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Here’s the Right Story for Vaccine Holdouts

Two public health experts explain how to cut through the noise about COVID-19 vaccines.

Blaise Pascal was a renowned French polymath of the 17th century, scientist, philosopher, mathematician, inventor, and later in life…By Stuart Firestein

Blaise Pascal was a renowned French polymath of the 17th century, scientist, philosopher, mathematician, inventor, and later in life a theologian. Among his many contributions was an attempt to prove by logical means the existence of God, which came to be known as Pascal’s Wager. Stated simply, Pascal reasoned that not believing in God, if there was one, would damn you to eternal suffering. Conversely, believing in God, if there wasn’t one, would cost you little in this life and nothing once you were dead. Therefore, the only sensible course of action was to believe in God.

Whether or not you find Pascal’s Wager to be theologically compelling, it turns out to be a very useful guide for making decisions under conditions of unresolvable uncertainty. And the major uncertainty that all of us are collectively facing right now is the virus known as SARS-CoV-2, responsible for COVID-19. The availability of a vaccine, several vaccines in fact, has brought all those uncertainties into focus.

There’s only one enemy here, and that enemy is a virus.

Given we are going to have a certain amount of uncertainty about all this for some time, we might resort to a Pascal-like strategy for making a decision. And right now there is no more important decision than whether or not to get vaccinated. As we know, many people in the United States and around the world are not ready to wager on a vaccination. To be fair, the uncertainty they face is due to simple misinformation, all too easily spread in the various forms of media. But much of the uncertainty is of legitimate concern. To help us understand why people are hesitant to be vaccinated, and how society should address them, Nautilus turned to two people who have been involved with disease and disease control internationally and nationally.

Heidi Larson is a professor of anthropology, risk, and decision science, and is the founding director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Science. She’s also a clinical professor of health metric sciences at the University of Washington, in Seattle, and the author of the recent book, Stuck: How Vaccine Rumors Start and Why They Don’t Go Away. Tom Frieden is a physician trained in internal medicine, infectious diseases, public health, and epidemiology. He is former director of the U.S. Centers for Disease Control and Prevention, the CDC, and former commissioner of the New York City Health Department. Frieden is currently President and CEO of Resolve to Save Lives, an initiative of the Global Health Organization Vital Strategies.

In our video interview below, Larson and Frieden are sympathetic to people reluctant to be vaccinated. They explain the lessons we can take from the polio and meningococcal vaccine programs. We discuss the problems with today’s “cult of science” and at the same time how astonishingly effective that science has been in developing today’s COVID-19 vaccines. The two public health experts counter misinformation about how the COVID-19 vaccine works and offer important insights into how the vaccine should be presented to people. “There’s only one enemy here, and that enemy is a virus,” Frieden says.


Video transcript

Stuart Firestein

Heidi, your book, Stuck: How Vaccine Rumors Start and Why They Don’t Go Away, was written and published a year or so before the current COVID-19 epidemic began in 2020. And so, I think it has an interesting perspective on the history of vaccines and attitudes toward vaccines. Could you give us a brief history and a perspective on how vaccines have been looked at in the past, how they’ve been developed, and so forth without the lens of COVID-19?

Heidi Larson

Well, in the book I reflect back on my work with vaccines over the last two decades actually, that this issue of vaccine confidence or hesitancy, I try to take the positive spin of confidence, it’s not new to recent vaccines. I mean, I’m here based in the United Kingdom now, which was the home of the first anti-vaccine league in the 1800s around smallpox. It wasn’t actually an anti-vaccine league, it was an anti-compulsory vaccine league, and it was all about the mandate that they had put on vaccines. And once they put in an opt out option for conscientious objectors, which I always thought was just about the Vietnam War, but turns out it goes back to the smallpox resistance or the opt out option, but then fast forward, that calms the resistance down for a while giving the conscientious objector option.

We’ve missed the opportunity to frame vaccines as, “Do it the natural way.”

