"You Think This Virus Is Real?"

How should we tackle vaccine skepticism and get people vaccinated? My take from the front lines.

“You think this virus is real?” one Oregon friend asked me. He was genuinely curious. He’s prone to conspiracy theories and he had heard that Covid-19 is all a hoax. He has not been vaccinated and doesn’t intend to be.

Another friend here in Yamhill County told me the virus is definitely a fake, and he hasn’t been vaccinated either. But then a few minutes later, he pooh-poohed my concern for his health and told me that anyway it’s all overblown. “I had it, and it was nothing worse than the flu,” he scoffed. (I’m still trying to sort out how he could boast of having contracted an ailment that he also claimed doesn’t exist.)

Yet another old buddy since grade school told me that he won’t get vaccinated because he’s heard that if he did, Bill Gates would be putting a chip in his brain. I gently told him that this wasn’t true, but he was adamant. He had read it somewhere on his phone.

 “I thought you were well-informed,” he teased me. “You better pay more attention to the news.”

I’m thinking of these friends as the Omicron variant of the coronavirus spreads around the state, country and world. We shouldn’t panic, but we should be ready to double down on basic public health practices — surveillance, testing, masking and above all, vaccination.

But how do we raise vaccination rates when public health is so politicized, when Fox News anchors who are themselves vaccinated sow doubts, when so many Americans inhabit a world of misinformation and delusion exacerbated by our political divide? In this flawed information ecosystem, a public health priority has been recast as a political litmus test with deadly consequences: Republicans are more than three times as likely as Democrats to be unvaccinated, for people follow the cues of their “team.”

My friends are not representative of Oregonians overall, for this state has done very well by basic Covid-19 metrics, including vaccination rates. We have the seventh-lowest Covid mortality rate among states, and a vaccination rate, 65 percent, that puts us 14th among the states. But that still means that a large fraction of Oregonians — and Americans — are resisting a life-saving intervention available at no cost.

Some of them are dear friends of mine here in rural Oregon, even if they exasperate me with their politics and frighten me with their health decisions; I worry about them even as I wish I could knock some sense into them. So what can we do to persuade them and create a healthier ecosystem?

One step: Holding right-wing “news organizations” responsible for their deadly misinformation. Fox News recently had a segment in which the hosts suggested that the Omicron variant was somehow created to help Democrats. That’s a lie, and it’s the kind of message that makes it harder to get people vaccinated — so more Americans die. I’d like to see pressure on companies to stop advertising on Fox News as long as it propagates deadly messages. (This isn’t just a theory: Early in the pandemic, researchers found evidence that watching Sean Hannity’s show on Fox News was correlated to higher Covid mortality.)

That’s me getting my booster shot in Yamhill County.

Another step: Accept that vaccine mandates will be a big part of our return to normalcy. These sorts of mandates, rather than usurpers of liberty and threats to freedom, have a long and patriotic history in the United States. The first American vaccine mandate was imposed by George Washington on troops fighting in the American Revolution, to reduce the risk of smallpox. And since then we’ve had lots of experience with vaccine mandates of all kinds, and they are enormously effective. The United States military is an example of an institution that uses vaccine mandates, including for Covid-19, to reduce risks of disruption and chaos. Likewise, private sector companies from McDonalds to Goldman Sachs have imposed vaccine mandates on some or all employees, and these have been very successful.

These vaccine mandates succeed for two reasons. First, many people are ambivalent about the vaccine and are unwilling to take the initiative to get it (particularly if their conservative friends will scold them for selling out) but they don’t care enough to resist if an employer requires vaccination.

Second, the best evidence is that for people under 65 who have been vaccinated and boostered, Covid-19 is becoming a manageable risk on the order of magnitude of the annual flu. In other words, vaccinations are how we rebuild the economy and recover our lives.

European countries have as big a problem with vaccine hesitancy as America, and they are succeeding with a variant of a mandate: tight limits on the unvaccinated. For example, Austria has seen the sharpest fall of cases in any country after it effectively imposed a lockdown on citizens who were not vaccinated. The result was an enormous rise in numbers who got vaccinated.

Yet even as most of us support vaccine mandates, we know that they’re insufficient (particularly if the Supreme Court invalidates the Biden administration’s mandate in the private sector). So we need to do more. We also have to combat the information ecosystem that has allowed public health no-brainers to become so contested. When 60 percent of Republicans say in a poll that the 2020 presidential election was stolen, when millions of the same people refuse a life-saving vaccine, we’re in the territory of deadly mass delusion.

I’ve thought a lot about that in my run for governor of Oregon, and I do think there are steps we can take that help. These steps also may address the Democrats’ justified angst about difficulties connecting with working class voters who should be allies. One starting point is simply for Democrats to engage and reach out to those voters even when they are now Republicans, holding town halls and listening to people on the other side of the divide; here in Oregon, Senators Ron Wyden and Jeff Merkley hold town halls in every county every year, and I do think that reduces the hostility a bit.

A second crucial step is that political leaders must be seen as representing those communities and addressing their economic needs. In Oregon, Lake County is the poorest county in the state and the only one in which per capita income has declined in the last decade; a governor has to be seen offering hope for Lake County as well as for the Willamette Valley.

Yet even if the landscape were less toxic, many people would still doubt vaccination. So how do we win them over? There have also been many rigorous experiments testing how to get people to agree to vaccinations (most of this predated Covid-19 and concerned other vaccines). Browbeating and finger-wagging don’t work, instead making people double down and become defensive.

The persuasive approach that seems somewhat effective is trying to build a bridge by acknowledging something the other side believes, and then planting a seed of doubt that can grow on its own.

For me, the argument that has had some success with friends is drawing a parallel between vaccine resistance and drunk driving. I do this very gently, but try to convey that both are irresponsible and reckless antisocial behaviors.

When someone makes the point that they haven’t been vaccinated and are doing fine, I say that’s true of most drunk drivers as well: Most of the time, they don’t cause an accident. Then the other person will say that anyway, it’s a personal decision or a matter of freedom. And I respond that I understand the point, but refusing a vaccination can also harm other people, just as drunk driving can. I make clear that I don’t think police should arrest vaccine resisters, and that the parallel is not about criminal justice but about our own personal responsibility to help our neighbors by keeping highways safe and by containing a deadly virus. I try to use a mallet, not a sledgehammer.

If you have a relative who won’t get vaccinated or obey protocols, let me know in the comments if this works, or another approach does. But truly, my message is: Don’t give up. Fighting the culture of drunk driving was hard too, but we did change laws and norms and saved countless lives in the process. We can change laws and norms about Covid vaccinations as well, and in an age of Omicron, we need to.