Old antivax tropes never die: “COVID theater,” “Urgency of Normal,” and the Great Barrington Declaration

As I tried to figure out what to write about today, I had a number of ideas. However, reading Dr. Jonathan Howard’s post yesterday about the consequences of a medical myth reminded me of a topic that I had been meaning to write about, parts of which I’ve alluded to on a number of occasions, but that I’ve never quite come out and explicitly written about in a way that I’ve meant to. I’m referring yet again about how “everything old is new again” in antivaccine messaging, this time around the idea that children don’t need to be vaccinated against a potentially deadly disease because the disease “only” kills a relatively small number of them. As I will show, this is not a new antivax talking point. The exact same argument has been used by antivaxxers to oppose vaccinating against, for example, measles going back years and years. Indeed, I now like to ask those who argue against vaccinating children against COVID-19 if they also oppose vaccinating against measles and chickenpox. (I’ll explain more explicitly why in the second half of this post.) It is also, at its heart, a deeply eugenicist viewpoint, as I will also argue near the end.

In the meantime, let’s start out with some context, conveniently provided in a widely publicized event that also prodded me to address this topic. Recall that Dr. Howard’s post was about the myth that “healthy children” simply do not die of COVID-19. Echoing that myth was an event that took place a week ago today, namely Florida Governor Ron DeSantis’ “roundtable” that he called The Curtain Close on COVID Theater. During that staged event, Florida’s Surgeon General Dr. Joseph Ladapo shocked public health officials by announcing that the State of Florida does not recommend vaccinating children 5-11 against COVID-19. In doing so, he used almost exactly the talking point I’m describing, namely that the risk of children dying from COVID-19 is so low that vaccinating them is not justified:

But it was not until the very end of this 90-minute event that Ladapo abruptly shared his news, telling the viewing audience: “The Florida Department of Health is going to be the first state to officially recommend against the Covid-19 vaccines for healthy children.” He did not elaborate on it or explain how this decision had been reached, when it would be official or what led to this decision. Later Monday, DeSantis clarified that Florida parents would have the choice, but he added: “We are not just going to follow the CDC in the state of Florida. … We’re going to do our own stuff.”

Whatever misfires in messaging that the CDC might have demonstrated during the pandemic, its recommendation that children ages 5-11 be vaccinated against COVID-19 was not one of them. Let’s just say that Dr. Ladapo is not a particularly reliable person to be making such a decision, particularly given his history and his membership in the COVID-19 grifting group America’s Frontline Doctors. Recall that America’s Frontline Doctors first came to prominence in July 2020 when they held a press conference to tout hydroxychloroquine as a highly effective treatment for COVID-19 and that Dr. Ladapo appeared in the infamous video from that press conference with Dr. Stella Immanuel, a quack who believes that a wide variety of gynecological complaints derive from “demonic seed” inserted in sleeping women when they dream about sex with demons, hence her designation as the “demon sperm” doctor. Although it is not clear whether Dr. Ladapo is still a member of America’s Frontline Doctors, since then the group has sued over supposed deaths from COVID-19 vaccines and been busted running a telehealth prescription mill for ivermectin, which is, as I like to say, the new hydroxychloroquine in that it is a repurposed drug that doesn’t work against COVID-19.

With that background, here’s the video of Gov. DeSantis’ “roundtable”:

It’s also on Facebook:

Note the tagline: “Governor DeSantis hosts a roundtable with physicians nationwide on ending COVID theater once and for all.”” Also note the talking point: COVID-19 mitigations are now “COVID-19 theater.” Before I go on, I can’t help but mention how about a week before his roundtable Gov. DeSantis berated high school students at an event for continuing to wear masks, contemptuously referring to wearing masks as “ridiculous” and condescendingly and sarcastically saying, “Honestly, it’s not doing anything, and we gotta stop with this COVID theater. So if you want to wear it, fine, but this is ridiculous.” It’s a talking point, but of course I can’t help but think: Project much? After all, this roundtable was primo “COVID theater.”

