A response to the complaints about my column on how to deal with COVID-vaccine hesitancy.
A response to the complaints about my column on how to deal with COVID-vaccine hesitancy
W ell, I had a strange feeling that a great deal of grief would come from writing an article in which I acknowledged that vaccine skeptics include people who are reasoning about their health in good faith. And it did.
I want to answer just a few of the most common objections to the piece.
Objection 1: The real problem is misinformation — we should be going after Tucker Carlson or Facebook, not henpecking public-health advocates.
My ideas were aimed at people who I think, at this point, are basically wasting the public’s money or their own time on counterproductive messaging.
And, I’ll be honest, I don’t think misinformation is the main problem. It may be a problem, but it’s not the most important one. A great deal of vax skepticism is simply rooted in a lack of fear of COVID. Or a fear of what we can’t yet know about the vaccines. Long before Big Pharma even asked for emergency-approval authorizations, a substantial portion of the adult population of the United States had decided that the risks COVID posed to people under 50 were being vastly overstated to justify the intrusive public-health restrictions on our lives. And they determined then to resist it at every turn. For many of them, this includes resistance to the vaccine.
In fact, there was a reservoir of demand for information showing the vaccine wasn’t good. I think cutting off the supply of misinformation you happen to dislike will do little or nothing to ease fear among the hesitant. The changing statements on the lab-leak question and the possibility of surface transmission have already sown doubt, and more censorship won’t lessen it.
I also don’t think cable news is the main source of vaccine disinformation. I think most of it is shared laterally across in-real-life social networks. Skeptics who consume a lot of info about public health rely on alternative experts. By any measure, Dr. Martin Kulldorff, of Harvard Medical School, appears to be an expert on vaccine safety. He designed some of the protocols we use currently. Having questioned whether it’s really necessary for everyone to get vaccinated, he is now consistently questioning the reigning public-health orthodoxies about masking children. His name constantly pops up in conversations I have about vaccines with skeptics.
And lastly, if it’s true that a substantial portion of vax skeptics have good-faith questions for which they haven’t heard good answers, a campaign of censorship is likely to make them more suspicious.
Perhaps a larger problem than disinformation is just excess information. One of the studies I cited in my piece was withdrawn later in the day after I published it. People who have their prior beliefs will remember lots of true information that supports them and discard piles of other true information that might complicate them.
Objection 2: You can’t convince them, so just find ways to mandate it.
I agree that mandates can cause more people to sign up for the vaccine. We’ve seen that in France: When certain public accommodations announced they were going to require proof of vaccination, 2 million people made appointments. My sense is that there’s a substantial number of people who are not particularly afraid of COVID and not anxious to get the vaccine but who are not particularly afraid of the vaccine either, and they’ll get it if it’s a hassle not to have had it. So yes, that may work.
However, France is also now seeing mass protests against these inducements. Which means that the portion of people who are really fearful of the vaccine, or really convinced they have no need of it, are becoming radicalized. Mandates present a tricky balance. And my own view happens to be that this is the wrong pandemic to test these cases in court.
Objection 3: You can’t convince people who believe there are microchips in the vaccine to get it.
Yeah, probably. I don’t believe all skeptics are persuadable. Probably about 20–25 percent of the public can’t be convinced at all; but the 10–20 percent who can be persuaded should be addressed intelligently. Spending money on messaging that doesn’t address their concerns is more likely to make them recoil from what looks like evasive propaganda.
Objection 4: You’re asking us to respect the vax skeptics, but you were a jerk to me once. And unlike them I deserve the respect you didn’t show me because I’m one of the really super-smart people who listen to the experts. Hypocrisy alert!
I’m sorry if I treated you unjustly. I may not always be patient and kind with my opponents and critics. Sometimes impatience and the infliction of humiliation and disrespect are rational strategies when arguing in public. But defeating someone in debate is not the same as persuading another to join you in something.
The effort to vax the American public is not a scorched-earth campaign to get to 51 percent. We’re already well beyond that. Instead, you actually do have to win over people predisposed to distrust “the other side” of our cultural battles. In this case, vaccine advocates really do have to win the man, not the debate. When I treated you badly, I wasn’t asking you to take a needle from me.
Objection 5: You should do more to educate the skeptics.
Well, the reason I wrote my piece is that I’m running into people and objections I don’t have the expertise to overcome. Overcoming those objections requires some medical or scientific background I don’t have. I suspect their objections could be reasonably addressed — though doing so would likely include candid admissions that might be uncomfortable to make.
Public-health messages that I think could make a positive difference might run along these lines:
(1) You’re right, we can’t know the long-term effects of these vaccines, because you can’t study over the long term when you’re in the midst of a pandemic. But given what we know about medicine historically, there’s a plausible explanation for why the risks of unknown long-term side effects are infinitesimally low. There is a leap of faith involved, but everything we know tells us that the mRNA vaccine is an exciting medical development.
(2) Yes, you’re likely to survive COVID, but its long-term effects in some people are real. We know this from testimonies of people who believed themselves to be healthy before getting infected but who nonetheless are suffering from long-term loss of smell and other symptoms.
(3) The government should develop a website that contextualizes, as much as possible, the information available on its own Vaccine Adverse Events Reporting System (VAERS) site. Vaccine skeptics have mined the information on the VAERS site for talking points. They combine it with anecdotal reports and video evidence of some pretty frightening-looking medical events. Without better interpretation of this data from vaccine advocates, the fearful will believe the skeptics who are talking about it with them.
(4) Vaccine advocates should address some of the myriad medical questions that people reluctant to get the vaccine bring up. “I might be getting pregnant soon, is it safe to get the vaccine?” is a reasonable question. So is “I already had COVID, don’t I already have immunity?” Level with people about the risks and acknowledge that we don’t have all the answers yet.
I don’t think messages like these would take us immediately to 80 percent having had their first shot. But I suspect putting them out there into the atmosphere would make the job of doctors easier when they treat unvaccinated patients and want to persuade them. The simple acknowledgment that, after the year we’ve had and the public-health screwups we’ve endured, people have a right to feel bewildered and uncertain would cut through.