The Great Education Debates of the Week

~ Laura

From the Newsletter.

In a week with some personal drama — COVID exposure at Easter dinner, tests, and vaccinations for Steve and myself just an hour ago — I’ve distracted myself by diving into dramas in the wider world, like voting laws, Prince Phillip’s death, and school stuff, of course. 

Even without a fully vaccinated public, rising COVID rates in the North, and very unhappy teachers’ unions, schools are opening around the country. In my town, all students will attend school in-person for five mornings per week starting in mid-April. In September, schools here are slated for regular, full days for all students. That’s a pattern that I’m hearing happening around the country. 

Now that the drama around whether or not schools should remain shuttered seems over, we’ve moved onto the second round of fights. 

Fight #1 – Should we measure learning loss this year? Should we even use the term “learning loss,” because it might stigmatize kids. 

Right answer – If kids fell behind in reading and math this year, as all studies indicate, then we should not sweep this fact under the rug. It would be like hiding the fact that too many folks in nursing homes died from COVID. Hiding that information would pretty scummy, right? So, why would we try to cover up the fact that kids didn’t learn a whole lot over the computer, unless they had families that could massively supplement their education. 

Also, if we don’t know the scope of a problem, we can’t fix it. I think kids should be offered free after-school tutoring, summer school, and extra enrichment opportunities for five years to make up for this year. Sure, we might have to hire extra staff to run those programs, but that’s an excellent use of federal money. 

Fight #2 – Biden said that 80 percent of all teachers have gotten shots, but there was some pushback on that number on Twitter. Some put that number as low as 40 percent. Others said that the system has no way of really knowing how many have gotten vaccinated, because nobody is keeping track, and because the unions are telling teachers to not disclose that information to administrators. 

Even if that 80 percent number is right, why haven’t 20 percent gotten a shot? I hope they’re not science teachers. Should schools make it mandatory for teachers to get vaccinated by September? What if they refuse?

Right answer – Yes, vaccinations should be mandatory for all teachers and health care workers. 

A commenter on my blog said his mother’s nursing home is now under lockdown, because some healthcare workers there refused to get the vaccine, got infected, and brought the virus into the nursing home. Isn’t that manslaughter? 

While an unvaccinated kindergarten teacher isn’t the loaded missile of an unvaccinated healthcare worker, keeping those folks healthy – even against their will — would seem to be of utmost importance. We already mandate MMR vaccinations, why not this one? If colleges, like Rutgers, can make the vaccination for all their students, then the rules have to apply to the adults, as well. 

Fight #3 – Even though nation-wide college applications dropped this year, particularly for young men, they surged at Ivy League colleges. Too many kids thought that they would have a shot at Harvard, because they dropped their SAT requirements for the year. hahaha. 

So, my friend, Helaine Olen at The Washington Post, and David Kirp in the New York Times, both argued for cloning those top colleges or adding more seats. 

Right answer — I’m not sure why we need Harvard to expand, when we have enough seats in college classrooms around the country. Seats aren’t the problem. The problem is that we don’t have affordable, quality seats for everyone. 

Community colleges, as I’m learning right now, need a major administrative overhaul. All colleges need to provide more support for students, especially those who were deprived of an excellent K-12 education and have complicated lives. 

Despite that influx of applications at Harvard, it’s not clear that parents even want their kids to attend college anymore. 46 percent of parents said they would prefer not to send their children to a four-year college. This is true across all income levels. People want job training for their kids. Again, this is an opportunity for community colleges, but they might not have the ability to rise to the occasion.

Published by Laura

73 thoughts on “The Great Education Debates of the Week”

  1. “Biden said that 80 percent of all teachers have gotten shots, but there was some pushback on that number on Twitter. ”

    https://www.cbsnews.com/news/covid-19-vaccine-teachers-81-percent/

    I never understand why you are always so quick to dump on teachers’ unions. I’ve had issues with some teachers in the past, but never because of anything having to do with the union.

    I also did a survey of the teachers among my FB friends. Everyone (except friends in Phoenix who said they didn’t know about 2 of their neighbors who are teachers) reported that all the teachers they know have been vaccinated. Locations of these FB friends:
    Chicago suburb (who says the union worked to make vaccines available to all teachers)
    Orange County, CA
    Columbus OH suburb
    My town in SE Mass; friend says she thinks many of the people in the middle school where she works have all had it
    Two friends in VA, one in Richmond and one in northern VA (not really DC suburb), both have the feeling that teachers are getting the vax; one of the friends volunteers in a vaccination clinic
    Charlotte, NC
    San Antonio, TX area – says her son’s rural school was tracking teachers who have been vaxed
    FL (inland and NE from Tampa)
    Philadelphia – “The school district and Children’s Hospital arranged for all of the teachers to be vaccinated.”
    Boston suburbs with family also in NYC area – says all the teachers in her family are vaxed and that one colleague of her sister isn’t vaxed because her doctor told her to wait because she already had had COVID
    Plus Rockland County, NY, where my BIL is fully vaccinated

    The only person I know who is in education who seems to be anti-vax is my RWNJ aunt. And she watches way too much Newsmax.

