alt Hacker NewsI think the idea that changing stated recommendations based on the public opinion is a questionable strategy that can just backfire into more distrust and behavior that follows the "true" best practices even less as they look for the 'sensible position between extremes'[1].
There are a lot of examples from the response to COVID: frequent early mixed messages around the effectiveness of masks for preventing infection and transmission not based on the actual understanding of said effectiveness but in order to manage supply shortages, arguable overstatement about the one-time long-term effectiveness of the initial vaccines against infection and transmission and not just severity of disease, overemphasis on ineffective measures like hand hygiene or six-foot-distancing over effective measures like air cleaning and masking based on the perceived willingness of the public to follow them, reduction of the stated duration of contagiousness without evidence of such.
It's one thing if it's genuinely not known what the best practices are, but knowing and misleading can confuse people who are willing to follow them and can further alienate skeptics who may seek out charlatans promising them the "real, unfiltered truth".
Expert opinions are pluralistic, not a monolith, so there’s a judgement call when a policy is written. There is a spectrum of importance when you consider medical interventions. A pluralistic society, including pluralistic opinions among experts, is the norm outside of 1984. It’s just reality.
Policymakers could prioritize more or fewer vaccines, and the reasons to prioritize any particular vaccine would be expected to change over the decades.
Why the CDC isn’t prioritizing more vaccines might be seen as reckless to some. I think it’s a huge mistake that there isn’t a strep vaccine and a universal mandate for that, but it’s clearly not been historically prioritized. Strep has been known for decades to cause mental health conditions in children.
On the other hand, some infections might be better handled by vaccinating around where cases show up, a capability that is possible only now that we have electronic medical records, better tests, the information era, etc. Just-in-time logistics is a huge success story of the modern world.
Opinions of experts are important: expertise requires that opinions should change as the realities do.
An expertise that’s required of a policymaker is to maintain the effectiveness of their institutions by translating expertise into policies that are actually listened to. We have serious warning signs that public trust in healthcare is disintegrating, and that the vaccination campaigns are failing. Policies that are more focused could play out better.