Antivaxxers are people who deny the need for or the efficacy of vaccines and their role in controlling some of the most dreadful diseases in the history of humanity. Not only this, but antivaxxers also claim that vaccines have huge side effects that actually harm more people than they benefit, and they have been particularly vocal about the COVID-19 vaccines. All this is, of course, not true. The COVID-19 vaccines have saved millions of lives by decreasing the proportion of hospitalizations and deaths among the vaccinated to a much greater extent compared to the unvaccinated. Antivaxxers have also spread misinformation and lies about the COVID-19 vaccines that have been repeatedly debunked over and over and over. Nevertheless, they ignore this while expressing outrage at pro-vaccine people, at best calling them “sheep” (sheeple), or at worst claiming that they are being manipulated by or are part of an immoral and unethical alliance of the government, pharmaceutical companies, and other organizations bent on profit and societal control.
So what should be my approach to dealing with antivaxxers? I see two alternatives: the inflammatory approach and the conciliatory approach.
Considering the high effectiveness of the COVID vaccines at decreasing the hospitalizations and deaths from COVID-19, considering that antivaxxers have been waging an aggressive campaign of spreading misinformation about the COVID-19 vaccines on social media, and considering that online misinformation is linked to COVID vaccination hesitancy and refusal, it is not surprising that many people were harmed or killed by the misinformation spread by antivaxxers. During the peak of the Delta variant the daily consequences of spreading misinformation have been estimated at 300 deaths, 1,200 hospitalizations, and 20,000 COVID-19 cases with a cost of 50 to 300 million dollars. I am appalled and outraged at how many lives antivaxxers have damaged.
So my question is: should antivaxxers pay for their crimes?
This is not a far-fetched concept. Alex Jones, the talking head from Infowars, spread misinformation and disinformation about the shooting at Sandy Hook Elementary School where 20 children and 6 adults were killed. He said that the shooting was a false flag operation carried out by anti-gun groups, that no one died, and that the children were actors. As a result of this, the families of the murdered children experienced years of harassment by the followers of Alex Jones. Thankfully, he was brought to court and tried and found guilty, and now he has to pay the Sandy Hook families millions of dollars. Alex Jones tried several defenses including his right to free speech, but the judges didn’t buy it. He spread falsehoods and this hurt people. That was the bottom line. So, if anything, the case against antivaxxers should be even more clear cut, because many people who followed their ideas were harmed or died.
Although in the case of Alex Jones the Sandy Hook families sued him for slander, a person or the family of a person harmed by antivaxxers could sue them for fraud. They would have to prove that the antivaxxer spread the misinformation while knowing that it was false. They would have to prove that the person who was harmed relied on the antivaxxer in their decision to forgo vaccination. And they would have to prove that there was economic loss (hospital bills, lost wages, funeral expenses, etc.). There are, of course, additional subtleties that have to be taken into account depending on the specific antivaxxer entity or person being sued, but this is a possible approach.
Following this rationale, I think that at the very least, any antivaxxer that fulfils the conditions outlined above should be sued for the medical and funeral expenses incurred by the people (or their relatives) who followed their advice in good faith and were harmed or died.
The above is the inflammatory approach. It’s the sort of thing you say/write to scandalize and infuriate people and increase their engagement, drive traffic to your blog, website, or podcast, and grow your brand. This approach makes tempers flare and generates a lot of heat and ill will as invectives fly back and forth and hatred is spewed everywhere.
But there is another way to do this. It’s probably not as successful for getting engagement, but it may be more useful to society, civil discourse, and the psychological well-being of the public.
Every time two groups of people have strong disagreements on some things, the recommended course of action is to find areas of agreement. Antivaxxers are concerned about the side effects of COVID-19 vaccines. The evidence we have indicates that the frequency of serious side effects as a result of these vaccines is very low, which makes the vaccines much safer than having the disease. However, even if rare, when hundreds of millions are vaccinated, the number of net cases start to accumulate. And some of these cases are severe enough that exceptionally susceptible people may end up impaired and saddled with huge debts due to their medical bills. Shouldn’t these people be compensated?
