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Why Aren’t The Vaccines Approved?

"The difference between emergency authorization and full approval matters." The F.D.A. is encouraging people to get a Covid-19 shot — but hasn’t formally approved those vaccines.

The F.D.A. is encouraging people to get a Covid-19 shot — but hasn’t formally approved those vaccines.

New York Times – It is the most discordant part of the U.S. government’s response to Covid-19.

Even as President Biden, the C.D.C. and virtually the entire scientific community are urging — pleading with, even — Americans to get vaccinated, the government has not formally approved any vaccine.

The Food and Drug Administration has instead given only “emergency use authorization” to the shots from Moderna, Pfizer and Johnson & Johnson.That’s a temporary form of approval that allows people to receive shots while the agency continues to study their effectiveness and safety.

The difference between emergency authorization and full approval matters. Right now, the military, schools and other organizations cannot easily require vaccinations. The “lack of F.D.A. licensure leave schools, colleges, businesses in a legal quandary,” Dr. Jerome Adams, a former surgeon general, recently wrote. Adams argued that lives were at stake and that the issue should be receiving more media coverage than it has.

“The F.D.A.’s leaders have failed to understand how most Americans really think about the vaccines.”

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The situation also feeds uncertainty and skepticism among some Americans who have not yet gotten a shot. Those skeptics, as Matthew Yglesias of Substack wrote yesterday, are effectively taking the F.D.A. at its word. The F.D.A. leaders’ official position is that “they don’t have enough safety data yet,” Yglesias noted.

The strangest part of all this is that the F.D.A.’s official position does not reflect its leaders’ actual views: They agree with the C.D.C. and other scientists that Americans should be getting vaccinated as soon as possible.

Dr. Janet Woodcock, the F.D.A.’s acting commissioner, has said that the F.D.A. “conducted a rigorous and thorough review” of the vaccines before allowing them to be given to people and that the Pfizer vaccine “meets F.D.A.’s high standards for safety and effectiveness.”

She also said, “Getting more of our population vaccinated is critical to moving forward and past this pandemic.”

Hurry up and wait

Why, then, hasn’t the F.D.A. taken the final step of formal approval?

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It is following a version of its traditional, cautious process for vaccine approval. That process has historically had some big advantages, reducing the chances that Americans end up taking a faulty drug. To move much more quickly would risk undermining the public’s confidence in the F.D.A. and, by extension, the medicines it approves, Dr. Peter Marks, who oversees the process, has argued.

But I think the F.D.A.’s leaders have failed to understand how most Americans really think about the vaccines. It is different from the way that scientists and epidemiologists do. It’s less technical and based more on an accumulation of the publicly known facts.

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