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    1. Did I say something anti-union in that newsletter? The union leaders are telling teachers not to report this info to administrators. I saw a screen shot of an email.

      Biden said 80%, but there is no large scale, statistical evidence that that number is correct. None. In some states, folks could check a box that there were in “the education profession,” but that includes everyone from tutors to CCD teachers to Kumon owners to classroom aides to college secretaries. They have zero information about how many K-12 public schools teachers got the vaccine.

      That’s just the facts.

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      1. But the union has surveyed its members, who are public school educators, and 81% have either been vaxed or have scheduled.

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    2. Wendy linked to the CBS report on the AFT (Randi Weingarten’s org) survey of their members, 80% said they are vaccinated, and of the remaining 20% about 50% said they did not want to be vaccinated (10% total, expressing vaccine non-acceptance). About 50% said the vaccine should not be required.

      Biden’s statement was based on the CDC report: https://www.cdc.gov/media/releases/2021/s0406-teachers-staff-vaccine.html which also surveyed teachers and said that 80% are vaccinated.

      I think the 80% number is quite plausible and that the evidence for it is comparable to the evidence for other groups on vaccinations. And, if rates reaches 90%, that’s comparable to doctors. My medico friends tell me that for the flu vaccine, those who don’t vax don’t lose their jobs, but have to engage in higher mitigation measures (like wearing a mask all the time).

      My kiddo got her first shot today, in her college town. We’ll have to find her a second dose here, but decided it was worth the complications for the benefits conferred by the first shot.

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    1. I think the residents are more vaccinated than the staff, though obviously they won’t tell you anything about the care of other residents. But they have good leverage over the residents (can’t participate in group activities if you aren’t vaccinated, moving is really a huge pain and frankly impossible for many).

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  3. Life during the pandemic is challenging and frustrating, but please refrain from socializing with friends and family or taking part in public activities that could spread the virus. The public’s health is at stake.

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    1. AB said, “Life during the pandemic is challenging and frustrating, but please refrain from socializing with friends and family or taking part in public activities that could spread the virus. The public’s health is at stake.”

      The problem is indoor mixing of unvaccinated people from different households.

      As long as people are outdoors and/or fully vaccinated and/or the unvaccinated people are only from one household, it’s not a high risk activity.

      I’ve had my second shot and my husband and two teens are going to have their second shot soon and once we’re all fully vaccinated, my husband and I will go out to dinner and my 10th grader will go to birthday parties and go back to PE (we pulled him out at the beginning of the year due to the coaches’ YOLO attitudes). There are a lot more question marks with regard to our 8-year-old, but we’re going to have to play that by ear.

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    2. AB’s statement is fully compatible with the clarification that some socialization might be compatible with *not* spreading the virus. But, I’d be wary of any absolute clarity on which activities are safe. Some activities are safer than others. And some needs are greater than others.

      When I’m fully vaccinated, I’m going out to dinner with my family (who will hopefully also be fully vaccinated by then — younger kiddo may be the last, but I don’t think he’ll be far off from me). But, I’ll probably still sit outside (which might be nice anyway, and I can chose to go out when it is nice).

      The next step is travel. Lots of folks are traveling right now and I’m pretty jealous of the pictures from Hawaii.

      My next risk assessment will be, when can a group of friends get together inside. And, spouse wants to get together with his poker pals. I don’t have anyone who isn’t getting the vaccine as soon as I can in those groups, so it will happen, hopefully fairly soon.

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      1. In other words, I expect everyone I want to interact with in person to have the vaccine soon — no vaccine hesitant ones among them.

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      2. I’m not ready to eat in a restaurant (and to be honest, I’m not someone who really enjoys restaurant dining to begin with) or fly on a plane. We are discussing driving down to NC to visit my SIL as we had planned to do last summer. I am looking forward to much outdoor socializing this summer. But that’s basically a typical summer for me. We live close enough to the Cape that we can do day trips, too.

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  4. As I understand it, because the vaccines are approved by the FDA under an emergency definition, employers are not able to lawfully require vaccination of their employees.

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    1. The Pfizer brochure I received very clearly states the vaccine is not FDA approved. It is being allowed, but it isn’t approved, it’s experimental.

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      1. If they’re so safe, why doesn’t the FDA approve them completely?

        Because there is a formal process for approval. This isn’t a hard question, nor is it a gotcha that this process hasn’t been formally completed yet.

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      2. Jay said, “Because there is a formal process for approval. This isn’t a hard question, nor is it a gotcha that this process hasn’t been formally completed yet.”

        A lot of people are going to want to ask, why not wait for the formal approval process to be completed, if it’s so essential for the FDA’s process to dot every i and cross every t?

