First, now is the time to get a flu shot if you haven’t gotten one already. Flu is spreading in some southern and western states. Holiday travel will bring it here. Don’t delay.
That said, I got the bill for the COVID-19 shot I had last month. Or rather, I got a record of the bill my insurance company got and paid. The nice retail pharmacy where I got the shot billed $249.99 for the vaccine and for giving me the jab. My EOB (Explanation of Benefits) says the total cost was $169.38, and the Plan’s share was $199.38. (This makes no sense to the uninitiated – it suggests that Blue Cross paid $30 more than Medicare allows, which is not what happened. What happened was that the bill included the cost of both the vaccine and the vaccine administration.)
But here’s where the rubber meets the road. Blue Cross paid Walgreens $169.38 for a vaccine that the taxpayers spent $18 billion upfront to develop, a vaccine that would eventually consume $31.9 billion of public funds. Each dose has been estimated to cost between 54 and 98 cents. So vaccine companies, Walgreens, and Blue Cross are all making $199.38 for getting that little number into my arm. My arm is making big bucks for other people, while the taxpayers – you and me – foot the bill.
Want to understand where public distrust of public health comes from? Look at that $199.38. Multiply by 330 million people. People understand that a vaccine mandate or even a recommendation creates a huge profit opportunity for lots of people, and nobody wants someone else profiting on their backs, or in this case from their arms, particularly if there is a risk of side effects or adverse reactions, and even more particularly if they aren’t convinced that the disease we are preventing is that serious.
Understand that almost no one in the US has ever seen rabies, or polio, or the birth defects that German measles caused, or the massive number of deaths of young people caused by influenza in 1918. The paradox is that we can’t know how severe an epidemic is going to be until it arrives, which means we are likely to overshoot sometimes, hoping to prevent lots of death and disability.
Public trust depends on two things: scientific accuracy (not telling people an epidemic is going to be way worse than it is) and keeping the public health process not-for-profit. We can’t always deliver the former, because science just isn’t that precise when it comes to prediction. But now it appears we can never deliver the latter, which means we live in a world of distrust we have manufactured for ourselves.
To all that, add RFK, Jr, whose CDC this week said that vaccines might cause autism, even though lots of very good science says vaccines don’t cause autism. To make it all worse, the CDC website on which this all appears has collapsed into double speak, saying that vaccines don’t cause autism in a heading but then says there is no conclusive evidence that don’t cause autism on the same page. That page doesn’t say vaccines cause autism. It just says they might.
RFK Jr promised a doctor senator whose vote he needed for his confirmation as HHS secretary that he wouldn’t say vaccines cause autism. So he left up the heading, but put an asterisk after it, and got CDC to post a series of statements that say vaccines COULD cause autism ON THE SAME PAGE. This way RFK Jr didn’t lie to the good senator, at least technically.
We have a saying about statistical analysis – the absence of evidence is not evidence of absence. Which RFK Jr. takes to means that even though there isn’t any good evidence that vaccines cause autism, vaccines could still cause autism anyway. That’s sophistry, exploiting certain vagaries about how statistics and knowledge work to inflame the fears of frightened people. And demagoguery. On the CDC website, displayed for all to see.
Talk about crazy. We are left with a world in which CDC contradicts itself and uses its website to promote a theory for which there is NO PROOF. Which leaves us with a CDC that is no longer an authority. There’s no trust left. But lots of craziness.
(There is no evidence that vaccines cause autism. I promise.)
You can find Michael Fine’s commentaries and short stories on https://michaelfinemd.substack.com/and on http://www.michaelfinemd.com
