Ever since it became clear to even those who used to cling the most tightly to the myth that the antivaccine movement is a phenomenon of hippie-dippy crunchy lefties that, not only had the politics of antivaxxers shifted sharply to the right over the last 5-10 years, but that the antivaccine movement and fascists have found a mutually beneficial alliance based on commonalities in the magical thinking at the hear of their respective world views, there’s been an effort to “explain” vaccine hesitancy to liberals and progressives. This sort of narrative is not new and generally comes from people who are eager to seem “reasonable” as they engage in bothsidesism, or, as I like to call them, “reasonable” apologists for the antivaccine movement. I came across just such an episode published in The Guardian by Musa al-Gharbi yesterday:
Reading this Tweet, I had no idea that what al-Gharbi’s Guardian article was peddling was a credulous recounting of typical antivaccine conspiracy theories, this time framed as an “explanation” aimed at those arrogant lefties who look down on the right wingers buying into these conspiracy theories. For instance, a passage early in the Guardian op-ed, after a recounting of how the Omicron variant has led to high levels of death and hospitalizations primarily among the unvaccinated, shows al-Gharbi in high dudgeon:
Explanations for persistent vaccine hesitancy abound. An increasingly dominant narrative, especially among progressives, is that failure to comply with the directives of public health officials is absurd and must be driven by some pathology or deficit. Among those who subscribe to this worldview, debates turn around identifying the primary malfunction of “those people”: Are they ignorant? Brainwashed? Stupid? Selfish and apathetic? All of the above? Left off the menu is the possibility that hesitancy and non-compliance may actually be reasonable responses to how experts and other elites have conducted themselves, both before and during the pandemic.
I note that the article linked to by al-Gharbi in the above Guardian quote is one long exercise in similar rhetoric. (al-Gharbi does do a fair amount of self-citation to his own blog, which, while acceptable in a blog, is rather odd in The Guardian. Where were the editors?) In particular, I like how al-Gharbi quotes Matt Yglesias in downplaying the role of conspiracy theories in vaccine refusal by claiming that the “misinformation problem” to him “seems like misinformation” and conflating the vaccine hesitant with die-hard antivaxxers. In actuality, as I have repeatedly argued at length, not only is antivaccinationism basically a conspiracy theory at its heart, but so is all science denial, of which the antivaccine movement is a subset. While it is possible that, at the level of individuals and their refusal of vaccines, conspiracy theories might not be at the heart of it, there is little doubt that conspiracy theories are the dominant narrative among the antivaccine “elite” who create and promulgate false claims about vaccines that fuel vaccine hesitancy. That is why many who combat antivaccine misinformation and disinformation repeatedly argue for “inoculating” the susceptible against the techniques of misinformation and disinformation, as well as the conspiracy theories at their heart, using techniques like “prebunking.”
There is, of course, a case to be made that the vaccine hesitant are different from die-hard antivax conspiracy theorists (because they are) and that the vaccine hesitant aren’t “brainwashed” (because, by and large, they are not), but al-Gharbi’s Guardian article seems to delight in attacking straw men, all while regurgitating common antivax conspiracy theories as though they were reasonable in the service of “explaining” antivax hesitancy. In doing so, he lumps together a few reasonable and semi-reasonable concerns about the vaccine that could fuel hesitancy with a whole lot of utterly bonkers typical antivax conspiracy theories that I’ve been writing about longer than I can remember as though they were equally reasonable concerns, which makes me think The Guardian is turning into The Daily Mail in terms of its dedication to science. (That’s not a compliment.) Worse, the Tweets after al-Gharbi’s Tweet linking to his op-ed are almost all nauseatingly laudatory.
I’ll start with the most egregious example of utter antivax disinformation repeated by al-Ghardi, in which he parrots misinformation about COVID-19 vaccine complications referencing the Vaccine Adverse Events Reporting System (VAERS) database. The misuse of VAERS, as I’ve documented more times than I can remember, is a technique that’s been a favorite of antivaxxers going back at least two decades. Indeed, vaccine advocates warned before COVID-19 vaccines were even approved for use under an Emergency Use Authorization (EUA) that antivaxxers would immediately mine VAERS to try to portray the vaccines as deadly, for example:
No one listened. A year later, al-Gharbi apparently didn’t listen either:
According to the VAERS (vaccine adverse event reporting system) database, nearly 12,000 Americans have died shortly after receiving Covid vaccines, possibly as a result of side-effects or allergic reactions from the vaccines. On the one hand, these casualties represent a miniscule share (0.0022%) of all doses given out, and are radically offset by the immense number of lives saved by vaccination. But at the same time, 12,000 lives are not nothing. There are many, many towns in the US with populations smaller than that. Nonetheless, people expressing concerns about vaccine-related deaths are often mocked or derided.
