Thread by @ASlavitt

COVID Update December 16: Why you won’t hear me use the phrase “anti-vaxxer.” 1/

First let me tell you my opinion of vaccines. If they hadn’t been invented we would be so much worse off as a planet.

It’s probably a more important invention than Tik Tok. 2/

And the story of the first people who took vaccines is a story of “you’re serious. You’re going to put that in my body. GTFO.”

But the story with small pox goes (more or less) the first does went to the vaccine makers kid & when it worked all the next went to the king’s kids. 3/

But the king in this story was not an anti-vaxxer. He had legit questions. They did a (admittedly small) clinical trial and he was like “wow, great.” 4/

In 2003 in Northern Nigeria, the world was on the cusp of Polio eradication when a rumor about a the vaccine caused a year long protest. That rumor turned out to have no substance but caused the world to lose years & $500 million in eradication efforts.5/

Rumors have lots of power when there’s no good information or very legitimately limited information out there. And this was before the Internet, Russian bots, Rudy Giuliani, bot farms, and all the other ways bad things spread. 7/

I have read multiple bot tweets today saying “Bill and Melinda Gates and not doctors.” Perfect bot tweet. Goes well with every conversation. 8/

But the moms in Northern Nigeria were not irrational people and most people who have questions about vaccines are not either.

The way to turn someone into an “anti-vaxxer” is to treat them like their questions or concerns are not legitimate. 9/

The vaccines so have amazing performance characteristics. Better than we can hope. But asking about ingredients, allergic reactions, newness, long term effects— these are natural questions.

Some are like the king. They want to know more. 10/

Yes people are being fed misinformation. That’s unfortunate. But the way to combat misinformation is only partly with truthful information. The bigger part of it is by building trust.

Sound squishy?? 11/

Building trust is direct answers to simple questions, including when we don’t know yet. Building trust is local people who can walk in the shoes of the ppl asking questions talking about it. It means not avoiding the racist history of vaccines but addressing it. 12/

40% of people will take the vaccine according to data without question. Another 30% or so are vaccine-curious. And another 10% or possibly more are fence sitters or lean against. 14/

One highly linear approach is to say “we need 70% immunity so we must convince the vaccine curious and fence sitters to take this vaccine. They must do it for the good of society. And if they don’t they are...

greedy
selfish
ignorant
fringe

Pick one. 15/

History shows that people don’t take vaccines for 4 major reasons—-
1- fear of a safety issue
2- libertarian/don’t tell me what to do
3- all natural
4- distrust of government/pharma

There are other reasons, including some that are more fringe, conspiracy, etc. but less.16/

Having one of those concerns to me doesn’t make one an anti-vaxxer. And disparaging people’s legit questions & making them seem backwards just doesn’t feel like the way to go. 17/

In fact if we’ve learned anything from this pandemic, it’s how turning on each other has become the easiest thing to do. It hasn’t worked out well with masks or other NPIs, why would we continue that here. 18/

Maybe we could do this one part of the COVID response right. Maybe we could be more understanding to the very emotionally challenging & honest place most people come from. 19/

For every 10% of the population who chooses not to take a vaccine the modeling shows that means another 100,000 people die. But I don’t think that’s necessarily what most people need to hear. I think the 40% that works for but not the curious or the fence sitters.20/

Our brains are funny. I find some people who are both upset that they’re not higher up the vaccine list and don’t want to be pushed to take it.

We’re not always reasoned decision makers, particularly under stress.

I guess that’s why I call it vaccine curious. 21/

Some communities & some people will soon be having indoor gatherings, safer schools, hugging family, being able to attend indoor events. Others won’t. 22/

Things will likely happen at a varied pace. Certain workplaces, concerts, schools, etc will likely require vaccinations. This will convince some to take a vaccine & others it may harden them against it. 23/

But getting people off the fence isn’t a shaming exercise. It’s about trust. The vaccine confidence project has been working on this for a decade. I find the info vital & fascinating. Listen here. 24/

https://twitter.com/aslavitt/status/1339232188408029184

I can only tell you I will be taking the vaccine gratefully when my turn comes. In the meantime I will cry real tears each day the death count begins to drop as many of the people living in such fear & danger get to turn the page. /end