Friday, November 12, 2021

Aaron Rodgers and the Absurdity of Media Coverage of Covid Policy

By Vinay Prasad, MD MPH - November 12, 2021 at 12:13AM

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Aaron Rodgers and other professional athletes have views about COVID19 vaccination. Of course they do. I imagine all adults in the United States have views on vaccine policy, and those views likely run the gamut from those who believe these vaccines should be mandated as young as 5-year olds to those who wish they should not have even been authorized to anyone to every possible position in-between those extreme poles. 

Recently, the media has yet again chosen to cover breathlessly the choices of one professional athlete. A few weeks ago it was an NBA player. Four months before that it was a rock musician. In a month from now, I am sure a race car driver, golfer or tennis pro may tweet in haste, and find themselves at the center of a media hurricane.

I’m sorry to break the news to you all: this coverage is journalistic malpractice. 

We need real debates with real debaters; not debates about personal choices made by celebrities.

When it comes to COVID19 vaccination and policy there are many debates that are desperately worthy of media coverage that get very little. Allow me to name 6:

Debate #1: Should schools mandate COVID19 vaccination? If so, how young? Sixteen and up, 12 and up or 5 and up? Should the rule be 1 dose or 2 ? Should the mandate permit parents to spread the doses further apart (than 21 days) or should it be inflexible? What should the penalty be for non-compliance? What unintended consequences might there be? Will this result in racial discrimination (due to unequal vaccine uptake)?

Debate #2: Should persons who recovered from SARS-CoV-2 be (a) encouraged to be vaccinated (b) mandated to be vaccinated (c ) given credit for proof of recovery? Should they be allowed to receive 1 dose, or do they need 2 doses? What evidence supports these choices?

Debate #3: Should healthy health care workers (particularly young ones <40) be mandated to receive boosters? If so, should this mandate begin at 6 months or 8 months or 10 months after the series? Is there evidence that this strategy will protect patients and staff or is that speculation? Will this help sustain the workforce over the winter season or will it erode the workforce (due to firing over non-compliance)?

Debate #4: Should the AAP and CDC continue to recommend we mask 2-year olds against the World Health Organization advice? Should airplanes throw families off flights if 2-year olds don’t mask? Should the policy have exemptions for children with disabilities or autism or those who cannot tolerate masking? Should daycares continue to mandate masking very young kids? Should vaccinated nursery workers wear masks where caring for babies?

Debate #5: Should schools continue to have masking mandates? If so, when should they end? Should we run prospective studies or continue to rely on confounded observational ones? 

Debate #6: Are federal workplace vaccine mandates sound policy? What unintended consequences might they have? What impact on politics and voting going forward? Will they spur backlash?

These are the debates that are worthy of broad public interest. Notice: they are not the choices made by one particular professional athlete.

Now, who should be the debater? Should Aaron Rodgers debate Tom Hanks? No. We want to select debaters who are skilled and knowledgeable on the topic. We want to have experts who disagree debate other experts who disagree.

Instead of the media fostering such debates, they offer Aaron Rodgers as the spokesperson for why workplace vaccine mandates are misguided. Aaron Rodgers, not a skilled debater, may not be able to withstand the battery and barrage of questions, and thus the public is led to believe that the mandates are justified. 

But are they? I am confident when it comes to the 6 questions, I would be able to win a debate against any leading scholar with an audience of the American people. Here are the positions I would hold:

Debate #1: Should Schools mandate COVID19 vax to attend in person? Absolutely not; doing so is regressive policy, and will hurt poor and minority students. Evidence this policy will result in net benefit is absent. This vaccine is different than others for which mandates exist.

Debate #2: Should persons who recovered from SARS-CoV-2 be mandated to get 2 doses of vax? I would argue that the evidence supporting this claim is confounded and unsuitable for firm conclusions. We ought to pursue a separate RCT in folks who recovered who are ambivalent about vaccination. We need 3 arms of the trial. No more doses, 1 or 2, and power for severe covid endpoints.

Debate #3: Should healthy health care workers (particularly young ones <40) be mandated to receive boosters? I would argue no; evidence that this strategy will protect their patients is absent, and moreover current rates of nosocomial transmission are already so low it will be hard to improve on. The argument it is needed to ensure a work force in the winter season is undermined by mandates which result in some people being fired (i.e. further lowering work force)

Debate #4: Should the AAP and CDC continue to recommend we mask 2-year olds against the World Health Organization advice? Uh… no. We have to finally admit we never had evidence for this policy

Debate #5: Should schools continue to have masking mandates? The CDC should have tested this policy with cluster RCT, but already the day to sunset it has come. It should end promptly.

Debate #6: Are federal work place vaccine mandates sound policy? I wrote about that topic here, but recent opinion poll data is sobering.

Instead of focusing on these debates, and inviting skilled debaters, the media loves to make Aaron Rodgers the face of all these issues. Yet, he himself might agree that debating these topics is not his skillset nor his interest. Next week it will be a new celebrity.

Ultimately picking weak spokespeople is a broader strategy that undermines debate itself and encourages rampant groupthink, which itself is the defining quality of our media response. If you pick a weak debater to argue the other side, it makes it easy for you to entrench in your own preexisting belief. It is a cheap tactic.

Going forward, I want to hear less about Aaron Rodgers, and more about these aforementioned topics. I want less videos of athletes and more of skilled speakers. Doing less than this is a disservice to the American people.

The author is is a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco.

Reprinted with permission from Brownstone Institute.

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