A Response to Richard Hanania on the Covid Vaccines

The commentator Richard Hanania has written an article on his Substack about the Covid vaccines. He and I agree on two major points: the vaccine mandates were a bad idea, and vaccinating the elderly saved lives. However, we disagree on several other points, which I’d like to focus on here.

In his article, Hanania takes aim not only at “pure deniers” but also at “moderate vax sceptics” – people like myself and Martin Kuldorff who questioned whether the vaccine was right for everyone.

He argues that even though “moderate vax sceptics” are “occasionally correct”, their contribution to the debate has been “overwhelmingly negative”. This is because they overemphasised “narrow issues”, thereby distracting people from “the lesson we should take from this experience”, namely that “the public health establishment is too risk averse”.

I don’t necessarily disagree that the public health establishment is too risk averse and the vaccines should have been approved sooner, so long as they weren’t mandated. After all, different groups of people face different risks.

Elderly people and those with certain pre-existing health conditions faced a significant risk of death from Covid, so it would have made sense for them to get vaccinated even before the safety data were in. By contrast, young people without pre-existing health conditions faced little risk of death or serious illness from Covid, so it would have made sense for them to wait slightly longer.

If the vaccines had been approved sooner and had not been mandated, each individual could have decided whether to get vaccinated based on the specific risks he or she faced. Most elderly people would presumably have chosen to get vaccinated straight away; many young people might have preferred to wait for more safety data before doing so.

Where I do disagree with Hanania is on the contribution of “moderate vax sceptics” to the debate. Naturally, I dispute that it is “overwhelmingly negative”. Even if you believe, as I do, that the vaccines saved many lives, the rollout itself was based on safetyism not science. And it was absolutely right that “moderate vax sceptics” called attention to this.

“Getting any vaccine was clearly a good idea for almost any adult,” Hanania claims, “even if they weren’t at a high risk of dying from covid.” I disagree.

Putting aside issues like myocarditis in young men, there was no need for people who’d already had Covid to get vaccinated. I’m not saying they shouldn’t have been allowed to get vaccinated; I’m saying they didn’t need to. Natural immunity provides excellent protection against serious illness and death, and better protection against subsequent infection than the vaccines.

As Jay Bhattacharya and Martin Kulldorff note, natural immunity to infectious disease has been known about since the Ancient Greeks. Yet its existence in the context of Covid was downplayed or outright denied by large swathes of the public health establishment.

This matters because there’s some evidence that adverse events were more common among vaccinated people who’d already had Covid. In addition, vaccine mandates initially failed to recognise natural immunity, which led to dozens of nurses and other healthcare workers being fired from their jobs – for the sin of being wary of a vaccine they didn’t need.

The situation was particularly egregious given the excellent protection afforded by natural immunity. As Kulldorff wrote in October of 2021: “hospitals should hire, not fire, nurses with natural immunity”.

Hanania claims that the vaccines “do make transmission somewhat less likely”, which means that “health care facilities are reasonable in requiring them for staff”. But the second part simply doesn’t follow.

Vaccine effectiveness against infection wanes to such an extent that several datasets showed evidence of negative effectiveness. (This may be partly attributable to many unvaccinated people having natural immunity, which provides better protection against subsequent infection.) Mandating vaccines for healthcare workers was therefore no guarantee of safety.

In fact, it may have done active harm by leading healthcare workers and their patients to believe there was no risk of transmission. The only surefire way of protecting those patients would have been requiring healthcare workers to take daily tests (which I supported – at least for those dealing with the most vulnerable patients).

As well as overstating vaccine effectiveness against infection, Hanania overstates vaccine effectiveness against death, suggesting that it is “at least 90%”. But this widely touted figure cannot be reconciled with the data from countries like South Korea, which saw large spikes in excess mortality even after vaccinating the vast majority of elderly people.

Studies claiming 90% vaccine effectiveness against death often fail to account for waning or the healthy vaccinee effect. One Hungarian study, which compared death rates among vaccinated and unvaccinated people during epidemic and non-epidemic periods, concluded that the Pfizer vaccine is about 50% effective against death, with the other vaccines being slightly more effective.

However, put all this to one side. Even if Hanania were right that “getting any vaccine was clearly a good idea for almost any adult”, the vaccine rollout would still have been based on safetyism not science.

Why? Any net benefit of getting vaccinated for healthy young adults and those who’d already had Covid will have been marginal at best. So instead of strong-arming those people into getting vaccinated, we could have donated the vaccines to people in poor countries who actually needed them, thereby saving thousands of lives.

Perhaps if the “moderate vax skeptics” had not been side-lined by the public health establishment we could have had a more rational policy that actually took account of the risks and benefits to different individuals.