Off Brand

Why Are We Picking Vaccines Like They’re Toothpastes?

An angsty public is turning the Pfizer, Moderna, and Johnson & Johnson vaccines into a dangerous brand battleground

A photo illustration featuring a shopping basket filled with vials of Covid-19 vaccines and shots.
A photo illustration featuring a shopping basket filled with vials of Covid-19 vaccines and shots.
Photo Illustration: Save As/Medium; Source: Getty Images

Worldwide, there are 11 vaccines available to combat Covid-19. And according to some observers, this has led to a problem: “People are doing what they do with cars and peanut butter and Tinder profiles — comparison shopping,” an On the Media segment this weekend declared. Host Bob Garfield noted that among his friends and family in Serbia, where people apparently have access to options from Pfizer, Moderna, and AstraZeneca as well as Chinese and Russian vaccines, some choices have more “status” than others. “It’s conspicuous vaccine consumption,” he said.

Similar thoughts have been burbling around social media, suggesting “people are angsty about the vaccines because they’ve been presented as consumer products,” leading to a process that is “like choosing a brand of shampoo or salad dressing.” This in turn is leaving “ordinary people … parsing the different vaccine brands,” as one tweet phrased it, in stark contrast to the boring vaccinations of the past, whose makers we could seldom even name.

Well yeah, it’s obviously true that the current vaccine scenario is like no other in our lifetimes: In response to a worldwide pandemic that has killed millions, multiple pharmaceutical and biotech companies developed lifesaving responses much faster than anyone believed possible. We live in a time of tragedy and miraculousness; things are chaotic and fluid. So obviously that’s more complicated than your annual flu shot — much less your choice of peanut butter — and a little “parsing” seems not so much surprising as practically unavoidable.

But on the other hand, no, it’s not as if that parsing is being driven by clever packaging or ad campaigns; the drug makers aren’t relying on influencer strategies or limited-edition merch promotions. In stark contrast to, say, the shampoo market, vaccine “efficacy” data is blasted at us all day through multiple news sources and health authorities. At this point, you’ve heard that the trials of the Pfizer and Moderna vaccines showed them to be 95% and 94% effective (respectively); the newer Johnson & Johnson vaccine is reportedly 85% effective against “severe” Covid-19. The data gets more complicated than that (as I’ll get to below), but it’s data. You don’t have to be a stooge of late-stage capitalism to believe the vaccine options differ materially. You just have to recognize that 95 and 85 are different numbers.

At the moment, the U.S. does not have the same range of choices evidently available in Serbia — Johnson & Johnson’s vaccine has just begun to ship, joining the Pfizer and Moderna options — and vaccine supplies are still drastically outstripped by demand. Yes, there are anecdotal reports of selfish individuals gaming the system or crossing state lines to get a dose; there will always be awful jerks. There have been logistical distribution stumbles. And by far, the more significant issue is those who still don’t want any vaccine at all. But to date, “vaccine shopping” and the emergence of a de facto vaccine hierarchy are more of a theoretical concern than an actual phenomenon. There is no crisis of vaccine snobbery; the actual U.S. vaccination rate is climbing smartly.

This is what the “vaccine shopper” critique is trying to get at: At our current stage of a still-spreading pandemic, pickiness and hierarchy formation are short-sighted and even outrageous.

This could certainly change over time. In the months ahead, supply will catch up; in the longer run, we will likely need boosters. Data sets will grow, reputations will develop as a result of that data, and the market will shake out. But to the extent that’s happening now, it’s not a function of shopper behavior; it’s coming from the top. For example, maybe as the Johnson & Johnson vaccine rolls out, we’ll see consumers demand even better options. But it wasn’t angsty comparison shoppers who rejected a shipment of the Johnson & Johnson vaccine in Detroit and declared Pfizer and Moderna “the best” — it was the mayor. It wasn’t a Super Bowl ad that asked of AstraZeneca’s vaccine, with its lower (but still high) efficacy rate, “Who are you going to give a vaccine like that to?” — it was Anthony Fauci.

This is what the “vaccine shopper” critique is trying to get at: At our current stage of a still-spreading pandemic, pickiness and hierarchy formation are short-sighted and even outrageous. But if there’s a “good vaccines and bad vaccines” dynamic taking shape, as a recent article in STAT put it, it’s coming from officials, not consumers. All the approved vaccines are quite effective — much more so than anyone was predicting they would be a year ago. If I had the (fair, not cutting in line) opportunity to take the Johnson & Johnson vaccine today, I’d do it. I respect the argument that the most relevant data point right now is that 0% of people who have received any of the approved vaccines have died of the virus. The best move right now is to take what you’re offered.

Nevertheless, the idea that the vaccines are just interchangeable and equally effective goods is misleading at best. Differing efficacy rates are only one distinction. “Some are more effective than others at preventing illness, for example,” health consumer advocate Hilda Bastian recently cautioned in The Atlantic. “Some cause fewer adverse reactions; some are more convenient; some were made using more familiar methods and technologies.” The mRNA vaccines (a new innovation) require two shots, and viral vector vaccines (a more tried-and-true method) need just one. The mRNA vaccines have higher efficacy rates but completed trials before new variants emerged, so those numbers might be lower if they were tested now.

It really would be dangerous if masses of Americans rejected one viable vaccine choice and insisted on another.

There’s a lot to digest. But doing your best to digest it all is perfectly rational — even if the bottom line right now is to take the vaccine you’re offered. It certainly doesn’t mean you’re behaving like a shopper for premium denim or limited-run handbags.

As that On the Media segment ultimately made clear, it really would be dangerous if masses of Americans rejected one viable vaccine choice and insisted on another. And incidents like the Detroit mayor throwing shade at Johnson & Johnson don’t help. But it would also be dangerous if long-term results suggest that masses of Americans suffered worse outcomes because they lacked full data about a vaccine’s effectiveness. The solution to that isn’t less information and less “parsing.” It’s more of each. As Garfield concluded after listening to STAT writer Helen Branswell break down the nuances of vaccine research results to date: “Seems like a no-brainer — but no, it’s a brainer.”

Yes, and that’s what “comparison shopping” — driven by research into available facts, not blindly following status signals — is all about. If only we did it more often.

Author The Art of Noticing. Related newsletter at https://robwalker.substack.com

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