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Sideways Looks #14: Vaccine Hesitancy, also Texas


Hello,


I am back from a holiday in lovely Leicestershire; as an added bonus, I got to meet my parents’ new Havanese puppy on the way back to London. I hope you didn’t feel the absence of a Sideways Look last week too keenly.

A twist on the usual request this week. I’m pulling together plans for some online training courses, in collaboration with ComSkills. I’ve had a few ideas, but I’m keen to crowdsource thoughts on which I should prioritise. So in addition to the usual short poll, I’ve put a few potential courses for you to rank in order of which you’d be most interested to see happen. Any input would really help me focus my planning effectively, which would be great.

As always, this and past posts can be found here. Have a great week.

Oliver


 

Thought for the Week: Vaccine Hesitancy

 

If you can bear it, cast your mind back to Brexit. I think it’s fair to say much public commentary, either implicitly or explicitly, portrayed two stereotyped camps. The Remainers were head-over-heart, elite intellectuals who argued Brexit was an objectively bad idea. The Leavers were heart-over-head, uninterested in economic arguments and spurred by ideas of sovereignty and nationalism.

This framing often had some pretty unpleasant implications, as I wrote in 2017 in a piece called Taking Back Ctrl for the think-tank Demos. Looking back I don't agree with all the content in it, but I think the central argument still holds up. I argued some Remain voices were very quick to publicly claim that Leavers had been duped – even, potentially, by deliberate disinformation campaigns. This risked making Leavers feel patronised, and that their political views were being dismissed.

Fast-forward to 2019, and Boris Johnson’s strongly pro-Leave campaign wins a surprising majority. And now there's a lot of hand-wringing amongst political elites, including in the Labour party, that voters felt patronised and dismissed by the whole Brexit debate.

This is not to say I predicted events correctly; my claim wasn't specific enough to be a proper prediction, and there's a lot of complicating factors (the idea that many voters felt patronised by elites is arguably a pre-Brexit trend; the issue might have been more that Labour's stance was unclear rather than unpopular; etc.). But nonetheless, I suggest it as evidence that publicly labelling a set of views as stupid might have considerable unintended consequences.

So what about Vaccines?

I don’t want to draw too much equivalence between Brexit and vaccines. Brexit is a complex debate; I voted Remain, but am sympathetic to some arguments on both sides. Whereas vaccination is much simpler. I'm pro.

But I think there are some parallels. There was a strain of strongly pro-Brexit people who overlapped with xenophobic and far-right movements; just as there’s vocal anti-vaxxers who overlap with hardcore conspiracy theorist groups. Then there’s a larger, quieter group of Leavers who voted with a bit of shrug; and there’s a sizeable group of vaccine-hesitant people who normally trust in medicine – note that the UK’s MMR vaccination rate is ~95% – but not this particular vaccine.

A key point, which I’ve learned from my work on counter-disinformation, is you need to (i) mentally separate those groups and (ii) don’t focus on the hardcore groups. The hardcore group make for good hero-and-villain stories; but vocally rebutting their messages can actually give them more airtime. Moreover, publicly blasting anti-vaccine views risks the blasé larger group feeling under attack - and hardening their views accordingly.

One risk of treating softer groups like outright villains is that we end up shining searchlights on their behaviour, turning normal human irrationalities into attacks. Leavers were often accused of voting against their best interests. But there was a strong wealthy-and-Labour-supporting cohort in the pro-Remain camp - so I suspect many of the people making those accusations have themselves voted to increase their personal tax liability in service of a greater good (I know I have).

Similarly, vaccine-hesitants who are nervous of ‘what’s in the vaccine’ are sometimes mocked for still eating fast food and drinking fizzy drinks (I saw a social media post doing precisely that as I write this). But this arguably implies that anyone who drinks fizzy drinks foregoes their right to be nervous about anything they’re putting in their body. That's an argument I think many would be uncomfortable making under more normal circumstances.

This isn't about stupidity

My big general concern is the risk of dividing ‘intelligent pro-vaccine’ people from ‘stupid anti-vax people’. It's an easy one to fall into, given the clever scientists involved in making the vaccines. But it's worth remembering the link between 'intelligence' and 'belief in strange views' isn't a clear one. Some have suggested that being traditionally 'intelligent' might make people better at making facts fit their beliefs.

Specifically in relation to Covid, an argument the vaccine-hesitant frequently express is “the vaccines are just too new”. The critics respond by saying “even after all that testing? Do they think they know better than the experts?”

But expertise does not provide certainty. We’ve seen during the pandemic that expert pronouncements on masks and lab-leak theories turned out to be overconfident, and bloggers on the same topic have turned out to be vindicated (useful list of those bloggers in part V of this). But of course, on a whole host of other things – from tests to therapeutics – experts were correct in a life-saving way, as they often are.

What expertise does provide is a guide to action, which short-cuts the need to re-do everything ourselves. You might be able to analyse some data and point out things experts are not (potentially due to group-think amongst experts, or potentially internal political pressures). But you want to develop rival testing facilities for vaccines and PCR tests, or even create your own from scratch? Good luck. And the rest of us shouldn't wait.

