Vaccines v. Monoclonal Antibodies
The difference is politics, not reason.
Before the pandemic, I used to joke that by 2030 all political science dissertations would be about either Donald Trump or Brexit. Clearly, a to of them now will be about the pandemic (which overlaps substantially with the Trump category). All quippiness aside, the pandemic has clearly illustrated the power of political identity and the role of elite signals to the masses and will provide a substantial amount of fodder for future study. For example, the evidence is extremely strong that substantial amounts of vaccine and masking opposition are directly linked to political identity and, further, to the signals that Donald Trump sent about the pandemic from the very beginning. He helped cast doubt on the nature of the pandemic, on mitigation practices like masking and distancing, and was not a zealous advocate for vaccinations. He, and others in his party, have fueled doubt and distrust over what should be straightforward public health policies.
However, it is should be noted that he spoke highly of the Regeneron monoclonal antibody treatment he received when was infected (and other Republicans, like Ron DeSantis, as well as right-wing commentators, have touted the treatment–as discussed here and here).
All of this leads into this NYT piece: They Shunned Covid Vaccines but Embraced Antibody Treatment.
Vaccine-resistant Americans are turning to the treatment with a zeal that has, at times, mystified their doctors, chasing down lengthy infusions after rejecting vaccines that cost one-hundredth as much. Orders have exploded so quickly this summer — to 168,000 doses per week in late August, up from 27,000 in July — that the Biden administration warned states this week of a dwindling national supply.
As the piece note, the infusions are arguably more experimental than the vaccines (undercutting any “they rushed the shots” logic). Further, there is no particular reason to assume that the vaccines might have some long-term, unknown consequence but that the infusions won’t.
And yet, millions eschew the vaccines, but,
Amid a din of antivaccine falsehoods, monoclonal antibodies have become the rare coronavirus medicine to achieve near-universal acceptance. Championed by mainstream doctors and conservative radio hosts alike, the infusions have kept the country’s death toll — 2,000 per day and climbing — from soaring even higher.
Indeed, the response to the infusion treatment tracks more with what might be considered “normal” public responses to health crises, which is to say trusting what medical experts assert is proper action.
There may be some psychological aspects of all of this wherein people are more predisposed to being willing to take treatment over preventative actions. For example, getting the shots and not getting sick is different from getting sick and then getting cured (or even just being made better). Prevention that leads to no infection looks a lot like no vaccine and avoiding infection while getting sick and then getting a treatment that make one feel better is more concrete.
One factor driving the demand is that many patients, including vaccine skeptics, have been spreading the word about their seemingly miraculous recoveries.
“They’re like, ‘I have Covid, I want this treatment, my friend or family told me about this,'” said Jennifer Berry, the Houston Methodist nursing director of infusion services. “Now the word is out.”
I think that the main driver here is a mass response to elite cues. After all, no state is passing anti-infusion laws or carrying on about how Regeneron is taking away your liberty. But there is plenty of elite-level signaling against vaccines.
“The people you love, you trust, nobody said anything negative about it,” Mr. Jones said of the antibody treatment. “And I’ve heard nothing but negative things about the side effects of the vaccine and how quickly it was developed.
And to demonstrate the illogic of the situation, Jones was anti-vaccine, got the disease, was treated with the infusion, and is still anti-vaccine (because the vaccine, like the treatment, was recently developed):
“If I can go get an infusion and feel as good as I do right now, man, I’d rather not take a vaccine that has just been developed,” he said. “That makes me nervous, still.”
Sigh.
And look, I am more than pleased that we are developing treatments for this disease. Indeed, in just the last couple of weeks, a close family friend and a member of my family had breakthrough cases and were treated with monoclonal antibodies, for which I am quite grateful. Similarly, an older couple that I know were infected pre-vaccine, and while one spouse received the infusion and recovered, the other did not want to go to the doctor and consequently was in-and-out of the hospital for weeks and now has permanent kidney damage. So, I have personal anecdotes that line up with the broader data that exists about these treatments.
The role of political identity as linked to elite cues has clearly been an issue of significance throughout the Trump era (or, at least, it has gathered significance and centrality in discussions of American politics). I think that national responses to Covid vaccinations help illustrate this fact and the disjuncture between anti-vaccination rhetoric and behavior v. pro-monoclonal antibodies add additional evidence to this contention.
To be clear: the point is while we might like it to be the case that the order of causation is that facts/evidence/information leads to policy preferences leads to party affiliation, the reality is that we (yes, that includes all of us) often let party affiliation lead to policy preferences which then leads us to decide which facts/evidence/information we will take seriously. This is partisanship in a nutshell.
