Tuesday Reads: What’s Behind Vaccine Hesitancy?

Good Morning!!

Richard Diebenkorn, Coffee, 1959

Richard Diebenkorn, Coffee, 1959

Trump is gone from the national stage, but the misinformation he promoted is still with us. Thanks to the Trumpists, we may never achieve herd immunity in the U.S. 

Dr. Rob Davidson, emergency room physician and Dr. Bernard Ashby, vascular cardiologist at NBC News: White Covid vaccine rejectors threaten herd immunity. Can we change their minds in time?

Even as we accelerate vaccinations, an immovable force stands in the way of achieving community immunity: Millions of Americans who are simply saying “No way.”

As of mid-April, both Florida and Michigan were hot spots for the more severe B.1.1.7 Covid-19 variant that originated in the U.K. and that is now the dominant strain nationwide. This variant is also sending younger, previously healthy people into our hospitals. With the coronavirus mutating to become more contagious and possibly more lethal, vaccination is more important than ever.

Yet, vaccine refusal — not reluctance, not “maybe later,” but flat-out rejection — could prevent us from reaching the threshold when epidemiologists say we can safely and responsibly fully reopen all aspects of society. Recent surveys like this one from CNN put that number at around one in four people. In rural, overwhelmingly white places like rural western Michigan, these are the folks who stagger into the Emergency Room, sick and struggling to breathe, yet still tell nurses and doctors that neither Covid-19, masks and vaccines are real.

Davidson and Ashby write that Black and Hispanic Americans have responded to efforts to educate people about vaccine safety and efficacy.

But though Black and Hispanic Americans are now increasingly rolling up their sleeves, one group continues to refuse vaccinationsWhite, evangelical and rural Americans.

We heard one rural Michigan patient call vaccines a form of government control. Another repeated the unfounded claim that Covid-19 was a Chinese bioweapons plot. One patient refused to get vaccinated despite getting Covid-19 twice, a rare reinfection. Rural white people scoffed at vaccines, citing microchips and infertility, or Fox News disinformation slandering health experts for lying about vaccine efficacy data and calling vaccines a tool for social control. We heard patients accuse hospital workers of being highly paid actors maintaining the pandemic charade.

Vaccines have struck conservative Republican leaders with a kind of stubborn anosognosia, an inability to line themselves up with reality.

Paul Wonner, Model Drinking Coffee, 1964

Paul Wonner, Model Drinking Coffee, 1964

 

The answer, say the authors must come from community leaders.

In Michigan, GOP legislative leaders are undermining vaccinations in word and in deed, including holding millions of dollars in federal vaccination funds hostage. The conservative base, however, says it would rather listen to doctors than politicians anyway. If the only information — or misinformation — about the pandemic is from Fox News and OANN, then the antidote is information from a source who understands the science, the medicine and most importantly, the community.

In the case of rural conservative communities, that source would be rural conservative family physicians who go to the same churches, fish the same stretch of river and volunteer every Friday night at local high school football games. These are the doctors who care for every stage of a family’s life. Births, broken arms, deliveries, disease management and deaths. They aren’t just trusted, they’re family —minus the birthright of blood. Most importantly, they know how vaccines and medicine work.

I hope this happens, but I’m not hopeful.

Sabrina Tabernise at The New York Times: Vaccine Skepticism Was Viewed as a Knowledge Problem. It’s Actually About Gut Beliefs.

For years, scientists and doctors have treated vaccine skepticism as a knowledge problem. If patients were hesitant to get vaccinated, the thinking went, they simply needed more information.

But as public health officials now work to convince Americans to get Covid-19 vaccines as quickly as possible, new social science research suggests that a set of deeply held beliefs is at the heart of many people’s resistance, complicating efforts to bring the coronavirus pandemic under control….

About a third of American adults are still resisting vaccines. Polling shows that Republicans make up a substantial part of that group. Given how deeply the country is divided by politics, it is perhaps not surprising that they have dug in, particularly with a Democrat in the White House. But political polarization is only part of the story.

In recent years, epidemiologists have teamed up with social psychologists to look more deeply into the “why” behind vaccine hesitancy. They wanted to find out whether there was anything that vaccine skeptics had in common, in order to better understand how to persuade them.

They borrowed a concept from social psychology — the idea that a small set of moral intuitions forms the foundations upon which complex moral worldviews are constructed — and applied it to their study of vaccine skepticism.