Science is a bit scary

That’s not just a Covid issue. Living in the modern world requires making constant leaps of faith in expertise; your car might explode around you, your phone might fry your brain, the safely stored nuclear bombs might detonate unexpectedly. (Indeed, some prominent sociologists have argued this view of risk is actually a way of defining ‘modernity’). But the alternative – trying to avoid the modern world entirely – isn’t great. At best it’s inconvenient to you, and at worse dangerous to others. You don’t trust experts to build your car, so you knock up your own with no help? Fine, but I won’t get in it and I don’t think it should be allowed on busy roads.

But nonetheless, entrusting your life and health to unknown expert processes is still a leap of faith. Do I worry that a couple of years hence the vaccine will turn out to have terrible side effects, a thalidomide scandal on a whole new scale? Yes, in a tiny part of my brain. But the history of vaccines, and medical treatment in general, suggests that is highly highly unlikely to happen (thalidomide doesn’t work as a precedent here, as that wasn’t properly tested). Moreover, I know that avoiding the vaccine is pretty likely to cause further deaths, illness, and lockdown. Given all that, I’ll take leaps of faith all the way to the vaccine centre.

But nonetheless, I think people are allowed to be nervous about that leap of faith, and it’s not stupid to feel that way. There’s maybe a fairer argument that vaccine hesitancy is selfish rather than stupid: ‘I’m not prepared to take the leap of faith, so I’ll rely on everyone else doing it’. But even then, if someone is genuinely anxious about something then saying ‘just get over it’ isn’t great advice.

So, what to do?

To be clear: I think vaccine hesitancy is a problem to be challenged, not a view we just have to respect. I also think people have the right in private, amongst their pro-vaccine friends to insult vaccine-hesitant people – they're difficult views to accept, particularly in someone close to you, and the need to vent is understandable. My concern is effects of discussion in less private spaces, whether that's online or a bigger social group.

Changing minds is hard, and has all sorts of pitfalls - some research suggests that even presenting basic facts can actually harden opposition. The best approach is to understand and directly address the root cause of concern. Some Muslims are worried the vaccine isn’t halal? Ok, let’s work with faith leaders to use mosques as vaccine centres.

But in practice, the reasons for vaccine hesitancy could be myriad – from distrust in authority, to fear of novelty, to simple apathy. Dealing with all these individual cases is a difficult thing to ask, whether of governments planning public health messages or of individuals trying to convince their family members. And it can take time, which is not ideal amidst a pandemic. So sadly, it isn't clear how to address vaccine hesitancy at scale and at pace.

My concern is that vaccine hesitancy could go down one of two routes. Either gradually concerns will fade and/or the inconvenience of continually taking tests will move people from the ‘hesitant’ group to the ‘vaccinated’ group. Or alternatively, vaccine hesitancy will be a gateway drug to people holding counter-mainstream views as a personal identity – most worryingly, on climate change. I worry that too much insulting could make the latter route more likely.

I might be wrong - this is all a complex situation. Maybe vaccine-hesitant behaviour is unaffected by surrounding discussion, or maybe harshness is needed to change minds. But that's not a leap of faith I'm happy to make.

 

Fun Fact About: Alaska and Texas

 

In 1867, the USA bought Alaska off Russia for $7.2 million. However it was an independent territory rather than a full state. In 1946 Alaska voted in a referendum to change that, and after considerable battles in Congress that finally happened in 1959.

At 1.7 million sq km, Alaska far outstripped all other states in size – including the previous frontrunner, Texas, at 700,000 sq km. I had heard a story that Texan pride in their state’s size had been a sore point during the negotiations. Indeed, I was told, eventually the Alaskan delegation got so annoyed they threatened to cut their state in half so that Texas would become the third largest state.

I had always suspected this story was apocryphal. And I have found no evidence that the issue was raised in Congress. However, to my surprise and delight, it does seem that this joke wasn’t just invented years after the fact – it was being reported in various American newspapers as early as 1958, when negotiations were ongoing. Which is close enough for me.

 

Recommendations

 

My favourite paper on disinformation: As we’ve touched on online disinformation, I have to plug this paper. It makes the argument that we shouldn’t be worried about dis-information, but rather ‘information warfare’; the problem is not fake stuff which can be rebutted, but rather “the selective amplification of reputable, mainstream media stories to fit an agenda”. It's about creating an atmosphere of doubt and division, which doesn't actually require direct lying.

Avoiding procrastination: This was a pretty comprehensive account of various daft mental processes humans have which can worsen our ability to get stuff done, and some pretty easy suggestions about how they might be addressed.

Exam results: Education wonk Sam Freeman has a good piece in the New Statesman about how the debacle of AI marking last year has unfairly cast shadows on AI marking in general, potentially leading to more unfairness for years to come.

Finally, an Aquapark. Rutland Aquapark, to be precise (though there are others). I mentioned previously that this was a planned holiday activity. Having not really looked at the site, I wasn’t quite sure what to expect – but as the massive inflatables hove into view, every fibre of my inner child lit up. Can confirm was a great way to spend a morning.

 

Thanks for reading. Please do let me know your thoughts via this short poll.

 

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