That theme of the public making a choice, having a choice, not being told what to do, I think has been one of the consistent underlying drivers and challenges to vaccination from the start. I spent years working in the UN on rights issues and human rights issues, that fine line between personal freedoms and right to health, when your rights become responsibilities, has been the cutting edge of a lot of what we’re seeing in COVID and before.

The other trend that we’ve seen since the beginning was, this is against God’s plan, putting an injection in you trying to perceive being manipulated. That goes back to the beginning and has come back and forth. And over the years looking for an opportunity, I mean, and I’ll wrap it up here, but in Stuck I talk about why vaccine rumors persist, they’re out there, they live out there, these are deep human sentiments that come up when the opportunity is there, and COVID has certainly laid it out in front of us as an opportunity because of the uncertainty, but has with different vaccines over different periods of time.

Stuart Firestein

So, Tom, you’re on the front line of the very first point that Heidi made. You made three quite interesting points and I want to get back to all of them, but let’s go to the first one first, which is the compulsory nature or the recommendations of government, which as we know is where there’s a lot of pushback. And of course you run or have run two agencies, which are their businesses to make recommendations, and in cases of emergencies, presumably even institute compulsory programs. So how do you deal with that? How do you work around that? Are you aware of that problem?

Tom Frieden

Yes, it is a very challenging issue because you want to encourage vaccination. There’s a little bit of challenge in that if you push too hard, you get more pushback, and yet, in certain circumstances mandating vaccination is indicated. I think for COVID those circumstances are relatively limited but they’re not zero. For example, if I were an administrator of a nursing home, a care home, as they’re called in the U.K., with older people, I would require employees to be vaccinated or have a valid medical exemption to not be vaccinated. Now, what we’re hearing from parts of the U.S. that are quite negative on vaccination is that, if people are going to make me do it, I’m just going to be more adamant about not doing it.

At the same time, we know that certain things have been constants in vaccination. One, for every vaccination program I’m aware of, there has been an anti-vaccination movement. So this is not new or different, and Heidi may be able to update this. There are some examples where acceptance is extremely high. As one example, when I was at CDC, we did a rigorous analysis of a very effective anti-meningococcal vaccine in Africa where meningitis is devastating, and we found uptake of well over 90 percent among ages up to age 29. So in the right context, even without a mandate, you can get a lot of interest. So, I guess the first thing to say is, we shouldn’t be surprised by an anti-vaccination movement.

The second constant is that mandates work. And where it’s indicated and when it’s appropriately done, mandates do result in big increases in vaccination. We’ve seen this in the U.S. with school mandates, when I started at the CDC there were outbreaks of measles all over the country, and some of them were lethal, and because of that, we went to a two dose series and we began mandating vaccination for college entry, two doses in preschool entry, and we saw a dramatic reduction, in fact, elimination of measles from the U.S. So mandates work.

And the third issue is, you really have to be specific to the communities you’re dealing with to understand, what are the factors that are encouraging and discouraging vaccination? In the meningitis example I gave, the disease was so apparent to people that they really wanted to get vaccinated. In contrast, where people don’t believe the disease is serious, or don’t trust the government, or don’t trust the health care system, then vaccination becomes much more difficult and it’s crucial to listen—communication is best when it’s two ways—to identify what the concerns are, and then to identify the best messengers and the best messages to get people to be more interested in vaccination.

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Stuart Firestein

One of the historical examples of this is the polio vaccine. When I was a child in the U.S., when it first came out, people lined up to get it, we couldn’t get it fast enough. There was no question of not getting the polio vaccine, you just went and got it. Everybody wanted it, and we were thrilled. But then attempts to eradicate polio around the world have run into a great deal of vaccine hesitancy in other places more recently. So what’s the difference between those two cases? Why was it so welcome at one time and in one place, and seemingly so unwelcome or mistrusted at another time in another place?