This makes me think about an interview on the Ezra Klein Show with political scientist Lilianna Mason (whose work I hope to discuss further soon):
And I think one of the most lethal things that Trump did was politicize it [the virus], and say it’s just happening in blue cities, right, let them rot, leave them there. So I think it was this sort of long journey, where Trump politicized the virus, and then all of the things that were used to try to stop the virus became connected to other identities within the Republican Party. And then at that point, it’s over.
And:
I mean, we have states where Republican leaders are prohibiting schools from requiring masks. It’s not even vaccines. They aren’t taking vaccines because they’re too young. They’re prohibiting schools from requiring masks, which puts kids in danger. There just must be some justification system going on, right, where it’s like, it’s child abuse to put a kid in a mask because they’re going to be breathing in carbon dioxide, or whatever the argument is.
But it really does demonstrate not only sort of like this extreme power of identity defensiveness to guide behavior, but also, I think, a really horrifying level of cynicism from leaders, who are definitely taking advantage of this. They know that they can use these identity- defensive feelings to get whatever policy they want, and they’re doing it to put children in danger, for no — I mean, I still don’t really fully understand what it does for these leaders to do this. But I think it is extraordinarily cynical. It is absolutely taking advantage of all of the worst parts of how identities can affect politics. It’s literally killing people, and for the party.
This really speaks to a feedback loop wherein elites see the masses respond to specific rhetorical stimulus, and the elites then reinforce the position for cynical political gain. People can far more easily be mobilized based on partisan identity than they can on evidence (especially in the context of ongoing misinformation in niche media). As she noted elsewhere in the interview:
there’s just so much intentional misinformation that people have been given. And most of the people who tell you that they’re not getting vaccinated are giving you reasons that are just completely false things, but they believe them, and they just read them on Facebook, right? So there’s a lot of kind of — it’s related to partisanship, but it’s also just kind of right-wing conspiracy theory stuff that’s driving some of this. And if they really believed that they were going to die from Covid if they didn’t get the vaccine and the vaccine was actually safe, then they would probably take it. There some misinformation going on with those decisions.
I saw a convincing argument that week is that anti-vaxxers are less political than commercial in nature.
The GOP is less a political party now than a MLM life-style brand built primarily on extracting money from customers. The reason they’re opposed to the vaccines is because there’s no way to monetize a free vaccine that requires no further action once taken, where as by being anti-vaccine they can sell a never ending series of phony preventatives.
I suspect one of the reasons is that no one on the right is having to in fact PAY for their Regeneron treatments. As of now, it’s still on the shoulders of the taxpayer.
If we had vaccine vs. Regeneron costs actually being charged to the people who took them, there might be a different reaction.
(I also suspect that none of these people ever had to fix their own clothes. Ever heard “a stitch in time saves nine”?)
A really good point was made to me today by a good friend: Nobody on the planet can know everything that is needed to survive. Humans have to trust other people. The way they decide who to trust is the issue.
Central to our current situation is how the political right has worked tirelessly for the last 30 years to deliver the message, “The Left cannot be trusted. They are idiots, if not downright evil”
This is where this has got us.
@grumpy realist:
The government needs to adapt right now and reimburse the cost of Regeneron only up to the cost of full dosage of the vaccine. Choices have consequences.
The political identity thing is huge. To take the vaccine now is to admit you were wrong about not taking the vaccine sooner. To admit you were wrong about the vaccine is to admit you were wrong about the severity of the coronavirus. To admit you were wrong about the severity of the coronavirus is to admit the Trump failed epically in his administration’s response to the pandemic. And to admit that is to admit that you were a fool to believe in Trump’s super genius as a leader.
Apparently, people would rather die than admit they are fools.
Additionally, some people who get vaccinated get breakthrough cases, and live to tell other people that the vaccine ‘failed’ them.
On the other hand, the people ‘failed’ by Regneron end up dead and aren’t around to talk about how it didn’t save them.
I don’t. Seriously, I don’t. And I don’t think I’m exactly the only one. I’ll tone down my criticism for political reasons, but I don’t make judgments based on my personal likes or dislikes, or even my identity, whatever that vague weasel word is supposed mean.
I’m not even sure how that would work. What, place a filter of ideology between myself and the thing I’m trying to understand? That’s like smearing Crisco on my glasses when I’m trying to read. The result would be a complete waste of my time. How am I going to understand some new phenomenon if I squeeze it through an ideological pastry bag first? What would be the point?
