On January 22 the Globe and Mail published a long opinion piece by psychiatrist Dr. Norman Doidge that completely misrepresented the relevant evidence on vaccines and COVID-19. The broader theme of the piece – the conspiracy-tinged idea that there is a coordinated “master narrative” to subvert the use of therapies – is also a deeply wrong and harmful notion. Below, we outline just a few specific places out of many that the piece gets clearly wrong.
In the initial version of his article, Doidge spent several paragraphs on preliminary data that suggested vaccines are only 37% effective against Omicron. However, as authors of the study noted, “the results are currently being updated with additional data that showed completely different [more positive] results.” In other words, a large portion of the Doidge article, which has since been “corrected” was based on incomplete research. Either Doidge was unaware of the well-known reality of these pending updates, or he chose to ignore them.
Doidge goes on to claim that achieving herd immunity through vaccination would eliminate the virus in the human population, implying both that this was at the expense of other countermeasures such as antiviral therapeutics and that the vaccines have failed to deliver. This grossly misrepresents the purpose of vaccination.
Eradication of SARS-CoV-2 was not the primary goal of COVID-19 vaccination campaigns and never has been. Rather, the goal from the start has been to limit morbidity and mortality caused by COVID-19 – an entirely reasonable end-goal, which vaccines have achieved as indicated by an ever-growing body of evidence, including 3 independent large-scale studies showing that effectiveness of 3 doses of COVID-19 vaccine against hospitalization and death due to Omicron exceeds 80% – an impressive feat given that current vaccines were modelled against the ancestral virus rather than Omicron. Indeed, accumulating data show that 3 vaccine doses confer robust immunity that protects against divergent viral variants, including Omicron This is due to successful imprinting of the immune response against SARS-CoV-2 Spike, something Doidge incorrectly and derisively refers to as “Original Antigenic Sin.” But rather than this being a bad thing, evidence shows this imprinting is precisely what elicits broad, cross protective immune responses against variants in a manner that exceeds that conferred by infection alone.
With over 3 billion people worldwide yet to receive their first shot, we remain a long way from achieving global protection against the harm exerted by COVID-19. Inaction in gaining control of viral transmission across the globe has profound implications because unmitigated transmission produces a much larger pool of mutations. It is a question of “when”, not “if”, a new variant will emerge. Although COVID-19 mitigation and control efforts rely on multiple tools, including equitable access to diagnostics, routine surveillance, high-quality masks, ventilation/filtration and therapeutics, vaccines are the cornerstone of our efforts against this virus. With billions around the world suffering from devastating consequences of infection, Doidge’s contention that the “master narrative” rejects so-called “natural” immunity is wrong and inhumane, because there is nothing “unnatural” about vaccine-acquired immunity and there’s nothing “natural” about promoting disease and potential long-term disability through infection. Relying on infection alone is also problematic due to the potential for long COVID, and the level of infection-generated immunity varies greatly even among immune-competent individuals.
Like his misrepresentation of vaccines, Doidge distorts the scientific approach to COVID therapeutics. From the pandemic’s earliest days, researchers repurposed drugs to treat patients. Approved medications such as corticosteroids and other immunomodulating agents have been essential to treating severely ill patients after scientific trials proved their effectiveness. Other repurposed drugs, such as aspirin and some antibiotics, have proved ineffective when rigorously tested, whereas hydroxychloroquine led to harm. Doidge implies that debate about the value of hydroxychloroquine has been suppressed by political polarization. This is an ironic assertion because the exact opposite is true: there is no good clinical evidence to support the use of hydroxychloroquine in the context of COVID and that reality has been spun by ideological agendas. Fluvoxamine may help patients, but Ontario’s Science Table has been careful to point out that it has “very low certainty evidence of benefit”.