Heidi Larson

Well, I think that picks up on Tom’s point on why the meningococcal vaccine was so readily and widely accepted, was because the community saw, I mean, this was really a fatal ... there would be outbreaks year after year and that people were very scared of it, it was very visceral to them and this was a help. And I think the same is true at the beginning with polio. I mean, my father had polio and I remember, I’ve heard a lot of stories about the fears, not going to the public swimming pools, staying at home, and the anxieties in his own personal experience. And when the vaccines were there, people got it. I mean, they knew why they were getting it.

Sorry, with the polio eradication initiative, I think it’s a fatigue issue. And also people aren’t seeing the polio. The success of the program means that they’re not seeing a lot of polio, but because it’s an eradication effort, you need to get every last child. And in some cases, this means a lot of these children have had up to 20 doses. And it’s also been a challenge to programs because I remember I did a lot in India, as Tom has spent a lot of time in India on TB, but at any rate knows what the front lines are like. In Hindi it was like one dose for life or two drops for life. And then how do you explain when you’re on the 20th drop? Wait a minute, that campaign we did. So people are like, well, wait a minute.

And it’s also, and this is a risk for COVID, why do you keep coming back on the same vaccine again and again, when our kids are dying of dirty water, they’re dying of measles, you’re not bringing the measles vaccine? So people want you to feel like you care about their overall well-being and not just one vaccine that’s going to make the government look good.

Tom Frieden

I think Heidi is actually right here. And one of the issues with polio, with public health more generally also, is that public health tends to be a victim of its own success. The more progress there is, the less interested people are in continuing the measures that ensure that progress. As Heidi says, when the polio vaccine came out, it was a miracle and people were lining up to get vaccinated, there was very little anti-vaccination sentiment. Even after there was a terrible contamination incident, what’s called The Cutter incident, and one laboratory contaminated polio vaccination, and kids actually did get polio from the vaccine because there wasn’t good quality control, even after that, the polio vaccination program was highly successful. But now, with polio close to, on the verge of eradication, people are saying exactly as Heidi says, why are you coming here for this disease that isn’t a problem and we have lots of other problems?

The analogy to that with COVID, is that COVID is a very unusual infection. In the U.S., 199 out of 200 infections are not going to be fatal. Now how many people have long COVID and how many other problems there are? That’s a different question. But you’ll hear people say, “I don’t know anyone who has had severe COVID, I know people who had the disease, it was no big deal, they’re making too much out of it.” So it’s playing into a lot of the partisan frame that too much of our Public Health and Science is being put through. And that divergent worldview is leading to a lot of resistance in a lot of places, not just the U.S., but my organization, Resolve to Save Lives, is active in many countries in Africa, now they’re getting hit harder with the Delta variant, but up till now there were a lot of concerns, “What is this vaccine? Is it experimental? Are you trying to experiment on me?”

And that really plays on the whole panoply of programs and experiences that people have. The one thing that you cannot surge in during an emergency is trust, that has to be built over time, and unfortunately, it can be destroyed very quickly.

Part of the challenge we’re facing is the lack of recognition that we are connected, that what one person does affects another person.

Stuart Firestein

I just read a report yesterday about how, in many Hispanic communities across this country, they’re turning vaccination centers into places where you also can receive financial aid and social support. So this becomes a center of places to come to fix all the problems that this virus has actually ... Let’s say this virus X-rayed our society and showed us where all the weaknesses were, in healthcare, in poverty, in discrimination, and so forth and so on, because it attacks, very carefully, every one of those places. And so, the idea of setting up a vaccination center where you don’t just come to get vaccinated but you come to have many of the problems associated with COVID or your daily life, you come for solutions. Which seemed to me an excellent idea for, in fact, improving this notion of trust and improving this idea that we’re not just here to vaccinate you and take off. Any thoughts on that?

Tom Frieden

Well, convenience overrules resistance in a lot of cases. And the more you make vaccination the default value of what’s done normally, whether it’s when you’re going to the drugstore, or the doctor’s office, or the social service center, that’s going to go a long way toward getting more people vaccinated, because there are many hidden costs of getting vaccinated, time off from work, if you feel sick, transport time. So the more convenient, the better off we all are.