The players and the message

Before moving on to the messaging and how the idea that we should not vaccinate children because “not that many of them die” of a disease is a longstanding antivax trope, it’s useful to point out briefly which physicians were invited and agreed to participate in this “roundtable” discussion. First, all three authors of the Great Barrington Declaration were there by Zoom: Oxford University theoretical epidemiologist Sunetra Gupta; Stanford University health policy professor Jay Bhattacharya; and Harvard University biostatistician Martin Kulldorff. I’ve written about the Great Barrington Declaration (GBD) a number of times before. In brief, the GBD is a statement that was published a couple of months before COVID-19 vaccines started being distributed under an emergency use authorization (EUA) that advocated a “natural herd immunity” approach to the pandemic. The GBD was written at the behest of the libertarian free market think tank American Institute for Economic Research (AIER). In brief, Martin Kulldorff,, after having been invited to meet with AIER editorial director Jeffrey Tucker, lawyer Stacey Rudin, and AIER officials at a weekend conference, soon enthusiastically spearheaded an effort to promote an “anti-lockdown” message advocating a “natural herd immunity” approach to the pandemic. The result was another weekend conference at AIER headquarters, to which Kulldorff invited Gupta and Bhattacharya and AIER invited sympathetic journalists and scientists. The result was the GBD, which was birthed at a second weekend conference held at AIER headquarters in Great Barrington, Massachusetts, hence the name. (Tucker even bragged about contributing to its drafting.)

Also featured at the roundtable was Dr. Tracy Beth Høeg. We last met Dr. Høeg when she coauthored a really bad manuscript that was published as a preprint and represented a dumpster dive into the Vaccine Adverse Event Reporting System (VAERS) database and was widely criticized, including right here on SBM, thus doing the same thing that antivaxxers have done with VAERS going back at least two decades, misunderstanding and misusing it to claim or exaggerate horrible harms from vaccines, this time myocarditis. More recently, Dr. Høeg has been most associated with an effort that has big GBD vibes, namely the “Urgency of Normal.” Basically, “Urgency of Normal” is an effort that is an offshoot of the antimask “open up the schools”—and damn the consequences!—movement. Dr. Høeg, along with a number of other of the “usual suspects” of COVID-19 minimizing doctors, argues that schools should, in essence, stop all COVID-19 mitigations, particularly mask mandates, social distancing, and virtual schooling because—sound familiar?—children are at such low risk of dying from COVID-19 that we should just let the virus rip and, of course, because masks and the mitigations supposedly do so much more harm than the virus to children:

Meanwhile, children’s already-low risk from COVID has become even lower. Vaccines are available to children aged five and up, the Omicron variant is causing milder disease, and vaccines continue to be extremely protective against severe disease in the Omicron era.

Based on a careful review of all of this evidence, we believe it is time to allow children the same return to normalcy that adults have enjoyed. Children’s schools, athletics, and activities should be restored to their 2019 norms. Masks should become optional in US schools (we suggest, by February 15), and we can also return to pre-pandemic norms for quarantines: if you are sick, stay home.

When the initiative was announced, I immediately found it rather interesting that, although “Urgency of Normal” mentions the vaccines as making “already-low risk” children even “lower” risk (whatever that means), “Urgency of Normal” pointedly does not recommend that children be vaccinated; instead it only notes only that vaccines are “available to children aged five and up.” This tracks with Høeg’s dumpster dive into VAERS regarding myocarditis that sought to portray COVID-19 vaccines to be at least as dangerous to children as SARS-CoV-2, the virus that causes COVID-19, itself. I also find it…interesting…how many reports I hear of parents citing “Urgency of Normal” to say that quarantines are no longer necessary for children with COVID-19.

