As the supply of covid vaccines continues to increase, and record numbers of people receive their dose every week, the next challenge in rolling back this pandemic comes more clearly into view: persuading those reluctant about getting a vaccine to get one. One group in particular looms large in whether or not we will be able to reach heard immunity through vaccination. Some 43% of Republican voters say they don't plan to be immunized, presenting a conundrum that blends politics and public health in toxic ways with which we became familiar during the Trump administration’s year of coronavirus failure.
Reading this Washington Post account of a recent focus group on GOP voter attitudes towards vaccination, at least one thing is clear: the effort of persuading such reluctant citizens is going to take near-God levels of patience and careful strategizing. Particularly worrisome to me is an apparent hardening of attitudes against vaccination: the more time goes on, the more people are reluctant to change their positions. This development goes against my own intuition, which had been that as more and more Americans get vaccinated without harm and with all the benefits of immunity, hold-outs would want to jump on the bandwagon.
The focus group that the article discusses found various sources of reluctance. There is a basic distrust of medical experts who tell them the vaccines are safe; skepticism about needing follow-on booster shots to maintain immunity; powerful reactions to perceived negative media messages about vaccination resistance (“A lot of the hesitancy that’s coming from the right is just from being bullied, being humiliated, basically, by the media,” said one participant); and long-term damage from President Trump’s efforts to downplay the virus and attack public health officials, as evidenced in participants’ particular distrust of Dr. Anthony Fauci.
But one finding in particular points to a unifying theme of the resistance. According to the Post, “Most participants said they would want a fake vaccination card that would allow them to claim they had received shots.” The willingness not only to cheat and break the law, but in a way that would propagate the coronavirus by making themselves and others sick by false claims of immunity, speaks in the first place to a basic inability or unwillingness to grasp the reality of the coronavirus. Even if you yourself don’t get sick, or don’t care about getting sick, you can still serve as a carrier to pass it on to someone who does. You get a vaccine not just to protect yourself, but to protect others, including people you will never meet. And so this attitude — that the most important thing is what each person can get away with, no matter the consequences — feels not just like individualism gone awry, but a pathological indifference to others: a fundamental rejection of the social contract, of the idea that we owe anything to each other. Again, these are people who belong to a party that purports to stand for law and order saying that they would be willing to break the law rather than act as responsible citizens and get their vaccinations.
Of course, this sounds exactly like the sort of criticism that pushes people with such a mindset even further away from ever getting vaccinated — which is part of the point I’m trying to make here. It’s hard to disagree with the conclusion reached by one expert in the article that the vaccination should not be treated as a “political debate”; it’s clearly going to take the wisdom and experience of health professionals who have dealt with such reluctance in other public health challenges to figure out how to get people to change their minds (one approach noted in the article is to rely more on people’s personal, more trusted doctors to get the message out). But for the good of our society’s long-term survival, we will at some point need to more openly confront the indifference to the common good and rebellion against scientific fact that are making the possibility of reaching herd immunity through vaccination such a close-run thing.