In Defense of Vaccine Hesitancy, Critical Thinking, and Credible Science

Parallel Republican

This polarization is literally gonna kill us.

I got vaccinated against Covid-19. I think you probably should too.

That said, I think you have plenty of reason to be hesitant, frustrated, and annoyed. I was and am. I am pretty unhappy that I feel this way, because I shouldn’t have to. An open self-governing society should and in times past has done better than this. But, alas. Navigating our current era is all we have. So, I am going to do some critical thinking so as to provide a long defense of the vaccine hesitant and some apologetics for some covid denialists from the position of someone who is informed about, trained in, and very much pro science.

I want to write about this because I think the railing against people as selfish, stupid, deranged, or just evil for being unvaccinated is probably wrong and definitely unhelpful. Too often the memes and slogans deployed are simply untrue (“mRNA vaccines aren’t new technology being deployed at this scale” or recently “We would have herd immunity by now if only there were no hestiants”), dissembling (“vaccines have nothing to do with politics or freedom”), manipulative slurs (“you sound like an antivaxxer”), or simply vapid sloganeering (“This house believes science is real” or “follow the science”!) This isn’t helpful.

Lying, manipulation, dissembling, and vapid sloganeering is unbefitting and dangerous for a public health campaign in a free society, and can only help realize the outcomes that the anti-hesitant vaccine enthusiasts fear most: A complete collapse of trust in scientific authority while threatening all of our rights for an imagined smidgeon of long-run safety in the process.

Current pro-vaccination attitudes and tactics in the community are running an extreme risk. This isn’t to say that aggressive vaccine denialists who refer to mandatory masking as ‘muzzling’ and who compare lockdowns to the Holocaust aren’t extraordinarily worrying. They are. Even if they are probably about 13% of of the unvaccinated eligible for vaccination. But, to characterize all vaccine hesitancy as selfish anti-vaxxers when they objectively aren’t, is a great way to create more people talking (accurately) about ‘muzzling’. Worse, once untruths and exaggerations are exposed, it further erodes any credibility of public health science and official discourse, which is hanging by a thread as it is.

To stress again (because I have to for many to read further) I think that everyone who can should choose among the vaccines available and get the one most risk mitigating for them, but I don’t think they should be happy about it or comfortable. Getting one of these vaccines shouldn’t feel like a gamble with unknown risks, but our current approach in the West demands it. But just because we are being offered a less pleasant gamble than we have good reason to expect, does not mean that we should take over-reactive postures as Covid denialists and the covid era generation of anti-vaxxers have done — even if it is an understandable reaction.

In these polarized times it is too easy to polarize from hesitancy to reactionary paranoia, or from reasoned confidence to certain ideological vaccine enthusiasm. And, of course, these two tendencies feed off each other. As people move from hesitancy to reactionary paranoia loudly and in public spaces, the “reasoned confident”,concerned about the implications and appalled by the extreme unsubstantiable claims of the paranoid, actively fear any information that might differ from that which support their preferred choice, and build an entirely fictional ideological and rhetorical artifice to which they ever more worriedly police the boundaries.

In this ideological universe “the science” and vaccination is not political (as they engage in political speech to make the point) and textbook in its operation, regulators are altruistic and concerned exclusively with ‘good science’ (except when Monsanto,GMOs, or government regulation of nearly any other industry are involved), ‘experts’ are nearly infallible (so long as they are the ‘right’ experts), and thus one must ‘follow the science’ or be a flat earther who should be denied any right to participate in society if they reach a different conclusion from the once reasoned confident, and now strict ideologue. The once reasoned confident becomes the ideological enthusiast. Of course, this messaging is now as extreme and full of holes as the ‘paranoid’s’, and serves only to make the ‘hesitant’ feel justified that they are in a groupthink conspiratorial situation and, yup, polarize to a more ‘paranoid’ position. This feeds the fear among the ‘reasoned confidents’ to become more ‘technocratic in their ideological enthusiasm’ and the polarization is in a positive feedback loop. Truth and critical thought are the first casualties. But, in the long run it is the common good that will suffer.

