The Vaccine Blog

Should post-lockdown freedoms of vaccine refusers be restricted?

Should freedoms of people who denied vaccines be restricted?

  • Introduction


It`s a contentious question, there's no point denying it. Should post-lockdown freedoms of vaccine deniers be restricted? Now anything that restricts people's freedom of expression, movement or travel is always contentious. However, in the midst of a global pandemic, something that affects everyone on the planet, it makes everything so much more emotional. Although that makes it contentious, it's also the exact same reason it needs to be talked about.


So this isn't just an attention grabbing headline or clickbait (well ok, maybe it's just a little bit clickbaity). It's not just media sensationalism. It's a real issue that affects the lives of real people, and their loved ones. It always did and it will for years to come. People have always been worried about vaccines ever since Edward Jenner developed the smallpox vaccine in 1796. It's also probably going to continue into the future, when other pandemics and events that put us in similar circumstances arise.  


So from that, it justifies an analysis of, first, whether or not freedoms should be restricted. It's important to note; this is an analysis more so than an attack on anyone. Also what kinds of restrictions? There are pros and cons to this. Not only this; people have differing levels of opposition to vaccines. Should the same level of restriction be applied across the board?  There`s pros and cons to this too. I think that those are the key points that need discussing here. 


  • Should post-lockdown freedoms be restricted for those who are denied vaccines?


2.1.1 Showing that actions have consequences:


Actions have consequences. I think that's been repeated ad nauseum at this point. That's fine, but there's a difference between saying something and actually showing these consequences. Sometimes, actually oftentimes, just stating the consequences of actions isn't enough. Often you do actually have to follow through. Sometimes it's good to show the consequences of denying vaccines and other public health interventions. Obviously one approach won`t work for everyone, so this might work better for those on the more extreme end of the vaccine hesitancy spectrum. 


I don't mean that in an authoritarian sense; you`re absolutely free to refuse vaccines if you choose. Nobody is forcing you to do or not do anything. It's not totalitarian. Nobody's going to invade your house, drag you to a vaccination clinic and hold you down. THAT would be authoritarian. That would be totalitarian. However, that's not what's happening here. Vaccines are like any medical procedure in that you can refuse treatment if you want. 


 However, if you do make that choice, things are going to happen. These are the consequences. That's universally true, It has nothing to do with authoritarianism, totalitarianism, or anything else. It's simply a universal principle. Actions have consequences. That's what the motivation behind that is. In my view anyway.


2.1.2 Keeping society safe


I suppose the most obvious benefit of restricting these freedoms is keeping society safe. If there's a chance that the community won't be safe maybe it's best not to take the risk. It reduces suffering to the greatest extent possible. Not 100%, admittedly, but to the highest extent practical. I think that when you're talking about difficult questions like this, that's ultimately the best you can really aim for. When it comes to ethical questions like this, there really is no perfect answer. When you spend enough time studying and thinking about these types of issues, that's really the conclusion you`re going to come to. 


Not everyone is going to like this of course. A huge majority of people I've spoken to want 100% effectiveness. 100% guarantee. I suppose that's understandable with a culture that prioritises 100% fresh food, 100% cashback. 100% guarantees etc. To be honest, it is a great marketing tactic. 


I`ve said this many times before and I`ll say it again; lack of certainty is one of our biggest fears as people. So this tactic taps into people's fears and emotionally engages them. 


Companies sell using emotions, not products (hot tip for anyone hoping to break into the marketing industry)..... 


We've become accustomed to that, so it's not surprising that that expectation is applied to science and medicine. However that`s really out of alignment with how the scientific method works. There are no 100% guarantees in science. Ever. Anyone stating otherwise is trying to sell something or has another agenda.  Again, I`m not meaning to be authoritarian here, it's simply a statement of fact.. 

2.2 Cons


However, it may or may not lead to more divisiveness, and ultimately more polarisation won`t fix the issue. The thing is, be it vaccines or any other topic, when it comes to issues of freedom, people always become emotional. Especially when children`s health is involved. When it comes to emotionally charged issues like this, logic takes a back seat. We`re really not very rational beings (spend 5 minutes on Twitter and you`ll see what I`m talking about).


For that reason, it is possible that these approaches will lead to more polarisation and division. So being careful about how the restrictions are communicated is critically important. 


This in turn might block communication between people everywhere on the spectrum of vaccine hesitancy. That's a problem because vaccines and herd immunity only work when scaled up to the level of a community. There's a reason why it's called “ community immunity”. It's a collaborative effort. It only works if a certain percent of people vaccinate. 


That said, there's a big difference between restricting access to leisure areas like restaurants, bars etc, and to essential services like schools, hospitals, supermarkets etc. In the first instance, you might have to give the pints after work a miss. While I obviously sympathise with that, it's obviously not the same as not being able to access food, education, and essential healthcare services. Obviously, this isn't going to be appropriate for everyone who rejects vaccines. Why? There`s variables between people. Why did they reject the vaccines? Which ones? Did they outright reject or simply delay? The list of questions goes on and on.


  • For who?

Not everyone has the same degree of opposition to vaccines. I`ve explained this before, but it's definitely worth repeating. It's a spectrum. It runs from completely accepting all vaccines at one extremity to completely rejecting all vaccines at the other. 


