“I wish we had somehow seen that coming”

Okay, I apologize for the clickbait headline. But it’s true. Vaccines don’t save lives, vaccination does. A vaccine rotting in a freezer doesn’t help anyone, and sadly, millions of vaccine doses have done just that. The consequences have been horrific. A recent analysis estimated that over 300,000 lives could have been saved had every eligible adult been vaccinated in the USA. Misinformation is one of the leading causes of death and suffering in America today.

The researchers behind this analysis diagnosed the problem astutely.

“The vaccine rollout has been both a remarkable success and a remarkable failure,” says Stefanie Friedhoff, a professor at the Brown School of Public Health, and one of the analysis’s authors. It was a success, she says, in the sense that “the United States was first in getting those vaccines developed and making doses available at high numbers quickly to the public.”

A lot of money and energy was invested in the logistics of the rollout – the supply side of the equation. Much less was invested in encouraging vaccine demand, she says.

“We did not start early on with information campaigns about why vaccines are important – what do they do for us?” she says. “We underestimated dramatically the investment it would take to get people familiarized with vaccines because, by and large, we haven’t had a deadly disease like this, so people have become estranged from the important impact of vaccination.”

She’s right. Our public health leaders also recognized the problem of misinformation, including from doctors, though only after it was much too late. According to one news article:

Outgoing NIH Director Dr. Francis Collins reflects about what could have been done differently in the nation’s battle against COVID-19. He tells Ali Velshi that vaccine hesitancy was drastically underestimated in the rush to get a viable vaccine approved. 66 million Americans remain unvaccinated, leading to more daily deaths, says Collins. “I wish we had somehow seen that coming and come up with some kind of a myth-buster approach.”

Not everyone was so naïve

So, who could possible have predicted this?

Well, not everyone was so naïve. Some people saw “that coming”. Evidence for this comes from the start of the pandemic when a doctor asked on Twitter, “So, are there still anti-vaxxers out there?” Our own Dr. David Gorski replied, “Yes. A lot of them. They’re forming an unholy alliance with #COVID19 deniers.” Dr. Gorski also linked to an article he had written titled, “COVID-19 Pandemic Deniers and the Antivaccine Movement: An Unholy Alliance.” In this article, Dr. Gorski said:

I fear that this alliance between COVID-19 cranks with the antivaccine movement, with its cross-fertilization of rhetoric and tactics, particularly when fueled by funding and support from various political groups pushing to “reopen America”, has the potential to make the pandemic so much worse than it had to be.

Though this is exactly what happened, I suspect that if Dr. Gorski were to be asked about this article now, he would likely say he underestimated the problem. He even expressed a faint glimmer of hope that the pandemic might marginalize the anti-vaccine movement. Instead, anti-vaccine beliefs are now baked into large swaths of American society, and the consequences of this are bound to extend beyond COVID.

Of course, pretty much everyone underestimated how much damage misinformation would cause this pandemic. Even those of us who correctly predicted a “deluge of misinformation about the Covid vaccines” were caught off guard, both by the scope of the misinformation and especially its source. It wasn’t just the usual quacks and cranks who claimed that COVID was overblown and that vaccination, especially for children, was either unnecessary or harmful. This message was relentlessly pushed by influential doctors at Harvard, UCSF, Johns Hopkins, and Stanford, none of who actually treated a sick child this pandemic.

I urge you to read Dr. Gorski’s article and compare it to those written by contrarian doctors at that time. Their early articles claimed the virus was much less deadly than feared and speculated that it might kill 10,000 Americans. They lamented that, “School closures may also diminish the chances of developing herd immunity in an age group that is spared serious disease”. That’s right, they felt that uninfected children were a problem, and even though the virus has since killed 1,500 children and hospitalized many thousands more, they haven’t deviated from this message.

Imagine that.

Sadly, these doctors greatly influenced our pandemic response. The Trump administration echoed their “plan” to reach herd immunity through mass infection, and Florida adopted anti-vaccine policies based on their misinformation. At the individual level, millions of people refused vaccination because they were falsely pacified about the dangers of the virus. According to one leader of a public health outreach organization in West Virginia, her pleas for vaccination “were overpowered by national voices denying the seriousness of COVID-19 or saying that herd immunity was imminent”.

Readers of SBM will be very familiar with national voices who denied the seriousness of COVID-19 and said that herd immunity was imminent. Bold declarations that “For people younger than 45, the infection fatality rate is almost 0%” and that “We’ll have herd immunity by April” had real-world consequences it turns out, though of course the doctors who made these erroneous pronouncements were sheltered from them. I urge you to read some stories of people, including many young people, who regret not getting vaccinated because they didn’t think COVID would be a big deal for someone like them. For example, according to one news report,

Tamra Demello had been begging her son Tyler Gilreath to get the COVID-19 vaccine for months. And for months, the 20-year-old resisted getting the shot, telling his mother he was young, healthy and didn’t have any pre-existing conditions, and therefore he didn’t need the vaccine’s protection.

As you can imagine, Tyler died from COVID as have thousands of other youngsters who thought they were invulnerable to the virus.

Unfortunately, it seems that many people prefer to listen to doctors who tell them what they want to hear, and some doctors are perfectly content to make wildly optimistic predictions for access and exposure. They know there will be coveted TV interviews and open doors to politicians’ offices as long as they keep saying only elderly people have any risk, herd immunity has arrived, and we don’t need to worry about variants. They’ve said exactly this for at least the past year.

In contrast, Dr. Gorski’s prescient warning went largely unheeded, a recurring theme this pandemic.

“The key is not to change the mind of current anti-vaxxers, but to educate the next generation”

Though no one anticipated the problem of misinformation would be this bad, some of us have been sounding the alarm bell about medical quackery for years. We knew that even seemingly harmless practices like cupping can’t be disentangled from more pernicious medical misinformation, nor can they be separated from broader disinformation movements. There are no vaccine advocates amongst QAnon adherents.

I also responded to the doctor who asked if “there still anti-vaxxers out there” by saying,

A virus reeking havoc on the world won’t affect any dedicated anti-vaxxer. Think about it this way- there’s no combination of words you can say to convince me chocolate tastes bad. The key is not to change the mind of current anti-vaxxers, but to educate the next generation.

I stand by this. Though we can’t reach the most fervent anti-vaxxers, we can reach many people and hopefully limit the next generation of anti-vaxxers. One of the chief lessons of the pandemic is that fostering basic critical thinking skills and countering medical misinformation is not a waste of time. It fact, it’s a vital undertaking.

After all, vaccines don’t save lives, vaccination does.

Some of us knew this already, and many thousands of Americans might be alive today if more people had understood this fact.

Author

  • Dr. Jonathan Howard is a neurologist and psychiatrist based in New York City who has been interested in vaccines since long before COVID-19.

Posted by Jonathan Howard

Dr. Jonathan Howard is a neurologist and psychiatrist based in New York City who has been interested in vaccines since long before COVID-19.