Moreover, there is now a media surge in whipping up these tribal boundaries, to dangerous conclusions. David Frum makes a great example here of scientifically illiterate vaccine tribalism, implying that the vaccinated are getting angry at the unvaccinated because if the unvaccinated had gotten vaccinated we would have herd immunity and the ‘pandemic would be over’ by now. Of course, this in all likelihood isn’t true. It is only true in a mythical world where some of the following claims hold true: America is the world, pandemic are about one country, we know the duration of immunity from recovery or immunization, current vaccines provide low transmissibility of new variants. None of those hold. Moreover, huge swaths of the population (children) still don’t even have a viable approved vaccine yet, and some just got approval. But, most importantly, this ‘impatience’ isn’t something that just emerges. It’s framed by the media. And people like Frum are all into that game (as are many others suspiciously all at once in a phenomenon known as ‘pack journalism’). But the result is an environment that probably makes all of us less safe. Particularly if the panic induced creates yet more illiberal faithlessness in persuasion and our ability to self-government, as Ezra Klein has recently terrifyingly signaled.

So, charting a middle and sober path through such a firestorm is challenging. But, I think people need to try if we are going to keep the benefits of science, public health, and the free society going.

Myth and Reality of Science and Vaccines

Somewhat weirdly, it is very often the same people who uncritically push the 100% obvious science-certified safety of the Pfizer, Moderna, and other Covid vaccines, and the clear necessity of mass vaccination who also tend to be convinced that Monsanto is an evil company for whom a network of profits and regulatory capture leads to routine lies about the science and safety of grocery-store vegetables for which we have had decades to study. In one instance the FDA, industry, and public implementation authorities (the CDC or the Department of Agriculture) are a perfect system of public accountability, while in the other they are a perfect system of rank corruption. I am going to go out on a limb and argue that the truth is somewhere in between our public health processes here being a unicorn or a demogorgon.

The picture portrayed or inferred about ‘The Science’ by the ideological narrative of vaccine enthusiasts seems to go something like this: Scientists are dedicated truth seeking scholars, who apply “the scientific method”. Any deviation from purity of purpose or accuracy is caught by a tight system of peer review, replication, and open criticism. Any serious problem will be found. This is because scientists submit research findings for publication and other random anonymous scientists evaluate the research with high integrity and concern for truth in an unbiased fashion. After, those findings are rigorously tested on the basis of new data and the result reported. Thus, over time, we develop accurate pictures of truth, and accumulate ever more knowledge that is absorbed and disseminated by experts. This expert knowledge strongly implies what one should do with it. Indeed, science not only develops the ‘is’ but the ‘ought’, because eliminating a problem identified by scientists or recognized generally is self-evidently good. Science doesn’t care what you believe (or about trade-offs, it turns out)!

The resultant scientific truths describe reality, rather than endorsing some theoretical stories offering a partial view of all the issues under consideration, as philosophers of science and — indeed — most serious practicing scientists would assert. Thus, those who deny the claims of scientists are not merely denying scientists arguments, but reality itself.

Experts grasp more about the situation than non-experts in any situation, including an individual’s situation. This is why vaccine mandates are a trade-off-free no-brainer for enthusiasts. If there was a danger for you and your particular health given your particular situation, the experts would know. The notion that someone hanging out on the internet could outperform experts is a laughable, meme-able notion. Scientists in industry and in government (from the CEO of Pfizer to Dr. Fauci) are more or less beacons of integrity unmoved by politics or profit by a concern for truth, science, and helping others. (Unless they work for Monsanto, or other industries at different times, where the politics are different… then they aren’t… because vaccines aren’t political!).

Basically, the perspective asks one to read the tale of the emperor’s new clothes, and dismiss the child pointing out the nude emperor as merely another case of the Dunning-Krueger effect (which is not what people think it is and is probably not real, and if it is is such a small effect that we probably shouldn’t be using it to shame non-experts or exaggerate the confidence of experts, by the way);’ That child needs it’s Twitter account banned and any youtube channel upon which he appears post-haste.

The paranoids, on the other hand, see only the failures of medical science, historically, and seem to believe most actors involved in the production of vaccines specifically, covid policy more generally, and sometimes just science more generally are not merely negligent or self-interested actors, but malevolent. ‘They’ have a plan, and it is very bad. The paranoids see attempts to silence critics as further evidence of an elaborate cover-up, hiding motives ranging from ‘simple’ totalitarian tendencies, to elaborate transnational pedophile conspiracies aimed at global domination. They cling to principles like ‘freedom’ as totemically as their opponents to ‘science’ and seek to apply it to justify any old nonsense. This group confuses the freedom to make poor uninformed choices as a moral directive to do so. But often, this view is motivated by a profound distrust in their sources of information more than an overwhelming confidence in themselves. How reasonable is their distrust? More on that later.

There are so many interesting aspects to this juxtaposition, such as how one side seems obsessed with centralization of authority and a requirement of rigid conformity to one view of the common good, while the other seems to want total decentralization and seem to only believe that they are exercising freedom if they are as difficult to live with as possible in their hackneyed decision-making. One side demands a prudish respectability on the matter of vaccination, while the other encourages total chaotic rebellion against norms of propriety or even good order.

