The Volokh Conspiracy

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How Many People Did NIH Director Francis Collins Kill?

He ordered Moderna to slow down vaccine trials to recruit more "people of color" for no valid scientific reason


From an NPR Interview:

ARONCZYK: People of color were disproportionately getting sick and dying from COVID. And at this point in time, Dr. Collins is overseeing the pharma companies that are in phase 3, that are recruiting tens of thousands of people to try out the shots. And he looks at who Moderna has been signing up.

COLLINS: They felt this enormous pressure to recruit quickly 'cause it's a public health crisis, and people are dying. And if you're trying to recruit quickly, you recruit the people who are most likely to say yes. And that tends to be white people, especially young, healthy white people.

ARONCZYK: Dr. Collins goes to Moderna's executive team, and he's like, what are you going to do about this? And he says that their response was less than satisfying.

COLLINS: I mean, it was hand-waving.


COLLINS: And this is where I got fairly directive.


COLLINS: And I made a little speech about, OK, if that's the strategy you're going to pursue, you may have a vaccine that turns out to be safe and effective for white people, but you will have failed, and we will not defend you.

HOROWITZ-GHAZI: So at this moment in the pandemic where it feels like every second matters, they pump the brakes. They don't want to go forward with the trials because, Dr. Collins says, if the people testing the vaccine don't represent the American public, the public won't trust the vaccine. Moderna then recruits more people of color.

ARONCZYK: So at this moment, you make this request to diversify the trials. What happens? Does it slow things down a little?

COLLINS: (Laughter) It, in fact, did have a modest effect of that sort.

ARONCZYK: But, Dr. Collins says, just by a week or two.

How many people died because Collins delayed Moderna's vaccine "just by a week or two?" I don't know, but how ever many it is, Dr. Collins bears responsibility for their deaths–a "request" from the director of NIH in this context is really a command. And this "modest effect" is certainly nothing to laugh about.

Let's be clear on several things: (1) There was (and is) no scientific reason to think that the Modern vaccine would act differently on people of different genetic backgrounds; (2) Even if there was reason to think it would, the categories the NIH requires researchers to use–African American, Asian American, Hispanic, Native American, and White–are extremely internally genetically diverse.* Asian Americans, for example, can be Austronesians, Caucasians, or East Asians, and there is much internal diversity within those subcategories. Hispanics can be any mixture of European, Indigenous, African, and Asian. And so on. There is no *scientific* reason to use these categories as proxies for genetic diversity; and (3) If Americans wouldn't "trust" a vaccine that didn't have "enough diversity," that's largely because government authorities like the NIH insist that vaccines aren't trustworthy unless they have been tested on a "diverse" population. If the NIH and other authorities consistently said that socially and legally constructed racial and ethnic categories are not scientific in nature and have no bearing on vaccine efficacy, then the public would be much more likely to believe it.

*When the federal government promulgated these categories, it warned that these "classifications should not be interpreted as being scientific or anthropological in nature." Yet NIH and FDA have adopted them anyway, for no good or even stated scientific reason. Directive No. 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting, 43 Fed. Reg. 19,260 (1978).