This is a paragraph that should be out of place in The Guardian because it would not be out of place on the websites of prominent antivaxxers like Mike Adams, Alex Berenson, Dr. Sherri Tenpenny, Dr. Joe Mercola, or Robert F. Kennedy, Jr. Come to think of it, RFK Jr. has maintained a weekly feature on VAERS since early last year, in which his minions have featured the most sensational reports of death and destruction attributed to the vaccine.
I have to ask why al-Gharbi apparently didn’t bother to ask people who actually know how VAERS works before publishing that credulous amplification of common antivax misinformation? After all, the reason that the vaccine-hesitant cite VAERS is because there is a whole right wing antivax social media (and old media like Fox News) ecosystem that keeps repeating the claim that VAERS shows that the vaccines have killed tens of thousands. Indeed, people like Steve Kirsch and Joe Mercola go further, trying to push the innumerate claim that, in actuality, hundreds of thousands have died due to COVID-19 vaccines because of undercounting in VAERS by a factor of 41, a nonsensical claim.
So egregious is al-Gharbi’s credulous recounting of VAERS misinformation that, instead of just linking to one of my posts that have explained VAERS over the years, I feel the need to include a brief explanation here. The main problem with using VAERS to estimate the frequency of adverse events (AEs) after vaccination is that, in essence, anyone with access to the Internet, mail, or the telephone can report anything to VAERS, as was demonstrated by bloggers years and years ago when one autism advocate filed a report claiming that the flu vaccine had turned him into The Incredible Hulk and another claimed a vaccine had turned his daughter into Wonder Woman. Both reports were accepted. In fairness, ultimately someone from VAERS did contact these people to ask about the reports, and the reports were removed. However, had they refused, reports that vaccines might turn one into the Hulk or Wonder Woman might still be in the database.
I hasten to add that no one is arguing that VAERS is unreliable primarily because lots of people are reporting fake AEs. Rather, we point out these examples merely as part of the overall discussion of how VAERS reports represent raw, unadjudicated data, with no ability to demonstrate causation. Antivaxxers leap to the assumption that any AE entered into VAERS must have been caused by the vaccine, but that is simply not the case. As I’ve discussed time and time again, raw VAERS data cannot establish causation, as, by its very nature, it cannot establish reliable estimates for the incidence of a given AE.
In addition, VAERS has been gamed several times in its 30 year history. For instance, one of the earliest times I wrote about VAERS was in 2006, when I discussed a study that examined how vaccine litigation could influence VAERS reports. Using VAERS reports from 1990 to 2003, the study found “most case reports to VAERS that were related to overdose, neuropathy, and thimerosal were related to litigation”, as were “many cases” that were related to “autism and mental retardation”. Since we now know with a great degree of certainty that vaccination is unrelated to autism, neuropathy, and mental retardation, we know with a great deal of confidence that these reports represented, if not overreporting, misreporting of AEs not related to vaccination as though they were. The study concluded, “This review shows a previously undisclosed rise in the number of reports to the VAERS related to pending litigation for vaccine injury.” In other words, this is not a new problem with VAERS.
Finally, antivax misuse of VAERS ignores is an exercise in the baseline rate fallacy, in that it ignores baseline rates of the AEs reported. In brief, in looking at the number of deaths after COVID-19 vaccination, one has to determine if it is greater than what one would expect by random chance alone in a given time period after vaccination; i.e., the baseline rate of death. (There are over three million deaths in the US every year.) I discussed this once in July, but will update the discussion. Our World In Data estimates that in the US as yesterday, 213 million people having been received two doses of a COVID-19 vaccine, or 64% of the US population. The estimate for the baseline death rate that I used back then was roughly 2.4/100,000 per day, which means that for a population of 213 million we’d expect to see an average of ~5,112 deaths per day by random chance alone. Using one year as a rough number, we’d therefore expect to have seen around ~1.87 million deaths in this time period by random chance alone, and that doesn’t even count the increase in the baseline death rate due to deaths from actual COVID-19 that has occurred. In actuality, 12,000 deaths in over a year is a tiny number in comparison to the number of deaths we’d expect to see soon after vaccination just by random chance alone, particularly early on, when, in addition to healthcare and frontline workers, the elderly (who, on average, have a much higher chance of dying in any given month than the young) were prioritized for vaccination.
