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Op-Ed: Needling Friends to Get the COVID Jab? Stop

— Here's a hot take on vaccine holdouts: leave them alone

MedpageToday
A man lifts up his sleeve to reveal a NO VAX tattoo on his shoulder.

Circumstances have thrust me into a curious social position: a strong supporter of COVID-19 vaccination surrounded by friends who resist it. These people are not just stubborn cranks to me, they're much-loved companions with whom I've broken bread, shared jokes, and commiserated about life's curve balls.

My vax-resistant friends come from different backgrounds, experiences, and interactions with the medical system. Some of them fall into the "wait and see" category -- people who don't feel comfortable getting jabbed until more time passes and more safety information comes out -- while others stand firmly in the "never" camp. Shaming them won't work. My friends have had all manner of shame heaped on them and they're not budging.

One of them is a breast cancer survivor. After spending two years wrestling with chemotherapy and gadolinium-enhanced MRIs, she decided enough was enough and dove into alternative treatments. Whether by happenstance or design, she got better. Now cancer-free for over a decade, she believes, as firmly as she believes the sky is blue, that her supplements and natural lifestyle are what cured her. She even wrote a book about it. The deep mistrust of the medical system she developed during her cancer treatment has carried over to her feelings about the vax, which she sees as a foreign invader in a natural and self-healing system: her body. That belief ain't going nowhere.

Another friend, who works with numbers and projections in his day job, believes that the risk curves for COVID-19 and for the vaccines are traveling in opposite directions and will soon cross each other. He uses a lot of x's and y's to explain his thoughts. While none of his equations have sold me on his theory, he knows his way around biostatistics and votes left-of-center, so I can't dismiss him as a science-denying alt-right whatever.

Another friend, a single guy in his 30's who makes whip-smart observations about human nature and group dynamics, refuses not only to get the vaccine but to date anyone who has got it. His reason? He doesn't want to jeopardize his dream of having a big family by dating people who have undergone a medical intervention that could make them less fertile. While I haven't come across any compelling evidence that the COVID-19 vaccines compromise fertility, my buddy isn't willing to take even a one-in-a-million chance. That's how badly he wants kids, mistrusts the vaccines, or both.

Let's be honest: these "irrational" people are in good company. Most of us espouse at least some beliefs that stand on shaky scientific ground. Take homeopathy, for instance. As Ben Goldacre describes in "Bad Science," homeopathy contravenes several basic principles of medicine (such as the dose-response effect), yet remains a popular treatment modality. Then there's Reiki, which rests on the belief that the palms can transmit the healing force of qi, a mystical energy that .

And don't get me started on ear-candling or magnetic bracelets.

I know one thing: my friends are not "selfish idiots." They want the best for their loved ones, as most people do. They're no fools, either. Their hesitation springs not from ignorance, but from the constellation of life experiences that have shaped their world views as a whole. It expresses something fundamental about who they are. Doing a U-turn on their vaccine stance would mean turning their backs on deeply held values.

Throughout the world, experts have plumbed the psychology of vaccine hesitation . From free doughnuts to free money for on social media, policymakers and private enterprises have dug deep into their marketing toolboxes to crank up the vaccination numbers. In the U.S., the White House has partnered with to give vaccinated people a leg up on the swipe-right action. Many experts advocate patience and empathy with vaccine holdouts, but the goal is always the same: to get them to change their minds. Some people will bite -- but not everyone.

Which brings us to a fork in the road: either accept an imperfect global vaccination program or crank up the pressure. Some pundits have advocated exactly this: making life so miserable for the refuseniks that they will have no choice but to roll up their sleeves. A Chicago Tribune columnist emblazoned with "I'm Selfish." In my forays online, I have encountered suggestions that anti-vaxxers be imprisoned for crimes against humanity, jabbed at gunpoint, and barred from grocery stores. The urgent goal of herd immunity surely justifies a bit of strong-arming, doesn't it?

Well, does it? As with all judgment calls, we have to ask: at what cost? If we back the unvaxxed into a corner -- if we make it impossible for them to live their lives without the jab juice -- we will lose some of the tolerance and understanding that make the free world what it is. While not as tangible as the harms from COVID-19, this loss is no less vital.

As the saying goes, the perfect is the enemy of the good. Gunning for a perfect vaccination program sets us up for failure. It also divides people and sets them against each other. Here's a scenario that, according to a report in The Mercury News, could result from : "Everyone who is vaccinated would work in one area, while those who are unvaccinated would work in another area, wearing masks or distancing." Some people may take comfort in this scenario. I find it sad. Dystopian, even.

Protection from COVID-19 is important, but it's not the only thing. After a pandemic that has left deep divisions between countries, political parties, and individuals in its wake, we arguably need doses of tolerance even more than doses of vaccine. What we don't need is more shaming, shunning, and coercion. We've had a year and a half of it and it's made us all angrier.

Besides, coercion has a habit of backfiring. Whether subtle or straight-up, it erodes trust and weakens the social fabric. Many of the vaccine holdouts will come around in their own time, once more safety data comes in or the urge to visit Edinburgh or Istanbul overtakes their resistance. A minority will dig in their heels, and that's OK. On a planet of close to eight billion people, it should come as no surprise that not everyone will agree. We don't need perfection to move forward.

I, for one, am done trying to convince my friends to vax up. And I certainly won't leave them off my barbecue invite list. I refuse to divide my circle of friends and relatives into good and bad people on the basis of their vaccination status. I would rather live with an increment of extra risk than insist that everyone march to the same drum. I desire an angry and polarized world even less than a world with a residual amount of COVID-19. If that's irrational -- well, I'm in good company.

, is a Toronto-based medical writer.