        It is a totally fair point that we can’t expect the public to universally jump at the opportunity to be vaccinated if the FDA isn’t ready to formally approve yet.

        Also, the CDC has made a lot of errors with regard to messaging on the vaccine.

        https://www.bloomberg.com/opinion/articles/2021-04-08/fauci-and-cdc-s-walensky-should-be-candid-about-vaccines-now

        A person who took their cues entirely from the federal guidance on vaccines would have gotten the message that vaccines don’t prevent transmission, and that after vaccination you still shouldn’t travel and you should keep wearing a mask…with no clear finish line anywhere in sight, or any sense of what the finish line would look like. They’ve gotten better on their messaging, but the first few months were a disaster.

        I know your instinct is to blame the public…but there’s a lot of blame to spread around to people in positions of responsibility who screwed up the messaging for the vaccine roll-out. It’s a miracle that it’s going as well as it is in the US, given how badly the feds have misrepresented the effectiveness of the vaccines and how little effort they’ve made to give people hope. Believe it or not, “here’s this vaccine that won’t improve your life at all and you need to get it or you’re going to get fired,” is not actually a winning message–and it runs the risk that there will inspire legislative backlash at the state level with regard to employer requirements of vaccination.

        This story is also unfortunately timed:

        https://www.jpost.com/international/st-vincent-volcano-only-those-vaccinated-for-covid-19-can-evacuate-pm-664781

        It’s understandable…but it looks really bad.

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      3. I don’t value blame in the public health game, except to the extend that blame means that we understand the reasons for vaccine reluctance/hesitancy/denial. You are raising the question of FDA approval v EUA here as though it might play a significant role in the current vaccine hesitancy. That hypothesis probably isn’t worth investigating significantly because it is not possible for the FDA to approve the vaccine except through the EUA because it cannot be done in the timescale we need to get handles on the pandemic.

        What is worth investigating, and what we should focus on is what kinds of information and rules and incentives would improve the likelihood that currently hesitant folk would take the vaccine.

        I’ve emphasized the role of trust in conveying the information, which I think means ever broadening the individuals conveying the message. I think that private institutions can apply vaccine rules (restaurants for example, except to the extent that they are prohibited — as with not allowing service animals). I suspect heavy handed requirements might create backlash that won’t be helpful to the end goal. If incentives work, great. But, there’s some evidence that incentives can decrease update because people interpret the incentive as being reflective of possible danger. You are also suggesting messaging on the benefit of the vaccination to the individual taking it. I’m up for doing all those things, when they work.

        An Atlantic article a couple of days ago echoed something I’ve said here — I think limiting community spread by limiting interaction & focusing on testing and tracing has failed in the United States. That leaves vaccines as our only method of mitigating the pandemic (not ending it, necessarily, but maybe). I will believe that vaccines are working when I see death rates decrease to flu levels. Until then, I will still be risk averse.

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      4. bj said, “I suspect heavy handed requirements might create backlash that won’t be helpful to the end goal.”

        Yeah. I see the US getting shots at the rate of about 1% of population a day (and Texas is at that rate right now, too), and I think it’s really dumb to mess with success.

        “If incentives work, great. But, there’s some evidence that incentives can decrease update because people interpret the incentive as being reflective of possible danger.”

        Right. Hence, smaller incentives. Nursing home workers probably ought to be offered bigger bonuses, though. I think $500 should do it.

        “An Atlantic article a couple of days ago echoed something I’ve said here — I think limiting community spread by limiting interaction & focusing on testing and tracing has failed in the United States.”

        …and in Europe and in Latin America. The success stories are East Asia and Australia/New Zealand. And that’s basically it. India is looking really bad right now after a pretty good patch and even Germany eventually failed with test-and-trace.

        I suppose there are some small Scandinavian countries with good numbers, but Europe on the whole is pretty bad.

        “I will believe that vaccines are working when I see death rates decrease to flu levels. Until then, I will still be risk averse.”

        I watch the UK and Israel. The UK has been in double-digit deaths for 2+ weeks now with 48% of the population having been given at least one shot. Israel, with about 59% of their population having gotten at least one shot, is at about 8 deaths daily. Adjust for population, and both the UK and Israel are pretty close to flu level fatalities (at least US flu level). Obviously, the US has some hotspots, but vaccinate 1% of population a day the way we’ve been doing, and sooner or later, COVID goes away.

        Obviously, we’re nowhere close to where Israel is right now in terms of vaccination levels, but we are actually really close to the UK.

        https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

        As of yesterday, the US has given enough shots for 29.1% of the population to be fully vaccinated, while the UK is at 29.2%. They did first-shots-first, though, so that translates to 35.9% of Americans having gotten 1+ shot and 48.1% of people in the UK having gotten 1+ shot.

        The US is within a few weeks of being where the UK is today–which is a really good place to be.

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    2. This statement is almost certainly not true.

