"You’re An Absolute Fool If You Don’t Get It" Might Not Be Enough To Convince Anyone To Get A Shot

The only person I know who has admitted voting for Trump is my brother-in-law and even he got the vaccine as soon as he could. I don't know anyone who either hasn't been vaccinated, is in the process of being vaccinated or wants to get vaccinated. This morning, Axios tried explaining vaccine hesitancy based on stats (above) from a poll Harris did for them. The polling posits that something like 1 in 10 Americans are neither eager nor opposed-- just waiting for it to be more convenient. Another 21% are waiting and watching... to see if the vaccinated neighbor grows a second nose or turns into a blob of jelly, presumably. Another 14% just say no, less than I thought would be the case.

The CDC reports that 56.1% of Americans over 18 have received at least one shot-- and 40.3% are fully vaccinated-- as of this past Saturday. Axios interprets that to mean "we're getting very close to the end of the 'vaccine eager' population. Making shots available where unvaccinated people are seems to be one way to proceed-- work places, mobile clinics, local pharmacies... But I suspect that making it available at local GOP headquarters or at police stations won't move the needle much. The deranged right-wing loons who inhabit those locations just don't want it.

This morning Issac Stanley-Becker, writing for the Washington Post, reported that even though cops were among the first front-line workers to gain priority access to coronavirus vaccines, their vaccination rates are low. "The reluctance of police to get the shots threatens not just their own health, but also the safety of people they’re responsible for guarding, monitoring and patrolling, experts say." It looks like about a third of cops have been vaccinated.

One solution is for departments to make vaccination compulsory, according to experts in bioethics and public health, just as some health-care settings and institutions of higher education have begun doing.

But department leaders and union officials said in interviews that such requirements could backfire or lead to lengthy litigation. Of more than 40 major metropolitan police departments contacted by The Post, none had made vaccination compulsory for employees.

That reflects a belief among officers-- and their unions-- that getting a shot is a private decision.

...Hesitancy within police departments is rooted in some of the same concerns expressed by the general public, according to police chiefs, union officials and experts in policing and public health.

Officers have voiced unease about the novelty of the shots and the speed with which they were developed, along with confidence that they can avoid the virus with proper protective gear. The vast majority of police are men, who are less likely than women to be immunized.

Many officers also reject immunization because they think previous covid-19 infections have given them immunity, said Sean Smoot, director and chief legal counsel of the Police Benevolent and Protective Association of Illinois. That assumption runs counter to federal health guidance, which indicates that recovered people should be vaccinated because the duration of post-infection protection is unknown.

Some of the differences in police uptake of the vaccine reflect disparities among the communities they serve. Hawaii, where 80 percent of officers in Honolulu have received at least one dose, has administered more doses per capita than all but four states, and the Democratic governor, David Ige, has moved forward with plans for certifications known as vaccine passports, a cousin of vaccine mandates. A greater proportion of residents in Denver County are vaccinated than in, for example, Clark County, which includes Las Vegas, or Fulton County, which includes Atlanta.

Smaller cities report even lower rates of police vaccination. Just 20 percent of officers in Mobile, Ala., have been vaccinated, said the city’s public safety director, Lawrence Battiste. Some may have gotten their shotswithout the help of the city, he said,and therefore have gone untracked. But many are young, he said, and think the vaccines may be linked to infertility, an idea spread on social media that experts say has no basis in fact.

...Some cities are turning to incentivesto boost participation. The Phoenix Police Department is offering a one-time $75 vaccine safety award to employees who get protected. But only 919 employees, out of 3,982 total, have submitted a completed vaccine card to receive the rewards, said a city spokesman, Dan Wilson.

Other places are using inducements of other kinds. To spur interest in the vaccines, Lombardo, the chief in Las Vegas, revoked a policy at the beginning of April that had treated all covid-19 infections as work-related. Now officers must use their own sick leave to quarantine and recuperate. But the order has had little effect, he said, as more than 30 employees have tested positive since.

Lombardo said he has also sought to make vaccination more accessible by offering shots in briefing rooms and jails. “I’m doing everything I can to make it readily available, but I hire from the human race, and sometimes people are just lazy.”