Seriously, does al-Gharbi even science? Does The Guardian? Apparently he does not, at least not any better than the antivaxxers who misuse VAERS.
If I were to address each and every nugget of misinformation and conspiracy theory credulously parroted in this Guardian article by al-Gharbi, this article would rapidly swell to several times the length of al-Gharbi’s article itself. So you’ll excuse me if I just pick some “greatest hits.” Unsurprisingly, al-Gharbi believes the “lab leak” hypothesis for the origin of SARS-CoV-2:
While Trump was in office, insinuations that Covid-19 may have originated from a lab leak were widely derided as a racist conspiracy theory and media content exploring the possibility of a lab leak was actively censored by Facebook. Nonetheless, significant evidence has continued to build in support of the “lab leak hypothesis,” to the point where senior Biden administration officials now view the lab leak theory as roughly as credible as the natural origins theory – raising questions for many about why some public officials so aggressively (and prematurely) sought to suppress and discredit this hypothesis.
I rather laugh at al-Gharbi touting the the Biden administration views the lab leak hypothesis as being as credible as a natural origin. Seriously, politics couldn’t have had anything to do with this, and al-Gharbi cited a CNN article about the review that the Biden administration ordered last spring that is a spectacular exercise in bothsidesism itself in that it basically takes both possibilities as equally credible and then throws up its hands saying, “We may never know.”
In actuality, every epidemic and pandemic has produced conspiracy theories that the causative agent “escaped from a lab” or was “engineered in a lab,” and the COVID-19 “lab leak” hypothesis has always been a conspiracy theory. Indeed, it’s one of the oldest—if not the oldest—of conspiracy theories about the origin of SARS-CoV-2, the coronavirus that causes COVID-19. Indeed, the recently deceased Nobel laureate Luc Montagnier was one of the first to claim that SARS-CoV-2 must have been “engineered” because there were short peptide sequences resembling those of an HIV protein in the spike protein of the virus, but he was far from alone in coming up with various features of the virus that must have been “engineered.”
As time went on and it became clear that there were no features in SARS-CoV-2 that couldn’t be explained by natural origins, the “lab leak” conspiracy theory shifted (as such conspiracy theories always do) to claiming that the the “leak” was of a naturally occurring coronavirus that had been collected and stored for study by scientists at the Wuhan Virology Institute. Again, as has been true since January 2020, it is not impossible that the origin of the pandemic was a “lab leak,” but it is a far less plausible explanation than a natural origin given how common zoonotic origins for human coronavirus pathogens are. Indeed, the “plausibility” of a “lab leak” origin for SARS-CoV-2 seems to correlate rather directly with the volume of right wing propaganda proclaiming it to be plausible. It’s odd that al-Gharbi didn’t even consider that possibility. Of course, considering the possibility that he might be wrong seems not to be what al-Gharbi is about.
In fairness, let’s look at one of the reasonable/semi-reasonable concerns al-Gharbi cites:
These rapidly produced vaccines also pioneered the use of “artificial proteins never seen in the natural world”. Again, a miracle of modern science, but one that left many wondering if there was sufficient research on possible long-term problems and side-effects, given that the Pfizer Covid-19 vaccine was the first mRNA vaccine ever to achieve full FDA approval in the US and was a developed and approved on a radically accelerated timetable.