      In the past vaccination requirements, by the government or employers have been upheld as legal and, although this has not been tested in court (yet) the employment law experts seem to be coalescing around the opinion that they would continue to be.

      The caveat is that the vaccine is currently only approved under emergency use by the FDA. However, this probably won’t matter in most cases. Most employment in this country is at-will, which means that employers can generally fire you for almost anything. If you are in that situation your employer can certainly say “vaccinate or get out” and there isn’t a thing you can do about it. They will probably have to offer medical and religious exemptions but will probably have some latitude in how those are drawn.

      Even if you are not in an at-will employer situation, many employers can still require “voluntary” vaccination if it is pertinent to your job. In this situation, if you choose not to vaccinate but this means you can’t perform your job then your employer can then terminate you (for cause) and does not necessarily have to further accommodate you.

      The people with the most latitude to refuse vaccination will be those with strong union protection or those in states with more employee-friendly labor laws.

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      1. It is absolutely true. The brochure is titled COVID-19 vaccine:Pfizer-Biontech what you should know.

        On the page titled “Fact sheet for recipients and caregivers” second paragraph states “The Pfizer-Biontech Covid 19 vaccine is a vaccine and may prevent you from getting COVID-19. there is no U.S. Food and Drug Administration (FDA) approved vaccine to prevent COVID-19.”

        The last paragraph at the bottom of the page, in response to the What is…question, says “The Pfizer-Biontech COVID-19 Vaccine is an unapproved vaccine that may prevent COVID-19. There is no FDA-approved vaccine to prevent COVID-19.”

        You should always read the drug facts.

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      3. Or, maybe the right way to say that is to say that the USE of the vaccine has been authorized (rather than approved).

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      4. “Under an EUA, FDA may allow the use of unapproved medical products, or unapproved uses of approved medical products in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions when certain statutory criteria have been met, including that there are no adequate, approved, and available alternatives. ”

        The FDA seems to have a term “investigational” for drugs that are not approved, or approved for a specific use. I think the “authorization” seems to have a similar affect as allowing “compassionate use”, but for everyone.

        But, I agree that we should be careful of the use of the word “approved” which is a term of art for FDA approved medical products.

        https://www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained
        https://www.fda.gov/patients/clinical-trials-what-patients-need-know/glossary-terms

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      5. It is absolutely true. The brochure is titled COVID-19 vaccine:Pfizer-Biontech what you should know…

        This statement is certainly true. What is most certainly untrue is the idea that the vaccine only being approved for emergency use will preclude employers (or others, such as business providers) from requiring vaccination for employment or other things.

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      6. Jay said, “What is most certainly untrue is the idea that the vaccine only being approved for emergency use will preclude employers (or others, such as business providers) from requiring vaccination for employment or other things.”

        If they’re so safe, why doesn’t the FDA approve them completely?

        I think they almost certainly are–but it’s a fair question for the public to have. Why should they be expected to get vaccinated when the FDA isn’t confident enough to give full approval?

        There’s no point in talking about the public having “vaccine hesitancy” until there is complete FDA approval. Up until that point, it would be more correct to talk about the FDA having “vaccine hesitancy.”

        I expect that more than a few employers have considered the fact that they’re not fully, formally approved and that if the employers require them as a condition of employment, there will be legal hell to pay if there turn out to be any serious side effects. (But at the same time, the flip side could be true of employers who don’t require vaccination of employees who work closely with medically vulnerable people–they could be liable if there’s a fatal outbreak that they could have prevented.)

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      7. Legal consequences for requiring the vaccine are almost certainly unlikely:

        “The declaration of a public health emergency by the Department of Health and Human Services in March 2020, however, resulted in exclusion of Covid-19 vaccine injuries from the VICP. This declaration triggered the Public Readiness and Emergency Preparedness (PREP) Act, a federal law that requires that all people injured by vaccines given as countermeasures during a declared emergency bring claims under only the Countermeasures Injury Compensation Program (CICP). ”

        (The VICP is the regular vacccine injury compensation program)

        https://www.nejm.org/doi/full/10.1056/NEJMp2034438

        Legal consequences for COVID caught at the workplace seem marginally more likely, but that would depend on whether employers have been given emergency legal protections. I think giving them legal protections were part of some of the stimulus/relief plans, and I don’t now which ones went through.

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    3. There’s legal quibbling about the interpretation of the law that authorizes emergency certification: https://www.healthaffairs.org/do/10.1377/hblog20210212.410237/full/

      The link says the use of the vaccine was approved under the EUA provision added to the FDCA in 2004 and the quibble over whether it can be required (though it only has emergency authorization) depends on the interpretation of the following section of the law

      “Specifically, under 21 U.S.C. § 360bbb-3(e)(1)(A)(ii)(III), each individual must be informed “of the option to accept or refuse administration of the product, of the consequences, if any, of refusing administration of the product, and of the alternatives to the product that are available and of their benefits and risks.”

