The AstraZeneca vaccine and our ongoing uncertainty problem

On Sunday, Shabir Madhi, a vaccines expert in Johannesburg, went on South African TV and shared news from a study he had been working on: the vaccine developed by AstraZeneca and researchers at Oxford University, he said, appears not to be very effective at preventing mild to moderate cases of the coronavirus variant that has become dominant in his country. The finding, which led the South African government to temporarily stop rolling out the AstraZeneca vaccine, echoed in grim headlines around the world. “A blow for vaccine touted as world’s best hope for defeating COVID-19,” CNN said. The New York Times led with “South Africa says AstraZeneca’s Covid-19 vaccine is not effective at stopping variant”; a push notification sent out by the Washington Post said that the study had found “‘minimal’ efficacy” against the variant; a headline in the New York Post, among other outlets, pinned the efficacy rate at “about 10%.” Under the shockingly ambiguous headline “Why you can’t get the AstraZeneca vaccine,” Politico referred to the South Africa news as a “scandal.” In the United Kingdom, which has been rapidly deploying the vaccine, Novara Media, a left-wing news site, welcomed viewers to a YouTube stream with the rubric: “The Oxford AstraZenaca Vaccine Nightmare.” (It later removed the misspelled proper noun and changed “nightmare” to “major setback.”)

These headlines and many others like them elided some crucial caveats. The study in question had a small sample size, young average participant age, and wide confidence intervals—so much so that, as Stat’s Helen Branswell noted, “it’s hard to know what was found”—and there are questions, too, as to the relation between vaccine efficacy and the time between doses. Many experts—including Madhi—stressed that the study did not assess the AstraZeneca vaccine’s efficacy against hospitalization and severe disease, which are more important metrics than mild to moderate disease incidence, and expressed optimism that the vaccine will still offer protection against severe illness; in any case, the South Africa variant, while present in other countries (including the US), isn’t yet dominant elsewhere, and the vaccine’s makers are already at work on an updated formula, which isn’t expected to be too hard to develop. Richard Hatchett, who helps lead the global COVAX program focused on vaccination in poorer countries, told Reuters that “it is vastly too early to be dismissing this vaccine.” In the US—where the AstraZeneca vaccine is on order pending official authorization—Dr. Anthony Fauci said, during a briefing, that he hopes the virus will be brought “under much better control” generally before the South Africa variant, specifically, can pose a widespread threat. “The stories and the headlines around variant viruses and vaccines are a bit scary,” Jonathan Van-Tam, a top health official in the UK, said, also at a briefing yesterday. “I wish they weren’t.”

New from CJR: Hiding in plain sight

This is far from the first time that the AstraZeneca vaccine—and media reporting about it—has caused confusion. As I reported recently, the German newspaper Handelsblatt stoked something approaching a diplomatic incident after it reported that the vaccine was only 8-percent effective in older recipients—a figure quoted by anonymous political sources (who may have committed a basic misreading of the vaccine’s trial data) that has not subsequently been supported by any public data (though some European regulators did point to a general lack of data to justify cautious recommendations around use of the AstraZeneca vaccine in older people). Last week, a study published by researchers at Oxford fueled a more positive story, spread widely by news outlets worldwide, that the vaccine significantly reduces viral transmission—but, as Branswell and Matthew Herper wrote for Stat, “the paper, which has not yet been peer-reviewed, does not prove or even claim that”; its authors argued that fewer people carrying the virus necessarily means a drop in transmission, but outside experts called that “a big and unjustified leap.” There has also repeatedly been confusion about the vaccine’s dosage regimen, with its efficacy, counterintuitively, seeming to decrease after a second shot.

News organizations aren’t solely to blame for such confusion—studies of the AstraZeneca vaccine raise a number of perplexing questions, there are real data issues, and the company (like many of its rivals) has not always communicated clearly. As Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia, told Politico yesterday, “We’re in an age of science by press release.” But much recent reporting on the vaccine clearly also speaks to a series of broader errors that have bedeviled coverage of the pandemic ever since it began: an inability to consistently process—and to reorient the typical pace and mechanics of breaking news toward—persistent, life-altering uncertainty. This has been communicated deftly in much good coverage—but it often hasn’t been, and it is routinely missing from the headlines and topline framing that busy readers skim and digest, while skipping right past the nuance.

