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In rich countries there are many vaccines, but it seems that we are running out of people who want them. This is frustating. Vaccines are a medical miracle: they are safe, more effective than we dared hope, and they are produced at unprecedented speed. They are the way out of this global crisis. Not surprisingly, vaccinated people often look at the handicapped with contempt, pity, or fury.
I chuckled at McSweeney’s recent article “Oh my gosh, you got the damn vaccine, damn shit”. Then I wondered who was really the butt of the joke. What are anti-vaccines? Or what are anti-anti-vaccines? Either way, it was unlikely to catalyze many decisions to get vaccinated.
I realize that a humorous tirade is not public health policy, but there was something about McSweeney’s article that perfectly symbolized a dangerous temptation. Do we want to do the patient’s job of increasing vaccine absorption? Or would we rather enjoy that conceited feeling of superiority over those incorrigible, unvaccinated idiots?
Not all unvaccinated people believe that Covid-19 vaccines are a genocidal conspiracy. According to vote in the US from the Kaiser Family Foundation, less than half of unvaccinated people say they “definitely won’t” get the vaccine. Others say they are eager to get it ASAP or will get it if needed or want to wait and see. The once large “wait and see” group is constantly moving up the ranks of the vaccinated. This is progress.
If we want vaccination rates to improve even further, we must help people who are already halfway to getting it. The starting point is clear and honest communication about benefits and risks, but we must also rethink the alleged problem. Too often I see headlines like “40 percent of adults under 30 are not vaccinated” instead of the identical arithmetic “60 percent of adults under 30 have already been punctured.” It is counterproductive to highlight antisocial behavior when instead you could be signaling that most people are doing the right thing.
“Most people are getting vaccinated so don’t miss it” is a more persuasive message than “Why are there so many idiots like you?” If the Kaiser Family Foundation survey is to be believed, 85 percent of Americans 65 and older are vaccinated. And despite the myriad stories about the Trumpist vaccine rejection, so are more than half of Republican voters.
Sociologist Zeynep Tufekci rightly warns against “the cartoon lure“Those viral anti-vaccine stories catching on from a severe case of Covid but refusing to back down even on their deathbed. However, while such gruesome stories loom large on social media, we could focus more on useful in worldly obstacles. Some people are afraid of needles or worry about missing work due to side effects or cannot easily arrange childcare to go to the clinic. Solving these problems does not have to be difficult : There are thousands of little things we could try to make things easier.
A great team of behavioral scientists that includes Katy Milkman and Angela Duckworth He recently tried a variety of tactics to persuade people in the US to get a flu shot. The most effective approaches were to send a couple of reminder text messages and say that the flu shot had been “reserved for you.” It’s all so mundane, but the increase (a few percentage points) is big enough to be worth a try.
After doing all these easy things, we have to ask ourselves a difficult question: what are we really trying to achieve?
It would not be difficult to increase vaccination rates by brute force. The UK government could introduce an “NHS rebuild” tax of £ 100 a month. Anyone who is fully vaccinated, or who can persuade two different doctors to sign an exemption certificate, does not need to pay the tax. There would be an uproar and some anti-vaccination activists would hope to become martyrs, but most people would shrug their shoulders and get vaccinated. I suspect that the vast majority of people already criticized would regard this as a perfectly reasonable tax on selfishness and idiocy.
But if that idea makes you squirm as much as me, maybe it’s because we feel that the real problem is quite different and much bigger. It is that a small but significant minority lacks confidence not only in vaccines, but in the state, corporations, experts and modernity in general. The heavy hand could force to complain of its conformity, but at what cost?
The Vaccine Confidence Project, a London-based group of researchers, has spent more than a decade studying attitudes towards vaccines, misinformation about vaccines and trust in vaccines. They recently launched The Confidence Project examining issues of trust, doubt and misinformation beyond vaccines. It is unclear whether this should be considered a noble undertaking or a serious mission.
They may be biting off more than they can chew, but I applaud the effort. Lack of confidence in vaccines is a problem in itself, but also a sign of a more worrying erosion of the social fabric. Repairing that fabric is a tougher job than simply increasing vaccination rates. This is because while vaccines have proven to be very effective, the same cannot be said for our governments.
From Tim Harford “The Next Fifty Things That Made Modern Economics“Now available in paperback
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