Heidi Larson

Yes, absolutely. And the whole notion that you talked about with offering other services was again, one of the things that made a big difference in the polio campaigns, they had what they called health camps, where they would offer a whole mix of different health services, and that made a huge difference. And it did send the same signal that we’re trying to address your felt needs, not just what we think is important.

Stuart Firestein

So I think one of the things that I believe, to some extent, causes some mistrust in the vaccine area is a phrase that frankly makes me cringe, which is “follow the science.” I’m a scientist, we all are here to some extent, but it just makes me cringe because I don’t think, of course, science is a cult, I don’t think you should follow. I think science is not prescriptive, it’s informative, and should be used informatively but not prescriptively. And so this phrase worries me a little bit and I wonder if you feel, either of you, that this causes a mistrust or backlash as well. It’s intended obviously to be rational, but I don’t find it that way myself and I wonder if other people who are not even scientists react even worse to it. You think it’s a good phrase, a bad phrase? Are we causing more trouble with it than we’re solving?

Heidi Larson

I think we’re playing into exactly some of the concerns they have, and I don’t think it’s actually far from the perception of some to when you say, science is not a cult. Well, it sometimes is perceived as one because of that aspect. And in my book I talk about, we’re coming to this near reversal of the enlightenment. When the whole enlightenment was embracing science as freedom from religious dogma, and that was free thinking. But now, the public actually looks at science as the new dogma, that it’s restricting their free thinking, they’re turning to philosophical and religious beliefs that have more humanity in them, or feel like they do.

I think, ultimately, we want to bring values, and science, and the practical realities together. Indonesia was very interesting. They had a pretty bad resistance coming from some of the local Muslim leaders in an MR, measles rubella campaign, a few years ago, and it really undermined acceptance and totally disrupted this nationwide effort. And when the case of COVID, the ministry, they not only went through, as they should, the safety, the regulatory, all the scientific assessments, after they did that, they went to the organization of the National Muslim organization to get their blessings also before they rolled out.

So they said, “Okay, we’re not going to get in that situation again, we want to upfront, embrace, engage the Muslim leaders.” So that I thought was quite important. I know we learned certainly in HIV and the HIV response the importance of considering the value of dimension, and that’s certainly a factor in vaccines. I’m sure Tom has some experiences and reflections on this.

Tom Frieden

Well, I think words do matter and approaches matter. What I’ve always found to be most helpful is to be very clear about what we know, how we know it, what we don’t know and what we’re doing to find it out. Often, there is scientific controversy. And I’ve generally found that the more vigorous the controversy, the weaker the evidence base. Science also changes, and I think that’s frustrating to people. And I’ve been part of focus groups with vaccine hesitant people, that’s very frustrating to people, they want there to be a plain truth and for it to be unchanging, but that’s not how science works. And I think the more we’re able to communicate regularly and share our path of discovery with people, the better they’ll understand the process and accept the recommendations, because the plain truth is that vaccines against COVID are astonishingly effective and extremely safe.

Heidi Larson

Yes. They’re remarkable. I mean, when you think that compared to other vaccines, yes, it’s been a scientific remarkable achievement, now we just have to bring all the other elements along with that.

Stuart Firestein

Yes, the issue to some extent of expertise and where that expertise comes from—I think we all believe in expertise even aside from scientific expertise. If you hire a plumber, you want the plumber to know what they’re doing. You want expertise. And you go to the dentist, you want an expert dentist, so we all like expertise. But on the other hand, the logical end of following expertise is not thinking for yourself. And so, I think it’s important for us to leave inside that bubble of expertise the notion that, indeed, you still have to do a bit of thinking for yourself or take knowledge from a variety of areas, whether it’s your religious beliefs, or your ethical beliefs, or your other beliefs besides science.

