Hello,
When I first wrote about vaccines in these pages last August, 400,000 Americans who have since died from Covid were still alive. The first clinical trials for Covid vaccines had just gotten underway, and at the time we broadly underestimated both how deadly the pandemic would become and how effective the vaccines would be.
The late fall brought this vertiginous period in which the death toll exploded just as news arrived that two mRNA vaccines provided almost full protection against the virus and real hope for a path out of the pandemic.
This spring the pace of vaccination accelerated so quickly that practical questions about the limits and benefits of post-vaccine life, which had only a few months ago been purely hypothetical, have suddenly become quite real and urgent for millions of Americans.
Including me! I received my dose of the Johnson & Johnson vaccine early this week, and after a day of mild grogginess I found myself facing a whole set of decisions to make about how to live my new antibody-enriched life. So this week’s newsletter is all about how I’m thinking through what just happened, and how to look ahead.
/ Spotting the assassin’s blade
The first choice I had to make was how to feel about receiving the J&J vaccine, as opposed to the Pfizer or Moderna shots, which both scored higher on efficacy in their clinical trials. The best shot is the one that’s offered to you, goes the public health advice. But is it, really?
You’ll probably have read already that the data from these trials aren’t really comparable head-to-head. They were held at different times in the pandemic, and in different geographies, contesting with different variants of the virus, and the trials had different exclusion criteria for participation. And anyway, as this video from Vox argues, efficacy probably isn’t even the most important metric on which to judge success here:
The bottom line is that all three vaccines were 100 percent effective against hospitalization and death from Covid. That’s what matters. And they were all strongly protective against severe disease. Because they all do essentially the same thing: instruct your body to produce copies of the SARS-CoV-2 spike protein that the actual virus uses to force its way into your cells. These spike proteins on their own are harmless — an assassin’s blade without the assassin attached. But the presentation of these spikes in your body trains your immune system to recognize and destroy them, along with anything that wields them. So when you do encounter SARS-CoV-2 in the wild it’s not a novel pathogen, from your immune system’s perspective. The virus loses the element of surprise. So if it gains a foothold at all in your body, causing an infection, it gets less severe before the virus is cleared from your system altogether.
To get a little sentimental for a moment here, it’s amazing to me that after 13 months of reading, writing, and thinking about this virus, getting vaccinated has given me detailed knowledge about it on a molecular level, though of course I’ll never consciously know what my immune system knows about the texture and consistency of these coronavirus spikes. And it’s selective, instrumental knowledge — unlike older vaccines, which use deactivated or weakened viruses to train your immune system, all three of these Covid vaccines use newly perfected, more sophisticated and precise methods. It’s just a wild time to be alive.
So I feel comfortable that, by 28 days after my inoculation date if I’m exposed to this virus by someone, I’ll be far less likely to contract Covid, and far less likely to pass it on to someone else. That’s good enough for me even if, somewhere down the road, I need a booster shot. Which is why I didn’t get my vaccination card laminated.
/ Vaccination cards: when to hold ‘em, when to fold ‘em
It was a little like seeing a celebrity, when the check-in clerk the clinic took a vaccination card off of the stack and scribbled my name on it. I’ve seen so many of these on social media the past few weeks as people show off their shots (it’s a good idea, when doing this, to hide your personal information).
So the first thing I did when I got out of the clinic—after signing up for v-safe, an online tool from the CDC that lets you report the presence or absence of side effects from the vaccine—was to take a picture of my card for my records and stick it in the protective pocket of the notebook I always carry around with me, to keep it safe but also accessible.
I don’t plan to use the card much, mostly because I still don’t plan to go often into public places that require people to show proof of vaccination, for reasons I’ll talk about in the next section. More adventurous types are apparently buying these attractive protector sleeves.
The main reason for keeping it accessible, and not laminated, is that in six or eight months we’re just as likely as not to need to get a booster shot, and I’ll want to bring my card with me to be updated. But whatever choice I make, even up to accidentally losing the card, the stakes are pretty low — I know I can return to the clinic where I got my shot and have them issue me a replacement card.
/ A portal to normalcy?
I’ve stood in my fair share of lines since this pandemic began, mostly to get in to the grocery store. It’s a line everyone vaguely dreads or resents, or to which they’ve finally resigned themselves as yet one more slightly draining chore, another isolating and socially dead ritual of pandemic life. The vaccination line felt different. Like something from Before. A line where everyone was looking forward to something at the end — it felt like being in line at Six Flags, or at the airport, or for a concert or movie premiere. A shared feeling that each of us were about to be in some happy way transformed on the other side.
