Convincing the Skeptics

By Michael Brendan Dougherty

Friday, July 16, 2021

 

There’s no doubt that vaccination rates have hit a wall of skepticism: 48.5 percent of the population is fully vaccinated, and 56.1 percent have had at least one dose of the vaccine. This is consistent with opinion surveys earlier this year showing roughly 40 percent of the public as wary or skeptical about the vaccines. A wave of outreach has begun to get vaccination rates up further, especially in light of the spread of the Delta variant. Some states have tried lotteries, in which people who get vaccinated are entered to win a substantial sum of money. Others are trying public-messaging campaigns, prominently featuring the “type” of people that the state believes need to hear the message.

 

Elected Republicans are also promoting the vaccine, in a way. Senator John Cornyn said that most vaccine skepticism was “based on conspiracy theories.” And Mitt Romney has recently said that the politicization of vaccines has been “moronic.” In the next breath, after having thus established that he believed he was speaking to morons, Romney said that refusing to get the vaccine was “an insult” to Donald Trump’s accomplishments as president.

 

These statements reflect a real problem of vaccine advocacy. Proponents of the vaccine are unwilling or unable to understand the thinking of vaccine skeptics — or even admit that skeptics may be thinking at all. Their attempts to answer skepticism or understand it end up poisoned by condescension, and end up reinforcing it.

 

Now first, it’s important for streets to run both ways, so I’ll offer that proponents have trouble doing this because many of the most prominent anti-vaxxers do indulge in conspiratorial thinking. Some of it is politically motivated; people may remember that while Trump was president, prominent Democrats expressed their fears about the corruption of the research process based on nothing more than their intuition.

 

Many people who have taken the vaccine have done so without the slightest sign of serious side effects and strongly associate doing it with the abatement of their fear and the justified relaxation of strictures on their life. They associate lack of vaccine take-up with the possibility of more restrictions. For vaccine proponents, it feels like lowering themselves to answer people they believe to be less intelligent. They will also likely have experience of running into people who use any and every argument against vaccination — whether or not the arguments cohere or are contradictory. So the idea of doing more intellectual work to answer people you think are morons, or are arguing in bad faith, is simply beyond them.

 

Sometimes the perception of irrationality is almost accidental, because arguments are usually social interactions, not strictly logical exercises. A vaccine skeptic may brush off a proponent by saying, “It’s approved for emergency use only; it’s not FDA-approved. I don’t think we should require it.” The skeptic is beginning with a fact that’s easily established and shareable. But when pressed, they might reveal that their line of thinking is elsewhere: “There are no long-term studies, and I’m worried about possible long-term effects.” Because the two objections aren’t exactly logically connected, the proponent concludes it is irrationalism all the way down.

 

But a study done at MIT showed that a substantial portion of public-health skepticism was highly informed, scientifically literate, and sophisticated in the use of data. Skeptics used the same data sets as those with the orthodox views on public health. From a writeup of the study:

 

Combining computational and anthropological insights led the researchers to a more nuanced understanding of data literacy. Lee says their study reveals that, compared to public health orthodoxy, “antimaskers see the pandemic differently, using data that is quite similar. I still think data analysis is important. But it’s certainly not the salve that I thought it was in terms of convincing people who believe that the scientific establishment is not trustworthy.” Lee says their findings point to “a larger rift in how we think about science and expertise in the U.S.” That same rift runs through issues like climate change and vaccination, where similar dynamics often play out in social media discussions.

 

So let’s take a shot at understanding, starting with John Cornyn. Some subset of vaccine hesitancy is conspiratorial. Some of it is just an understandable anxiety in people who have had bad experiences with conventional medicine or have dealt with chronic and unexplained conditions. An even smaller amount is from people who, for instance, are trying to get pregnant and note that there’s been considerably less testing on pregnant women for well-established legal reasons. Some are hesitant to take it because they believe the natural immunity they acquired is sufficient.

 

But most vaccine skepticism, if by that we mean reluctance, is not based on conspiracy theorizing — it’s based on risk-benefit calculations. You may think it’s an innumerate calculation. But when you look at patterns of uptake in the United States, two factors stand out, factors that are larger in their effect than partisanship: age and density. The older you are and the denser your community, the more likely you are to be vaccinated. The younger you are, and the more rural your community, the less likely you are to have gotten it. This reflects the real facts about the risk of death from COVID. People may be wildly overestimating their risk from the vaccine and underestimating their risks from COVID — but they have the directional thinking correct. Those who are in less danger, act like it.