It’s not just vaccines. Yesterday, for instance, The Atlantic’s Derek Thompson returned to the topic of “hygiene theater,” a term he first used last year to describe our collective obsession with surfaces, even though the virus travels more effectively by air; since he last wrote about it, the evidence has become even more compelling, yet still, he writes, we are wasting precious resources—and fostering a false sense of security around—cleanliness. Crucially, Thompson situates hygiene theater as part of a wider problem: the clichéd idea that we must all “follow the science,” when science is not, and never has been, a singular thing. “Bad studies, good studies, and mediocre studies are all part of the cacophonous hydra of ‘science’ that is constantly ‘saying’ stuff,” he writes. “In the telephone game between scientific research, media reports, and public understanding, dubious studies get simplified, exaggerated, and concretized as gospel.”

As I’ve written before, science advances through a messy process of trial and error, advance and retreat. That’s a good thing, but it has not translated well to the immense, fast-moving gaze of public scrutiny that the pandemic has occasioned, nor to an information climate characterized by mass conspiracism and the broader pursuit of false certainty. “The science”—as a blunt moral concept—was arguably a necessary rhetorical weapon early in the pandemic, when everything was new, simple mass actions were required, and the president was pumping out garbage, but it seems since to have ossified into a procession of glib cable-news-style talking points and sloganeering. Last summer, medical pundits coined the phrase “herd immunity is mass murder” to fight the specific, terrible idea, then gaining traction with Trump, of letting the virus rip. When I searched “herd immunity” today on Google News, all the top results concerned the specific, good idea of mass vaccination. It’s no wonder we all have whiplash.

We do, of course, now know a lot more about the pandemic than we did in its early months. But our collective accretion of knowledge has not been linear, and new developments, from vaccines to variants, keep throwing up hurdles to our understanding. The result is that we’re still disoriented while growing increasingly tired of disorientation. As Nate Silver, of FiveThirtyEight, put it yesterday, there arguably hasn’t been “any point in the pandemic at which there’s been such a confusing mix of good *and* bad COVID news”; this uncertainty, he added, “demands nuance, but ironically, people aren’t looking for nuance at times of greater uncertainty.” The media’s job, still, is to persevere with nuance and avoid contrived certainty, even if that means holding off on the banner headlines and just waiting to see how things pan out.

Last week, Branswell and Herper, of Stat, noted that a rigorous American study of the AstraZeneca vaccine, which it is hoped will provide more definitive answers, is on the way, and could be published before the end of the month. “Unfortunately,” they wrote, “in a pandemic, there is nothing more difficult than waiting.”

Below, more on the pandemic:

• Filling the knowledge gap: Last week, NPR tackled an uncertainty problem head on. In a bid to address the huge race and ethnicity gaps in federal data on vaccines administered so far, a team of reporters compiled data on the locations of vaccination sites in several Southern states, and cross-referenced it against demographic data from the US Census. They identified “disparities in the locations of vaccination sites in major cities across the Southern US—with most sites placed in whiter neighborhoods.”
• Misinformation: Late last year, Facebook pledged to crack down on misinformation about coronavirus vaccines—but CNN’s Kaya Yurieff and Oliver Darcy found that “misleading and fearmongering content about the Covid vaccines, as well as outright misinformation,” remains easy to find on the platform. Yesterday, Facebook announced plans to tighten its crackdown, expanding its conception of problematic content, and pledging to focus more on unpaid user posts as well as pages and groups. (In an interesting response thread on Twitter, Zeynep Tufekci, a sociologist and prolific writer on the pandemic for The Atlantic, argued that Facebook’s new policies, if strictly enforced, would necessitate it taking down some news reports and official public-health guidance.)
• All the news that’s fit to preprint: For Nieman Lab, Naseem Miller reports on a new study, in the journal Health Communication, that found wide disparities in the language news organizations use when covering preprints, or academic papers that have yet to be formally reviewed. “Researchers looked for specific keywords in their analysis among news outlets including the New York Times, Medscape, and Business Insider,” Miller writes. “While a little over half used at least one phrase to indicate the study was a preprint or that the findings were unreviewed or preliminary, the rest didn’t make that distinction.”
• An important reminder: Yesterday, Olivia Messer, who covered the pandemic and other beats for the Daily Beast, announced on Twitter that she is leaving her job. “While I’m tempted to be vague about my departure, I also believe it’s important to acknowledge the profound exhaustion, loss, grief, burnout, and trauma of the past year covering—and living in—a mass casualty event that has changed all of our lives,” she wrote. “I hit a mental and then physical breaking point after the death of a loved one and, for now, I must take a break.”