But the reality of science, issues with vaccine production, and covid response generally are the casualties of these dominant delusional camps sucking all the air out of the public deliberative room.

Back on earth, science looks totally different. That’s because politics is exactly like Jesus when Jesus said in the Gospel of Matthew 18:20 of the King James “For where two or three are gathered together in my name, there am I in the midst of them.“ When two or three scientists are gathered together in the name of science, there is politics in the midst of them. And, the ‘midst of them’ get ever thicker with politics the greater in size the congregation, and the pandemic provides a mighty congregation indeed.

Indeed, when people speak about ‘experts’ with singular authority it sounds alot to me like how people used to talk about priests and bishops (and I take it about as seriously). People are people. People are flawed. No human enterprise under the sun has ever escaped this reality in the history of mankind. I think most people know from experience that reality never works according to the ideal; They just forget in heated conflicts. It’s intellectually dishonest to just assume that somehow this wouldn’t apply to science and technology, and particularly during a pandemic when everything has to happen at speed and there are billions of dollars and votes to be earned.

This is not to say that science is not to be trusted so much as ‘science’ not really being ‘a thing’ at all. It is a way of discovery composed of and latched into a variety of socio-political-economic systems that affect both its course, and the implications of its discoveries in a myriad of ways. Some scientific knowledge is more certain and complete than other scientific knowledge for a given purpose or decision. The challenge is sorting the wheat from the chaff. What knowledge is the best knowledge for this problem, and what other knowledge matters from other experts needs to be taken into account as well. That’s the difficult and uncertain part. That’s why there is no such thing as a meaningful ‘expert’ in pandemic policy.

The science itself is less certain than is usually advertised. Scientists usually know this. Though, they routinely overestimate confidence in themselves and more often over communicate confidence to the general public in my experience with scientists in academia. Scientists ‘p-hack’ which is to say engage in a variety of practices to inflate the reported confidence of findings. There are strong incentives for them to do so a the level of their immediate professional success and prestige. This, combined with other elements here has led to a widespread replication crisis in multiple disciplines, where we discover that foundational robust findings upon which other research has built was absolutely false, and all following research built on a foundation of sand. And, mind you, this is just talking about general factors. When we get into the institutionally specific domains of universities and major pharmaceutical and other tech companies things get murkier.

The institutional practice of science does not look like what science is meant to look like, and it looks less like it all the time. Rather than a large group of independent and loosely aligned scholars chafing against each other, the bureaucratic constraints of corporations, and government as we might imagine the scientists of the Manhattan Project, Science today selects for more corporate types. Team players. And the structure of scientific production has become massively bureaucratic and depersonalized. This matters, because the successes of science of the past are built on the basis of a totally different institutional structure of scientific knowledge production today, and the independent error correction of many different scientific scholars is a big part of the secret sauce that made the Big Science Burger so delicious. If most scholars writing in a given field are co-authoring in large groups with whom they are professionally mutually reliant (for grants, publication, and thus promotion and prestige), independent checks go way down.

Let’s talk about peer review as an example. It’s gotten more play in the public than probably ever in history since Trump was elected. 50 years ago that enthusiasm might have been more justified than it is today. What is peer review and why is it not the truthmaking elixir the March for Science placards promise? Peer review, basically, is the practice of sending potential publications to other scholars for their review. If those reviews are negative, editors won’t publish the piece. So, the gold standard is blind or double blind review, those being models where the reviewer and author don’t know each other’s identities, or one where no one including the editor knows their identities. The idea is that if a panel of one’s colleagues don’t believe the paper is up to a requisite level of quality, it’s better safe than sorry.

Unfortunately, there are many known issues with peer review, and some less well known that deviate from this model. So, if people are arguing in good faith about their confidence in science being not a statement of blind faith but a reasoned conclusion based on a particular model of science, these revelations should reduce their confidence.

So what are some of these issues?

Peer review procedures are not regulated or even strongly normative across scientific disciplines and sub-disciplines. Each journal determines its own policy. Now for a variety of reasons this has led to situations where editors send articles from senior scholars to easier reviewers, small fields often make blind review impossible, and in many specialized subfields blind review is abandoned entirely. Authors suggest their own reviewers. The grounds for that is that science is so specialized that finding adequate reviewers is too costly for editorial teams. Perhaps. But obviously, doing so means that trustworthiness of integrity has been sacrificed for convenience. In the Netherlands, for instance there are exactly two research groups that study key questions in environmental science. That’s not a robust ground for independent checking of results. Moreover, team competitive pressures create incentives to defend the group’s claims, because to allow doubt could be extremely costly to all.