Edvard Munch, At The Coffee Table, 1883, Munch Museum, Oslo

Edvard Munch, At The Coffee Table, 1883, Munch Museum, Oslo

What they discovered was a clear set of psychological traits offering a new lens through which to understand skepticism — and potentially new tools for public health officials scrambling to try to persuade people to get vaccinated.

Dr. Omer and a team of scientists found that skeptics were much more likely than nonskeptics to have a highly developed sensitivity for liberty — the rights of individuals — and to have less deference to those in positions of power.

Skeptics were also twice as likely to care a lot about the “purity” of their bodies and their minds. They disapprove of things they consider disgusting, and the mind-set defies neat categorization: It could be religious — halal or kosher — or entirely secular, like people who care deeply about toxins in foods or in the environment….

“At the root are these moral intuitions — these gut feelings — and they are very strong,” said Jeff Huntsinger, a social psychologist at Loyola University Chicago who studies emotion and decision-making and collaborated with Dr. Omer’s team. “It’s very hard to override them with facts and information. You can’t reason with them in that way.”

These qualities tend to predominate among conservatives but they are present among liberals too. They are also present among people with no politics at all.

Dakinikat quoted from this one yesterday, but it fits in with my theme so I’m posting again. Derek Thompson at The Atlantic: Millions Are Saying No to the Vaccines. What Are They Thinking?

What are they thinking, these vaccine-hesitant, vaccine-resistant, and COVID-apathetic? I wanted to know. So I posted an invitation on Twitter for anybody who wasn’t planning to get vaccinated to email me and explain why. In the past few days, I spoke or corresponded with more than a dozen such people. I told them that I was staunchly pro-vaccine, but this wouldn’t be a takedown piece. I wanted to produce an ethnography of a position I didn’t really understand.

The people I spoke with were all under 50. A few of them self-identified as Republican, and none of them claimed the modern Democratic Party as their political home. Most said they weren’t against all vaccines; they were just a “no” on this vaccine. They were COVID-19 no-vaxxers, not overall anti-vaxxers.

Pierre Bonnard, Coffee, 1907

Pierre Bonnard, Coffee, 1907

Many people I spoke with said they trusted their immune system to protect them. “Nobody ever looks at it from the perspective of a guy who’s like me,” Bradley Baca, a 39-year-old truck driver in Colorado, told me. “As an essential worker, my life was never going to change in the pandemic, and I knew I was going to get COVID no matter what. Now I think I’ve got the antibodies, so why would I take a risk on the vaccine?”

Some had already recovered from COVID-19 and considered the vaccine unnecessary. “In December 2020 I tested positive and experienced many symptoms,” said Derek Perrin, a 31-year-old service technician in Connecticut. “Since I have already survived one recorded bout with this virus, I see no reason to take a vaccine that has only been approved for emergency use. I trust my immune system more than this current experiment.”

Others were worried that the vaccines might have long-term side effects. “As a Black American descendant of slavery, I am bottom caste, in terms of finances,” Georgette Russell, a 40-year-old resident of New Jersey, told me. “The fact that there is no way to sue the government or the pharmaceutical company if I have any adverse reactions is highly problematic to me.”

Many people said they had read up on the risk of COVID-19 to people under 50 and felt that the pandemic didn’t pose a particularly grave threat. “The chances of me dying from a car accident are higher than my dying of COVID,” said Michael Searle, a 36-year-old who owns a consulting firm in Austin, Texas. “But it’s not like I don’t get in my car.”

And many others said that perceived liberal overreach had pushed them to the right. “Before March 2020, I was a solid progressive Democrat,” Jenin Younes, a 37-year-old attorney, said. “I am so disturbed by the Democrats’ failure to recognize the importance of civil liberties. I’ll vote for anyone who takes a strong stand for civil liberties and doesn’t permit the erosion of our fundamental rights that we are seeing now.” Baca, the Colorado truck driver, also told me he didn’t vote much before the pandemic, but the perception of liberal overreach had a strong politicizing effect. “When COVID hit, I saw rights being taken away. So in 2020, I voted for the first time in my life, and I voted all the way Republican down the ballot.”

Thompson’s interpretation of his findings:

My view of the vaccines begins with my view of the pandemic. I really don’t want to get COVID-19. Not only do I want to avoid an illness with uncertain long-term implications, but I also don’t want to pass it along to somebody in a high-risk category, such as my grandmother or an immunocompromised stranger. For more than a year, I radically changed my life to avoid infection. So I was thrilled to hear that the vaccines were effective at blocking severe illness and transmission. I eagerly signed up to take both my shots, even after reading all about the side effects.

