Fri. Feb 3rd, 2023


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Biden Promised to Follow the Science. But Sometimes, He Gets Ahead of the Experts.

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WASHINGTON — As he announced on Friday that booster shots would be available to some Americans, President Biden made a prediction: His administration was likely to soon provide third doses of the vaccine “across the board” to anyone who wanted one.

“In the near term, we’re probably going to open this up,” he told reporters in remarks from the State Dining Room at the White House.

But that assessment — a politically popular one in a country where most people vaccinated against the coronavirus say they are eager for a booster — was the latest example of how Mr. Biden and some of his team have been ahead of the nation’s top public health scientists, who have emphatically said in recent days that there is simply not enough evidence to suggest that boosters are necessary for the entire American population.

In fact, two panels of scientists — one for the Food and Drug Administration and the other for the Centers for Disease Control and Prevention — voted in recent days against recommending boosters for everyone after fierce public debates streamed online.

The president’s Friday remarks were the second time in two months that he had suggested boosters would be available to everyone. And they were issued on the same day that Dr. Rochelle P. Walensky, the C.D.C. director and one of the president’s political appointees, came under fire for allowing boosters for a broader group of people than her agency’s own immunization panel recommended.

Taken together, the announcements by Mr. Biden and Dr. Walensky did not sit well with all of the scientists who advise them, raising questions about the president’s pledge to always “follow the science” as he fought the pandemic. While some of them credited the C.D.C. director for charting a course through uncertain waters, others warned that politics had intruded on scientific decisions — something that Mr. Biden had promised to avoid after the blatant pressures seen during the Trump administration.

“Everybody uses this statement ‘follow the science’ very glibly, and I think that the science here did not warrant picking out a group of people and saying that you may be at more risk for acquiring an infection,” said Dr. Sarah S. Long, a member of the C.D.C.’s advisory committee, referring to the groups of workers who were made eligible for booster shots.

Dr. Long, who is a professor of pediatrics at Drexel University College of Medicine, said that a president telegraphing his opinion before the formal public health process undermined the expert advisers, calling it a violation of the “checks and balances” built into the system. She also criticized Dr. Walensky for expanding the number of people eligible for the boosters.

If that pattern of reversals were to extend beyond boosters, she said, that “would be the end of the vaccine program as you know it.”

But a number of other committee members — including some who also resisted a broad expansion of the booster program — defended Dr. Walensky’s ruling, adding that federal regulators authorized additional shots less than 24 hours before the C.D.C.’s advisers were asked to give guidance. That left them little time to hammer out the language of their recommendations, much less to debate the type of issues that were weighing on Dr. Walensky, like staffing needs at hospitals or schools.

“During a time when we have over 2,000 Americans dying per day, we’re not in a position to sit on our hands and wait,” said Dr. Camille Kotton, the clinical director of transplant and immunocompromised host infectious diseases at Massachusetts General Hospital. “We need to act as quickly and thoughtfully as we can.”

Still, the C.D.C.’s medical advisers largely said on Friday that fresh attempts from the White House to get ahead of parts of the booster campaign undercut the sort of clarity that the public desperately needed.

“I hope, despite the pandemic being a public health emergency, that we would have the space and the grace to be able to continue to use our process,” said Dr. Grace Lee, the immunization committee’s chairwoman and a professor of pediatrics at Stanford University School of Medicine.

For the president to be subject to that kind of criticism is exactly where he promised he would never be.

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As a candidate, Mr. Biden repeatedly denounced President Donald J. Trump for pressuring scientists at the C.D.C. and the F.D.A. In March, after becoming president, Mr. Biden repeated what officials have said is his North Star on the pandemic during a visit to the C.D.C.’s headquarters in Atlanta.

“There’s an entire generation coming up that is learning from what you’ve done,” he told employees there that day. “I don’t just mean learning about how to deal with a virus. Learning about it makes a difference to tell the truth, to follow the science, and just wherever it takes you, and just be honest about it.”

White House officials insist that the president is doing just that, and they dismiss criticism that his comments about the additional doses amount to undue pressure on the government’s public health experts. They say that the discussion about boosters was initiated by the government’s top doctors and that he made it clear from the beginning that any decision by the administration would be subject to independent review and approval.

And Mr. Biden has deferred far more to the public health experts than did Mr. Trump, who publicly and privately pushed F.D.A. and C.D.C. officials to act more quickly to approve vaccines and actively promoted unproven treatments for the coronavirus like hydroxychloroquine. The former president also clashed repeatedly with scientists about wearing masks and decisions about when to reopen schools, churches and other activities.

But Mr. Biden’s public embrace of booster shots has rankled many in the public health sector, including those working inside the government, who say it could have the effect of putting undue pressure on scientists to make a recommendation they do not believe is supported by the evidence.

Some public health officials and doctors say they fear Mr. Biden — who has staked his presidency on successfully managing the pandemic — is pushing for boosters because they are politically popular. A Reuters/Ipsos national survey conducted Aug. 27-30 found that 76 percent of Americans who have received at least one shot of a vaccine want a booster. Only 6 percent do not, the poll found.

Understand Vaccine and Mask Mandates in the U.S.

    • Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
    • College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
    • Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.  
    • Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
    • New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
    • At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

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