Casual Misinformation on COVID Vaccines and Obesity

This has become annoying. Casual misinformation about COVID vaccines is spreading through otherwise reputable news sources. “Experts” who haven’t bothered to look at the data are helping. Perhaps it comes from innocent ignorance. Or maybe from unconscious bias. But that really doesn’t matter. It is flatly wrong to keep reporting that COVID vaccines won’t work as well for people with obesity.

In fact, the data is clear. Results from randomized, placebo-controlled trials tell us that either FDA-approved vaccine – from Moderna or Pfizer – works equally well in people whether they have obesity or not.

Promoting Skepticism

The latest example comes from the Washington Post. Last week the Post ran a story to suggest “experts are skeptical” about giving priority for vaccination to people with obesity alongside people with other chronic conditions that put them at risk for bad COVID-19 outcomes.

That’s the headline. Part of the story is a debate over whether priority status for people all the way down to a BMI of 30 makes sense. But when obesity is clinically significant, there’s little debate. Harvard’s Fatima Cody Stanford explained to the Post:

“Obesity is a disease state characterized by significant inflammation. What we know about COVID is it’s also a state characterized by significant inflammation. We can call this the perfect storm. When a patient with obesity gets covid – it’s a recipe for not good things.”

Kaiser epidemiologist Sara Tartof explained that severe obesity eclipses almost all other risk factors for bad outcomes with COVID-19. Advanced age, of course, would be the most notable exception.

Misinformation About Vaccine Efficacy

But the really noxious misinformation is the false suggestion that “we don’t necessarily know” COVID vaccines will be as effective in people with obesity. The truth is simple. In a randomized, placebo-controlled study the Pfizer vaccine was 95 percent effective for people with obesity. For lean individuals the effectiveness was identical – 95 percent. With the Moderna vaccine, effectiveness in RCTs was the same whether people had obesity or even severe obesity, or not.

To justify stirring up doubt, the Post interviewed a researcher looking at vaccine effectiveness for the flu in people with obesity. But that data is observational. It’s not from an RCT. What’s more, it’s the flu, not COVID. So really, this is an absurd excuse for misinformation.

What’s the Big Deal?

This misinformation really does matter. Vaccine hesitancy is a serious problem – especially in minority communities where obesity is more prevalent. Misinformation and mistrust lie at the root of our problems with vaccine hesitancy. So when the Post and others add more misinformation, it’s making a grievous error.

On top of that, this kind of reporting taps into resentment directed at people with obesity. As Tonya Russell points out in a recent commentary, vaccine prioritization is hard enough. Stirring fatphobia into the dialogue makes it harder.

Andrew Brown of the IU Bloomington School of Public Health explained it to us quite simply. He points out that we prioritize some people for vaccination because they are more vulnerable. No one questions priority for older people. So if people with higher BMIs are more vulnerable, we should prioritize them. Both science and our values inform this decision.

Click here for the flawed reporting from the Washington Post and here for Russell’s commentary.

Moş Gerilă, Romanian communist propaganda character by unknown artist / Wikipedia

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January 25, 2021