      . . . . [a] plausible interpretation is to view segment two as a qualifier to segment one. According to this interpretation, the provision as a whole could be interpreted to dictate that, although a person has the option to refuse an EUA product, refusal can come with “consequences.”

      So, could a consequence be loosing your job? I think there would have to be litigation to interpret. Will someone test it? I’m guessing it will depend on whether sufficient vaccination occurs to limit the spread of the virus (or mitigate its consequences sufficiently). We’re not there yet. Detected cases are still at 60K and deaths at 1000K/day. Cases in Michigan have reached their winter peak again and deaths are creeping up there. If voluntary vaccinations aren’t enough I think workspaces are going to want to see people vaccinated.

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      1. So, could a consequence be loosing your job? I think there would have to be litigation to interpret

        In an at-will employment situation you can lose your job for almost anything that is not explicitly mentioned in law.

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      2. Yes, at will employment means little protection, but I think we started the conversation with teachers, who are pretty protected.

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      3. Also there are folks who interpret the informed consent and the right to refuse to mean that you can’t be kicked out of the military, and potentially for refusing a medication authorized with an EUA.

        There seems to be some concern burbling up about military folks refusing the vaccine. I don’t think there will be any immediate attempt to force them to get it, But that could change.

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      4. There seems to be some concern burbling up about military folks refusing the vaccine. I don’t think there will be any immediate attempt to force them to get it, But that could change.

        The military may not be able to force people to take the vaccine as long as it is under emergency authorization. However, they have the power to do a lot of things that are effectively forcing people to vaccinate. For instance, they could almost certainly make certain deployments or assignments contingent on vaccination, were they to want to. This would make not vaccinating effectively career killing.

        So far they have not chosen to do this, but this is more likely to be a cultural thing and not a lack of power to do so thing.

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      5. The articles suggested that there’s some kind of emergency that Biden could declare that would allow the military heads to require the military folk to take vaccines. I don’t think anyone (other than politicos, democratic congressman) are suggesting that option. It would be a political mess and potentially undermine the military in ways different than concerns about a virus that many younger people seem to survive.

        The articles said that vaccine refusals might be greater than the 1/3 that were initially being reported, because everyone hasn’t been offered the vaccine, and the first groups included health professionals in the military. Maybe 50% of Marines, and even higher in some other subgroups.

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  5. I read somewhere that several vaccines have gathered all the data necessary for approval, and that it’s possible approval might occur this summer, in which case the legal complications will be moot.

    When I hear people complain they haven’t been tested enough, I wonder if they have considered that 0ne of the reasons vaccines take so long to be developed and tested is that the researchers have to wait for enough of the test volunteers to be exposed to the illness. You can’t tell if the vaccine works if you don’t have exposure–because there will be no difference in infection rates between the subjects receiving the placebo and the vaccine if nobody’s exposed. In fact, I remember last summer some suggesting that once the spring wave had subsided it might take longer to test the vaccines. Of course, that didn’t turn out to be a problem. In other words, the proliferation of the pandemic made the testing of the vaccines much, much quicker.

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  6. Another way to think of it is that the testing has been horizontal rather than vertical. This vaccine has been tested significantly more–in more people, and against more potential infections–than most vaccines where they’re approved. I have no doubt they will receive approval soon.

    I’m sure at that point the goalposts will be shifted.

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  7. The US Military is not requiring vaccination and a fairly large percentage is refusing. This is largely due, in my opinion, to the clusterfuck that was the anthrax vaccine. Given that experience, it is not surprising, nor, I think, all that anti-science.

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  8. I would hope that any stigma would end up on the systems of education that haven’t been able to catch all the students (understandable!) and not on the students themselves. Maybe the right term is “instructional gap.”

    At my work, we’re talking a bit about working with a tutoring centre that operates in the same plaza as one of our locations about setting up “catch up camps” – we would do the physical/organizational end, they would supply tutors and curriculum – but not until summer 2022. I cannot speak for kids with special needs, but for other kids – we can do this. A school year is indeed a long time, but it’s not forever, especially in elementary school.

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    1. I hope such services are made available and funding provided for them.

      I’m usually not a fan of privatizing, but I think that pulling together what might be a emergency need is well suited to providing government funding and private services. I would limit the terms of such funding, so that if the money is not providing value, it would go away, rather than become a new status quo.

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      1. Ours won’t be free but we have a charitable branch so we give scholarships for seats – but yes, I expect the school boards to offer help too.

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      2. I think there may be a role for volunteer services, partially because I think there might be true volunteers (meaning people who do not want to be paid and have the time and energy to commit) willing to help. But, in general, I think that people should be paid for their work. Absolutely think of providing interventions to help children bounce back is an important infrastructure project.

        I love the WPA projects and the lasting monuments they have left on our country, but children are the infrastructure of tomorrow.

