VIRAL UNBOXING — It's easy to put a person in a box, to write someone off as an anti-vaxxer. But it isn't always that simple. Take Marty Makary, a professor of surgery and health policy at the Johns Hopkins University School of Medicine. He has made a name for himself during the pandemic, partly through his appearances on Fox News shows like Tucker Carlson's. But while he's certainly a contrarian pandemic pundit, he isn't a fringe voice, nor a political one. He writes op-eds for places like The Washington Post and The New York Times. He told Nightly, unprompted, that he wasn't a partisan, during an interview this morning. He had another piece published on the website for Fox News this morning, calling for new leadership at the FDA. He also told me I could call him any time if I wanted to hear a perspective on Covid policy that was different from the "standard party line." Some on the left have said Makary is spreading misinformation, while some Republicans have accused him of being an alarmist. He's argued against masks for children. He's criticized the CDC for not conducting its own research on boosters. He's pro-vaccine, but he opposes blanket vaccine mandates unless they're for health care workers. Lately Makary has been questioning whether children, especially boys, need two doses of a Covid vaccine. Once again, he falls outside the consensus of his fellow public health experts with his views. Makary is particularly concerned about a condition known as myocarditis, inflammation of the heart, and its potential as a risk factor for young men after receiving the second dose of an mRNA vaccine. He's proposed a one-dose regimen for young men, to lower their chances of developing the condition. So, no, Makary is not an anti-vaxxer, though you might be tempted to sort him into that box. But he also isn't sold on the recommendation that a 12-year-old boy should be receiving two shots. "It may be that vaccines are a game changer for children, but that the dose is not quite perfected," Makary told Nightly. The latest study out of Israel Makary points to, published last week in The New England Journal of Medicine, found the incidence of myocarditis was highest among males 16 to 29, with about 11 out of every 100,000 developing the condition after receiving the second dose. While the figure is higher than previous estimates, the risk is still small and the condition is usually mild and temporary. A CDC panel in May unanimously voted to recommend Pfizer's vaccine for kids 12 to 15, saying the benefits outweigh the risks. CDC research has estimated that among every million fully vaccinated boys, ages 12 to 17, the shots might cause a maximum of 70 cases of myocarditis, but would prevent 5,700 infections, more than 215 hospitalizations and two deaths. Other studies have shown the risk of heart problems after getting Covid is higher than the risk after vaccination. The risk of myocarditis was among the reasons the FDA called for more children in vaccine trials this summer. The condition will likely be a hot topic during the agency's Oct. 26 meeting about vaccines for children 5 to 11. Makary doesn't disagree that myocarditis is rare, though he countered that the rate of severe disease or death in children is also rare. And the absence of a statistical breakdown of the roughly 650 childhood Covid deaths in the U.S. by comorbid condition doesn't sit well with him. Makary wants the vaccine recommendations to factor in the nuances when it comes to kids. He questions whether a 13-year-old girl should receive the same dose regimen as a 55-year-old man. (Pfizer used a smaller dose of its Covid vaccine when conducting trials for children under 12.) He isn't entirely alone in his thinking. Health officials in Hong Kong, Britain, Norway and other countries have recommended a single dose of the Pfizer-BioNTech vaccine for children 12 and older. Health officials in these countries have become increasingly worried about new data suggesting myocarditis may be more common among this group than they originally had thought. But other U.S. public health experts, like Mark R. Schleiss, a pediatric infectious disease doctor at the University of Minnesota Medical School, told Nightly today that the vaccine is still the lowest-risk option. Schleiss recommends getting your kids vaccinated with both doses as soon as you can. Follow the blanket recommendations. Protect your child before it's too late. "I stand by what I have been saying for months: the best Covid vaccine to get is the one you can get RIGHT NOW (today!)," Schleiss said in an email to Nightly. "Definitely less myocarditis after just one dose of an mRNA vaccine. But 'less'...relative term...SO RARE to begin with!" Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight's author at mward@politico.com or on Twitter at @MyahWard.
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