Other notable stories:

• Trump’s second impeachment trial begins today. Senators will first hear arguments about, then vote on, the constitutionality of the trial, with each side then granted two days to lay out their respective cases; proceedings are expected to last around a week, and there will not be a break for the Jewish Sabbath, after Trump’s legal team withdrew its request for one. We don’t yet know whether the impeachment managers will call witnesses, but we do know that they will make heavy use of shocking video footage, much of it previously unseen, of the insurrection—a tactic aimed at the viewing public as much as the Senate jurors. Trump’s defense will rest on the constitutionality question, the First Amendment, and, apparently, the far-right website the Gateway Pundit.
• Today, The Atlantic is launching “Inheritance,” a new, ongoing project focused on “American history, Black life, and the resilience of memory.” The magazine is dedicating its March issue to the project, with contributions from Anna Deavere Smith, on her coming to consciousness on campus; Danielle Allen, on early abolitionism; Clint Smith, on the New Deal effort to preserve the voices of the formerly enslaved; and Vann R. Newkirk, II, on the Voting Rights Act. In other Atlantic news, the magazine is hiring Tim Alberta, of Politico, and Jennifer Senior, a columnist at the Times, as staff writers.
• Yesterday, groups including the Committee to Protect Journalists, Human Rights Watch, and the Knight First Amendment Institute signed onto a letter, coordinated by the Freedom of the Press Foundation, urging Biden to drop the federal case against Julian Assange, the WikiLeaks founder who was charged, under Trump, with violating the Espionage Act. “While our organizations have different perspectives on Mr. Assange and his organization,” the letter reads, “we share the view that the government’s indictment of him poses a grave threat to press freedom both in the United States and abroad.”
• Marianne Lavelle, of Inside Climate News, checked in on the progress of a defamation suit that Michael Mann, a climate scientist at Penn State, brought against National Review, the Competitive Enterprise Institute, and two bloggers who used those platforms to attack his work. Recently—as the case entered its ninth year—Mann asked a court to bar the defendants from claiming that their attacks were true; if the court agrees, Mann could still lose on other grounds, but would gain a judicial endorsement of his science.
• According to Vanity Fair’s Joe Pompeo, Rolling Stone is now among the growing number of outlets looking for a new top editor in 2021. Jason Fine—a Rolling Stone veteran who has led the magazine since its takeover by Penske Media, in 2018—is stepping down after “not quite working out in the editor’s chair”; he’ll take on a new role as director of content development, with Sean Woods and Jerry Portwood serving as interim editors.
• Punchbowl, Inc., a Massachusetts firm that makes online greeting cards, is suing Punchbowl News, the media company founded recently by the Politico Playbook alums Anna Palmer and Jake Sherman, for trademark infringement. Punchbowl, Inc., alleges that the two companies have similar brand identities and appeal to similar customers; Punchbowl News has yet to comment. Washingtonian’s Andrew Beaujon has more.
• Pedro Gomez—who covered baseball for the San Jose Mercury News, the Sacramento Bee, the Miami Herald, and the Arizona Republic, then spent nearly twenty years at ESPN—has died. He was fifty-eight. “Pedro was far more than a media personality,” his family said. “He was a dad, loving husband, loyal friend, coach and mentor.”
• Mahmoud Hussein, an Al Jazeera journalist who spent four years in jail in Egypt following his arrest on spurious charges, has been freed. His release follows a thaw in relations between Egypt and Qatar, which owns Al Jazeera. (In 2019, Ruth Margalit wrote for CJR on the Egyptian President Abdel Fattah El-Sisi’s war on the press.)
• And the New Yorker’s crossword, which was previously online only, will now also run in the print magazine. “Print crosswords may be superior in bathtubs (fewer waterlogged devices), on beaches (less glare), and off the grid,” Liz Maynes-Aminzade, the puzzles and games editor, writes. “Whatever your milieu, the medium is now yours to choose.”

ICYMI: Covering the insurrection, one month on