 

These risk-benefit calculations are not entirely defined by health outcomes either but involve psychology and politics. Some people, having read or seen that rates to achieve suitable herd immunity may be substantially lower than 80 or 90 percent, conclude that they don’t have to overcome their fears and can free-ride on the immunity achieved by others. The risk-benefit calculation is also complicated by other factors. People find acts of God easier to accept than mistakes of their own volition. So they may find it easier to accept the risks of facing COVID in nature, which they did not choose to get, than the unknown risks of a vaccine that they did consciously choose to take. This is obviously one of the larger hurdles people face when talking to parents about vaccinating their children. Parents aren’t just fearful of the vaccine; they may be fearful of living with guilt over their decisions.

 

To understand vaccine skeptics, proponents need to understand that the skeptics typically don’t fear COVID. They may fear that taking the vaccine is, in some way, to consent to the view that their freedoms are dependent on compliance with public health. Arguing that the vax is the path back to normality and fewer public-health restrictions backfires with skeptics, in my experience. They see consent to this view as a promise to willingly go under house arrest once a new variant hits the front-page headlines again. For them, excessive fear of COVID is the primary cause of public-health restrictions, and their refusal to take the vaccine is, in some small way, an attempt to model a life unruled by this fear.

 

Some proponents of vaccines, especially among conservatives, are willing to grant that public health has occasionally wasted the trust of the public on interventions. John Podhoretz and Noah Rothman on Commentary’s daily podcast have often pointed this out, but they don’t quite grasp how sinister things can look to a skeptic.

 

Take for instance this message, from NYC Health.

 

The messenger offers a few reasons to get vaxxed now. (1) The Delta variant is a “more contagious strain” of the virus. (2) Life-threatening complications and long-term effects on brain and body can occur in young people. (3) It’s available for free. (4) It’s about joy; getting the vaccine helps you travel more safely, visiting the people and places you love.

 

An attentive listener will note that the ad doesn’t claim the Delta variant is actually more dangerous — just more contagious. The last reason isn’t even strictly true. Most vaccine skeptics are seeing their family regularly already. States no longer impose mandatory quarantines between them and certainly don’t govern travel by vaccine passport. And international travel is currently governed by a rapid-testing regime, not vaccine status.

 

Public-health messaging that is constant but doesn’t address your actual concerns will, quite understandably, feel sinister and propagandistic. That’s doubly true when public-health authorities and major corporations have become so much more interested in censoring “misinformation” about COVID-19. Skeptics could already point to the lame attempts to suppress conversation about the lab-leak hypothesis.

 

The most serious phenomenon feeding skepticism, among the skeptics in my life, is the ongoing and bizarre public-health treatment of children.

 

We know now from experience that COVID-19 is less deadly to children than other common diseases and illnesses. Many quality studies show no frequent incidence of long-term complications for children who do get COVID-19. It is hard for children to get COVID. And the masks we make children wear have potentially serious negative consequences. CDC director Rochelle Walensky explained that she was withholding her vaccinated teenager from summer camp because of the dangers of unmasked interaction, just two days before the CDC, under pressure from the public, withdrew its guidance that children should be masked outdoors.

 

The CDC and Dr. Fauci say alarmist, fear-mongering nonsense about the risks to children all the time and seem to suggest constantly that life cannot return to normal for children until pediatric COVID vaccines are approved and taken up. That is, people can see with their own eyes that our public-health establishment is not only anxious to censor dissent but is also habituated to lying about the risks in order to justify unnecessary public-health interventions.

 

One unvaccinated friend expressed to me that it was this pattern of lying about children and censoring dissent that set off his intuition that something about the vaccination effort was unseemly. He acknowledged that many anti-vaxxers lie or don’t understand what they’re saying. But the people in positions of public authority aren’t supposed to lie.

 

Getting skeptics on board will require abandoning efforts that seem like open manipulation in defiance of the evidence. It will also mean leveling with people. An ad might acknowledge that indeed there aren’t long-term studies and cannot be any when we are responding to a sudden pandemic, but it could offer medical reasoning to trust that long-term health complications due to these vaccines are unlikely, given how few short-term complications there have been. A public-health campaign would give context to the information about vaccine reactions reported on the government’s own websites — such as the VAERs system — and explain how the government assesses them. In the absence of this, skeptics will take the word of whoever is willing to give this information context.

 

The American people are unruly and in a sour mood about their authority figures. The 40 percent of people who reported their initial hesitance have barely budged so far — despite millions wasted on public education and ham-fisted attempts to prevent them from sharing their concerns and fears. If vaccine advocates really do want vaccination uptake to increase more than they want to feel superior, they have to change course.