This is bit of a misdirection. It is, of course, true that the mRNA sequence that lets the Pfizer and Moderna vaccines coax human muscle cells to produce SARS-CoV-2 spike protein to serve as an antigen to provoke an immune response is slightly modified from that of the natural mRNA sequence, but the alterations are small and designed to stabilize the protein to serve as a better antigen. The misdirection comes in citing the the linked article, which is not about the current mRNA-based COVID-19 vaccines but rather about investigators seeking to develop the next generation of COVID-19 vaccines by using a small key portion of the spike protein known as the receptor-binding domain (RBD), the part of the spike protein that binds to the ACE receptor and allows the virus to enter a cell. That is the “protein not found in nature” far more than the slightly modified spike proteins used in current vaccines, and the rationale for such a strategy is even spelled out in the article:
The first-generation COVID vaccines, including the mRNA vaccines that have been such lifesavers, work by introducing the virus’s spike into the body, without a functional coronavirus attached, so the immune system can learn to recognize the RBD and rally its troops. But the RBD is periodically hidden by other parts of the spike protein, shielding the domain from antibodies looking to bind to it. This blunts the immune response. In addition, a free-floating spike protein does not resemble a natural virus and does not always trigger a strong reaction unless a large dose of vaccine is used. That big dose increases costs and can trigger strong side effects.
Such new vaccines could be expected to go through the full regulatory approval process given that they would be intended to supplement or replace current vaccines. I’ll also mention part of the article that really impressed me was its account of how much progress has been made in predicting from its primary amino acid sequence how a protein will fold into its final 3D configuration. I also can’t help but note that another large section of the article was about engineering novel antibodies not found in nature.
As for “long-term” adverse events from vaccines, as I’ve said before, that’s a longstanding antivaccine canard that was easily weaponized against mRNA vaccines. Before the pandemic, among the “long term” side effects antivaxxers proclaimed were autism, autoimmune diseases, chronic neurologic diseases, and cancer, none of which has ever been shown to be linked linked to vaccines. Moreover, AEs due to vaccines generally show up soon after vaccination; vaccines have not been shown to produce AEs years after vaccination and even the ones that show up 6-12 months later are very special circumstances. So while it is not entirely unreasonable for people to be concerned about “long-term” problems, when one discusses this concern, the responsible thing to do is to put such concerns into context, also noting that the technology for mRNA vaccines has been under development for nearly two decades. Five years ago, it is highly unlikely that the Pfizer and Moderna vaccines could have been ready to go a year after a novel coronavirus first hit Wuhan because the technology was insufficiently mature. We were fortunate that by 2020 it had matured to the point that allowed such rapid creation of COVID-19 vaccines.
al-Gharbi even spins another somewhat reasonable concern about the vaccines in the most antivaccine manner possible:
In the wake of Omicron, even people who have been “boosted” with a third shot are regularly experiencing breakthrough infections. And so, over time, the justification for getting vaccinated has shifted. Rather than being sold as a means of preventing infection altogether, it is now argued that people should take the shots in order to reduce hospitalizations and deaths (the vaccines remain very effective at this). That is, the main benefit of vaccination has been revised down dramatically – from outright preventing infections to reducing severe infections – even as people are encouraged to get more and more shots in order to achieve that benefit.
It was initially reported that a single shot provided great protection, although a booster could conceivably be suggested down the line. Then two shots became the standard to be “fully vaccinated.” Now, according to Fauci, three shots will soon become a requirement for being considered “fully vaccinated” – and the CDC is urging some Americans to pursue a fourth shot. There does not seem to be a clear end in sight for how many shots may ultimately be suggested.
It’s also long been recommended that we all receive the influenza vaccine every year. Dammit, why isn’t one dose of influenza vaccine enough for my lifetime?
Seriously, though, is al-Gharbi unaware that this is how many vaccines work and that many, if not most, vaccines don’t provide life-long immunity and do need periodic boosters, the time between boosters varying depending on the disease? Is he not aware that it was long expected that a coronavirus vaccine would not provide sterilizing immunity (complete prevention of infection and transmission) but that 100% effectiveness in preventing transmission and infection is not a requirement for vaccines to make a huge contribution to ending the pandemic? Scientists have long been warning that it is unreasonable to expect a vaccine against a coronavirus to produce sterilizing immunity, and even over a year ago were pointing out that, not only do most vaccines not produce sterilizing immunity, but that sterilizing immunity is not necessary to end the pandemic. Moreover, it’s not as though scientists haven’t been warning about the possibility the appearance of new, more transmissible variants that could evade postinfection and vaccine-induced immunity. Omicron is just such a variant, and such variants have the reason why vaccinating as large a proportion of the population as possible was always important and why many have warned against the very inequity in vaccine distribution that al-Gharbi himself expresses concern about.