But to my surprise I feel less transformed than I expected. There’s still a pandemic going on, with the number of diagnosed Covid cases edging up past 70,000 a day and climbing. And while post-vaccination my personal risk of contracting and transmitting Covid wanes every day it seems ghoulish to go on as if nothing’s happening. And, as Katherine Wu writes in this great piece in The Atlantic, there is still risk in a post-vaccine world. So until case counts start to decrease in a meaningful way, my daily risk calculations are pretty much the same as they were before I got vaccinated, with the exception of being more comfortable seeing vaccinated family and friends and having more peace of mind when I’m walking around masked. I imagine things will change as I get closer to the 28 day post vaccination maximum protection mark. But honestly, until daily reported cases fall into the low thousands or hundreds, there’s no real ‘normal’ to be had.
Something I think people are underestimating, and I’ll write about this more in a future issue, is how turbulent and intense things are going to get as people return to pre-pandemic levels of social interaction. There’s a steady drip of articles performatively anticipating a party-filled new “roaring 20s,” complete with quotes from social scientists who shrugged over the phone to an eager reporter and admitted “sure, there’s a libertine future ahead of us after all of this.” But the early 1920s also saw a spike in interpersonal violence most of which, contrary to popular belief, had nothing to do with prohibition and organized crime. The 20s were a time of massive social upheaval, and we’re poorly served by the sanitized callbacks currently circulating in the press.
Something I’ve heard a lot in my research, and you see this cropping up on social media and in news reports too, is a certain edginess in people—an unwillingness to put up with other people’s crap, to put it bluntly. “I’m not going to try to be polite anymore,” one person told the New York Times in this beautiful package about people looking forward to post-pandemic life. “I am going to hopefully become a little less behaved, less likable, ballsier, more outspoken, more dangerous woman. All the rules I had followed, these rules will not save me.”
It’s a good thing for people to stand up for themselves, and if the pandemic ends up encouraging people to become more outspoken, less likely to follow rules that were designed to hold them at a disadvantage, that’s the road to social progress. But it’s not going to be a smooth ride. It’s especially going to be difficult as people become exposed again to the full force of daily interactions, and their expectations for their more liberated post-pandemic selves come up against the constraints of social forces large and small. In other words, a lot of us have spent time in this pandemic formulating an idea of who we are going to be when this is over, and we’ve done it in relative isolation, forgetting how much of who we are depends on other people being willing to play along.
But all that is still a ways off in the future. In the meanwhile, I’m just letting my antibodies percolate and taking a minute of rest at this waypoint at the beginning of the end of the pandemic.
Speaking of rest, this newsletter will pause for one week, returning April 24th.
// Link Roundup
Fork hands, behind the music: You’ve probably seen this very funny video by Vick Krishna explaining how the mRNA vaccines work (personally, my mental model of my immune system is always going to be Krishna lounging around in a lab coat reading Men’s Health waiting to spring into action). Turns out Krishna works for NPR, which did a short interview with him about his 15 seconds.
— “The Viral TikTok That Explains Vaccine Science — And Makes You Laugh.” Joe Palca and Suzette Lohmeyer, NPR.A patchwork pandemic: Thanks to vaccination we’re exiting a phase of the pandemic in which waves would pop up regionally and spread across the country, to something more like a “tornado” phase, in which outbreaks cut narrower paths of destruction through under-fortified segments of society. We’re seeing this in Michigan, where, alarmingly, hospitalizations and new cases are already back at levels rivaling the winter surge, and deaths are starting to climb.
— “The Threat That Covid-19 Poses Now.” Alexis Madrigal, The Atlantic.Work from home is a trap: Work from home has its perks, but it’s a labor rights catastrophe, as political scientist Paul Musgrave sketches out in his newsletter here.
— “Stakhanovites in Sweatpants.” Paul Musgrave, Systematic Hatreds.A short biography of the J&J vaccine: The Pfizer/Moderna vaccines are real darlings of the pandemic, but I’m for obvious reasons interested in the story of the J&J vaccine, which is based on the same basic idea but uses a different delivery system. So I was fascinated to read this profile of the shot I got.
— “The Story of One Dose.” Jeff Wise, New York Magazine.You get the virus from people, not things: You don’t have to sanitize your groceries of course. You don’t have to be afraid of door knobs. You should wash your hands of course, but the CDC has finally changed its guidance on the risk of transmission from surfaces, which is to say the evidence is that surfaces play a very small role in transmission of the virus. It’s in the air.
— “Has the Era of Overzealous Cleaning Finally Come to an End?” Emily Anthes, The New York Times.Which is why you shouldn’t dine in at restaurants: Just don’t do it until the case count drops. You don’t have to do it. Nobody wants to be there. Everyone will be happier if you just get takeout and leave a large tip.
— “Probable Airborne Transmission of SARS-CoV-2 In A Poorly Ventilated Restaurant.” Yuguo Li et al, Building and Environment.The sound of late-lockdown: I’ll leave you this week with the sounds of Chicago-based singer/songwriter and friend Lindsay Weinberg, whose new single perfectly captures this moment of waiting at the beginning of the end of the pandemic. Stream it below, or through Bandcamp!
That’s it for this week! Make sure to share this newsletter with your recently-dosed friends as they convalesce, subscribe through the link below, and I’ll see you in your inbox two Saturdays from now.