Few liberals and even fewer progressives like my notions of foreign or defense policy. Conservatives would hate me on taxes, and so would liberals though they’d pretend to agree. The progressives would like me on taxes, but they wouldn’t like the fact I’m a capitalist or that I find them to be insufferable prigs. And as far as I know I don’t have an identity other than me. An ‘identity’ of one. Both cons and progs would dislike that answer.
Everyone starts out life programmed to some degree by DNA, then programmed further by their life experiences, with early experiences carrying disproportionate weight. What people need to do is chuck all that out. You want to examine your own software, delete the bad code, rewrite it if you can, or leave a blank to be filled in later. You want to achieve – insofar as it is possible – a state of presuppositionlessness, a state of mind where all that can be taken out and closely examined, has been, and will continue to be. Americans pay a thousand times more attention to what they put in their mouths than they do their minds, and yet the result is that we’re fat as well as stupid.
@Michael Reynolds:
I have an identity of at least two.
So I get to outvote you. 🙂
@Michael Reynolds:
What is the sound of one political party clapping?
@Michael Reynolds:
Yeah, yeah, you’re the One True Man, freed from all the monkey social dynamic instincts haunting the psyches of all us poor mortals.
@Stormy Dragon:
Lots of non=GOP hustlers, ideologues etc. pushing anti-vax.
Dr. Mercola peddling supplements, Naomi Wolf, RFK etc.
@charon:
Lets not forget that FOX News boosts its ratings with this stuff, their messaging is hugely influential on the political right.
@Michael Reynolds: You know your own mind, I suppose, but if you really are a human who makes all his decision based solely on the facts and rationality alone, you are a unicorn and I doff my cap to thee.
I do find it odd that you dismiss the notion of identity, as I would think that how characters’ self-identity is a rather significant element of understanding them in storytelling. Further, you constantly talk about how your personal biography (and profession) shape your views.
FWIW, I think that people can, through education and self-reflection, lessen the way in which identity and other issues affect reasoning, but it is highly unlikely that anyone is truly logical, disppassionate, and reasonable most (and certainly not all) of the time.
Quite frankly, no one is immune from filters.
@charon:
I forgot the fundie preachers, this stuff gets spread within church peer/affinity groupings too. More identity stuff.
@charon: I didn’t name-check Fox in the OP, but I did link to a story that references Hannity and Ivermectin and FNC and other outlets fit into the misinformation that Mason discusses.
@Michael Reynolds: I was not aware that you had reached the state of Buddhist Nirvana. For the rest of us, however, we pick our data quickly by deciding what sources we trust, and a lot of that comes from our identity.
If Donald Trump, doing his own research, discovered that sheep semen cured covid, and had orchestrated a double blind test where interns are unaware whether they are blowing a goat or a sheep, would you believe it? Of course not.
If Anthony Fauci presented information that some biological chemical found triggered an immune response that prevented covid’s spike protein from attaching to the N71 binding site, you would be much more open, even if Fauci sheepishly acknowledged the collection of the chemical did involve certain barnyard animals.
Why has Hostess not launched a large PR campaign saying that despite what people had heard, there is no evidence Twinkies can cure an active covid infection? Just keep pushing the denials with a few weasel words to get the story out there and sell an enormous number of Twinkies.
But what if you don’t HAVE any party preferences?
Obviously I’m an outsider looking in re. American politics, but even in the British context I don’t really have a political allegiance
And a lot of other people I know have no fixed, or at least overt, political allegiance.
Even my mother, who was in her younger days a Labour Party activist, or maternal grandfather, similarly, never really identified with the party.
It sometimes seems to me that the American tradition of registration of party affiliation encourages political group identities to an extent that may be socially damaging.
Re my church point above:
https://64.media.tumblr.com/aefb024ad956d539a52d75f270ad0ac1/66b220850789e28e-81/s1280x1920/39e9df986dbe0186b9f11881ab78dcb0e1079133.png
The one big thing that explains it all is seductively attractive, but sometimes things are more complex.
.@Steven L. Taylor:
This is true.
But the identification and filtration based on rigid political “tribes”, that are essentially cultural rather than political groups is really worrying.
It’s particularly evident in America, but has parallels in the Brexit/Remain schism in Britain.
The really nasty thing for civic systems is the increasing amplification of the division by social media, to the point that, unless actively countered, different political alignments increasingly mean entirely different information access.