I would venture that most people, whether pro or anti-vaccine, would agree with this. Unfortunately, this is not what is happening. There is a federal program known as the Vaccine Injury Compensation Program (VICP) that is available to people who have been injured by the routine vaccines that are administered in the United States. This program in its lifetime has awarded $4.7 billion in compensation for vaccine injuries to cover 36% of the claims it has received. But this program does not cover the COVID-19 vaccines. Compensation for harm from the COVID-19 vaccines is handled by a program called the Countermeasures Injury Compensation Program (CICP). The CICP program was designed to handle compensation for people injured by treatment for rare events such as an Anthrax attack, but this program is now handling compensation claims for a treatment dispensed to hundreds of millions of Americans. The CICP program is underfunded, understaffed, and overwhelmed with claims, which it is resolving at a glacial pace, and so far congress has not done anything about this.
So here is the chance for antivaxxers to make a difference and actually achieve something positive. If they stop their attacks on vaccines and pro-vaccine people and focus on lobbying congress to, for example, expand and fund the CICP program or move the COVID-19 claimants to the VICP program, that would be a major achievement that would help people affected by the side effects of vaccines. At the same time many pro-vaccine individuals and organizations that advocate for the rights of patients could join ranks with them to work together towards a common goal and actually benefit people.
The alternative, of course, is to keep engaging in the usual cycle of claims, counterclaims, insults, counterinsults, and endless vitriol, which may help increase engagement but which does not accomplish anything meaningful to benefit society.
So my question to antivaxxers is, what is it going to be: inflammatory or conciliatory?
Image from pixabay by Gerd Altmann is free for commercial use and was modified from the original.
I came across an interview that journalist Bill Moyers did with Christian climate scientist Katherine Hayhoe back in 2014. The topic of their conversation is about the particular situation of Evangelical Christians in the United States as it relates to denial of climate change, but I believe the interview is remarkable because of the broader applicability of Dr. Hayhoe’s ideas as to why denial of many issues has been embraced by various communities and what can be done about it.
You can watch the interview in the video above, but I will provide a recap of the major points of the interview.
Dr. Hayhoe’s argument is that climate change is a hot button issue for many people because they feel it threatens all that they hold dear. However, what people reject about climate change is not so much the science but the solutions. Climate change is something that affects the community, and as such, efforts to deal with climate change require large numbers of people to work together, which means that the government has to be involved. But opposition to government is deeply rooted in the American psyche, and any legislation to limit what people can do or use is viewed with mistrust. Thus, climate change has become a casualty of much larger societal issues. This has been compounded by the fact that people have been lied to by those in whom they deposited their trust.
On the one hand, the leaders who many of these people trust because they share their values, have told them that climate change is a hoax, or that it’s real but it’s not a big deal and nothing has to be done about it. Or in the absence of clear leaders, political and media personalities who don’t like the solutions to climate change have stepped in. And because these individuals say the same things that people believe with regards to many other issues, the people put their trust in them. On the other hand, the spokespeople for the opposite point of view have often been scientists who do not share the values of the communities they are addressing. People will not believe messengers whom they do not trust because they perceive them as not sharing their values.
The remedy to this situation will not come from more information and more science, but rather from dealing with who we are as humans and how we function politically. Dr. Hayhoe says that, although caring about the climate is consistent with who people are as Christians, we have increasingly confounded our politics with out faith. Instead of allowing faith to determine our attitudes to political and social issues, we are allowing our political party to dictate our attitude towards issues that are clearly consistent with who we are.
Finally, Dr. Hayhoe says that everyone has a list of things they care about such as the health of their kids, job security, the cost of living, faith etc., and climate change should not be viewed as one more thing to put on the list that competes with the others because climate change is already affecting the top things on everyone’s list. Climate change is affecting the things most people care about, love, and hold dear.
There are other aspects to the interview, but the ones I’ve mentioned above are those that I think are more generalizable to other situations where misinformation and social dynamics are getting in the way of people accepting and acting on a reality. One possible such situation is COVID-19 vaccine denial.
Despite overwhelming evidence that the COVID-19 vaccines are safe, effective, and necessary, there is a certain proportion of the population of the United States that refuses to accept the vaccine. In parallels with climate change deniers, the sector of the population opposed to vaccination tends to be conservative and distrusting of government. In another parallel to climate change denial, this group of people tends to listen to media that reinforce their fears feeding them misinformation about vaccines. At the same time, this group of people is distrusting of what scientists say about vaccines, and especially of those scientists associated with the government.
