Tuesday Reads: What’s Behind Vaccine Hesitancy?
Posted: May 4, 2021 Filed under: morning reads | Tags: coronavirus pandemic, Covid-19, herd immunity, vaccine hesitancy, vaccine refusal
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 vaccinations: White, 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
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
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
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
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.