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Don’t Shame Vaccine-Hesitant Republicans

Don’t Shame Vaccine-Hesitant Republicans

Sunday, 25 April, 2021 - 04:30

As if we didn’t experience enough Covid shaming in 2020, pundits are now advocating the shaming of vaccine-hesitant people — especially the roughly 40% of Republicans who say they’re in no rush to get the jab.

Political outrage has clouded scientific reasoning here.

The data show some Republicans are indeed turning down the shots — though the extent of the hesitancy is hard to measure. Many of them aren’t so much vaccine-skeptical as just vaccine-indifferent. Not everyone is going to spend hours refreshing their screens hoping to nab the first available appointment, or drive an hour or more to a mass vaccination center. Some would rather wait for demand to die down and go to their local pharmacy.

And the reason everyone should get shot soon hasn’t been made all that obvious. It’s partly a personal health decision but it’s also a civic duty.

Mixed messages about whether vaccines will get us to herd immunity may have some wondering why they should bother getting vaccinated. The same goes for telling vaccinated people to keep masking, distancing and avoiding restaurants. There are good reasons to get a vaccine, but the amount of uncertainty experts are expressing may be unwarranted at this point — and discouraging some from seeking out the shot.

The reason vaccination is part civic duty is that mass vaccination campaigns help protect everyone, including those whose bodies don’t produce a good immunity response to vaccines. With flu shots, for example, elderly people — who are most at risk of dying from flu — also get the poorest protection from the vaccine. If younger people get vaccinated, then there’s less flu in circulation and better odds their elders will stay healthy.

With Covid, experts last December thought the situation would be similar. Now we have more data on the Covid vaccines, and experts are saying they seem to work extremely well in young and old alike. The breakthrough infection rate is very low, though it’s not perfect. This week, there was one reported death of a vaccinated nursing home resident in Kentucky after an unvaccinated health care worker sparked an outbreak there.

There’s still concern that some immune-compromised people might get severely ill despite being vaccinated. That’s not only bad news for them: New mutations of the virus are more likely to occur in immune-compromised patients because their bodies may allow the virus to make a lot more copies of itself. Those variants can then spread to others.

It’s confusing because advocates for shaming are saying the vaccine-hesitant are free riders, gaining protection from other people’s immunity. At the same time, experts have claimed that vaccines are 100% effective at preventing hospitalization and death — in which case there would be no reason to think getting vaccinated is needed to protect others. But others have argued that the 100% number is an extrapolation from limited clinical trial data, and isn’t holding up in the wider population, so refusing to get your shot could still put others in danger, as happened in that Kentucky nursing home.

The vaccine is also a smart personal health decision, although the public health community could do a much better job of clarifying what we know and what we don’t.

Forget the rare blood clots. As some informal surveys have reported, vaccine-hesitant Republicans aren’t particularly concerned about the clots that led to the “pause” of the Johnson and Johnson vaccine. They knew the problem was extremely rare. Some were concerned, however, at the temporary loss of the only one-shot option. And others are worried about not-yet-catalogued side effects that might emerge months or years later.

One expert who has addressed such concerns clearly and thoughtfully is immunologist Florian Krammer from the Icahn School of Medicine at Mt Sinai. He explained to me that there’s nothing the vaccine does to your body that the virus can’t do in a more extreme way. The vaccine introduces a very small amount of nucleic acid — the RNA — into your cells, while the virus will hijack your cells to spread vast numbers of copies of its own genetic material through your body. In contrast, the RNA from the vaccine is unable to make copies of itself and dissipates quickly.

The virus can create much more viral protein than the vaccines, and the virus will induce a much greater variety of antibodies, vastly increasing the odds that some of these will cause collateral damage. Anyone worried about unknown long-term effects would be better off avoiding the virus — and the best way to do that is to get vaccinated.

This kind of explanation could help many people — not only Republicans — feel motivated to get the vaccine and to confident about that choice. No shaming needed.


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