Like the evangelicals who have allowed their politics to replace their faith in guiding them with regards to climate change, the vaccine deniers have allowed their politics to replace their common sense and instinct of self-preservation when it comes to vaccines. And like climate change deniers, vaccine deniers have a list of things they hold dear and care about, and COVID-19 has probably affected every single item on the top of their lists, from the health of people they admire, acquaintances, friends, and family, to the impact on the economy.
Dr. Hayhoe advocates finding trusted messengers within the evangelical community (people who are like them, such as she is) to spread the message that we need to act on climate change. This is indeed a strategy that is currently being pursued in the case of vaccine denial. The government is trying to recruit media personalities and local respected leaders to talk in favor of vaccination. But I think we can go about finding these trusted messengers in an additional way which relies on another parallel between COVID-19 and climate change.
Much like climate change, COVID-19 affects everyone, and there is a growing list of vaccines deniers, who have been seriously ill or died due to the virus. The people who listened to these vaccine deniers have now been knocked back to their senses in the most brutal of ways. And I think that their stories should be used to snap vaccine deniers from the stranglehold that their politics have on their common sense and instinct of self-preservation. And unlike climate change, there is no ambiguity as to the cause of the harm. If someone loses their property, a friend, or a loved one to rising sea levels or a fire or a hurricane, they can always be told that there is no direct proof that climate change caused it. But if someone dies due to COVID-19, that reality cannot be denied.
So, find out who are those vaccine deniers that were harmed by COVID-19 and seek out their audiences, their acquaintances, their friends, and their families, and ask them to tell their story to those in their communities and to champion vaccination. Every serious vaccine-preventable COVID-19 illness or death among the community of vaccine deniers is a tragedy. But the silver lining is that these illnesses and deaths will generate a group of people willing to open their minds to vaccination and promote it. I think these people have an important role to play in stopping vaccine denial.
Image from pixabay by Gerd Altmann is free for commercial use and was modified from the original.
Those opposed to vaccines (antivaxxers) are fond of quoting government figures to argue that there have been many adverse events due to COVID vaccines. They then proceed to state that because the government figures underreport these adverse events this means that the problem is much, much, worse. They also argue that there is a conspiracy to keep this information from the American public, and they demand that COVID vaccination should stop.
What are antivaxxers talking about? What are these government figures? Are they quoting them correctly? What do the numbers mean?
By the time vaccines are allowed to be used on the US population, they have gone through multiple clinical trials and other evaluations that have certified they are safe. But this vaccine safety is based on data gathered from at most a few tens of thousands of people. Therefore, it is understood that when vaccines are applied to a population of tens or hundreds of millions there may be some low frequency adverse events that may have not been detected in the clinical trials with a smaller group of people. To account for this, the government in 1990 created a federal database called VAERS (Vaccine Adverse Event Reporting System) that is meant to act as an early warning system to detect possible safety problems with vaccines.
However, VAERS is a passive reporting system. This means that anyone can file a VAERS report regardless of its nature, and that report is entered into the database and cannot be removed without the permission of the person who reported it. Although knowingly filing a false VAERS report is a violation of Federal law, if you are convinced that the adverse event you are describing, no matter how outlandish, is tied to a vaccine, it will be incorporated into the database.
For example, Dr. James Laidter mentioned in the neurodiversity weblog that back in 2005 he entered a VAERS report claiming that an influenza vaccine had turned him into the incredible Hulk, and the claim was accepted into the database. However, due to its unusual nature, a VAERS representative did contact him, and after an amicable discussion about the limitations of VAERS, the representative requested his permission to remove the claim to which he agreed. If he had not agreed to that, the claim would have remained in the database. Another example, Kevin Leitch writing for the Left Brain Right Brain science blog mentions that he submitted a VAERS report claiming that a vaccine had turned his baby girl into Wonder Woman, and he is not even a US resident!