“Urgency of Normal” provided a toolkit to parents to use to argue to school boards to drop mask mandates and other COVID-19 mitigation measures. I have relatives who have pointed out to me just how successful this effort has been, with lots of parents whom you wouldn’t otherwise think to be susceptible to such an effort enthusiastically embracing the slogan. Almost immediately, though, it was pointed out how “Urgency of Normal” misused and misrepresented scientific studies. I’ll cite just a couple of examples of contemporaneous Twitter threads ripping apart its misuse of suicide statistics:

Also:

Others have also piled on, given how obvious the propaganda of “Urgency of Normal” is. When you boil it all down, both the GBD and “Urgency of Normal” argue that COVID-19 isn’t dangerous to most people, and therefore we should just stop trying to stop its spread and use “focused protection” to keep massive numbers of the vulnerable from dying. In the case of GBD, the argument goes that “lockdowns” cause far more harm than COVID-19 (which, according to the GBD, is not dangerous to most people) and that we should therefore let the virus rip to achieve “natural herd immunity” faster, while using “focus” protection for the elderly and those with chronic health conditions that make them more vulnerable to severe disease and death from COVID-19. In the case of “Urgency of Normal,” the argument goes that school mitigations such as mask mandates and virtual school have caused a wave of depression and child suicides far worse than any harm from the virus and that we should therefore drop all those mitigations and let the virus rip through schools, which will eventually result in—you guessed it!—”natural herd immunity.” And guess what? Last week, Martin Kulldorff himself published a new article in his new gig as scientific director of the Brownstone Institute (a.k.a. the “spiritual child of the GBD that now spreads antivaccine misinformation in addition to promoting the GBD) entitled Should I Vaccinate My Child Against Covid? In the article, Kulldorff argues exactly the same thing, that children are at such low risk from COVID-19 that risk-benefit ratio of vaccinating is unfavorable.

As I like to say, “Urgency of Normal” is the GBD, just for children and schools. Both base their arguments on essentially the same claim, that COVID-19 is not dangerous to “most people.” Both oppose any COVID-19 mitigation mandates. Both oppose masking, falsely claiming it to be ineffective. Both oppose vaccine mandates of any kind and, indeed, seem to go out of their ways to discourage vaccination against COVID-19 by downplaying its effectiveness and exaggerating its risks. Indeed, underscoring that last point, neither the GBD authors nor Dr. Høeg seemed the least bit disturbed that they had been placed on the same roundtable with Dr. Robert “inventor of mRNA vaccines” Malone, a physician and scientist who 30 years ago did some work getting RNA into cells using lipid nanoparticles and now claims that he “invented mRNA vaccines” even as he is now a bona fide antivaccine crank and conspiracy theorist who claims that the vaccines are causing mass death and claimed on Joe Rogan’s podcast that we are all victims of a “mass psychosis.” If any of the GBD authors or Dr. Høeg were not at least antivaccine-adjacent, they would have refused to be associated in any way with someone like Dr. Malone.\

Back in time…the measles

The core argument against vaccinating children used by people like Drs. Ladapo, Gupta, Kulldorff, Bhattacharya, and Høeg is that COVID-19 is not dangerous to children or, at least, that it kills so few children that the risk-benefit profile of vaccinating is not favorable. To their credit, they don’t make ridiculous claims of the sort documented by Dr. Howard yesterday, in which he described how Dr. Marty Makary repeatedly claimed this:

In reviewing the medical literature and news reports, and in talking to pediatricians across the country, I am not aware of a single healthy child in the U.S. who has died of COVID-19 to date.

As Dr. Howard noted:

As evidence for this extraordinary claim, Dr. Makary referenced his own paper and claimed it was a study of “pediatric COVID-19 deaths”. It turns out that in this study, a three children died, and Dr. Makary used these three children to extrapolate to the hundreds of children who had died by that time. Dr. Makary would later speculate that “maybe the rate of death from the vaccine parallels the rate of death from COVID in a healthy child”. It’s no surprise Dr. Makary has been favorably profiled on RFK Jr.’s anti-vaccine website.

