Letter to the Editor

Response to Rebuttal by Lissemore and Barnes

Thomas Frazier and Anthony Tarescavage

We are (vaccinated) psychology faculty writing in response to Professors Lissemore and Barnes rebuttal of our Carroll News column opposing vaccine mandates. When rebuttals occur among scientists, it is customary that the authors who are being rebutted obtain a copy of the rebuttal beforehand and get the opportunity to craft a response to that rebuttal. In academic debate, the response is customarily published alongside the rebuttal. We were not offered this opportunity, but in the spirit of scientific discussion we have prepared this response to Lissemore and Barnes’ rebuttal for publication in the Carroll News.

We begin by reiterating what we stated at the outset of our column: “COVID-19 is a very serious public health risk…at this point a simple cost-benefit analysis would indicate that getting the vaccine is probably a very good idea for many people.”

Lissemore and Barnes’ thesis is that our column was “a political tract that uses a veneer of science in an attempt to lend their arguments credibility; it has nothing to do with public health.” On two occasions they accuse us of intentionally misleading people by presenting “disinformation.” They conclude that our opinion was “irresponsible,” “misleading, “and “puts at risk the lives and health of JCU community members.”

In response to Lissemore and Barnes’ global characterization our original piece as one that “puts at risk the lives and health of JCU community members,” consider as an example that the risk of death from suicide in young, healthy college students is substantially higher than risk of death due to COVID-19 in this age group. Now consider how the risk of suicide might increase when one of our students is put in the situation of either getting a medical treatment against their will or facing loss of educational opportunity and being subject to marginalization/social ostracism. These are complex issues that require nuanced reasoning. It is counterproductive to engage in oversimplified political rhetoric such as what Lissemore and Barnes use in an attempt to discredit our position. Next, we further illustrate how it is Lissemore and Barnes who advance a “political tract” in their response to five of our claims.

Claim 1: Lissemore and Barnes assert that the information we provided on side effects of vaccination among young people “completely lacks context”; they cite research purporting to support that the short-term risk of side effects of vaccination among young people is lower than risk or morbidity/mortality due to contracting COVID-19 for this age group.

Response: As we wrote for the context of our claim that side effects of vaccination are a reasonable consideration for young, healthy people, “Importantly, although some research would suggest that even for young people the risk of hospitalization secondary to COVID-19 is higher than the risk of hospitalization due to vaccine side effects, there are no focused studies comparing hospitalization rates for individuals who are both young and healthy (emphasis original).” The data presented by Lissemore and Barnes on direct benefits of vaccination for young people do not represent the benefits for young and healthy people because most major problems secondary to COVID-19 are likely to occur among individuals with underlying medical comorbidities. As can be seen, it is Lissemore and Barnes who are making a claim that “lacks context” and scientific rigor.

Our point remains that myocarditis secondary to vaccination is a reasonable consideration for young, healthy people as the evidence suggest it is a short-term side effect of vaccination; the long-term risk of myocarditis is unknown; and young, healthy people are also at very low risk of morbidity or mortality from COVID-19. As evidence of the reasonableness of our position (although not of its accuracy), consider that just recently several Scandinavian countries (Denmark, Sweden, and Finland) paused the use of the Moderna vaccine for young people or young men due to concerns about myocarditis.

To further expand on this point, blanket mandates require running stratified analyses (e.g., across age and health status) showing risks and benefits. To date, analyses that are stratified typically do so only by age and although they may show seemingly impressive relative risk reductions in young people the absolute risk reductions are small. These reductions would only get smaller (and approach zero) if a cross-section of young, healthy people was examined. Therefore, a blanket mandate that includes healthy, young people is not supported.

In response to Lissemore and Barnes’ point that vaccinating young people has benefits for others due to reduced rates of transmission—they ignore the fact that, as pointed out in our column, there is inadequate evidence to support reduced community transmission among young people. To be fair, early in the vaccine rollout there was justified hope that the vaccine would eliminate transmission. However, recent data indicate that, while protection for untoward health outcomes remains strong out to 6-8 months, the Pfizer vaccine provides only short-lived reductions in infection and by extension transmission(with no evidence provided regarding transmission reduction in young, healthy people).

Claim 2: Lissemore and Barnes assert that we wrote “clear disinformation” that was “patently false” by characterizing the approval of the Pfizer vaccine as conditional.

Response: This is a weak semantic argument. We agree there is no approval category called “conditional approval.” Our point, which was clearly articulated, was that the FDA ordered Pfizer to conduct additional studies on the risk of myocarditis. Thus, ongoing approval is conditional on Pfizer agreeing to conduct these studies. It is not uncommon that long-term risks, including risk not identified in short-term studies, are identified and that these risks alter future labeling, including how the intervention is administered to sub-populations that are at lower risk from the medical condition (e.g., healthy young people and COVID-19). In this case, Lissemore and Barnes’ characterization of what we wrote as “clear disinformation” is a patent example of political rhetoric, not scientific discourse.

