Coronavirus week 123: Are there legitimate, non-conspiratorial reasons to discuss "Big Pharma"?

Kaiser Health News, an outlet of the Kaiser Family Foundation, representing a hospital biz that ain't exactly small potatoes, raised that issue relatively recently.

I included the link, without extracting details, in my blog post about "vaccine losers" last month.

That, in fact, needs separate linking, for these people, to quote this paragraph:

(A)s society moves into the next phase of the pandemic, the pharmaceutical industry may be moving into more familiar territory: developing products that may be a smidgen better than what came before, selling — sometimes overselling — their increased effectiveness in the absence of adequate controlled studies or published data, advertising them as desirable for all when only some stand to benefit significantly, and in all likelihood raising the price later. 

This last point is concerning because the government no longer has funds to purchase covid vaccines after this autumn. Funding to cover the provider fees for vaccinations and community outreach to those who would most benefit from vaccination has already run out. So updated boosters now and in the future will likely go to the “worried well” who have good insurance rather than to those at highest risk for infection and progression to severe disease.

What else do you want to be said? 

Maybe that other countries, as the story notes, do a non-wingnut version of cost-benefit analysis in such cases? OR that, to riff on Offit, vaxxes in general were oversold a full year ago, and now the vaccine public health world, less skeptical division, is sleeping in the bed it made?

And, from that same piece, here is more of why, contra "Your Local Epidemiologist" but per the likes of Paul Offit, you should be skeptical.

The updated booster vaccine formulations are identical to the original covid vaccines except for a tweak in the mRNA code to match the omicron BA.5 virus. Studies by Pfizer showed that its updated omicron BA.1 booster provides a 1.56 times higher increase in neutralizing antibody titers against the BA.1 virus as compared with a booster using its original vaccine. Moderna’s studies of its updated omicron BA.1 booster demonstrated very similar results. However, others predict that a 1.5 times higher antibody titer would yield only slight improvement in vaccine effectiveness against symptomatic illness and severe disease, with a bump of about 5% and 1% respectively.

So, a 5 percent boost, on average for all ages, from the mighty bivalent booster, especially if you're uninsured or underinsured? Why doesn't alleged left-liberal Walker Bragman talk about that angle? And, yeah, he's going to get hammered here as long as he doesn't.

Note the "all ages," per the cost-benefit issue not done here. Because:

As population immunity builds up through vaccination and infection, it’s unclear whether additional vaccine boosters, updated or not, would benefit all ages equally. In 2022, the U.S. has seen covid hospitalization rates among people 65 and older increase relative to younger age groups. And while covid vaccine boosters seem to be cost-effective in the elderly, they may not be in younger populations. The CDC’s Advisory Committee on Immunization Practices considered limiting the updated boosters to people 50 and up, but eventually decided that doing so would be too complicated.

So, the likes of Bragman and Katelyn Jetalina should stop pushing the bivalent for people under 50.

But, they DID study it on mice, didn't they?

Well, good biological scientists know that mice research data is often not worth the serum it's written with. So does this piece:

Though the studies of the updated omicron BA.5 boosters were conducted only in mice, the agency’s authorization is in line with precedent: The FDA clears updated flu shots for new strains each year without demanding human testing. But with flu vaccines, scientists have decades of experience and a better understanding of how increases in neutralizing antibody titers correlate with improvements in vaccine effectiveness. That’s not the case with covid vaccines. And if mouse data were a good predictor of clinical effectiveness, we’d have an HIV vaccine by now.

Ooops. I sank your battleship.

And, there's more. And, if you will, I buried the nut graf:

Unfortunately, history shows that — as with other pharmaceutical products — once a vaccine arrives and is accompanied by marketing, salesmanship trumps science: Many people with money and insurance will demand it whether data ultimately proves it is necessary for them individually or not. ... 

The federal government has been paying a negotiated price of $15 to $19.50 a dose of mRNA vaccine under a purchasing agreement signed during the height of the pandemic. When those government agreements lapse, analysts expect the price to triple or quadruple, and perhaps even more for updated yearly covid boosters, which Moderna’s CEO said would evolve “like an iPhone.” To deploy these shots and these dollars wisely, a lot less hype and a lot more information might help.

There you are.

Bragman offers enough left-liberal bona fides elsewhere that he needs to stop being a two-sider tribalist on this issue, as in tribalist of antivaxxers vs "COVID maximalists" or whatever term you prefer.