However, even when considering reasonable adverse events, it must be understood that VAERS reports do not stablish that there is a link between the adverse events reported and vaccination. Each day thousands of people develop a health problem and/or die in the United States in a manner unrelated to vaccines. If any of these people received a vaccine around the time they developed the health problem or died, they could be reported to VAERS thus constituting a false positive.
The experts understand that the VAERS database has a high number of these false positives, and they use the database as a very preliminary step to perform more research, gather more data, and establish for sure whether a given event being reported is a real adverse event due to vaccines or not. These experts know that quoting numbers directly from the VAERS system is meaningless insofar as learning anything about the safety of vaccines is concerned. But this is exactly what antivaxxers do! And while some antivaxxers may be ignorant about the nature of VAERS, many of the leading antivaxxer influencers know the shortcomings of VAERS and nevertheless choose to continue reporting or quoting the raw numbers to advance their platforms and promote their agendas.
Antivaxxers are also prone to saying that VAERS vastly underestimates the number of vaccine adverse events by as much as 99%, so in some of their alarmist literature they suggest that VAERS numbers should be increased by large multiples. However, although reporting to VAERS of non-serious adverse events such as soreness at the injection site is indeed very low, estimates of the sensitivity of VAERS to serious adverse events, while variable, is much higher than antivaxxers would like us to think. For example, for anaphylaxis due to seven different vaccines, estimates of VAERS reporting sensitivity ranged from 13% to 76%, while for Guillain-Barre Syndrome after three different vaccines the sensitivity ranged from 12% to 64%.
Despite its shortcomings, the VAERS system has been useful for detecting rare side effects of the COVID-19 vaccines. For example, an elevated risk of myocarditis and pericarditis has been detected in males 12-29 years of age who have received mostly two doses of the Moderna or Pfizer mRNA COVID-19 vaccines. This is a treatable disease that involves inflammation of the heart or its surrounding membranes. The CDC convened a meeting of experts (the Advisory Committee on Immunization Practices: ACIP) to analyze these cases. The analysis involved weighing any harm caused by the vaccine against its benefits. The committee concluded that the benefits of vaccination outweighed the risks. However, now that we know that this age group is at an elevated risk of myocarditis/pericarditis, vaccine providers and healthcare professionals have been alerted to this side effect and its treatment.
This is the way VAERS and science are supposed to work. Rare adverse events of a vaccine are detected, and the risk/benefit is determined after a thorough evaluation of the data available. Then a rational course of action is pursued to achieve the greatest benefit with the least harm. The irresponsible use of VAERS by antivaxxers’s to concoct alarmist articles and memes promotes vaccine hesitancy which in turn prolongs the pandemic, leading to more hospitalizations and deaths and may give rise to new variants of the virus that are more resistant to the vaccine.
Photo of the Pfizer-BioNTech vaccine from Max Pixel is in the public domain.
As I have written several times, science is a process that involves a lot of back and forth. Scientists have different opinions and exchange arguments. They adopt positions based on the available evidence and change their mind when new evidence comes along. As is expected, this process is ongoing for the COVID-19 vaccines. These vaccines have been found to be safe and effective in clinical trials and in studies conducted afterwards in real-world situations. But all vaccines, as everything, do have small risks. For example, the COVID-19 vaccines can cause an anaphylactic reaction in individuals prone to severe allergies, and this is recognized in vaccination decisions and procedures.
Because scientists want vaccines to be as safe as possible, there is an effort to identify other rare side effects of vaccines as well as figuring out how the COVID-19 virus works so more effective and safer vaccines can be made. Most COVID-19 vaccines rely on making the cells at the site of injection produce the viral spike protein, which is the protein that allows the virus to get into the cells and infect them. These spike proteins are anchored to the surface of the cells expressing them and trigger the immune response. Therefore, this protein is an object of ongoing research.
Several articles have been published in the scientific literature regarding this protein. In one article, researchers found that the spike protein alone in the absence of the rest of the virus can damage the wall of blood vessels (the endothelium). In a another article researchers found that the spike protein alone or its subunits (the spike protein is made up of two subunits) can disrupt the barrier that protects the brain from blood borne substances (the blood brain barrier). These findings, although preliminary, are important in that COVID-19 displays many symptoms involving the circulatory system and indicate that the spike protein alone could be responsible for them.
