I’ve been seeing a growing number of social media posts that are arguing for non-judgment over decisions whether or not to vaccinate. While I think that these posts are coming from a well-intentioned place, I’m concerned about the harm that may be done by taking such a stance. I thought I’d tackle some of these issues here.
The Case for Non-Judgment
Part of the reason I think these posts are growing is that there is, in fact, some appealing reasons to take such an approach. I want to explore a few of these reasons before going into why I feel a different approach is more warranted.
Informed Consent/Medical Ethics
The first, and perhaps most valid reason, is where medical ethics largely falls. A keystone of contemporary medical ethics is the right to informed consent. There’s been too many sorry incidents in our past where the trust of basically everyone whose not a cishet middle-upper class white man has been used and abused by medical practitioners and researchers. The right to informed consent is meant to guard against such atrocities being perpetuated.
The right to informed consent is, largely, a concession to the practical realities of human existence and corrupt power systems. The issue in terms of vaccine hesitancy is that much of the information people are deciding on is mixed with misinformation and disinformation. This complicates the question of whether “informed” part of “informed consent” is actually being followed for many of the folks deciding not to get vaccinated.
The other reason the right to informed consent has been adopted as a major principle is the recognition of bodily autonomy as important to respect. I will come back to this later, but for now I will just point out that the ethics of informed consent mean that folks can, and do, have the right to make their own choices regarding their bodies, they are not free from the consequences of that choice.
It is a truism that a little bit of knowledge on a topic can be more harmful than no knowledge, and that is certainly being born out in this aspect. As the public has been kept informed every step of the way in our knowledge of the virus and the vaccine, lay people have struggled to keep up. The guidelines we’ve been issued and information we’ve been given has been fast-changing and oft-contradictory. The good news is that this is how science actually works in real-time–we’re seeing the self-correcting process with more transparency than ever before. The bad news is that many folks weren’t really prepared properly for that process and now are oft-repeating outdated, or just plain false info as a result.
This leads even folks who are quite happy to get a vaccine often uncertain enough to adamantly argue it to others–whether because they have their own doubts, or because they want to be on guard against the science changing again and being inundated with “I told you so’s”.
Perhaps one of the most compelling reasons for many to pursue a non-judgment approach is because of personal relationships. Many of us have friends and family who are at various places on this. Rather than taking an adamant stand and risking alienation and discord, we argue for restraint and respect for autonomy.
This is indeed a compelling reason, and again, I’ll address this more below. For now though, I will simply point out that what is right is not always what is easy, and that discord and discomfort are not ultimate evils we have labelled them. Many of us, as a social species, have a strong inclination to keep the peace of our communities at all costs–and yet disrupting the peace has been necessary many times in history and will likely continue to be necessary for many times to come.
The Case For Standing Firm
Now, let’s move on to why I think a firmer approach is a better stance to take.
Individual Reasons To Get Vaccinated
Since vaccine hesitancy often revolves around individual decisions to get vaccinated, let’s start with some of the areas of confusion here. This alone will not make the case for a firmer approach but it’s good information to have as a foundation.
Many folks have expressed concern at the pace of the vaccine development. There’s a few reasons why it’s not quite as simple as that. The virus we are dealing with is actually called SARS-COV-2–it’s this virus that then cause the disease known as COVID-19 (for an analogy, think of how the virus HIV causes the disease known as AIDS). As the “SARS” in SARS-COV-2 may alert you to, scientists and researchers have been working on and studying SARS-COV-1 since the early 2000s, and were spurred on once again by MERS in the mid 2010s. Research and development of mRNA as a possible alternative to more traditional vaccination methods has been going on for even longer, and studies of mRNA on treating coronaviruses was already ongoing when this pandemic hit. So while it looked like the vaccine development came together suspiciously fast, it was very much a fortunate culmination of decades of research at exactly the time we needed it, combined with some amazingly talented minds cooperating and sharing data with more advanced technological resources than ever before being focused on the the problem. In many ways, the COVID-19 vaccines are a testament to what is possible when the global community actually decides to tackle a pressing issue with the full force of human ingenuity and technological resources brought to bear.
One thing I’ve seen rising of yet is folks fretting over the days they’re out of commission after mRNA shots and the blood clotting after Astro-Zeneca and J&J shots. First, the blood clotting–there IS a high enough incidence of blood clotting that Astro-Zeneca has been suspended in many countries; it is important to note, however, that this is being done out of an abundance of caution. The incidence of blood clots are still far lower from Astro-Zeneca than they are from simple birth control pills, and are still far lower than blood clots from COVID-19 itself. The fact that Astro-Zeneca has been suspended is a testament to our vaccine safety monitoring systems working exactly as they should; if this was some sort of plot, halting vaccine distribution over such low incidence rates wouldn’t make any sense whatsoever.
Pfizer and Moderna are both incredibly safe and incredibly effective at preventing moderate-to-severe COViD-19 infections. Now, there will still be some “breakthrough” infections–no vaccine is 100% perfect but the over 90% efficacy of both of these vaccines is far higher than even the seasonal flu vaccine. There is risk of feeling sick (cold & flu symptoms at worst) for a couple of days after getting the vaccine. This is more common in women due to a generally more robust immune system—usually a good thing, but it means that the side-effects can be more unpleasant and more common in women as a result. I know all too well that our society, which idolizes productivity so, is aghast at the idea of a couple of days of being non-productive–but far better to be out of it for a couple of days than facing months, if not years of disability, or even dying in one of the worst possible ways–alone, drowning in your own bodily fluids.
The Collective Good: Thinking Beyond Yourself
Now, we get to the meat of the issue, and why I think the non-judgmental approach misses the mark. If the choice of whether or not to get vaccinated ONLY affected the individual it would be one thing; yet that is NOT the case. SARS-COV-2 is a virus that can be spread SO easily. You only have to breath the same air as someone who is infected to get it. With such high transmissibility, getting vaccinated is incredibly important.
A lot of folks have been repeating the earlier cautions of not knowing whether the vaccine will, in fact, prevent against transmission. While there is indeed still some uncertainty about this aspect, vaccines remain the ONLY effective way to put an end to this pandemic and protect those around us. A few countries have reached the coveted 75% vaccination rate and seen drastic reductions in COVID-19 cases which certainly suggests transmission may be drastically reduced. Furthermore, even IF getting vaccinated only prevented the development of more severe symptoms we would all still save the lives of others by getting vaccinated as it would cut down on the current drain in hospitals and ICUs and mean that folks who WERE admitted could get proper care and be far more likely to survive.
The science and data are clear that vaccines are our way out of this pandemic, that they are safe and effective, and that they will not only protect us as individuals but will serve to protect the most vulnerable and marginalized in society. Given this, a stance of neutrality is not something I can, in good conscience, adopt.
That said, condescending, demeaning or insulting folks who are vaccine hesitant gets us nowhere. Those who are pro-vaccination should openly share their excitement at getting vaccinated, and the activities and opportunities that open up as a result. They should also NOT throw studies and data at those who disagree–lots of psychological research has shown such approaches to be ineffective. Finally, in my opinion, those who are pro-vaccination should not compromise by giving validity to those who are against vaccination; rather, share your relief, your excitement at getting vaccinated, and hope that in enough time, enough others will join in celebrating with you.