Henri Matisse, Coffee, 1916, Detroit Institute of Arts

Henri Matisse, Coffee, 1916, Detroit Institute of Arts

The under-50 no-vaxxers’ deep story has a very different starting place. It begins like this:

“The coronavirus is a wildly overrated threat. Yes, it’s appropriate and good to protect old and vulnerable people. But I’m not old or vulnerable. If I get it, I’ll be fine. In fact, maybe I have gotten it, and I am fine. I don’t know why I should consider this disease more dangerous than driving a car, a risky thing I do every day without a moment’s worry. Liberals, Democrats, and public-health elites have been so wrong so often, we’d be better off doing the opposite of almost everything they say.”

Just as my COVID-19 story shapes my vaccine eagerness, this group’s COVID-19 story shapes their vaccine skepticism. Again and again, I heard variations on this theme:

“I don’t need some novel pharmaceutical product to give me permission to do the things I’m already doing. This isn’t even an FDA-approved vaccine; it’s authorized for an emergency. Well, I don’t consider COVID-19 a personal emergency. So why would I sign up to be an early guinea pig for a therapy that I don’t need, whose long-term effects we don’t understand? I’d rather bet on my immune system than on Big Pharma.”

For both yes-vaxxers like me and the no-vaxxers I spoke with, feelings about the vaccine are intertwined with feelings about the pandemic.

There’s much more at The Atlantic link.

So maybe my notion that vaccine refusal/hesitancy comes from Trump propaganda is wrong? I still think that’s a significant element of the problem. But clearly there are other psychological and sociological explanations. Is there a solution?

A few more vaccine reads:

The New York Times: The F.D.A. is set to authorize the Pfizer-BioNTech vaccine for those 12-15 years old by early next week.

Science News: The surge in U.S. coronavirus cases shows a shift in who’s getting sick. Younger, unvaccinated people aren’t just getting mild infections; they’re landing in the ER too.

CNN: Vaccines are helping bring down US Covid-19 numbers. But the virus is now hitting one group of Americans harder.

USA Today: US nearing vaccine tipping point, dramatic decrease in COVID cases could come without herd immunity, some experts say.

Have a great Tuesday, Sky Dancers! As always, this is an open thread.


22 Comments on “Tuesday Reads: What’s Behind Vaccine Hesitancy?”

  1. bostonboomer says:

  2. bostonboomer says:

  3. bostonboomer says:

    • NW Luna says:

      The Girl in the Kent State Photo

      In 1970, an image of a dead protester immediately became iconic. But what happened to the 14-year-old kneeling next to him?

      Last May, when Mary Ann Vecchio watched the video of George Floyd’s dying moments, she felt herself plummet through time and space — to a day almost exactly 50 years earlier. On that afternoon in 1970, the world was just as riveted by an image that showed the life draining out of a young man on the ground, this one a black-and-white still photo. Mary Ann was at the center of that photo, her arms raised in anguish, begging for help.

      That photo, of her kneeling over the body of Kent State University student Jeffrey Miller, is one of the most important images of the 20th century. Taken by student photographer John Filo, it captures Mary Ann’s raw grief and disbelief at the realization that the nation’s soldiers had just fired at its own children. The Kent State Pietà, as it’s sometimes called, is one of those rare photos that fundamentally changed the way we see ourselves and the world around us. Like the image of the solitary protester standing in front of a line of tanks in Tiananmen Square. Or the photo of Kim Phuc, the naked Vietnamese girl fleeing the napalm that has just incinerated her home. Or the image of Aylan Kurdi’s tiny, 3-year-old body facedown in the sand, he and his mother and brother having drowned while fleeing Syria.

      These images shocked our collective conscience — and insisted that we look. But eventually we look away, unaware, or perhaps unwilling, to think about the suffering that went on long after the shutter has snapped — or of the cost to the human beings trapped inside those photos. “That picture hijacked my life,” says Mary Ann, now 65. “And 50 years later, I still haven’t really moved on.”

  4. quixote says:

    The tell-me-why-you’re-a-no-vaxxer article is still looking at a concomitant symptom and not the root cause of both.

    Vaccine hesitancy and moral code are both symptoms of ingroup vs outgroup markers.

    What he should have looked at was the correlation between vaccine hesitancy and how strongly people want status in their peer group.

    I’m willing to bet that both loonie fundies and the pure foods crowd gain points in their groups for their principled stand against the Forces of Darkness. (The point that their principles are based on fantasy doesn’t affect their status *inside their group*.)