There are varied standards about what constitutes sufficient grounds for rejecting or accepting a paper. Some editors blindly follow the reviewers. If one says ‘I don’t like the font. reject’, the editor will reject. Other editors read and treat reviews as advice. Still others have specific grounds upon which reviewers are required to comment. This patchwork bears little resemblance to the peer review of our model.

Most scholars I know have encountered situations where their papers are rejected for less than entirely above-board science-preserving reasons. Sometimes, they can be downright corrupting. For instance, one paper was rejected because I didn’t use a data set that the reviewer possessed but which was not accessible. This blocked findings differing from theirs. I found out the identity of the reviewer only accidentally.

In industry things are even more complicated. Serious mainstream medical scientists like Ben Goldacre made a career fighting for good science against both pseudoscientific quacks in the nutrition industry and seriously unbecoming scientific practice in the pharmaceutical industry — which are widespread. Indeed, this is the reason why there have been so many cases of drugs being approved and then pulled off the market. So why are these new vaccines so obviously perfect and safe for long term use, and above any question?

I have no idea.

Then, finally, there is the issue of scientific knowledge itself which is grounded in something I know quite a bit about: statistics. A little known secret is that medical journals are well known well beyond just ‘geeky docs’ like Ben Goldacre, but among statisticians and statistical methodologists more generally as hotbeds of malpractice in both inference (how strong the result is) and interpretation (how important it is, in terms of the magnitude of the effect). Indeed, in advanced graduate courses we used the New England Journal of Medicine as a source for replication and critical evaluation studies to demonstrate what not to do in our — I must sadly confess — far less important social science research.

There are at least two big problems with statistical studies of vaccine safety and efficacy even under the best of practices.

Firstly, is the impossibility of getting long term studies on a short term basis. Without a time machine we can only study short run side effects of these vaccines. And, despite what might be implied, mRNA based vaccines have never been used at this scale before. The long run implications for different subpopulations is difficult to know.

Secondly, is the problem of analysis itself. Analysis comes from the greek root ἀνάλυσις meaning to unbind, split, or divide. We break up processes and systems into pieces via analysis such that we can understand them. We do this in statistics too. We break up causal processes and evaluate one ‘effect’ or ‘dependent variable’ at a time. Usually, studies of vaccines don’t study side effects as the ‘dependent variable of interest’ until much later, if at all. Rather, they study the ‘big concerns’, like ‘does the vaccine prevent disease’, ‘does the vaccine prevent transmission’, and ‘how long does immunity last’?
To get an idea of side-effects (read: safety) we can do a rough cut of data, and just look for associations between vaccine interventions and lots of observed symptoms versus those receiving a placebo. But, of course, we have no idea if those associations are real and if they apply particularly to any subgroups. Knowing that requires further study with those side effects as dependent variables. A new ‘lysis’ or ‘cut’ of the issue.

Whenever I say ‘further study’ I actually mean ‘tons of money and more time’. That matters, of course, because the general inference from these ‘side effect studies’ is basically the risks for ‘the average person’; not ‘you’. So, if you are someone who suffers from a very poorly understood chronic ailment like auto-immune disease there is a good chance that your likelihood of certain potentially dangerous side effects is quite high at worst or unknown at best if there are only a handful of people with that ailment in the study (as is likely the case).

So, if you tell someone that ‘the science says that the vaccine is safe for you and you should take it’ to someone with one of these disorders you are not following ‘the science’ you are going well beyond it. That is, assuming we even accept the fiction that science is a thing that ‘leads’ to any one place. When you suggest a mandate, you are saying that people who have rare conditions for which no link has been yet established for serious chances of side-effects should operate as human guinea pigs so you can hope to go maskless to the store. It might be good to hold that thought in mind the next time you criticize those not getting vaccinated as a group definitionally lacking civic virtue on the basis of their hesitance. You aren’t so hot on that score yourself.

My Vaccine hesitancy…

… is therefore not a disbelief in “science”, per se, as it is a belief in a disembodied ideal social process by which we would pursue knowledge, and where ‘peer review’ actually is some sort of marker of perfect confidence as opposed to ‘better than nothing’. I have a disbelief that our current system of science even loosely approximates the story enthusiasts and the establishment media suggest to us because we know for a fact that they aren’t being truthful when they do so.