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  9. About the Marines, the officer interviewed did say that Marines might have received vaccines through other channels. We just got our vaccines (yay!) I then removed my name from the other lists it had been on. So, one authority knows I’ve been vaccinated, but for the other three, might I not count as a “refuser?”

    I presume electronic databases could be reconciled, but maybe not. At this point, the vaccine provider and my health plan know I’ve been vaccinated. They did take a picture of my driver’s license, so presumably the state will know, eventually. I have no problem with that, but I gather some people do.

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  10. We caught up with friends in Germany over the weekend. They are immensely fed up with their government’s response to the epidemic.

    One friend referred to this story: https://www.welt.de/politik/ausland/plus229915201/Impf-Reise-in-die-USA-Eine-Deutsch-Amerikanerin-fliegt-zur-Coronaimpfung.html

    Sorry, I’m not going to subscribe to read the story. As related to me by my friend who did, this American was on a list of people with medical conditions who should receive the vaccine in Germany, but had not yet received it. So she flew to Texas, and was vaccinated in 2 hours.

    Germany is now considering ordering Sputnik vaccine.

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  11. I’m getting texts from friends telling me that vaccination centers around Newark have an oversupply of the vaccine and to go down their to get a shot. I think that the state concentrated the vaccine supply around urban areas, because they were hit by the virus the hardest. No problem with that.

    At some point, hopefully not for a quite a while, we’re going to get to a point where everyone who wants the vaccine will have gotten it, and we’re going to have to figure out what to do with the people who won’t get it. It’s going to be a diverse group – people who don’t trust experts/news/medicine/big Pharma, people who don’t think they need it, people who are just too lazy to get it. It’s going to cut across race, gender, age, political affiliations.

    How are we going to get them to get a shot? With sticks or carrots? With laws and penalties? With information? With compassion?

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    1. At that point, it will be time to roll out amended vaccines to deal with the variants. I’m not sure it would be worth the effort–depending on how many there might be–to try to vaccinate the unwilling, when people who are willing to be vaccinated would need boosters.

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      1. Cranberry said, “At that point, it will be time to roll out amended vaccines to deal with the variants. I’m not sure it would be worth the effort–depending on how many there might be–to try to vaccinate the unwilling, when people who are willing to be vaccinated would need boosters.”

        Boosters are one of the problems with a stick-based policy–are we going to keep on threatening people with job loss and having their kids kicked out of school through several iterations of booster shots? Or a yearly booster? Maybe that makes sense for people who work in health care and nursing home jobs, but beyond that?

        And frankly, one of the things that we haven’t really come to terms with is that a lot of families really don’t care about school or education and the pandemic has been a godsend in terms of providing excuses for not educating their kids. Threatening to not allow their kids to go to school is not going to make a big impression on them.

        But it’s hard to understand that if you are a solid UMC citizen with lots of degrees who thinks that education is everything.

        Also, are we prepared to threaten parents with CPS and having their kids taken away for not having their kids vaccinated and in school? It’s going to be largely poor, minority people, and my oh my, that’s going to raise some issues.

        Practically speaking, there’s only so much stick that can be used on the public before things break down.

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    2. I think a lot will depend on whether we get enough voluntary vaccinations to show an acceptable level of cases and disease. we’ve talked about using flu deaths as a criterion, and, given the transmissible of this virus, that might be the goal. Averages deaths are still 900/day averaged over the week, but maybe deaths are decreasing? Cases are so far stabilizing at 65K/day averaged over the week. But if we get to 150 or so deaths/day average? Then, I think we move on, though those who interact with vulnerable people (health care, nursing homes, prisons, schools) might require different approaches. If not, and we have to push more people to get vaccines to protect entire communities?

      1) information: not in public service announcements or fancy adverts with ex-presidents, but with your doctor, nurse, pastor reaching out to you about the vaccine. Of course that requires buy in by those folks, but, without it, I don’t see reaching those who don’t trust the CDC.

      2) access: at workplaces, doctor’s appointments, schools, pharmacies, a place you are going to any way, including for routine health care.

      3) international travel: I think this will happen (some vaccines are already necessary).

      4) requirements for access: Rutgers, Brown, and Cornell are already saying vaccines will be required. I think private schools are going to be able to do it (with the appropriate health exceptions). Rutgers will be an interesting test.

      5) requirements for private travel/private institutions: airlines, stadiums, music venues, theaters (restaurants and stores will be harder, since those locations don’t require tickets)

      6) requirements for necessary spaces: schools, hospitals, doctors (including workers). This one will be tough

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    3. The NY Times has an article about the MLB and their efforts to “incentivize” vaccines, which are also a plan to lift restrictions (so, not entirely incentives).

      “Vaccinated people can gather on team planes, trains or buses again (read: card games are back); indoor gatherings without masks or distancing with other vaccinated people is permitted outside of team facilities; virus testing can be reduced from every other day to twice a week; vaccinated family or household members can stay at the team hotel on the road.