@Gustopher: I can give a couple of recent tests:
1. If Trump had been re-elected and we had the exact same images from Kabul that faithful day, would one have given Trump the same benefit of the doubt a lot of OTB readers gave Biden?
2. If Trump had dissed the French the way Biden did, same question.
@JohnSF:
Maybe this difference in structured identification of party = religion = culture in US vs UK accounts for:
UK vaccination 89.3%
US vaccination 63%
@Gustopher: Especially at this time of year when we get Halloween (chocolate sponge cake) Twinkies with “scream” filling. That would almost make me willing to buy a box ($4.79 at Fred Meyer/Kroger’s last time I visited the store).
@Steven L. Taylor: Americans of all stripes love to hate the French. Sure, Statue of Liberty and all that, but they liked Jerry Lewis.
They’re good people, but we love to pick on the cheese eating surrender monkeys in their silly berets and their silly striped shirts eating snails on baguettes.
And the withdrawal of the ambassador is just ridiculous overreaction. I’m pretty sure a gentle mockery of the French would unite 70% of Americans (with 10% offended, and 20% wanting a more mean spirited mockery)
@Just nutha ignint cracker:
Take me to your Twinkies… seriously, I’ll go halfsies on a box with ya!
Just ignore the aisle with the Halloween Peeps. For the love of God, please, no Peeps!
I don’t think party affiliation is that big of a deal when it comes what you experience as a person. Millions of Democrats claim to believe in new age stuff and alternative medicine and, amazingly, astrology and no young hip Democrats are running as the Virgo candidate. What’s happened is that the Republican party took this inchoate skepticism people have about modern existence, and used it for their advantage. And they offered it to people who believe in the literal truth about Jesus and the Free Market. That both of these idols have turned sour made the blowback even worse, i.e. Trump.
Have you tried considering it from the p.o.v. of the French in general, and the French government in particular?
I’m a Brit, and annoying the French is a national hobby.
But there are very serious reasons why they are displeased.
Even an Australian has commented that if US wants Oz to tie themselves to the US versus China, Washington needs to look to its credibility in regard to not shafting allies.
You have bad rep in that regard.
My beloved Governor (sic) DeSantis has made a big deal of Regeneron. He has teams roaming FL setting up Regeneron clinics. As best I can tell from local news stories it’s first come first serve with no requirement for a positive test, only a claim of exposure. One would think medically it would be better to turn over the limited supply, provided by the Feds of course, to the major hospitals to use as they see best. But it probably is better for DeUseless reelection to keep it under his own control. At a minimum, he’s inoculated, one might say vaccinated, himself from the charge he’s doing nothing.
If Trump had been re-elected and we had the exact same images from Kabul that faithful day, would one have given Trump the same benefit of the doubt a lot of OTB readers gave Biden?
This is a bad question. Trump would have reacted in a completely different way than Biden, who took responsibility and didn’t start shrieking about it. Also, the supposed-liberal media slammed Biden hard and Biden didn’t start shrieking about that either and he let it go. Trump and his base don’t forget any criticisms from the media, ever.
The reaction to the images would have been the reaction to Trump’s personality and how terrible it is.
Everyone has an understanding of the world, a weltanschauung if you will. Lakoff talks of it in terms of “framing”. As a consequentialist I may believe I am totally rational. But the criticism of consequentialism, that there are, in the end, assumed moral rules, is true. It’s just that the assumed rules: the good of the many outweighs the good of the few, democracy, equality of opportunity, etc. are assumed, but seem (to me) pretty sensible, and close enough to work. But it does lead to different answers than assuming, say, that capital is scarce and should be prioritized or that most people are incapable of self-government, which are defensible positions.
We all judge truth or falsity on how well a statement meshes with our understanding of the world. I like to think my weltanschauung aligns pretty closely with reality. I may be wrong. Someone who has been following FOX “News” for decades will have a largely different weltanschauung than mine. I believe his view is nuts, but I can’t counter it without challenging his whole life.
@JohnSF:
They lost a sale. And they are pulling Ambassadors.
It’s really very silly. For a few submarines they are going through diplomatic steps that are generally done on the brink of war.
What’s next, a demand to rename loaves of bread because it’s only a baguette if it comes from the baguette region of France?
Again, 20 years is long enough for any commitment, and there’s been a deal on the table to leave for over a year. Did you think we were joking? We had an election between one guy who wanted us out, and another guy who had wanted us out. What did you think would happen?
Not sure why the Brits want to have a forever war in Afghanistan, but they are welcome to do it without us. The French are likely willing to sell you some submarines if that will help, but many countries prefer ours.