Sound familiar? The GBD makes similar claims for “healthy adults” under the age of 65 as being so incredibly unlikely to die that we should just open up society, stop enforcing mask mandates, and let the “healthy” be exposed to COVID-19, just as “Urgency of Normal” tries to argue that children are so incredibly unlikely to die of COVID-19 that we should just stop all virtual schooling and open up the schools, stop enforcing mask mandates in schools that are open, and let “healthy children” be exposed to COVID-19. In contrast, as Dr. Howard pointed out, thus far according to the CDC’s COVID Data Tracker, over ~1,638 children have died of COVID-19, one third of these during the recent Omicron surge, with thousands having been hospitalized. Yet, during Gov. DeSantis’ roundtable, one of the other doctors, Dr. Joseph Fraiman, claimed, “The question is, if you have a child who is at risk or has co-risk factors for COVID-19, that’s a discussion with your pediatrician, but if you have a healthy child, the chances of that child dying are incredibly low, essentially close to zero if not actually zero.”

One Twitter denizen made a particularly callous analogy and got called out:

Which brings me to the measles.

Whenever I hear the sorts of arguments that I just listed, I like to respond thusly. The doctors who make the sorts of arguments commonly used to say that children shouldn’t be vaccinated against COVID-19 (e.g., that “only” ~1,600 children under 18 have died of COVID-19 during the pandemic and therefore COVID-19 is not “that dangerous” to children) don’t realize that antivaxxers have been making the exactly the same argument about measles and varicella vaccines (among others) for decades. Again, everything old is new again in antivaxland, and these doctors apparently don’t realize that they are parroting a longstanding antivaccine trope, which is why I’m happy to educate them. Indeed, whenever I hear this argument, I like to counter it by observing that the measles used to kill around 500 children per year right before the measles vaccine was introduced (and a lot more a few decades before that, 6,000 per year in 1912) while varicella used to kill around 100 children per year. Of course, neither of these figures counts the many more cases of permanent neurological injury from both diseases. As I like to ask all these physicians arguing that COVID-19 “isn’t very dangerous” to children, if you make that argument for COVID-19, then why don’t you also oppose school vaccine mandates for MMR and varicella? If you make the same argument about COVID-19 vaccines, like it or not, believe it or not, you are parroting very old and more general antivax talking points.

In case you don’t believe me, let’s go back to 2015, when I wrote about a certain talking point that antivaxxers were using very frequently back then. I used to like to call it the Brady Bunch gambit. The gambit is named after an episode of the classic sitcom The Brady Bunch that first aired in 1969 and featured the hijinks that ensued when all of the Brady children caught the measles, a situation that was mostly played for laughs. A variation of the Brady Bunch gambit included examples of old sitcom storylines that played getting the measles for laughs or didn’t treat it as that big a deal, with the measles being represented as a childhood disease that everyone got and recovered from. For example, here’s a video example that I cited last time, the videos of the original Brady Bunch episode having all been taken down over the last seven years:

I also note that that 52 year old Brady Bunch episode also features “natural immunity.” When Mike Brady (the father) catches the measles near the end of the episode, it is revealed that he never had measles as a kid but that his wife Carol had and was therefore immune to it as an adult.

At the time, I wondered why the writers had all the kids unvaccinated against measles, given that the measles vaccine had been licensed six years before the episode aired and that the incidence of measles had dramatically plunged in just that time and speculated that, while it might not have been so implausible that the older kids remained unvaccinated, it strained credulity that they younger ones were. I also couldn’t help but note that The Brady Bunch wasn’t exactly a font of scientific knowledge, citing an infamous three-part “very special episode” of the show in which the family vacationed in Hawaii and Bobby found a tiki statue claimed to cause bad luck. Once the tiki statue was in Bobby’s possession, all sorts of bad things started happening to the family, including a surfing accident and Peter nearly being bitten by a tarantula. In the story, there was a curse that couldn’t be lifted until the tiki was returned to an ancient burial ground. Perhaps that particular story from The Brady Bunch serves as an argument that there actually do exist tiki statues in Hawaii that confer extreme bad luck on the ones who possess them.