I always like to say, in science, revision is a victory, but that’s not true in many other places. And so, unless you’re a scientist, you don’t have that experience of, “Wow, we found something better out. We were wrong before, we’ve corrected it, and that’s a thrilling moment.” But unless you have that experience it’s very hard to communicate it, I think.

Can we talk for a moment about the difference between anecdote and data, which I think is a tricky business in the vaccine area because people hear anecdotes, as Tom pointed out earlier, none of my friends got COVID, I don’t know anybody who died from it, et cetera. But I do know people who got terrible reactions from the vaccine, and they say, even though millions and millions get virtually no reaction, there’s always a few who do. And so how does one present anecdote, which is very powerful because it’s a personal narrative, versus data, which is statistics and nobody cares about statistics or nobody listens to them carefully, and let’s face it, you put people to sleep with them? How do we deal with that?

Tom Frieden

The plural of anecdote is not data. And the second thing to say is that stories really do make a difference. We’ve just published research that shows that when you have first-person narratives about long COVID, people who were vaccine hesitant before get much less hesitant. And that’s consistent with what we’ve studied in tobacco control and other areas, that when people see particularly the reality of disability, disfigurement, or problems with daily life, they’re much more motivated to get things done.

Heidi Larson

Yes. Well, it’s great because you captured one of the things I was thinking, that data is not the plural of anecdote, per se. But I think that from the public perspective, they’re both types of evidence and they talk about, well, whose evidence, because they feel like they have experience evidence. And so, in a way, what we really need at the end of the day is data, but with a human face, and I think that comes through anecdote.

We have these risk biases, I mean, Daniel Kahneman’s work for sure talks about all this that when one person dies it can be quite dramatic, but when the second one does, somehow, there are certain numbers that as you get more and more of them the power of the story changes. And I think that we do need the data to inform policy, to do a lot of important things, but not by itself. And I think that’s the big message is we really, again, need to bring in the personal experience, the collective experience, and not exclude one or the other.

This has been a terrible, distressing, awful event for the world. But if this had happened 25 years ago, it would have been so much worse.

Stuart Firestein

I think one of the early mistakes that was made with the vaccines in the case of COVID was that those of us in the business found these new vaccines, these new mRNA vaccines, just absolute miracles. And of course, they’ve been around for a long time, at least the idea has been around and people have been researching them in relative obscurity, I have to say, for a long time, but now they burst onto the scene and they’re miracles, in my opinion, or scientific miracles anyway. But they do contain genes and we’ve taught people in many other ways to be wary of genes, the genetic manipulations, whether it’s a food, or animals, or even people, and all the scary business, I mean, there must be 100 movies from Jurassic Park down on the dangers of messing around with genes. And now here we’re asking people to take a vaccine, to stick into their arm a needle full of genes. And it seems we’ve failed in many ways to address that.

So it seems to be so easy to not see what would be scary to somebody, rightfully scary to them in fact. Any comments on what we could have done differently there, or what we can do differently now, or how we can communicate how RNA is not going to turn you into Jurassic Park or the world into Jurassic Park?

Tom Frieden

We have to be really clear with how we say and what we say. The fact is that an mRNA vaccine doesn’t change your DNA, it travels all over your body and it teaches your immune system how to fight COVID, and then poof, like a Snapchat message, it disappears. In contrast, if you get COVID, it’s going to travel all over your body, make billions and billions of copies, stay in your body for at least a week or 10 days, and possibly cause long term harm.

Heidi Larson

Couldn’t have been more precise than that. And I think we didn’t talk about that enough sooner. I think we threw a lot of science at the public in fast mode and it left people with a lot of room to try to understand it. Again, this is a brand new platform, it’s never been used before for vaccines. We also could have done a better job to talk about, as these vaccines were being developed, we could have talked more about why these things were moving faster. We had a lot of new technologies from the characterization of the virus that made it possible to even start vaccines.