      Among the many benefits for a team reaching the vaccination mark: Masks are no longer required in the dugout or the bullpen; mandated contact tracing sensors can be tossed aside; eating indoors at restaurants is allowed; nonvaccinated family or household members and vaccinated nonfamily can stay with players and staff at the team hotel; shared clubhouse activities (such as pool tables and video games) can return.”

      The Angels & the Cardinals have apparently met the 85% threshold to get vaccine benefits.

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      1. That’s a lot of carrots.

        I know Hometown U. is dropping weekly testing requirements for staff and students that are fully vaccinated.

        Hometown U. wants everybody to report their vaccinations to them, so Hometown U. can make plans for the fall. I kind of wish that they’d give exact numbers…

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  12. In related news, my BFF’s somewhat hesitant husband has just gotten his shot. My BFF (who has also been hesitant) is now looking for a shot for herself.

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  13. A few more issues:

    –Is the vaccine available and known to be available at neighborhood pharmacies, and is it available to the general public? (Some pharmacy supplies have been limited to very specific categories.)
    –Do primary care doctors and pediatricians have supplies?
    –Is it possible to get the shot as a walk-in?
    –Are large workplaces offering it on-site?
    –Are large churches and schools hosting vaccine clinics?
    –Are appropriate allowances being made so that workers can take a recovery day after their shot?

    Until most or all of those conditions are met, it doesn’t really make sense to beat on people for not being vaccinated yet.

    Also, are they doing this yet?

    https://www.independent.co.uk/news/world/americas/new-orleans-shot-for-shot-covid19-b1829553.html

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  14. Nate Silver referred to a Osterholm interview on NBC as an example of health communicators overstating risk. I’m cautious, but reading the interview, I agreed with Silver. Osterholm used an overblown analogy: that vaccination was like a fireproof suit that protected you from 95% of fires. Then, he asked, would you walk into a fire with 95% protection? And, I think, most of us wouldn’t (though some might, and we ask fire fighters to do it). But, would I walk into a place where there was some probability of a fire, say, in a place where 20/100K people are covid+? Yes. I’m not going to calculate an actual simulated risk, but if you take into account community case rates, the venue and likelihood of risk, and the likelihood of illness, it certainly doesn’t come out as high a risk as actively walking into a raging fire (even with a mostly fire proof suit).

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    1. bj said, “Osterholm used an overblown analogy: that vaccination was like a fireproof suit that protected you from 95% of fires. Then, he asked, would you walk into a fire with 95% protection?”

      Wow, that is annoying, particularly since the 95% is often protection from ALL symptoms, with the 5% being something very mild and manageable–not the viral equivalent of being burnt alive.

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  15. My kiddo, who got her first vaccine on Saturday in her college town and needed to schedule a second dose when she returned home, texted us this morning to say that she had successfully arranged her dose here, on the date reqired. I am so incredibly proud of her that I could burst!

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    1. bj said, “My kiddo, who got her first vaccine on Saturday in her college town and needed to schedule a second dose when she returned home, texted us this morning to say that she had successfully arranged her dose here, on the date reqired. I am so incredibly proud of her that I could burst!”

      AWWWW!

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    1. I cannot even with the idea that a) the FDA needs to take their sweet time with full approval and b) it’s stupid and selfish for members of the public to wait, believing that full FDA approval means something.

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    2. To be pragmatic, with a condition that may show up in fewer than 1 in a million subjects, no testing will discover such an effect.

      To put it in perspective, Covid-19, in the US, has an observed case fatality ratio of 1.8%.

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    3. Vaccine approvals are really tough, because we give them to healthy people, to protect them, potentially, but also for the good of the community and the at risk, especially those who cannot take vaccines. Vaccines are vulnerable to the tragedy of the commons, counting on everyone else taking the vaccine so that an individual person doesn’t have to take any personal risk.

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    4. Very disappointing about the J&J vaccine, but I am not sure what the alternative to EUA would be? To the extent that it requires simply waiting, there is a significant cost to people getting and transmitting COVID, too (and to mitigation measures).

      To the extent that one might make a personal decision to protect oneself from the individual risk and not concern oneself with the risk to others of not being vaccinated, consequences seem reasonable. If an unvaccinated person is dangerous to others and society, limits on what they can do might be reasonable.

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      1. bj said, “Very disappointing about the J&J vaccine, but I am not sure what the alternative to EUA would be?”

        I don’t think the process is wrong–but it is wrong to beat up on the public for not taking a fully-approved vaccine and to come up with lots of ingenious ways to punish people for not wanting to take a vaccine that is only availably under EUA.

        “If an unvaccinated person is dangerous to others and society, limits on what they can do might be reasonable.”