We might also have fighters or helicopters or something more practical. Up until recently, we had a few military bases right there, we would have sold them off cheap.
Seriously though, why the hell do Brits want to be in Afghanistan? Because that’s utterly baffling. Does the sunk cost fallacy require another decade for you folks?
The enthusiasm for Regeneron exposes very anti-vaccine talking point as garbage:
So are the antibodies.
Neither are the antibodies. In fact, they’re less effective.
Regeneron is WAY more expensive than vaccines. The anti-vaxxers have been pushing this nonsense for years even though treating, say, measles, is massively more costly than a vaccine.
Viruses don’t evolve to evade vaccines. They can evolve to bypass immunity. And they are way more likely to develop resistance to a therapeutic (as indeed, Delta has).
The one thing I will never forgive the GOP for is politicizing this. Well, that and, by the end of the year, what is sure to be their open support for the January 6 insurrection.
@Michael Reynolds:
What that reminds me of starts at 1:30.
“And why beholdest thou the mote that is in thy brother’s eye, but considerest not the beam that is in thine own eye?”
I mean, c’mon… Really? An Aussie complaining that the US shafted the French in this deal??? A FVCKING AUSSIE???????? And you, a Brit, who have quite the beam in their own eyes, quoted him.
Jesus Christ. Hypocrisy is certainly not the sole province of the US.
@JohnSF:
Identity is more than partisan preferences. Indeed, being fiercely independent can be its own identity, yes?
@Gustopher:
That’s not the point.
The point is: what shape’s one’s view of a particular bit of news? Does one react in X way if Trump does Y and Q way if Biden does the exact same Y? If one uses pre-established views of Trump and Biden to filter how one responds to Y versus assessing Y independently, one is using a filter and it is a highly likely at least some of that filter is based on partisan preferences.
@Modulo Myself:
You are missing the point.
@Modulo Myself: How about this: do you think that the following is true or not?
A Democratic voter sees a Democratic president make a decision. Is it likely that that Democratic voter start their mental response to that policy choice with the benefit of the doubt, and maybe even start to rationalize why the decision is good or are they going to stop and independently assess each decision de novo?
How will a Republican voter respond to that decision?
How would the Republican have responded if a Republican president had made the same decision?
And as it pertains to Afghanistan I have zero doubt that the story of Afghan’s falling from US transport planes as they left Kabul would have set the comment section on fire if Trump was still president. There would have been a lot less forgiveness for the collapse of the ANA and the fleeing of Ghani, too.
And I am talking here not of the rightness or wrongness of the responses, or even of the long-term analysis. I am talking about how we all tend to react in the moment and how that continues to shape opinions.
@Hal_10000:
Indeed. What I am getting at in the OP is that it shows how what people are told by leaders and media they trust shapes their views more than the logic of their position or the evidence for it.
@flat earth luddite: Tell ya what i’m gonna do (in my very best Heckle and Jeckle voice) we’ll go to Winco today and get a box for a little over half that–well closer to 2/3rds. I may even spring for it completely; depends on how much side work you been doing.
@Modulo Myself: True enough (and FG can, as we used to say, “fwk up a sh!t sandwich), but speaking only for myself, I’m glad that we finally figured out a way of the quagmire and would be equally happy, but sad about those left behind and killed in the process, no matter who is in charge. It’s an advantage that stems from not being a stakeholder to a political system.
Of course, as you noted, it wouldn’t be the same. The FG “plan” was to go leaving the key on the B&B dresser (if you will). Certainly neater, but more costly. How much Americans care about costs borne by others I’ll to experts.
@Steven L. Taylor:
And as it pertains to Afghanistan I have zero doubt that the story of Afghan’s falling from US transport planes as they left Kabul would have set the comment section on fire if Trump was still president. There would have been a lot less forgiveness for the collapse of the ANA and the fleeing of Ghani, too.
These images set many liberals on fire though. The ‘liberal’ media treated this as another Vietnam. Yeah, if Trump were president and the same happened would the people who defended Biden been less likely to defend Trump? Possibly. There would have been a connection of these images to Trump’s incompetence and then whatever crap he would have said would turn into the story. But would this have swung Democrats into wanting to go back into Afghanistan? No.
The thing about masks and vaccines is that all it took was a Republican to make them partisan. There’s nothing bad about a mask, sorry. And there’s nothing scary about vaccines. Whereas the images out of Kabul were actually bad. You can say that somebody is at fault for something that is bad. With masks and vaccines, it’s all just gibberish, unless there is an epidemic of swollen balls.