However, like I said - they`re extremists. Outliers. By definition, they`re not the majority of people who ask questions about vaccines. Most people are in the middle. The “vaccine hesitant”, the fence-sitters, the worried-well`s. What about them? They actually form by far the largest group of people who ask questions about vaccines. That is for many reasons. So shouldn't we give these people air time too? Wouldn't that lead to greater understanding of how complex the issue actually is, and allow us to achieve solutions? 


On every news broadcast, interview, meme, comedy sketch, or any other coverage of this, it's always one extreme pitted against another. It doesn't matter if it`s pro vaxxers against anti vaxxers or a different issue. That's irrelevant. The largest proportion of people, who I`ve just discussed are actually never really mentioned much. If they are, it's in passing or tweets/videos that don't get much engagement. Common sense isn't very entertaining I suppose. The extremists get likes, clicks, views, engagement etc. So the media likes to report on them. That's understandable, media staff have to earn a living too…


However this is where it causes problems. Media is one of the biggest influencers of culture. Or maybe it reflects what our culture is, it can be debated either way. The point is, sensationalist reporting misrepresents vaccine hesitancy (and many other issues) to the public. We want to be able to have good discussions about vaccines, and other important issues that really affect people's lives. That involves having a clear understanding of what the issue at hand actually is. Otherwise you`re not even talking about what the issue actually is. You`re talking about a sensationalised, blown-up distortion of the issue. In the short term, sure, that might help people blow off steam. That said, down the line, all it does is divide and polarise people. Which only makes the original issue worse. There's no point in just paying lip service to an issue, to only make it worse in the long term. 


Here's where it circles back to my original point. We need discussion with the aim of achieving solutions. Communication isn`t always quite enough. This isn't something that people talk about a lot, but the intention behind communication is crucial too. Two people can be the most educated, articulate communicators in the world, however if what they fundamentally want is different it won't go anywhere. Now scale that up to the level of thousands, and I think you get the picture of why vaccine discussions can be so divisive, as well as other issues involving freedom. 


 Not just arguments for the sake of views, engagement etc. That isn't a productive way to achieve good solutions. Not even just good solutions, any solutions really. Not just for now, for future pandemics too. 


That principle could also be more broadly applied too. Outside the realm of public health, to even issues outside of health too. Politics, education etc. All of which affect our lives. All of which are interconnected. Which means that applying this to one part of society will have positive ripple effects on others. What's more, if we teach this style of communication to children from a young age, we`re creating a generation of better communicators. Just maybe a better society, and a better future for them. 

          So bottom line; better communication = better decisions




But; a question


How do you make decisions about a group of people if you don't even know most of them?t


How do you even have discussions about them?


We`re making assumptions about what a huge group of people are like based on a very small sample…..


…which is exactly what we accuse them of when we talk about the vaccines/autism myth. We`re not accounting for the diversity of reasons why people are vaccine hesitant in discussions about vaccines. 


We`re not even talking about them. Because the media is the only exposure many laypeople (and maybe even some healthcare professionals) have to vaccine hesitancy, the stereotypes presented of them is the only understanding they have of these people. Which can have real effects on how they`re perceived and treated. Not just in a healthcare setting but in broader society. We`re talking about a stereotype, a persona. Not real people. That's one reason why vaccines aren't the only problem. The way we communicate about them is. 

Having intelligent discussion that leads to solutions requires an understanding of a topic or problem. As I've said, that hasn't happened. So I personally believe that an accurate representation of what vaccine hesitancy really is will be an important step forward. Stereotypes, memes, and jokes are all good for engagement and views. You know what? In the vast majority of cases, they don`t do any harm. Most conspiracies don't have any direct impact on people's health or lives.


If you want to fall off the edge of the flat earth, fine by me! . 


Have your debates. Argue with people in comments over the Internet. Go for it!


However, when it comes to issues that really affect people's lives, we need proper communication. Real conversations. The truth is, very few people are actually talking about that. There`is sufficient information available for everyone to make their own decision on the matter. This is a crisis of communication, not a crisis of scientific investigation. What I`m not seeing is discussion around how to have better discussions around difficult topics like this. Except in maybe a few corners of the Internet. So the tide is turning, however I do think this needs to be more mainstream and more the norm. 


That can't happen quickly enough. The World Health Organisation has listed Disease X, a placeholder name for a novel disease that has epidemic potential. It was listed as a pathogen of concern alongside Ebola, Marburg virus, COVID-19, Lassa fever, Zika virus and Crimean-Congo haemorrhagic fever. Any of these could cause a pandemic at any point. It could in a day, a year, a decade or a century. It's unpredictable. Increased international travel and climate change all put us in closer contact with animals. Thus creating more opportunities for pathogen transmission. That trend is only more likely to continue in the future, as all those factors I mentioned are likely to increase.


So for that reason, it's important that we develop the strategies to communicate properly now. Communication is a priority. Meaning it's important. All the time. It's a feature of longer term relationships. That's the way we need to think about relations between the public and health authorities.  


  • Conclusion


Here's the thing. There's never one right answer to tricky questions like this. If it was a question like; are vaccines generally safe and effective, the answer would be yes. That said, when you're addressing questions that involve value systems, saying one thing is either “right” or “wrong” creates a false dichotomy. Because people vary so much. The influences, environments they`re in, people they engage with and so so many others. So the problem isn't “the problem” (ie. vaccine hesitancy). The way we talk about it is. Thanks for reading. 


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  • References:


  1. Smallpox
  2. WHO to identify pathogens that could cause future outbreaks and pandemics