The issue we are discussing today arises from another article where researchers were able to measure the spike protein in the circulation of patients who had received the COVID-19 vaccine. A Canadian immunologist, Dr. Byram Bridle, saw the above data and (apparently without consulting with colleagues or the authors of the articles) started claiming that we have made a mistake with the COVID-19 vaccines. He unwisely gave interviews where he claimed that the vaccines make our cells produce the spike protein which is a toxin that leaks to the circulation where it can cause damage in some people. Needless to say the antivaxxer social media pages and websites lit up like a Christmas tree and unleashed upon the internet a torrent of posts and memes proclaiming how unsafe the COVID-19 vaccines are, demanding that vaccinations stop, and bragging about how they had been right all along.
I am not going to debunk this in detail, as others have done a very good job of that, but here is the gist of the argument. The method used by the researchers that detected the vaccine spike protein in the blood was 100-1000 times more sensitive than regular methods. The amount of protein they measured is basically the background that you would get from a very, very small fraction of the protein making into the circulation because of, for example, cells dying. These levels are tens of thousands of times lower than the spike protein concentrations reported to be detrimental in the other articles. Additionally, the spike protein generated by the vaccine is different from the spike protein from the virus as it has been engineered to be safer. Many scientists including colleagues of Dr. Bridle and even the authors of the papers claim that he is overinterpreting the data. Finally, if indeed the spike protein alone turns out to be responsible for a sizable portion of the COVID-19 pathology, then that is excellent news because the antibodies produced by the vaccine (unlike natural immunity) are all against the spike protein, so they will likely neutralize this toxicity too.
Now let me get to the question I formulated in the title of this post. How can you do science in this environment? Scientific research is no cakewalk. There is a lot of frustration and anxiety involved. There are many defeats and few victories. But finally, when scientists find something worth publishing, how do you think they feel when their results are misinterpreted? Every scientist in the COVID-19 field who deals with the demands of research and the toll it takes on their lives must now consider the possibility that the results of their investigations will be splashed in misleading memes all over the internet by the antivaxxer crowd. This means that they will have to devote some of their limited time to dispelling these ideas by doing interviews, writing articles, or answering e-mails from scores of people.
But the worst part is that if scientists find something that may be negative about the COVID-19 vaccine, they may be inclined not to publish it just to avoid being in the center of the media hurricane that will surely form around them. And this is terrible, because we need every piece of information so we can have a more complete picture of the safety and efficacy of the vaccines in order to improve them.
Science thrives on an open debate among scientists. In the old days this debate, which involves highly technical information with a lot of detail and nuance, took place mostly within the scientific community. Today the public can gain access to this debate by several means. Although this is a positive development, the preliminary data and tentative ideas that scientists generate as part of this debate, are being misrepresented by many people, sometimes out of ignorance, but most of the time as part of an agenda to generate viral stories to cause confusion and sow doubt.
And scientists are stuck in the middle of this.
The photo of the COVID-19 vaccine by Lisa Ferdinando (DOD) was taken from the Flickr photostream of the US Secretary of Defense and is used here under an Attribution 2.0 Generic (CC BY 2.0) license.
We have begun to detect early signs that COVID-19 vaccination is having a dramatic effect in reducing the number of new cases and deaths. This data comes from studies performed in nursing homes where the vaccine was made available first. Despite this good news, there is a substantial amount of misinformation about the COVID-19 vaccine that is stoking doubt among people that would otherwise elect to be vaccinated. In this post I will address some of these claims.
Vaccine development is a process that takes a decade or more. The COVID-19 vaccines were developed in a year (Operation Warp Speed), so they were rushed, therefore there is no way they can be safe.
This claim reveals a misunderstanding of what Operation Warp Speed did. This vaccine development operation was not fast because they cut corners. There are several reasons vaccine development was fast, but one of the most important ones was that the government funded multiple stages of the vaccine development process at once. For example, the vaccine was produced at the same time the clinical trials were ongoing. A pharmaceutical company normally waits for the results of the trials before producing the vaccine, because if the trial fails, then it would lose all the investment in producing a vaccine that wouldn’t be approved. In Operation Warp Speed it was the government that assumed this economic risk, and this accelerated the pace of vaccine production. No corners were cut in the development process. The vaccines were tested in regular clinical trials and they were found to be effective and safe.