But it also springs from things more directly in my wheelhouse as a political economist. It springs from the realization that the number of steps between that scientific process and a vaccine jab in my arm is orders of magnitude longer and containing an awful lot of non-ideal science, embedded in a political and social institutional structure with incentives pressuring outcomes to deviate dramatically from what an idealized process would permit, and a recognition that a solid authoritative public scientific system requires a healthy civic culture to support it with checks and independent informational feedback loops.

Indeed, my biggest bailiwicks are largely political and economic and spans the entirety of the pandemic response (but that is a topic for another long post). I think that the political and economic context of this virus makes all the problems I have discussed above worse with respect to this pandemic, and why the social context of our tribalized debate I highlighted at the outset gives us all reason to be less confident in the process itself.

The core of the problem is a simple matter of asymmetric information and incentives between vaccine producers (broadly defined), the state, and the population. Ultimately, to trust vaccines, we need to trust vaccine producers and government regulators and each other to help hold them to account.

Now, there are two ways to look at trust, basically. One is a type of emotional affect. This is the type that boosters for vaccines go for by trying to connect a vaccine to trusted things. It’s the ephemeral trust that we offer on sentiment. The other type is rational. This notion of trust suggests that trust is based on that which is reasonably assessed as being trustworthy based on logic and evidence. So far, most of our attention, socially, has been focused on manufactuing consensus with the emergency vaccination regime through centralized and decentralized PR tapping into emotional sources. Are you a good person? You don’t want to be stupid, do you? Do you not believe in science? Hey, you trust me and I got the shot, you should too? These are all attempts to leverage emotion to drive trusting action.

Very little has been talking about whether it is reasonable to trust. Is the process, on its face, trustworthy? How would we know?

So let’s lay out the situation as I see it.

Vaccine producers exist to make money by making drugs. We have government regulators because we realize that vaccine producers, like makers of sausage or GMOs, have incentives to not necessarily poison us, but to maximize profits and externalize costs. Our safety is not their first concern. This can lead to a combination of corner cuts and ‘little fudges’ that can add up to dead rats in your SPAM without anyone conspiring maniacally to do so. No demogorgons per se. So, recognizing this, we created a government agency to aid in oversight of the making of sausage

The FDA was born because so long as product quality is difficult to assess ex ante, consumers will have difficulty determining quality and people can have very bad things happen to them before someone finds the obvious rat tail in their SPAM and writes the papers. Hopefully, this creates a national scandal and leads people to abandon the SPAM en masse (I actually love SPAM for the record). So, without some government oversight, the only protection we have is market discipline, albeit probabilistic and delayed. But both direct oversight by the FDA and your ability to flee the product create incentives for producers to prioritize things they would not otherwise do.

Now let’s look at the government. Who guards the guardians? We can largely trust the FDA most of the time because, ultimately, the government doesn’t have a strong interest in one or two particular producers of processed chopped meat filling American bellies, and they don’t want to get blamed for poisoning people. They are perfectly happy to discipline firms knowing full well there are a million producers in the sea. Moreover, for the most part, we citizens are perfectly happy for them to do so.

Of course, we know, that as pharmaceuticals and (Ahem) the science (TM) has gotten more sophisticated and expensive with massive economies of scale, that this has led to fewer viable independent producers of both knowledge and vaccines. We have seen plenty of examples of worrying revolving door issues between regulators, politicians and the industry.

This worries us. Democrats have criticized Republicans since the Reagan Administration for politicizing basic health and safety regulation, and easing the creation of revolving doors between partisan politicians, regulators, and the firms they are meant to regulate.

How do we deal with this problem? It’s difficult to see how to solve this problem without fundamentally changing how science and industry are organized, and with massive reform (none of which has happened, for all you enthusiasts out there).

But, thankfully, there is one last part of the picture, right? Us! A big component keeping industry and government more vigilant is the threat of a panic about the safety of drugs leading to a precipitous loss of sales and votes! More on that soon. Not a great picture. (foreshadowing)

Now, vaccines are obviously a pretty important pharmaceutical. It would be great if human organization was such that we could all just trust the entire process to be a holy and good unicorn in much the same way that people thought ‘the church’ was for a very long time. But, in both cases, the tragedy of human political economy gets in the way of the so tempting technocratic/theocratic goal.

Unfortunately, there probably is no viable path to high quality vaccine with high levels of inoculation without doing the hard work of building trust, persuasion, and genuine education (As opposed to indoctrination — which is fragile to the first sign of falsification). There is no ‘lazy strategy’ that gets us there. Everything has trade-offs and we don’t know the magnitudes of the costs or the probability of them being realized. Systematic risk sucks, and just like with the financial regulatory disasters that made risk assessment of assets woefully incorrect before the financial crisis, we have the same problem in the realm of pharmaceuticals. And when we look at our current situation, I fear the picture is a little more bleak.

