Thread by @JoshRosenau

There’s an interesting debate going on over whether it’s better to pause J&J vaccinating while we investigate rare side effects, or better to balance that rare risk against the greater risk of COVID. IMO, a pause followed by a justified unpause should increase confidence.

The closest analogy I can recall is the 1992 Tylenol poisoning case. Someone injected cyanide into Tylenol capsules, killing 7 people. In response the manufacturer recalled all Tylenol, urged people not to take their drug, and introduced new tamperproof containers.

Because they reacted quickly and against their own short-term interests, Tylenol returned to the market with a strong reputation.

Tylenol, BTW, is a brand owned by Johnson & Johnson. time.com/3423136/tyleno…

That's the model I suspect the FDA and J&J have in mind here. Show that the safety net is so cautious that even rare side effects prompt careful review, so that confidence in every vaccine is increased. Keeping J&J shots going is probably warranted by short-term cost-benefit.

But FDA, J&J, and the entire vaccination effort, are ultimately enhanced by detecting and addressing even extremely rare risks. Ditto for the very public J&J factory shutdown over a flawed ingredient from a supplier. It's good that people know the watchdogs are there.

It's the same reason that efforts like @RetractionWatch and @MicrobiomDigest's work ultimately increase confidence in science. Yes, there is bad science, and even outright fraud. But we catch it.

Yes, bad actors will cite these incidents to fearmonger. But they'll do that regardless. A day's bad headline will leave people with bad associations. But when an investigation allows J&J back on the market, that'll generate more good headlines.

Vaccine advocates will be in much stronger position to point to this process because the FDA is being so cautious. 5 years from now, when your sister-in-law hesitates to have her baby vaccinated, you'll remind her that the FDA stopped pandemic vaccination over a statistical blip.

We don't want the FDA playing politics. Their job is to regulate safety. And that's what they're doing. And because they can do that even in a global pandemic, against intense political pressure, we can all feel better about every shot we get from a doctor.

NB: This is clearly an unpopular opinion. And in the end, it may not work the way I'm hoping (and the way I think the FDA is hoping). But here we are, and to the degree that your conversations shape things, I think this is how to explain it to increase vaccine confidence.

A different take.

https://twitter.com/Sheril_/status/1382024243039330308