The coronavirus is a new virus and the Moderna and Pfizer messenger RNA (mRNA) vaccines are a new technology. There is no way that a new technology can be applied to a new virus and result in a safe vaccine in such a short time.
This claim ignores the history of both the involvement of scientists with coronaviruses and the history of the development of the mRNA technology. Scientists had been researching coronaviruses such as SARS (2003) and MERS (2012) for many years. By studying these and other viruses they discovered how the proteins in the surface of the virus change when attacking a cell, and they figured out how to make antibodies to the right proteins to avoid problems that can compromise a vaccine. The mRNA technology they used had also been researched for decades and had reached its full potential by the time COVID-19 came around. Finally the Johnson and Johnson vaccine is also as effective and safe as the others and is not based on mRNA technology.
The mRNA vaccines will change your DNA, and can give you COVID-19.
This is not how mRNA works. DNA produces mRNA, and mRNA carries the instructions for the production of proteins. However, mRNA cannot go back to DNA and alter it. If I asked you whether you are concerned that while you are walking on the sidewalk the concrete under your feet will turn into quicksand and swallow you up, you would probably reply that is silly because it’s not in the nature of concrete to do that. Similarly, it is not in the nature of mRNA to alter DNA. The SARS-Cov-2 virus that produces COVID-19 has a total of 29 proteins. The vaccines contain an mRNA molecule that carries the information to produce ONLY ONE viral protein (the spike protein that the virus uses to enter the cells). The body then produces antibodies against this protein, and the mRNA is degraded after a few hours. The mRNA does not carry the information to produce the rest of the proteins of the virus, thus it is impossible for the mRNA vaccine to give you COVID-19.
They tell us that after we get vaccinated, we still need to wear a mask and social distance, so why get vaccinated at all?
It is not known if the vaccine can prevent you from being infected with the virus. What we know is that the vaccine will help you fight the virus and protect you against moderate and severe COVID-19 disease. However, scientists don’t know if vaccinated people are still capable of carrying the virus and transmitting it to other people. Thus, scientists are just being careful and recommending that vaccinated people still use masks and social distance while in the presence of others that may not yet be vaccinated until they can answer this question.
The COVID-19 vaccines have side effects and have caused severe allergic reactions.
The side effects of the COVID-19 vaccines are an indication that the immune system is working. These side effects, such as pain at the site of injection, fatigue, headache, and muscle pain, normally last 24 hours and are an acceptable tradeoff for gaining immunity against a disease that can potentially be lethal or debilitating to you and others you may transmit it to. In rare cases an allergic reaction to the vaccine has been documented which mostly occurs within 30 minutes of vaccination and can be treated by the medical personnel administering the vaccine. This is why it is recommended that people who have a history of allergic reactions should consult with their doctors before getting the vaccine.
The COVID-19 vaccines have caused several deaths.
This piece of misinformation is straight out of the antivaxxer playbook, and it is based on claims that people who died or had a problem after receiving a vaccine died or had the problem because of the vaccine. In a population of millions of individuals, thousands of people naturally die or have health issues every day. If millions of people get a vaccine, some of them will naturally die or have health issues around the time they received the vaccine, but in a manner unrelated to the vaccine. In other words: correlation does not imply causation. So far the alleged vaccine deaths that have been investigated have not been linked to the vaccine.
More than 500,000 American have died as a result of COVID-19 and tens of thousands have been left with long-lasting side effects. All this could have been avoided if we had had a vaccine for the disease at the begining. Well, now we have 3 vaccines against the disease (not counting the Russian, Indian, and Chinese vaccines). There are still tens of millions of people in the US who have not yet had COVID-19, and therefore there is potential for additional morbidity and mortality from the disease. It is important for everyone to get vaccinated to protect both themselves and those around them, so please don’t fall for the vaccine misinformation. Get vaccinated.
The photo of the COVID-19 vaccine by Lisa Ferdinando (DOD) was taken from the Flickr photostream of the US Secretary of Defense and is used here under an Attribution 2.0 Generic (CC BY 2.0) license.