In this pandemic we have global capital, business, political leaders in democratic nations, and a population that is overwhelmingly motivated to get back to “normal” as soon as humanly possible, and vaccine manufacturers are looking at the largest demand for any medical product over a short time period in the history of the planet. This is not an exaggeration.

This strikes me as an incentive structure that is far more ill-suited to collective disaster than the situation established that led to the financial crisis in 2008. Quite literally, everyone directly involved is motivated to be overly optimistic and dismissive of evidence that suggests we might best off stay in our dancing lockdown situation of the last year and a half. In this pandemic, you don’t have to be a politician in a revolving door with big pharma to have an incentive to move it along. Yet, those forces are still there too. They are now just less scrutinized than before, not least because people are terrified to create ‘vaccine reluctance’. In other words, there is a direct incentive to hide potential problems, and there is suggestive evidence that this is happening given attack on supposed ‘disinformation’ (which assumes that the information we have is of the highest most unassailable quality, which I hope I have convinced you is at least very possibly a conceit).

And, to make matters worse, getting back to the ‘us’ in the regulatory story above, the recent polarization in the country has apparently created what in some quarters look like a cult of science and authority worship on much of the left, and a cult of science denial on much of the right, that spurs much of the left, big media, capital, and most institutions to react by engaging in more lax oversight of potential issues with the vaccine and to turn a blind eye to genuine attempts to curtail the flow of information in exactly the same way as occurred with regard to the Wuhan Lab Leak hypothesis and in deed, the Chinese initial response to that outbreak. Further, worrisome signs will not drive massive swings in votes or support (as we have seen in public opinion polls across everything over which we see polarization, which is why Trump’s approval rating was the flattest in presidential polling history), thus reducing the pressure on all those in industry and government to fear dire consequences for anything but the most dramatic crises.

Unfortunately, the degree to which we are being overconfident is unknown and probably unknowable. It might be, in practice, tiny or not even matter. The vaccines might be just that good, just by luck. But it may also be large. Systematic risk is really hard to measure. All we can be sure of is that it is positive and that our risk estimates are underestimates.

And the final elephant in the political economic room is the media, which I touch upon at the outset but don’t want to belabor. But everything I have said about industry and government applies to the media as well. And, frankly, we have good reason to be suspicious given the persistently lack of interest in investigating claims deemed ‘unfit’ in our new culture war, be it the actual story about the dispersal of protestors around the White House ‘for Trumps photo op’ (How is it possible this wasn’t discovered before a few months ago, did no one call the park service?), the source of the outbreak, or stories about effective treatments for Covid-19 because they happen to be suggested by the wrong people even if the people in question invented the mRNA technology in the current vaccines, or evaluating whether pharmaceutical companies are suppressing research on existing treatments because they have a fiduciary incentive to do so if that research would endanger emergency approval of new drugs to fight covid — including vaccines. (Somehow, mRNA vaccines in some mines are based on such flawless and pristine a science that we much ignore their inventors concerns because he is clearly an antivaxxer crackpot. This contradiction seems unworrying to those advancing this argument.)

How is everyone not absolutely flabbergasted that the reaction and claims that the notion of a Wuhan lab leak was fantastical and debunked last year? Everyone, but especially my more vaccine enthusiastic leaning friends should be nervous I would think about what that portends. How were we so convinced, that just because Donald Trump first popularized the theory that it was inconceivable that one of China’s highest security Viral Research Lab was a less likely source for a weirdly behaving virus than bats at a ‘wet market’? We should really be chastened.
Not proud and confident. How does Jon Stewart need to mainstream that skepticism, and still be subject to weird Pravda-esque handwringing about how comedians shouldn’t speculate on the cause of the outbreak, but should be left to medical professionals?

The same publications that cared not one whit about comedians roasting any public figure who echoed Trump’s claim about the Wuhan lab, and the same mental health professionals like Fauci who’s public statements on the plausibility of the leak trail rather than lead the broader critical discussion should not inspire the level of confidence that they do in some but it goes some way to paint a picture of where trust in authority has gone? It’s largely dying the altar of media malpractice and political polarization. But any objective assessment is clear. We have a bias in our media system in favor of overconfidence.

This is not a system that I can deem trustworthy, and thus it is a bit foolish, in my view, to trust it’s fruits. It’s a calculated risk I had to make to get the vaccine. And, honestly, I probably wouldn’t have taken it now if I didn’t need to get back to my parents in case something happens and there is increasing danger of vaccination being required to travel or work (which makes me more nervous).