Mandatory vaccination, especially for police, is politically charged. The dispute in Durham County gained notice in the right-wing media, where a Facebook page called “Thin Blue Line” posted a January article attacking the requirement as “communism” in a group with more than 73,000 members titled “We Support Our Police.”

Vaccine mandates are likely to pass legal muster, according to specialists in employment law, providing they adhere to guidance issued last year by the U.S. Equal Employment Opportunity Commission outlining exceptions for disability and religious belief. The broad authority of states and localities to protect public welfare would encompass compulsory vaccination of police, said Catherine Ruckelshaus, legal director of the National Employment Law Project.

But most police leaders see the legal and union fights as minefields they’d rather avoid. “We have made a very deliberate decision not to mandate it for staff,” said Joseph Chacon, chief of the Austin Police Department, who has refrained from questioning officers about their immunization status, saying they have “trepidation in thinking we might be trying to track that somehow, which we’re not.”

...Some officers think talk of mandates is premature. More than half of the Los Angeles Police Department has received at least one dose, said Mark Cronin, a 27-year veteran of LAPD and a union official handling virus-related issues.

Most of the questions he fields are from officers asking how to decide among the three authorized vaccines, how to arrange their vaccination and how to plan for a booster shot, he said.

And for officers who refuse vaccination, Cronin’s message is blunt. “I tell our members that you’re an absolute fool if you don’t get it.”

I would love to see how much police vaccine hesitancy correlates with right-wing politics, which is rampant in many-- probably most-- police departments. In light of the NY Times piece this morning by Apoovra Mandavilli, Reaching ‘Herd Immunity’ Is Unlikely in the U.S., Experts Now Believe, this is a serious question that has to be dealt with. "Widely circulating coronavirus variants and persistent hesitancy about vaccines will keep the goal [herd immunity] out of reach... [T]here is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable-- at least not in the foreseeable future, and perhaps not ever. Instead, they are coming to the conclusion that rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in the United States for years to come, still causing hospitalizations and deaths but in much smaller numbers. How much smaller is uncertain and depends in part on how much of the nation, and the world, becomes vaccinated and how the coronavirus evolves. It is already clear, however, that the virus is changing too quickly, new variants are spreading too easily and vaccination is proceeding too slowly for herd immunity to be within reach anytime soon."

As a result, experts now calculate the herd immunity threshold to be at least 80 percent. If even more contagious variants develop, or if scientists find that immunized people can still transmit the virus, the calculation will have to be revised upward again.

Polls show that about 30 percent of the U.S. population is still reluctant to be vaccinated. That number is expected to improve but probably not enough. “It is theoretically possible that we could get to about 90 percent vaccination coverage, but not super likely, I would say,” said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health.

...Herd immunity is often described as a national target. But that is a hazy concept in a country this large.

“Disease transmission is local,” Dr. Lipsitch noted.

“If the coverage is 95 percent in the United States as a whole, but 70 percent in some small town, the virus doesn’t care,” he explained. “It will make its way around the small town.”

Skepticism about the vaccines among many Americans and lack of access in some groups-- homeless populations, migrant workers or some communities of color-- make it a challenge to achieve that goal. Vaccine mandates would only make that stance worse, some experts believe. [Though not expert Howie Klein.]

A better approach would be for a trusted figure to address the root cause of the hesitancy-- fear, mistrust, misconceptions, ease of access or a desire for more information, said Mary Politi, an expert in health decision making and health communication at Washington University in St. Louis.

People often need to see others in their social circle embracing something before they are willing to try it, Dr. Politi said. Emphasizing the benefits of vaccination to their lives, like seeing a family member or sending their children to school, might be more motivating than the nebulous idea of herd immunity.

Maybe we could get Q to say that if everyone uses it, it will mean that Trump will be president the next day. Mandavilli concluded that "Over time, if not enough people are protected, highly contagious variants may develop that can break through vaccine protection, land people in the hospital and put them at risk of death. 'That’s the nightmare scenario,” said Jeffrey Shaman, an epidemiologist at Columbia University. How frequent and how severe those breakthrough infections are have the potential to determine whether the United States can keep hospitalizations and deaths low or if the country will find itself in a 'mad scramble' every couple of years, he said. 'I think we’re going to be looking over our shoulders-- or at least public health officials and infectious disease epidemiologists are going to be looking over their shoulders going: ‘All right, the variants out there-- what are they doing? What are they capable of?' he said. 'Maybe the general public can go back to not worrying about it so much, but we will have to.'"

