To Vaccinate or Not
About fifteen years ago, back when I was a full-time President and CEO of the Washington Health Foundation, I got a telephone call from a participant in our then annual Governor’s Bowl Health. The Bowl was a 6 week statewide health competition within our innovative Healthiest State in the Nation Campaign. It engaged thousands of Washingtonians to improve their health through both personal responsibility and group action (washhealthfoundation.org).
The caller began with compliments about our organization and the Health Bowl. She was appreciative of our support to people and organizations looking to improve their health, and events like the Governor’s Bowl.
The conversation soon turned to our position on childhood immunizations. Our position was public support and encouragement that parents immunize their children per state health department guidelines. We even provided bonus points in the Bowl to those who had gotten these vaccinations.
She asked about an editorial of mine published in a Seattle newspaper about the issue. I shared with her our extensive review of vaccines and why we reached our conclusion that childhood immunizations were on a short list of priority health behaviors that would pave the way toward Washington becoming the Healthiest State in the Nation.
This was when the phone call went off the rails. She challenged our position, asserting that vaccines led to autism. She cited Jenny McCarthy and a discredited research study. I offered to share the extensive research base we had relied on in our conclusion that they were safe and effective.
It was then that I encountered her intensity on this issue- and an early personal taste of what are now more common personal attacks on those expressing conventional views on health issues. She began to scream at me. I was wrong, she said, and should be ashamed of myself. As I tried to calmly discuss the issue with her, she yelled that “I was going to hell” and hung up.
That there were those who disagreed with childhood immunizations was no surprise to me; I had encountered this many times before. Nor was I naïveté about the emotions around this or many other health issues- this just came with our territory. But her raw hate was a bit of a shock to me. It seemed even odder since I was not even a government official with some power over people’s behavior- our position was to encourage people to voluntarily make the decision to vaccinate their children, based on data and science.
Angry arguments about health behaviors is now part of our daily life in Covid America, with tools for expressing this rancor readily available in our public discourse. Social media allows folks to state their views without much filter, and many times somewhat anonymously. More traditional media has grown pockets that gather like minded people to their world view, whatever it is, freeing up extreme, undocumented and aggressive views.
This is a growing problem as vaccines come on line that might protect us from the virus, individually and collectively. In a society where a culture war has broken out over the low personal imposition of wearing masks, a vaccination holds far greater potential to sow the seeds of discord. Masks are not only easy to do but hold no real individual risks except in bizarre exceptions, certainly in contrast to vaccines which inherently have a level of real health risk attached.
I am encouraged by what we are seeing in the early studies on the COVID vaccines. They have impressive early results in terms of efficacy, and seem safe enough to give a try. But only the actual rollout will prove their true merit and safety. Their availability is most welcome good news, after almost a year of watching the virus rage across the Nation.
So what do we do as we move from the existence of vaccines to vaccination, and need a healthy chunk of the population to do so in order to truly turn the tide? For one, we need to move forward. Sure, the virus will someday run its course, as a different malady did with the Pandemic of 1918. But just waiting for it to naturally subside will take some time. Remember that the 1918 epidemic ultimately took between 50 and 100 million lives worldwide, and over half a million Americans.
We will have to get creative in getting people to vaccinate though. I don’t see the political will to mandate these vaccinations, though it is worth noting that there is United States Supreme Court legal precedent upholding such an approach with respect to smallpox vaccinations. Maybe we should use a combination of incentives and trusted messengers to get enough people to do what needs to be done without mandates? I think we will see these efforts.
Or maybe we need more creative strategies. I recall a year there was a shortage of adult flu vaccines. This was another health action that our Foundation encouraged. Even more people objected to these vaccinations than for children, or chose to forego them for other reasons. We similarly tried to encourage this as a personal health behavior of choice each year.
That one year, the public message quickly shifted to one of “you can’t get a flu shot”- there just weren’t enough doses available and these were targeted for very high risk populations. The reaction was a bit weird, but maybe predictable- demand for the flu shot blew up, and some voiced their outrage that not everybody could get one. Flu shots were available in Canada, and many flooded north to get what was suddenly a critically desired vaccine.
Perhaps our COVID vaccine message should lead with the proposition that “you can’t get it”, or maybe that you have to be on a special list to be eligible for it. Experience suggests that maybe this will flip public sentiment toward an “I have to have it and now” attitude.
Do I think this will happen? No. But I do think it suggests our need to question our emotional reactions and resistance to interventions like vaccines, and ultimately the trade off of liberty and social obligation in our society. We must if we are to meet the challenge before us this coming year to vaccinate.
For now, sign me up. Others will have to reach their own conclusions. Just remember that it is not just about you.