There is simply no substitute for long-term panel studies for novel treatments, because side effects simply take time to manifest. These unknowable unknowns can only be caught by careful long running observation. Even then, they won’t be caught perfectly. And, routinely, scientists across fields cut corners due to practical limits in research funds or time.

The ‘masks are muzzles’ people are clearly unhinged as well, but I am not sure they are more irrational than dire hard vaccine enthusiasts. Both are making arguments that are driven almost entirely by emotional affect and either preponderances or absences of trust based on little more than that. That, on balance, I think that enthusiasts get closer to the right choice is an accident not due to the quality of their reasoning.

Creating Social Conditions for Good Science

Last February I gave my last in-person lecture for our general first year interdisciplinary course called ‘prosperity’, and I was giving a lecture on governance. This was right before ‘the science’ and ‘the public health experts’ let us sleepwalk into the end of our pre-pandemic world and miraculously earned the trust and loyalty of all right thinking people according to most of the mainstream media.

In response to a student’s question (which I can’t recall) I argued that there would be no worry about a pandemic if the outbreak had occured in the Netherlands rather than China because free media and rule of law meant that it would be easy for doctors detecting the virus to speak out and sound an alarm generally compared to China, where information is centrally controlled in order to protect the population from panics, and whistle-blowers silenced if speaking out might unwittingly disrupt the progress the CCP is trying to make in China. Indeed, the facts around China’s forced silencing of the now deceased Doctors who did try to alert the authorities and the public has since come to light.

Thus, information flows more freely and in a decentralized manner in the West, I argued, because gate keeping is harder and because the disincentive to dissent is much lower. So, we may not have ‘police patrols’ monitoring from a central authority willy nilly, but we have ‘fire alarms’ distributed around society for anyone to pull in the event of danger.

I could not give that lecture today. It has become pretty clear that while better than a totalitarian police state like China, the West is not open as the ideal openness. Social media bans constricted media access, and strong partisan incentives to build narratives and enforce them reduce the free flow of decentralized information, as do decentralized ‘calling out’ and ‘holding to account’ by the paranoid and the highly enthusiastic.

But theoretically potential problems affecing female fertility which could only be accurately assessed over long time horizons would be the kind of thing that should give a decision-maker pause, as a source of risk. The primary person concerned about this is the same doctor who invented the mRNA vaccine technology. He has been banned from LinkedIn and youtube channels he has been on have been demonetized. He is widely attacked for spreading vaccine disinformation, one concern being the manner in which spike proteins produced by the vaccine lodge in women’s ovaries. And, while there is no evidence that female fertility is necessary hampered, just a few days ago the side-effects monitoring agency in the Netherlands reported a worrying number of changes in menstruation after receiving the vaccine. It could be nothing. But it certainly is worth investigation. But so much of the necessary pieces have to fight through increasing amounts of formal and informal censorship one can only guess what else is being missed. And on what grounds is this censorship? That we know this is vaccine is perfectly safe. Yet, the experts are collecting this information and investigating?

The classic media method for dismissing this is to say that ‘there is no evidence of problems’. But of course there aren’t. There can’t be. You need more time to pass in controlled testing environments to have that evidence. But this statement violates a basic tenet of scientific inference: Absence of evidence is not evidence of absence. It’s up there with ‘correlation is not causation’ in the canon of scientific maxims to live by. Some of those ‘following the science’ could use a refresher on this one.

Critical Honesty Is Bedrock

It is a seriously risky and short sighted gambit to exaggerate our confidence about the safety of vaccines or other treatments when they are being deployed at scale and with such attention, because if we end up wrong while doing so, and it comes out that risks were downplayed it seriously harms the deserved legitimacy of good scientific knowledge. And, we need science to to be credible in informing, even if not actually drive, our decision-making. This goes double when things go wrong.

And, in this pandemic, the entire globe is watching, listening, picking sides, and vaccinating on a mass scale. So, if this goes sideways such that, for instance even in a moderate but dramatic manner (think 10% increases in infertility among 20–40 year olds globally) it could irrevocably destroy the legitimacy of medical science for a generation or more. It would make our current know-nothing anti-Vaxx movement something we look back at with misty eyed nostalgia.

Truthful communication of risks, uncertainty, and real costs is more important when stakes are high than when marketing SPAM. The PR-ified nature of our thinking about how to promote vaccination is built on a logic deriving from the art of self-serving manipulative communication. So, if you have a trustworthy system, good PR is just a good idea. But if you have an untrustworthy system or unreported risks, good PR is a risky gambit best played by companies making sausage rather than companies making life saving pharmaceuticals. People hate feeling played for fools. But, they really hate it when the health of themselves or loved ones hangs in the balance.

