Lessons From Eric Rubin, MD, PhD
Posted on October 29, 2021
by Don Shaughnessy
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Doctor Eric Rubin is a professor at Harvard, editor of the New England Journal of Medicine, and a member of the 18-person FDA committee that gave emergency use authorization 17-0 with one abstention for the use of Covid-19 vaccine in children aged 5-11. He has been cast in a bad light recently.
If you listen to the news, you will hear one of two things depending on where you notice the announcement.
- The FDA has approved Covid-19 vaccines for use in children aged 5-11.
- “We’re never going to learn about how safe this vaccine is unless we start giving it.”
I heard 1) first and put it down as inevitable caving to the government’s preferred narrative. A day or so later, I heard 2) and was amazed.
How could someone as accomplished as Dr. Rubin make such a tone-deaf statement? It shows abysmal judgement.
Many, maybe most, parents are reluctant to get the vaccine for their children because children are very close to having zero risk from the disease. The vaccine, if anything, has more trouble attached.
Every vaccine has some chance of harm. I cannot imagine the parent of a child between 5 and 11 who would treat that statement as an absolute reason to have their child vaccinated. If anything, it makes it even less likely they would do so.
My immediate response was if Dr. Rubin is so judgement impaired to say that, how good is his decision on other things? I looked at his history and discovered a career one does not achieve with poor judgement skills. I decided there must be more to it, and there was.
Enter the Washington Post
A much-expanded statement in the Washington Post was easy to find. It’s not my favourite source for news by any means, but this time it seemed more objective than usual. In that it made Dr. Rubin’s comment plausible, I have included it here.
The statement “we have to test to discover if it is safe” is the scientist talking. Dr. Rubin has not been trained to say nothing like a politician can do so easily. From a scientific perspective, his unfortunate statement is probably true. In the article, Dr. Rubin’s more complete statement includes.
- He recognizes the need to use it with children with a severe co-morbidities, immune suppressed for example. That’s fair and some sort of authorization would be needed for that.
- “We see a benefit that isn’t the same as it is in older patients.” Reasonable, but it would be helpful to know what they see the benefit to be.
- “The question of how broadly to use, I think, is a substantial one.” Judgement based. No guidance as to widespread use though.
- “But I do think that it’s a relatively close call. As Dr. [Ofer] Levy just said, and Dr. [Hayley] Gans said, it really is going to be a question of what the prevailing conditions are. But we’re never going to learn about how safe this vaccine is unless we start giving it. That’s just the way it goes.” That’s how we found out about rare complications of other vaccines like the coronavirus vaccine.” The scientist trying to learn
What it all means
- There is a risk to giving the vaccine to a child. No one knows how much or what the underlying conditions are that might trigger the adverse effect.
- The risk of not giving it may be greater in a very few situations.
- The FDA permits its delivery under an emergency use authorization.
- An Emergency Use Authorization cannot form the basis for a mandated taking of the vaccine. Regardless of mandates, parents can decide not to have it given. The government may only mandate a fully authorized vaccine. A version of the Pfizer vaccine has been approved for use in adults, but none of the authorized version is available. Some have decided they can mandate taking an EUA vaccine from the same supplier, but they are technically wrong.
- The probability of a child with no co-morbidities dying from Covid-19 is in the range of 1 or 2 per million. A somewhat lower probability than of being struck by lightning. How much new risk would you accept to avoid being struck by lightning? For me, none. No chance at all. Especially if no one knew what the risk would be and how it would be triggered.
- Use your best judgement for your children. If they are a transplant patient or candidate, maybe vaccinate.
- Scientists make sense when you hear their whole story and can understand it.
- Journalists who think a 16-word quote or sound bite summarizes everything a scientist is thinking or knows has not been around scientists much.
- Science is never certain. Dr. Rubin makes clear that it is nuanced.
- I expect there would be a more complete and maybe more instructive assessment if we had access to the whole panel. I particularly would like to know the thinking of the abstaining 18th person.
- Don’t be bullied by the tyrants.
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