Dr Mike Lee - Anti-vaxxers and covid-19: who will get the jab?

Our thanks to Mike for taking the time to answer the following questions asked by our viewers that he didn't have time to address during the webinar.

How is taking money away from families supportive?

It's not really, hence our own government's reluctance to implement similar 'no jab no pay' policies as they have done so in Australia. Research also shows that such policies disadvantage 'non-vaccinators' who may not be against vaccination but simply have trouble accessing vaccines: Li, Ang and Toll, Matthew (2021), “Removing conscientious objection: The impact of ‘No Jab No Pay’ and ‘No Jab No Play’ vaccine policies in Australia,” Preventive Medicine, 145, 106406.

Misinformation comes from both those pro-vaccine and anti-vaccine

Yes, that's probably true, so the ability to have constructive conversations is vital.

I can see that people prefer to comment anonymously. Is that because they worry anti-vaxxers will make their life more difficult?

Perhaps, the same could also be said of anti-vaxxers or those who are vaccine hesitant as they may also feel judged by people they deem as the 'vaccination police'.

In the future do you see serious health risks from the vaccine challenging once healthy individuals?

I understand your concern as it refers to 'uncertainty' about the long term health risks of vaccines. However, vaccines are one of the oldest and most well studied medical interventions, as well as the medical intervention with the most data available. So comparisons with other 'medical interventions gone wrong' such as the Thalidomide tragedy of the 1960s, are not equivalent. Even though no two vaccines are identical, the majority of the technology and processes involved are similar enough that probabilistic assumptions can be made with greater confidence than just about any other modern medical intervention.

Mike have you had the vaccination?

I proactively made an appointment for July 8th as I am in Group 3 due to asthma. Happy to report only a sore arm afterwards.

Interesting kōrero. Vaccine injured here, Māori, wahine, only emergency visit to hospital in my life was after my MMR vaccination. Multiple autoimmune diseases later, 12 miscarriages and no way of connecting the cause to the vaccines. Your time would be well spent by researching VAERs data and the like from around the world. You'll see that most of our serious injuries occur soon after our vaccinations, therefore more likely to be related to this as a cause. Living in France, north of Paris, we have experienced first hand herd immunity without vaccines, which is another reason for being allowed our pass sanitaire and not actually needing to be vaccinated, because we've already had Covid and recovered.

Kia ora, I'm so sorry to hear about your loss. As you mention, while a direct link to the MMR vaccine could not be determined, there is always a risk with any medical intervention. As I mentioned in my talk there is about a 1/25000 chance of a severe adverse reaction to the COVID-19 vaccine. I'm sure there are similar statisitics about the MMR vaccine. So I am not discounting your experience, you could have been one of those really really unlucky people. And it is your right to be hesistant about other vaccines. However it's important to remember the risk of something going wrong if you catch a disease, particulary if pregnant. That risk is still much higher than the risk of a vaccine related injury. Here is some information about the limitations of VAERs data: https://youtu.be/cOH7cFWS7o4?t=693  Nevertheless, in your case, that is also why herd immunity is so important. We need to create an environment where everyone around you is willing to shoulder the very very low risk of the vaccine so that you do not have to, given your history. He Waka eke noa.

Why do some anti-vaxxers try hard to convince others to become anti-vaxxers, rather then keep quiet about it?

It depends on their reasons. At the ideological level they do not believe that vaccines are necessary or that vaccines work, therefore they really have nothing to lose if everyone believes in what they also believe. In fact, they gain solidarity and a sense of shared resistance. On the other hand, if they are worried about the cost to benefit ratio, then their best strategy is to keep quiet, or to encourage others to get vaccinated so they can sit back, observe and benefit from herd immunity. But game theory aside, people are also social creatures so it's natural to want to share our opinions and advice with others even though it may sometimes not be in our own or their best interests!

Mike do you think that it might be best to stop talking about anti-vaxxing, and instead focus on pro-social collective enactment?

Yes, some of the recent ads about the 'greater our immunity, the better our opportunities' paint a collective picture, which is positive.

You mentioned that storytelling might be used to turn around anti-vaxxers. How could this be achieved through government communication campaigns? And how could this apply to Climate Change Deniers?

I always say that people think in stories not in stats. So making the stories of climate change 'personal', focusing on the extremes of the human experience, are far more impactful to the average person, than stats/data on how much sea water is increasing by 0.5 degrees etc. Imagine instead a story about a family or village in the Pacific islands, whose livelihood has been destroyed due to climate change? That is why Sir David Attenborough's work on nature conservation is so impactful. How much data do we actually remember from his documentaries versus the stories he showed us?

In regards to “Please roll up your sleeves and get your shot.” Freedom of choice will always be my personal go to.

Yes, freedom of choice is a major reason against vaccination.

What makes anti-vaxxer propaganda any different from the Covid campaign?

Good point. What makes religion any different from mass delusion? The number of believers I suspect. In other words, socio-cultural legitimacy. Although, I would hope that the data on which the Covid campaigns are based have been gathered in a way that is transparent, verifiable by others and not easily influenced by funding incentives. The inaccesibilty of research is what breeds uncertainty. People can't trust what they can't understand. So better communication of the science behind vaccinations is an ongoing challenge.

Do rewards (donuts, $1million!) inspire the hesitant to get vaccinated, or is it more likely to speed up vaccination in those who had already decided to get it?

It depends on the reasons driving the hesitancy. Rewards are unlikely to shift the ideologically opposed or those who see it as an attempt to coerce their freedom of choice. It may be a good nudge for those who are struggling with the risk to benefit ratio. But it may also have the perverse unintended consequence of shifting the point of vaccination from individual and community well-being to an extrinsic reward, and once you train people to do something for an extrinsic reward, it's hard to get them to do the same thing again in the future without offering the same or an even bigger reward.

What about some people who are against some vaccines but receive others? Are they categorised separately?

Good question. I would classify those people as vaccine hesitant, as they are not totally anti-vaccinantion, but may be uncertain about specific vaccines.

How much is an actual tonne of evidence? How is having a vaccination good for you? What evidence do you have to prove this?

Bloom, David E. (2015), “Valuing vaccines: Deficiencies and remedies,” Vaccine, 33, B29-B33.  David E. Bloom, David Canning & Erica S. Shenoy (2012) The effect of vaccination on children's physical and cognitive development in the Philippines, Applied Economics, 44:21, 2777-2783, DOI: 10.1080/00036846.2011.566203. Bärnighausen, T., Bloom, D., Cafiero-Fonseca, E., & O'Brien, J. (2014). Valuing vaccination. Proceedings of the National Academy of Sciences of the United States of America, 111(34), 12313-12319. Retrieved July 8, 2021, from http://www.jstor.org/stable/43043128.