But the middle class liberal freak out following the election of Donald Trump has seemingly convinced many of the aforementioned freaking out people that the primary mode of dealing with people is not persuasion, but a combination of PR-informed communication, and decentralized vigilance where everyone is a cop screaming at unmasked joggers in parks and smearing PhDs trying to independently check the authorities as anti-Vaxx Covid denialists. This is not the best way to ensure reasonable vaccination rates long term. It’s difficult to exaggerate how dangerous these arguments against persuasion are, and I will address it another time and place.

I kind of think that this PR and enforcement of the enthusiastic confident is uncritically backing up a pretty untrustworthy and rotten infrastructure, populated by individuals acting collectively to “PR” and cajole their desired outcomes into existence. I think that our denialist movements are reflective (if exaggerated reflections) of real underlying issues of trustworthiness of our institutions of scientific learning, industry, government, and media that are being dismissed at our peril. I don’t think that anti-mask paranoids are more deluded than the ‘March for Science’ crowd who ‘believes and follows the science’ and views each new announced discovery with uncritical enthusiasm. Both are deluded about the reality of our situation, and both are doing so for ultimately self-involved and emotional rather than rational reasons.

So, playing people you think are fools for fools, and then being wrong (which is always possible) is potentially devastating not merely to the credibility of the medical science to the polity, but the polity to each other. So, it isn’t going to be just trust in the scientific and government that would be sullied if something goes wrong. It will be the foundations of the trust and unity required for democracy to work at all that could be damaged.

So, the more ‘realistic’ people become about the need to convince people that vaccines are safe by downplaying or outright suppressing contrary information, whether they be from random Qanon cultists or Biology professors talking with the inventor of the vaccine technology itself, the less comfortable I get. Because, I don’t know what I don’t know, but I know that there are things that ‘the experts’ are missing and that the entire information system and scientific institution is far more biased against locating them than our ideal model of the self-correcting science leads us to believe.

Bottom Line

Get vaccinated, but do your best to choose the best one for you, if you can. Push for your governments to stop waiting to approve new vaccines. Novavax has been waiting in line for a long time, and is based on similar technologies as the flu vaccine, and is likely to for that reason trigger less reluctance. Covid is almost certainly worse than the most cautious assessment of the risks, but those risks are certainly greater than current reports would suggest due to systemic risks. If you have a poorly understood disease, you have a tougher choice ahead of you. I know this well. But know that it not an irrational reason for hesitance and irritation with browbeating scolds who would present simplistic black and white views on vaccines and vaccine hesitancy.

Those with a low appetite for risk and an awareness of the facts deserve honest encouragement, not manipulation. If the improbable does happen, we will need an aggressive response from scientists and pharmaceuticals to deal with it, so it would be good not to have all trust and confidence understandably fall out of the bottom of medical science. That means being honest about risks we know, risks we don’t, and the trade-off we are making. Science works best in a free society dedicated to values of honesty, self-governance, and a concern for the common good.

When that third goal overrides the first two and demands to rest on lies, dissembling, or manipulation, and when we threaten to take away the choice of individuals over what they put in their bodies for the common good, you risk fundamentally weakened science and public health in the long run while magnifying confusion and ignorance. You are no friend of scientific knowledge by being uncritical, unskeptical, overoptimistic, or dishonest in its service.

Far more valuable than pushing vaccines, if the common good is really our concern, is keeping measures up like masking, distancing, and reducing certain high risk associations, until a sufficiently high vaccination rate is achieved, currently underinvested in treatments are available, and the global south where lockdown and social distancing is harder if not impossible has higher vaccination rates. We are working against vaccinations with our intuition that vaccination equals immunity from Covid, and the only barrier to ‘a return to normal’ is attaining some magic percentage of vaccination. Each variant that mutates risks raising that number or even rendering herd immunity an impossibility, and likely has already done so if the CDC report is right (but not if the Dutch RIVM report more or less the same day is to be believed #TrustTheExperts). More active infections being allowed among the unvaccinated and vaccinated by reducing measures does immeasurably more harm to the cause of ending the pandemic than hesitant vaccinators — many of whom already carry antibodies presently.

There’s a middle path founded on critical thinking, respect for one another, reason, and a sober look to the common good. That path involves recognizing the lack of control we have over this pandemic, the nature of the tools we have to work with, and a recognition that at the end of the day we only have each other, and so we may want to heap a little less judgement and be a little more compassionate and charitable.