    So my bet is also that you’re right, bb. The Dump had a huge effect on the batshit wingers, because he’s their reference for what’s cool in their group. The purity goofballs get their stance from somebody else, but I’m certain there’s some Authoritay there too.

    It matters because the way you change the mindset, if it’s about status, is identifying who or what these people admire and then having a blizzard ad / video / music / whatever campaign where the Kool Krowd is all vaccinated. It has to just be a footnote in something glorifying their Koolness, so that it slips under the defensiveness wall.

    For Trumpistas another useful tack might be to work on their paranoia by pointing out all their “thought” leaders, including Dump, who quietly got vaccinated without telling them. “Why are they leaving you out in the cold? 😯 “

    • quixote says:

      (Good grief. Sorry for the book-length comment.)

    • NW Luna says:

    • djmm says:

      Great comment, Quixote. If former President Trump did a psa on the vaccine, many more would get it. I am not holding my breath.

      Part of what is so shocking is that so many of the anti-vaxers are also anti-maskers.

      I asked an acquaintance (while wearing double masks myself) why he took that stance. He said that he trusted his immune system (which would not recognize the virus as it would other viruses it has been exposed to), he takes supplements to strengthen his immune system, vaccines weaken the immune system (not true), and that he was already exposed when his wife had Covid and it was mild for her (she was fortunate). He knew I had been vaccinated and then stated, “You are probably going to get the booster when it is offered.” I affirmed that I would do so in a heartbeat. “And it has glass (silicon chips?) that the government could use to track you!” I explained that was not true, but said if the government wanted to watch me mulch the garden, they were welcome to do so. Probably cruel and unusual punishment for whoever is watching. He has a smart phone and is likely on Facebook, and he is worried about government tracking …?

      This is the result of generations of Republican brainwashing, starting with Spiro Agnew and maybe back to Goldwater and the John Birch society. There is no hope of changing the minds of such people. Some have already died from their beliefs, nurses having reported that some Covid patients don’t believe they have it even as they are dying. I am hoping some of their children somehow escape being indoctrinated.

      • quixote says:

        Interesting, about your acquaintance. As you say, inventing a whole new impossible surveillance technology when you have your phone implanted in your pocket is just funny.

  5. Enheduanna says:

    Really interesting post BB. I am so relieved to be fully vaccinated, and have no idea why people want to play Russian-roulette with this thing. I’m perfectly happy to wear a mask whenever I go out. You’d think anyone worried about the purity of their body would too.

    • bostonboomer says:

      Exactly. I’m thrilled to be vaccinated and I’m still going to be cautious.

    • quixote says:

      Because it’s not really about purity. It’s about getting points for whatever marker is important in that group.

      You can point out the senselessness till the sky turns green. Since that’s not really the issue, it doesn’t speak to them.

    • NW Luna says:

      They get crazier every day!

      When a Miami school said earlier this week that it wouldn’t allow vaccinated teachers in its classrooms, its founder cited “vaccine shedding” as her main concern.

      The trope is currently abuzz in anti-vaccine circles, said Nicole Baldwin, MD, a pediatrician who has been a target of attacks by the anti-vaxxer community. “It’s amazing, and sad, what people will believe,” Baldwin told MedPage Today.

      Essentially, they believe that people who’ve had the vaccine can somehow shed the spike protein, which in turn can cause menstrual cycle irregularities, miscarriages, and sterility in other women just by being in close proximity. “This is a new low, from the delusional wing of the anti-vaxx cult,” said Zubin Damania, MD, a.k.a. ZDoggMD, in a video he recently posted to bust vaccine shedding myths.

      Damania said the misinformation originates from an earlier claim that syncytin, a protein involved in placental formation, bears some structural similarities to the spike protein, and therefore vaccination would interfere with women’s reproductive systems. Many a fact check has shown that vaccines don’t target the protein.

      Once injected, the vaccines prompt cells to make the spike protein, but it’s usually cleared in 24 to 48 hours, leaving little opportunity for “shedding,” even if it could occur — which it can’t, Damania emphasized. Another logical fallacy he pointed out: “Why, then, wouldn’t natural spike protein do the same thing? Wouldn’t you be more scared of natural coronavirus infection? Oh, but it’s ‘natural.'”

  6. dakinikat says:

    https://www.politico.com/news/2021/05/04/trump-obstruction-justice-doj-485360

    Judge orders release of DOJ memo justifying not prosecuting Trump
    U.S. District Court Judge Amy Berman Jackson blasts former Attorney General William Barr’s spin on the Mueller report as “disingenuous.”

    Look them up!!!


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