The fact that the mRNA, as a platform, as an approach, has been used and worked with for a decade, not specific to this vaccine, but it wasn’t like they invented it overnight. And that usually the vaccine development process is quite linear. And in the case of COVID, in the context of an emergency, they unpacked it and did parallel processes, not compromising safety, it wasn’t short cut, they reorganized the whole process. And also there was a lot of funding upfront because of the nature of the emergency which is not typically available at the beginning of vaccines.

So I think we could have, as a scientific community, talked a lot more early about why we were able to make these things faster. But this anxiety about RNA messing with DNA does also touch a nerve in the public which also goes way back, which is about extinction, anxieties about sterilization, making people infertile. Whenever you have something that’s particularly a mass vaccination program, particularly minority or groups that feel like they’re discriminated against, anything that is statewide or mass vaccination creates anxieties in people and their DNA is part of their existence and procreation, frankly.

Tom Frieden

Absolutely correct that the idea that these were experimental vaccines rushed to the market is really wrong. This is a technology that’s been researched for 20 years and the fact is that this showed how quickly governments can work when they don’t cut corners on safety, but do work in parallel to move faster. And more people participated in these clinical trials, over 100,000 in different vaccine trials, than in any other vaccine trials. This is the best studied vaccine that we’ve had in vaccine introduction. And if you look at all of the vaccines we’ve used, Paul Offit, one of the world’s top vaccine experts just commented earlier this week, there has never been an example of a vaccine which has caused long-term harm that you haven’t seen in the first few months. It just hasn’t happened, and there’s no reason to think it will happen here.

Now, I like to be a scientist about it and say, I can’t guarantee you that this won’t be the first time ever, but I can guarantee you that your risk of a long-term problem or serious illness from COVID is massively higher than it is from the vaccine.

Stuart Firestein

Yes, that’s certainly the case. I’m fond of pointing out that the genetic sequence of the 1918 flu epidemic, the 1918 influenza virus was only solved in 2005, almost 90 years after the virus arrived, whereas the entire sequence of the Coronavirus, SARS-CoV-2, was solved, I believe, 11 days after the first reported case. And so that’s a reflection of tremendous progress in technology that made all this possible, but nothing new in a way. I mean, it’s just this is progress and we should all be thrilled for it.

I just have to say, I think, this has been a terrible, distressing, awful event for the world, but if this had happened 25 years ago, it would have been so much worse, so much worse. I mean, we would be even more devastated than we are now. I wanted to bring up one last, at least, vaccine hesitancy issue which I think is a legitimate one, which people will state, and which is that I believe in my body’s defenses. My body’s defenses are natural, they do this, they fight off colds, they fight off things, and I would rather believe in them than this synthetic thing that you’re going to give me. Why not just rely on my body’s natural abilities?

Heidi Larson

I was asked to write a commentary for Nature Immunology, and I said, “I’m really not an immunologist.” But they said, “Well, actually, we need a perspective that we can help to explain to the public.” So I spent a good bit of time with some immunologists to try to think through some concepts. And basically, like our emotions, from birth we’re training our immune system, we’re training our emotional makeup. And our immune system is, as you know well, it grows based on the exposures it has. And the reason our body does well with colds is because we’ve been exposed to those viruses and we have some strength. But in the case of COVID, particularly in 1918, these massive things, nobody in the world has been exposed to this particular virus, nobody had defenses, except for when we managed to develop the vaccine.

I think we’ve missed a massive framing of vaccines as “do it the natural way,” because basically, what vaccines do is trigger your own natural immune system to do better without making you sick, without killing you, which the virus itself is much more likely to do. So, I think we’ve missed an opportunity and I think we should rethink how we move forward with describing the whole mechanism of vaccination.