First it was Jim Justice (R-WV) and now it's Larry Hogan (R-MD) offering some people $100 pops if they get vaccinated. Good idea. Phil Murphy (D-NJ) is offering a free beer.

A few days ago Derek Thompson noted that about half of Republicans under 50 say they won’t get a vaccine. States with larger Trump vote shares are where people are refusing to get vaccinated. Maybe they think they're owning the libs. Maybe they just recognize how pointless their miserable lives are and prefer to die. Thompson wants to know: "What are they thinking, these vaccine-hesitant, vaccine-resistant, and COVID-apathetic?

My view of the vaccines begins with my view of the pandemic. I really don’t want to get COVID-19. Not only do I want to avoid an illness with uncertain long-term implications, but I also don’t want to pass it along to somebody in a high-risk category, such as my grandmother or an immunocompromised stranger. For more than a year, I radically changed my life to avoid infection. So I was thrilled to hear that the vaccines were effective at blocking severe illness and transmission. I eagerly signed up to take both my shots, even after reading all about the side effects.

The under-50 no-vaxxers’ deep story has a very different starting place. It begins like this:

"The coronavirus is a wildly overrated threat. Yes, it’s appropriate and good to protect old and vulnerable people. But I’m not old or vulnerable. If I get it, I’ll be fine. In fact, maybe I have gotten it, and I am fine. I don’t know why I should consider this disease more dangerous than driving a car, a risky thing I do every day without a moment’s worry. Liberals, Democrats, and public-health elites have been so wrong so often, we’d be better off doing the opposite of almost everything they say."

Just as my COVID-19 story shapes my vaccine eagerness, this group’s COVID-19 story shapes their vaccine skepticism. Again and again, I heard variations on this theme:

"I don’t need some novel pharmaceutical product to give me permission to do the things I’m already doing. This isn’t even an FDA-approved vaccine; it’s authorized for an emergency. Well, I don’t consider COVID-19 a personal emergency. So why would I sign up to be an early guinea pig for a therapy that I don’t need, whose long-term effects we don’t understand? I’d rather bet on my immune system than on Big Pharma."

For both yes-vaxxers like me and the no-vaxxers I spoke with, feelings about the vaccine are intertwined with feelings about the pandemic.

Although I think I’m right about the vaccines, the truth is that my thinking on this issue is motivated. I canceled vacations, canceled my wedding, avoided indoor dining, and mostly stayed home for 15 months. All that sucked. I am rooting for the vaccines to work.

But the no-vaxxers I spoke with just don’t care. They’ve traveled, eaten in restaurants, gathered with friends inside, gotten COVID-19 or not gotten COVID-19, survived, and decided it was no big deal. What’s more, they’ve survived while flouting the advice of the CDC, the WHO, Anthony Fauci, Democratic lawmakers, and liberals, whom they don’t trust to give them straight answers on anything virus-related.

The no-vaxxers’ reasoning is motivated too. Specifically, they’re motivated to distrust public-health authorities who they’ve decided are a bunch of phony neurotics, and they’re motivated to see the vaccines as a risky pharmaceutical experiment, rather than as a clear breakthrough that might restore normal life (which, again, they barely stopped living). This is the no-vaxxer deep story in a nutshell: I trust my own cells more than I trust pharmaceutical goop; I trust my own mind more than I trust liberal elites.

So what will change their minds?

I cannot imagine that any amount of hectoring or shaming, or proclamations from the public-health or Democratic communities, will make much of a difference for this group. “I’ve lost all faith in the media and public-health officials,” Myles Pindus, a 24-year-old in Brooklyn, said. “It might sound crazy, but I’d rather go to Twitter and check out a few people I trust than take guidance from the CDC, or WHO, or Fauci,” Baca, the Colorado truck driver, told me. Other no-vaxxers offered similar appraisals of various Democrats and liberals, but they were typically less printable.