Another deeply-flawed false equivalency presented by Doidge is his misuse of the Amnesty International Report to bolster his claims of censorship. He equates the pushback received by North American experts who promote fringe ideologies rather than scientific facts with that of journalists and healthcare professionals who are punished and imprisoned under autocratic and totalitarian regimes for promoting evidence-based strategies or sharing with the world the humanitarian crises unfolding in their home countries. Most North American MDs who have attracted attention from the regulators have pushed harmful and absurd misinformation (the vaccines will not make you magnetic) and are not engaging in constructive “scientific debate,” as suggested by Doidge. Dissenting voices in Canada have not been “censored” (being proven wrong is not censorship or an infringement of freedom of expression). Indeed, there is evidence that their misleading messages are so ubiquitous – they are on podcasts and cable news shows with large audiences, and in the popular press – that the bigger issue is false balance (creating the impression the evidence on both sides of a debate is equal). Regulatory bodies, like the provincial Colleges of Physicians, have a legal duty to maintain a standard of care in the best interest of the public. We need more, not less, oversight. As recently noted by U.S. Federation of State Medical Boards, there has been a “dramatic increase in the dissemination of COVID-19 vaccine misinformation and disinformation by physicians,” such as that featured in Doidge’s inaccurate piece.
The harm caused by such insidious distortions of science reverberate beyond the traditional anti-vaccine echo chambers. They cause harm even among many conscientious Canadians who do not typically fall prey to misinformation. The Saturday morning ritual of reading the Globe and Mail for a Vancouver family was turned on its head when the Doidge article was read. The family is vaccinated and waiting for third-dose appointments for their two teenage sons. However, reading this misleading piece fraught with misrepresented evidence opened the way for doubt and anxiety in the mind and heart of one parent. The other parent, a professor of immunology and microbiology, was able to address their questions and offer reassuring, accurate information with ease. What of the many Canadians who have experienced similar anxieties, doubts, and fears because of the misinformation sprinkled throughout this article and have little to no access to accurate sources of information?
The scenario is similar to what occurred in other households in 2015 when a Toronto Star article spread fear about HPV vaccines. The article was subsequently challenged by Canadian scientists who asserted, rightfully so, that evidence should be our guide in judging the safety of vaccines. Let’s be evidence-based again in 2022 as we review the successes of COVID-19 vaccines, an essential and effective arrow in our quiver in our response to COVID-19.
Authorship
- Ninan Abraham, Professor, Department of Microbiology and Immunology, Department of Zoology, University of British Columbia; Director of Equity, Diversity, Inclusion and Indigeneity, CoVaRR-Net
- Timothy Caulfield, Canada Research Chair in Health Law and Policy, Professor, Faculty of Law and School of Public Health, University of Alberta; Director of Misinformation Assessment and Response, CoVaRR-Net
- Jen Gommerman, Canada Research Chair in Tissue Specific Immunity; Professor and Acting Chair, Department of Immunology, University of Toronto; Pillar 1 Co-Lead, CoVaRR-Net
- Jason Kindrachuk, Assistant Professor, Canada Research Chair in Emerging Viruses; Department of Medical Microbiology & Infectious Diseases, University of Manitoba; Pillar 2 Deputy, CoVaRR-Net
- Marc-André Langlois, former Canada Research Chair in Molecular Biology and Intrinsic Immunity, Professor, Department of Biochemistry, Microbiology and Immunology, University of Ottawa; Executive Director, CoVaRR-Net
- Andrew Morris, MD, Professor, Department of Medicine, University of Toronto; Pillar 8 Deputy, CoVaRR-Net
- Angela Rasmussen, Research Scientist, Vaccine and Infectious Disease Organization and Adjunct Professor, Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan; Pillar 2 Lead, CoVaRR-Net
- Raphael Saginur, Chair of the Ottawa Health Science Network Research Ethics Board; Co-Director of Bioethics, CoVaRR-Net
- Fatima Tokhmafshan, Geneticist, Research Insitute of McGill University Health Centre; Director of Community and Patient Engagement and Outreach, CoVaRR-Net