The reason to be vaccinated was always primarily to prevent severe disease and death, and the vaccines remain very good at that, as the figures cited by al-Gharbi at the beginning of his Guardian article attest. Sure, there was some overenthusiastic selling of the vaccine when it was first rolled out, but that was rather understandable given the death toll up to that point and the hope that the vaccines presented. I’ll also give people the point that we in the US are guilty on overreliance on vaccination to get us out of the pandemic and have been far too quick to drop other nonpharmacologic interventions (NPIs), like masking, as soon as case counts start falling and even if the daily death toll is still high. We’re doing it now.
Unfortunately, a lot of that is fueled by the very sorts of narratives that al-Gharbi frames as factual or at least reasonable. Several of the other bullet points he includes are just restatements of common right wing conspiracy theories, such as “Fauci lied,” claims that pharma profits fuel vaccine mandates, and risible arguments that the numbers of hospitalizations from COVID-19 are “exaggerated.” Indeed, al-Gharbi even cites David Zweig, a journalist that he should know to be very friendly to right-wing “anti-lockdown” propaganda. Indeed Zweig even attended the weekend conference in October 2020 hosted by the libertarian think tank American Institute for Economic Research (AIER) that birthed the Great Barrington Declaration (GBD). The GBD advocated, in essence, a “let ‘er rip” strategy for the pandemic, while handwaving about “focused protection” of those most vulnerable to severe disease and death from the virus. In doing so, al-Gharbi inadvertently proves my point about how antivaccine, antimask, and anti-“lockdown” propaganda and conspiracy theories originate mainly from right wing dark money-fueled sources.
al-Gharbi concludes his Guardian “analysis,” with a mix of the reasonable and unreasonable:
Likewise, most of the Covid-related “resistance” movements have not been oriented around opposition to vaccines per se, but rather to vaccine mandates and passports and to Covid-19 related lockdowns, closures and masking requirements. That is, they are typically opposed to coercive (and often quite costly, dubiously effective and legally questionable) state policies intended to contain the pandemic. Irrespective of whether one agrees or disagrees with these campaigns, it is misleading and unhelpful to conflate these dissenters with “anti-vaxxers,” as many have done.
All said, despite all the significant problems described above, the Covid-19 campaign has actually been one of the most ambitious and successful rapid vaccination drives in US history. Pockets of skepticism remain. From a public health perspective, this is unfortunate. From a humanitarian perspective, it is often tragic. Yet, it is important to bear in mind that many have legitimate reasons to be apprehensive towards authorities and skeptical of their advice – and it is possible to effectively mitigate their concerns. Most holdouts are persuadable. Indeed, they are being persuaded every day.
Note how al-Gharbi misses the fact that these “anti-mandate” movements and protests are all very thinly disguised antivaccine movements and protests. I could go into detail, but, really, if you are featuring a bevy of antivaccine heavy hitters as the featured speakers at your protest and RFK Jr. is using your protest to liken vaccine mandates to the Holocaust, you are not “anti-mandate”; you are antivaccine, and it is not “conflating” resistance to “mandates” with the antivaccine movement. The two are the same, and both are being amplified by same usual suspects behind right wing antiscience disinformation. Let’s just put it this way. There’s a reason (actually a number of reasons) why such an affinity between the antivaccine “anti-mandate” movement and outright fascists has become increasingly evident. al-Gharbi can, in his eagerness to “bothsides” the issue deny the conspiracy theories and current right wing tilt to the antivaccine movement, but he’s just denying what is obvious.
I’ll conclude by noting that al-Gharbi is correct that most “vaccine refuseniks” or holdouts are persuadable. I always say that that’s because they have not fallen completely down the rabbit hole of antivaccine conspiracy theories—yet. The problem is that, even as he tries to point out that the vaccine hesitant are indeed reachable, al-Gharbi unskeptically parrots a lot of the very misinformation and conspiracy theories that fuel vaccine hesitancy, framing them as a false (or at least misguided) view among the “left” to conflate the vaccine hesitant with right wing antivaxxers, making his Guardian article more propaganda than sober analysis. In doing so, he uncritically accepts outright conspiracy theories as “reasonable” and fails to recognize them as conspiracy theories and pseudoscience and thereby does exactly the opposite of his stated purpose. He amplifies antivaccine disinformation, framing it as “reasonable, making him yet another in a long line of seemingly “reasonable” apologists for antivaxxers, and The Guardian let him do it.