The reality was, of course, different from the fuzzy-headed nostalgic thinking of comedy writers in the 1960s, all of whom likely suffered from survivorship bias; i.e., that they had the measles and it wasn’t so bad led them to believe that it wasn’t bad for anyone. In fact—as I like to point out—according to the CDC, before the vaccine, 48,000 people a year were hospitalized for the measles; 4,000 developed measles-associated encephalitis; and 400 to 500 people died. By any stretch of the imagination that was a significant public health problem, and the introduction of the measles vaccine in 1963, followed by the MMR in 1971, made it much less so. As Dr. John Snyder reminded us nearly 13 years ago in his response to Dr. Sears making the same arguments in his vaccine book that touted an “alternative vaccination schedule,” measles is not a benign disease, regardless of what popular culture thought of it 50 or 60 years ago. (More recent data show that a severe complication of measles,subacute sclerosing panencephalitis (SSPE), is more common than we used to think.) Meanwhile, over 13 years ago, Dr. Sears was claiming that “the risk of fatality from measles is “as close to zero as you can get without actually being zero,” or one in many thousands,” in other words, practically a rounding error (as our Twitter troll quoted above put it).

Sound familiar, “Urgency of Normal” and GBD?

I also can’t help but note another similarity in this line of argument about COVID-19 vaccines, which echoes the same line of argument about measles vaccines. Right before the COVID-19 pandemic, the biggest story about antivaxxers spreading disinformation was the story of a massive and deadly measles outbreak in Samoa. One of the major talking points of antivaxxers was that measles is a “mild disease” in “developed countries” and is only deadly in those countries (like Samoa) that are less developed. It is of course true that measles is much more lethal in less developed countries, where poverty, overcrowded conditions, and malnutrition are much more prevalent. (Indeed, it was widely reported last month how concerned public health officials are about a measles outbreak in Afghanistan that had already killed over 150 people.) However, none of that means that measles is a “mild disease” here in the safety of our rich nations. Again, even here in the US, disturbingly large percentages of children suffering from measles require hospitalization, and measles can still kill roughly 1-2 in a thousand due to neurologic or pulmonary complications. As I just mentioned, even for survivors, subacute sclerosing panencephalitis (SSPE) is a horrible and fatal late complication of measles that typically manifests itself 7-10 years after infection. Antivaxxers want you to think that it’s only “those” people (i.e., mostly brown and impoverished) who die from measles, while for our well-off “healthy” (white) children measles is only a minor disease. They’re wrong. Poverty and malnutrition do make measles a lot worse, but it’s still not a minor disease, the contortions of logic and science antivaxxers go through to blame measles deaths in Samoa (and, at the time, Congo) on anything but measles notwithstanding.

Again, does any of this sound familiar, “Urgency of Normal”? Aside from death from COVID-19, what about long COVID? Or multisystem inflammatory syndrome in children (MISC), severe complications of COVID-19 seen in adults and children? I ask again: If you oppose COVID-19 vaccine mandates for children, why do you support such mandates for MMR and varicella vaccines? The arguments that you deploy against COVID-19 vaccines are exactly the same as the arguments long deployed by antivaxxers against these vaccines. Or maybe you didn’t realize that.

