not really have legit fears that government entities are trying to stick me with an inferior product.

But let's make sure we're thinking about ALL of this in how we communicate. Because "THEY ARE THE SAME" is not actually good messaging. The reality is messy and confusing. But that simplified message is not actually helping.

So @TomLevenson just said a thing that I think distills some of the stuff that has been bugging me about this messaging issue from the perspective of How To Journalism.

"I often find myself reminding them that their responsibility is to their readers, not their sources."

This is an easy one to lose sight of sometimes. But there's a difference, I guess, between "make things more clear and transparent for the readers" and "help the experts educate people".

And my job is the former, not the latter.