Claim 3:  Lissemore and Barnes assert that our discussion of the lab-leak theory is “completely irrelevant to the question of having a vaccine mandate at JCU.”Lissemore and Barnes also write the following, “Furthermore, the ‘lab-leak theory’ is anything but—there is no evidence whatsoever to support it, so it is simply speculation at this point.”

Response: This is a straw-man argument. As we wrote, the lab-leak theory is “under serious consideration”; we never wrote that it was true, and what we wrote is patently factual (e.g., the theory is the subject of an ongoing investigation by the WHO).  Our observation was that as early as four months ago this opinion was censored on social media, yet now it is under serious consideration, so it illustrates that distrust in government institutions and the media is a legitimate reason for vaccine hesitancy. Our point, which was plainly stated, was that forcing people with legitimate concerns to get vaccinated, including racial and ethnic minorities with warranted mistrust based on history (i.e., Tuskegee Syphilis Study), will only increase vaccine hesitancy. Better to address their concerns. The lab leak theory, when considered in the context that we provided, is obviously relevant. Lissemore and Barnes’ mischaracterization of our claim is, at best, a product of sloppy thinking and, at worst, illustrative of an attempt to smear us and make our whole piece seem like it is based on crackpot ideas.

Claim 4: Lissemore and Barnes criticize our assertion on natural immunity yielding substantially greater immunity to COVID-19 than vaccination. They write that we “cited a news article that refers to an unpublished study from Israel, that, like all studies, has limitations.” They cite a counterpoint CDC study indicating that vaccines improve immunity among those with prior COVID-19 infection. They end this section by writing, “No single research study is ever definitive, especially studies on SARS-CoV-2 and COVID-19 given that we are less than two years into the pandemic with much still to learn about immunity against this virus.”

Response: We applaud Lissemore and Barnes for presenting a point that is not based in political rhetoric. Now, to respond, the referenced study from Israel is “unpublished” because it has not completed the peer-review process. It was finished in late-August. The “news article” we cited was from Science magazine, which covered the study due to its importance and the very large sample size. The study includes data from about 800,000 people (with analysis sizes of 14,000 and 32,000 for the main analyses), whereas the CDC study Lissemore and Barnes referenced as the counterpoint to this study has about 800 people. Nevertheless, we agree with Lissemore and Barnes that the literature is not yet settled on this topic (although at this juncture the best evidence supports natural immunity is stronger than vaccine immunity).

We also applaud Lissemore and Barnes for acknowledging that this literature is not settled, because in order to compel someone to undergo a medical treatment against their will, using threat of potential loss of education or occupation, it is necessary (but not sufficient) to have clear scientific evidence to support such a position. Given that we all now acknowledge that consensus has not been demonstrated on the benefits of vaccination compared to natural immunity, we encourage Lissemore and Barnes to join us in calling for an exemption to the JCU mandate for those with natural immunity.

Claim 5: Lissemore and Barnes assert that we wrote a “total distortion” of the findings of research on the parasite-stress model of authoritarianism.

Response: Reasonable people can disagree on the interpretation of the data used to support the parasite-stress model, which was developed several years before the COVID-19 pandemic. To be clear, the data on the parasite-stress model of authoritarianism are as follows: The relationship between the incidence of infectious diseases with both societal and individual authoritarian attitudes is as strong an association as one will ever see in the social sciences. To put it in context, it’s stronger than the relationship between SAT scores and college GPA. Our interpretation of this data, in the context of the COVID-19 pandemic, is that the parasite-stress model is a relevant consideration when, for example, Western societies like Australia impose draconian lockdowns; when a Jesuit institution imposes a vaccine mandate when the scientific evidence does not support it; and when reasonable scientists like Lissemore and Barnes use political rhetoric to discredit colleagues who provide a voice of reason account of why it is inappropriate to force our fellow community members to get a medical treatment against their will.

Summary & Conclusion

The burden of proof rests with people pushing vaccine mandates, and Lissemore and Barnes have yet to provide adequate scientific evidence to support a blanket vaccine mandate at JCU.  They acknowledge the lack of scientific consensus on natural immunity, which means a mandate is not indicated for individuals from this population (estimated to be at least 1/3 of Americans). Their response continues to ignore that there is inadequate scientific justification for mandating vaccination in healthy, young people.

It would be best if, as colleagues, we would sit down and discuss and debate these issues, with scientific papers available to reference and inform the discussion. Even better, we invite Lissemore and Barnes to publicly debate us on these issues. We welcome these in-person opportunities for discourse. These are complex problems that require nuanced solutions. Our approach, as an educational institution, should be to prioritize rather than politicize diversity of thought. If we are true to the principles that form the culture of JCU, we should agree on that. And that’s a start.

Thomas Frazier is Professor of Psychology at John Carroll University. Anthony Tarescavage is Associate Professor of Psychology at John Carroll University.