Children shouldn’t die

Perhaps a more “nuanced,” if you will, description of the argument against vaccinating children for COVID-19 goes more like, “Children account for ‘only’ less than 0.2% of COVID-19 deaths.” Is that really such a strong argument? No, it is not, as has been pointed out:

Also from our very own Dr. Howard:

Exactly. While it was true that before vaccines and modern healthcare, children died in huge numbers due to vaccine-preventable diseases, including measles, to the point that many children never made it to adulthood and old cemeteries are full of headstones showing deaths at a very young age, today children die at such a small frequency that even small numbers of children dying are considered horrific. Imagine, if you will, someone making the argument in the 1950s that because only a few thousand children per year die of cancer that it wouldn’t be worth it to invest all that money in research that ultimately led to childhood cancer being 85% survivable (all comers) today.

Eugenicist thinking about the pandemic: It’s not just for activists

There’s a final point that needs to be mentioned. Supporters of the GBD and Urgency of Normal howl with wounded self-righteous outrage when I bring this up, but it needs to be said. The arguments being made in favor of these very similar initiatives reek of eugenics. Remember that the key idea behind both is to “let the virus rip” through the “healthy population,” be they younger adults without comorbidities that make them vulnerable to severe disease from COVID-19 (the GBD) or the vast majority of children without comorbidities (“Urgency of Normal”). In fairness, the GBD was making this argument before there was a vaccine while “Urgency of Normal” made this argument over a year after there was a vaccine and months after it had been approved for children. Even so, the idea is the same: Unless you are “vulnerable,” you don’t need to worry about dying from the virus, making all mandates for mitigations unnecessary and even more harmful than doing nothing. Even so, I like to quote this article from when the GBD was first published:

“We’ll get herd immunity, but let’s do that with a vaccine, not by sacrificing people,” said Halkitis. “It’s not 1918, for God’s sake.” In the meantime, both Halkitis and Gonsalves agreed that it would be dangerously unwise to follow the Great Barrington Declaration’s advice. “The idea that you can keep outbreaks among the young away from the elderly is ridiculous,” says Gonsalves. “They can spin it however they like, but they don’t really have a plan—it’s grotesque, and it borders on eugenics.”

As I said at the time, it didn’t “border” on eugenics. It still doesn’t “border” on eugenics. It is eugenicist thinking.

What still never ceases to amaze me is how, now that there are safe and effective vaccines against COVID-19, GBD advocates and “Urgency of Normal” don’t actively advocate that everyone get vaccinated. After all, what better means of “focused protection” of the “vulnerable” is there than vaccination? Even if the vaccines are unfortunately imperfect in preventing infection and forward transmission (although that does not mean, as antivaxxers like to say, that they don’t prevent infection and transmission at all), they nonetheless remain very effective at preventing serious disease. Instead, both groups seem to emphasize “natural immunity” over all else, including vaccine-induced immunity, even though the ability of new variants to evade immunity due to prior infection in addition to immunity from prior vaccination, rather demonstrates that postinfection immunity does not appear to be long-lasting or superior to vaccine-induced immunity. That means that any true “focused protection” effort against COVID-19 requires vaccines.

Unfortunately, it’s not just Urgency of Normal or the GBD espousing eugenicist thinking. As Laura Appleman has argued, the COVID-19 pandemic has exposed just how prevalent eugenicist thinking is in our society and in medicine:

Far from being a shameful moment of our past, eugenic philosophy is alive and well in the twenty-first century. Nowhere has this been more apparent than in our response to the current public health crisis. The COVID-19 pandemic has exposed the viral nature of eugenic philosophy, which has continued to guide U.S. treatment of the captive and vulnerable for over 100 years. The long tail of eugenics informs our choices over those we institutionalize, detain, and sequester in long-term care and group homes.

And:

The hidden history of eugenics continues to affect the world today. Our nationwide response to COVID-19 illustrates how public health policies and medical practice are still guided by a belief system disadvantaging the captive and vulnerable. Premised on a subconscious blueprint of eugenic thinking, our COVID-19 response has highlighted an underclass of the “unfit” and “undervalued,” whose lives are literally treated as less valuable.

And:

Accordingly, it should be no surprise that our response to COVID-19 uses the familiar blueprint of eugenics, with predictable consequences for the captive and vulnerable, who are pushed to the side, ignored, or sacrificed for the “greater good.”