From my conversations, I see three ways to persuade no-vaxxers: make it more convenient to get a shot; make it less convenient to not get a shot; or encourage them to think more socially.

1. Try something like “DoorDash for vaccines.”

To get people to participate in an activity they don’t really care about, you make it as easy and tantalizing as possible. Some people have already suggested offering money, free food, or even lottery tickets in exchange for vaccination. But one source who asked to remain anonymous suggested that state health departments should offer something like DoorDash for vaccines.

With any new technology, the early adopters are the ones most willing to tolerate glitches and a bad experience. That’s fine when supply is limited, but as you try to get to mass market, you need to perfect the product and experience.

All of which to say: Cities should start to roll out a vaccine in-home service, which people can book on short notice. Providers come to you, and maybe bring you some sort of gift along with the vaccine. Cities should have enough capacity and staff to do that at this point, and a service such as this would be key to getting young people in particular to take it.

2. Make it suck more to not be vaccinated.

Governments and companies may find that soft bribery is the best way to get the no-vaxxers to the clinics. Michigan Governor Gretchen Whitmer, for example, has linked her state reopening policies to progress in shots, letting restaurants and bars increase their occupancy once 60 percent of the state has been vaccinated, and promising to lift mask orders when 70 percent of Michiganders have received both doses.

Millions of people want to go to sporting events, attend concerts, or travel internationally. If those who cannot prove that they’ve been vaccinated are denied service, I expect that some will sign up for shots purely as a means of reengaging in their favorite activities. “If all or most countries instituted vaccine passports, that might change [my mind],” Younes, the attorney, told me.

But the cultural backlash against domestic restrictions could be prodigious. If blue-state governors and sports stadiums deny economic activities to the unvaccinated while red-state stadiums allow anybody to sit at a bar or in the bleachers, it will deepen the culture-war tensions between scolding liberals and accommodating conservatives in a way that might not be good for Democrats politically, even if they have the upper hand in the public-health argument.

3. “What if natural immunity isn’t enough to protect your grandmother?”

The most common argument against the vaccines is: My immune system is good enough for me. One counterargument is: That’s right, but the vaccines are even better at protecting others.

Even for people who have already recovered from COVID-19, getting fully vaccinated strengthens the antibody and T-cell protection against the disease and likely provides superior protection from variants that can pierce our natural immunity.

Why do more levels of protection matter? Because the vaccines aren’t just about building a defensive wall around safe young bodies. We’re also collectively building a wall around the more vulnerable members of society. And little holes in the wall can lead to unnecessary deaths.

In April, the CDC reported that an unvaccinated health-care worker set off an outbreak in a mostly vaccinated Kentucky nursing home. Several vaccinated seniors got sick and two vaccinated residents died. To be absolutely clear: The vaccines worked to protect most residents. But no vaccine is perfect, and the COVID-19 vaccines won’t stop all infections, especially for some people with weak immune systems.

I made this case to several no-vaxxers: Your grandparents, elderly neighbors, and immunocompromised friends will be safer if you’re vaccinated, even if you’ve already been infected. I played with the “COVID is no worse than driving” metaphor that many of them offered. I agree that driving is acceptably safe for most people, I said. But imagine, I added, if you could have a forward collision warning system installed in your car for free? An already-pretty-safe activity would become an even safer activity; and what’s more, you’d be protecting other people on the road at minimal cost to yourself.

I can’t tell you this argument got a lot of people to drop the phone, sprint to a vaccine clinic, and sign up for a Fauci tattoo on their arm. The truth is that I’m not sure that I changed anybody’s mind. But I can honestly say that this argument gave several no-vaxxers a bit of pause. They responded by talking about chains of transmission throughout the community, rather than focusing on their own immune system. Several of them asked to see evidence of my position so that they could examine it for themselves.

The United States suffers from a deficit of imagining the lives of other people. This is true of my side: Vaccinated liberals don’t take much time to calmly hear out the logic of those refusing the shots. But it’s also true of the no-vaxxers, who might reconsider their view if they grasped the far-ranging consequences of their private vaccination decisions. Instead of shaming and hectoring, our focus should be on broadening their circle of care: Your cells might be good enough to protect you; but the shots are better to protect grandpa.