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LogicChecking Johnson and Johnson

It’s been a while since I provided you a LogicChecker that looks at the arguments behind important news events, which is why I’d like to turn back to an argument (actually a set of arguments) from a few weeks ago when the Centers for Disease Control (CDC) ordered a halt to COVID vaccinations using a vaccine created by the pharmaceutical company Johnson & Johnson (or J&J, for short).

Unlike vaccines from Pfizer and Moderna, the J&J vaccine requires only one shot, instead of two. J&J’s vaccine also uses “traditional” biological strategies similar to vaccines used to fight flu every year, vs. Pfizer and Moderna’s treatments which make use of newer, more targeted Recombinant DNA techniques.

Bio-talk aside, I – like many Americans – was shocked when CDC decided to call a temporary halt to J&J distribution after a handful of people (initially six out of six million people treated) developed dangerous blood clots which led to at least one death.

Given the COVID crisis we’ve all been living through, how could anyone ban a treatment whose one-shot convenience made it an ideal choice for people needing fast immunity, or those living in hard-to-reach places? Were we really going to nix those benefits because of a side-effect (albeit, a potentially deadly one) that had literally impacted only one-in-a-million people?

I sought out editorials that might present the CDC's case or argue against it and came across a podcast in which the decision was debated. While I normally like adding original editorials to these LogicCheckers so you can read the arguments I’m describing, I’m going to make an exception by referring to a podcast that included many linked arguments, especially since the participants in that discussion demonstrated a tell-tale sign that critical thinking was taking place: people changing their minds.

I’ll try to sum up the arguments in case you don’t want to listen to the podcast in its entirety, but before I do so I should note that this was an episode of the podcast from the conservative magazine Commentary which I mention only to remind readers that potential biases of a source should be something to be aware of while fighting the tendency to agree or disagree based entirely on conformity with one's own political dispositions.

With that warning taken care of, people on the show had the same reaction I did to CDC's decision to shut down a promising and convenient treatment that was known to be effective against COVID due to a one-in-a-million risk calculation. They also supplemented that observation with additional numerical information I did not know: that the specific side effect (blood clotting) was a problem impacting nearly a million Americans every year.

If one were to draw a Venn diagram in which the overlap of six million J&J recipients and nearly a million blood clot victims only included a half dozen people, that would seem to represent a case-closed argument for CDC being too cautious (a belief most of the people on the podcast already held, which made the J&J decision one more indictment of an organization that they alleged had lost perspective).

But then another guest, a science writer who contributes to the magazine, pointed out that the specific type of blood clot J&J recipients suffered from was extremely rare, meaning the numbers critics were operating from, while dramatic, were not the right ones to base judgements on entirely.

The guest also pointed out that one specific group (women under 50) seem to suffer from the clotting problem, indicating that there was something about that demographic that might make them uniquely vulnerable if J&J’s vaccine truly was the cause of a significant increase of an unusual type of clotting.

As others became convinced by the science-writer’s arguments, I could also tell that critics of the ban were putting effort into trying avoid letting their general beliefs in the over-cautiousness and inertia of the public health bureaucracy box them into a single, uncompromising stand over any decision that bureaucracy made.

Another good sign that critical thinking was taking place was a quick transition from forensic arguments over what had taken place in the past (including what many believed were overly cautious and restrictive CDC policies) to deliberative ones over what could be done in the future to make things better.

In a nation where two other vaccines are in abundant supply, temporarily pulling a third from the market meant vaccination could still proceed apace. But the prevalence of J&J’s side effects within a narrowly defined population also meant those who were members of that demographic could be steered towards alternatives, even as scientists tried to figure out what might cause the unusual clotting issue. (Since listening to the podcast, I have talked to some medical friends who thought that birth control – which is also associated with blood clotting – might be a culprit, one that does not impact those who are not younger women.)

This future-orientedness did not let public-health decision-makers off the hook, with one Commentary commentator continuing to criticize the decision over the message it might send to a public which should be getting vaccinated: that vaccines might be dangerous.

Like most future-oriented arguments, that one can only be proven true or false after time has elapsed and in the time since the podcast aired, J&J is back in circulation with a CDC warning that younger women should consider other options.

It remains to be seen if vaccine skepticism grows or wanes, and whether any growth can be attributed to the specific decision to temporarily ban J&J. But one hopes that those who might feel concerned over the risks of getting vaccinated – based on any rational or mostly rational reason – will engage in the kind of deliberation modeled by those who want to think through important matters, rather than closing their minds to reasoned arguments for and against.


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