I quote Appleman because she discusses a number of examples of eugenicist thinking with respect to the pandemic, which shows how, unfortunately, the GBD and “Urgency of Normal” are far from aberrations. Unfortunately, they are all too much consistent with a lot of the response to the pandemic. Moreover, the GBD at least was never a legitimate strategy for “focused protection” of the vulnerable. As Gideon Meyerowitz-Katz points out, GBD’s “focused protection” never really made sense, as it advocated very little different from what was already being done and included proposals that were wildly impractical, such as relocating large portions of the population to individual housing and providing older workers with a 3-6 month sabbatical, noting that these ideas “ignored the reality that the pandemic was never going to be over in such a short time, and has proven to be a worthless argument given that we’re nearly 2 years on from the GBD publication and these older people are still at risk.” He refers to the GBD as a “branding exercise,” and I would say that the same description applies to “Urgency of Normal.” Meyerowitz-Katz is, of course, too polite to refer to “focused protection” for what it was, a sham based on eugenics, but I will.

If you don’t believe how impractical “focused protection” always was, listen to a Councillor in Local Government in the UK named Adrian Cooke, who noted just how utterly impractical the GBD was:

Accordingly, “Focused protection” (which, reading through, consisted of 17 initiatives that were already routine, one that could be useful (free N95 masks), and one that was barking mad (split “vulnerable” people away from families and house them in hotel rooms for however-many-months-or-years)) would need to somehow isolate around 50% of the country (the JCVI Categories 1-9 (available here: https://www.gov.uk/government/publications/priority-groups-for-coronavir… as priorities for vaccination) would make this very clear to everyone, published in early January 2021). Of the 50% left, more than half would be children.

We would need to run the country (of 67 million people) with about 15 million adults. Including the health system, which would still certainly collapse with the number of people (of the “less vulnerable”) who would need treatment, unless spread out (somehow, without NPIs) over 2 years or more.

Notwithstanding that protection was voluntary, and even a small fraction of the more vulnerable would further swamp the system.

Moreover, despite the shift in the politics of the antivaccine, antimask, and “anti-lockdown” movement to the far right, the ideas behind the GBD and “Urgency of Normal” are all too appealing both ends of the political spectrum and everywhere in between, as evidenced by how fast the “Urgency of Normal” toolkit found its way into political discussions in even the most “progressive” and “liberal” of school districts to argue for ending mask mandates. Indeed, back when the antivaccine movement was viewed as more a phenomenon of the hippy-dippy crunchy left, the same sorts of arguments against measles vaccination were made, that “only” those who weren’t healthy were at risk and “healthy children” didn’t die of the measles, at least not in developed countries.

Again, no one is arguing that early in the pandemic the choices weren’t very difficult and that the probability of a given person surviving COVID-19 wasn’t part of the equation. Nonetheless, from my perspective, GBD and Urgency of Normal both devalue the lives of those who are less than perfect, less than healthy, by in essence telling everyone who is healthy that they don’t have to worry and shouldn’t be expected to sacrifice anything to protect who are less than healthy and at high risk. It even devalues the lives of healthy children, viewing the few of them who do die of the coronavirus have been described as a “rounding error.” (Do I need to emphasize yet again that children should not die if it can be relatively easily prevented?) The sooner we recognize how deeply this sort of thinking is still embedded in medicine and society, the sooner we can work to expunge it.

In the meantime, I will keep asking these doctors who so indignantly claim that they “aren’t antivax” as they use exactly the same argument that antivaxxers have long deployed against the MMR vaccine alongside the debunked claim that MMR causes autism, namely that measles is not dangerous to “healthy” children and therefore MMR is unnecessary: Why do you oppose vaccinating children for COVID-19 but not measles, given that COVID-19 is clearly more deadly to children than measles? I fear that I will wait long for a coherent answer.