Tom Frieden

I think that’s absolutely right. And we believe in our immune systems also, that’s why the vaccines work. The vaccines teach your immune system how to fight it without you having to go through the trouble of getting an infection that might kill you or that you might spread to someone else and make them very sick or kill them. It goes beyond vaccines actually, it’s antibiotics as well. When you look at what antibiotics do for infections, it’s really not antibiotics that kill the infections, antibiotics knock down the number of bacteria so our body can mop up the rest. And you see that when you see what happens with people who have weakened immune systems, antibiotics and vaccines don’t work nearly as well, that tells you that what these wonderful scientific breakthroughs are doing is serving as assistance to our natural immunity.

Stuart Firestein

I think it’s a great phrase, that they’re assistants to our natural immunity, not some replacement for it or not some synthetic invention of science that does something different than what we do anyway, I think that’s exactly right. But again, an important message that has been hard, I think, to get out in many ways. Do either of you anything you’d like to add to all this? We’ve been through a lot of the various reasons for hesitancy, I think we’ve talked about them, we may have convinced a few people, we may not have, everybody is going to get to place their wager and decide whether to be hesitant or a victim of a variant, it seems to me. But is there anything we want to add to this? Heidi, would you like to make a last statement about all of this?

Heidi Larson

Yes, one of the things that I’ve seen change over the last couple of decades in the case of vaccine hesitancy and the reverse of confidence is the volatility—it’s much more like political opinion polling these days. It’s partly because of the communication environment. But the message is that because of this volatility of vaccine sentiment, because you did a survey this week, or because you did some social media listening this week, don’t assume that it’s going to be the same next week. We used to keep these knowledge attitude practice studies on our desk and rely on them for a year, two years, sometimes three years, and a lot of the time it was pretty consistent, that is absolutely not the case now.

And what that means for public health officials and people who are delivering vaccines, it means you have to be on your toes all the time. We need to be nimble and responsive. We can think we’re building trust, which is good, but don’t rest on our laurels, you need to keep supporting that because it can change on a dime. And the other side, we can also build confidence, and we’ve seen that also change in a good way. So, I think that’s just my parting shot.

Stuart Firestein

I find I’m optimistic about this all in all. I mean, we have done an amazing thing with this vaccine and when the next one of these viruses rolls out from wherever it’s going to roll out from, I think we will indeed be much better prepared in spite of the hesitancy that we’re experiencing in some areas, but little by little as you know, it is decreasing. Tom, would you like to add anything here at the end?

Tom Frieden

I’ll make three points. First, virtually every doctor who’s been offered a vaccine has gotten it as soon as she or he can. That’s something that I think moves people to understand, if the doctors are doing it, maybe I should do it too. Second, the vaccine really is our route to more freedom from the virus. The more of us who are vaccinated, the more we can get back to our jobs, entertainment, things that we like doing together. And third, this really is about all of us. I think part of the challenge that we’re facing is the lack of recognition that we are connected, that what one person does affects another person. There’s an old saying that your right to swing your fist ends at my nose.

Well, at a certain point, if you’re doing things that are not protecting yourself, you’re also putting others at risk. This infection is so unusual because you can feel completely fine and yet be highly infectious and spread it to someone who dies from it. And in our world, it doesn’t sound like we’re all in it together because there is so much division, there’s not just the volatility that Heidi spoke of, but also increasing fragmentation within countries, between countries. And maybe, just maybe, we can understand that we have the opportunity to use health as a bridge, to understand that there’s only one enemy here, that enemy is a virus, and the more we work together, the more progress we can make against that.

Stuart Firestein

Thank you. Excellent sentiments. I think that’s certainly true. So thank you both for your time and your thoughtfulness about all of this. I think it’s been extremely helpful. We’ve confronted, I think, more serious reasons for people being hesitant about vaccines, and that’s been very important. I think it’s important to take people’s attitudes seriously, I know you both agree with that as well and I feel like we’ve done something of that here today. So, thank you both very much for your time. I know you’re both very busy, there’s a lot of work to do out there. And let’s all place our bets.


Stuart Firestein is a professor and the former chair of the department of Biological Sciences at Columbia University in New York. He is the author of Ignorance and How it Drives Science and Failure: Why Science Is So Successful, both from Oxford University Press.

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