        It gets really dicey, though, when that unvaccinated person is a kid who hasn’t been to school in over a year…At some point, we start needing to add up the danger to society from kids being left uneducated and to their own devices.

        https://www.tmz.com/2021/03/28/teen-girls-kill-uber-eats-driver-in-car-jacking-washington-dc-mohammad-anwar/

        There’s been a huge national wave of carjackings this past year, with many of the perps being joyriding teens.

        https://abcnews.go.com/US/carjackings-skyrocketed-parts-country-pandemic/story?id=74674597

        “Minneapolis Police Commander Charlie Adams told ABC News [back in December] that “80% of our carjackings and robberies are being done by juveniles, ages from 9 up to 17.””

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      2. I agree — the consequences of not being vaccinated have to be reasonable and shouldn’t be life altering for the individual. I’m not ready to require the COVID for attending schools, though there might be restrictions for those who aren’t vaccinated (for example, wearing masks, even when we stop requiring mask wearing of others). I heard from a doctor friend that’s what happens with those who don’t take the flu vaccine in her hospital.

        We also have to make reasonable assessments of what the risks to others are. If we get a handle on the pandemic, and deaths decrease, requiring people to take the vaccine becomes less pressing.

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      3. bj said, “We also have to make reasonable assessments of what the risks to others are. If we get a handle on the pandemic, and deaths decrease, requiring people to take the vaccine becomes less pressing.”

        Right.

        I look at where the UK and Israel are right now, and I have a lot of hope. There are 10 or so US states that have given 1+ dose to 40% or more of their population, with more every day, and both the UK and Israel are seeing very powerful effects without being anywhere near 75% vaccine coverage. Not that that wouldn’t be nice–but good things start happening a lot earlier than that!

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    5. Apparently the 6 people who got blood clots were women aged 18 to 48, which is also prime time for hormonal birth control, which can also cause blood clots. So, that is intriguing.

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  17. Pennsylvania just opened up to everyone above 18-plus, so I will be on VaxxMax all day trying to find appointments for my 18-plusers!

    My second shot is this afternoon near Scranton. Another road trip! There’s a Krispy Kreme near the Rite Aid where I’m receiving vaccine, but I will be good and not go. My oldest daughter will be with me and she is a good health influence.

    What in the world is happening with Naomi Wolf?

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    1. Day after tomorrow for us, when we start trying to find a vaccine for our 17 year old. I don’t think the vaccine is risk free but life is about balancing risk.

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      1. https://mobile.twitter.com/NateSilver538/status/1381936112311148548

        Nate Silver wrote, “6 [blood clot] cases out of 7 million people [vaccinated]. What a disaster. This is going to get people killed. And it’s going to create more vaccine hesitancy. These people don’t understand cost-benefit analysis. They keep making mistakes by orders of magnitude.”

        “Public health bureaucrats have some weird habits in how they reason under uncertainty and how they communicate to the public. It might help if they sought out experts from economics, sociology, psychology, etc., instead of telling everyone to stay in the their lane.”

        Or probabilists!

        It wouldn’t be so bad, but we walked through exactly this same discussion with Astrazeneca and the EU a few weeks ago.

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      2. In defense of the public health folks, if we have enough of the pfizer & moderna vaccines that vaccinations aren’t significantly slowed, a pause might be acceptable.

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      3. bj said, “In defense of the public health folks, if we have enough of the pfizer & moderna vaccines that vaccinations aren’t significantly slowed, a pause might be acceptable.”

        That’s true, and a pause in J&J is not as big a blow to the US as the Astrazeneca pause was to the EU–because Astrazeneca was their whole game plan.

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  18. https://www.nydailynews.com/opinion/ny-oped-our-dishonest-vaccine-passport-debate-20210414-3xdmbrtq6bgdlc7neydooprjce-story.html

    I see that there is suddenly red state political pushback against vaccine passports.

    “For example, Florida Gov. Ron DeSantis recently issued an executive order that prohibited not only Florida government entities, but also private Florida businesses from requiring customers to provide any type of vaccine passports — defined broadly as “any documentation certifying COVID-19 vaccination.””

    “While Florida’s executive order has received significant media attention, similar bills prohibiting private businesses from requiring customers or employees to be vaccinated have been introduced in other states around the country including Alabama, Arizona, Iowa, Montana and Wisconsin.

    “Unlike DeSantis, Gov. Greg Abbott of Texas has somewhat recognized the distinction between government and private mandates. While Abbott recently issued an executive order prohibiting COVID-19 vaccine passports by “all state agencies and political subdivisions” the Texas order only covers private businesses that “receive public funds.””

    Some of this is going to be overreach (as we’ve discussed, you really do want employees who work closely with vulnerable populations to be vaccinated), but at the same time, I have to point out that this political activity is a very predictable response to all of the cackling and mwahaha-ing about how “we” are going to force the unwashed to get vaccinated, whether they like it or not. A couple of problems with that plan: a) the unwashed vote, too and b) even people who are enthusiastically pro-vaccine (like myself) dislike the punitive and moralistic tone that some people take about COVID.

    Carrots, people, carrots!

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