Can you tell the difference between an “anti-vaxxer” and a “vaccine-doubter”? An anti-vaxxer will outright deny and reject vaccines and may be quite rigid in their views. In contrast, a vaccine-doubter understands the importance of vaccines but has many valid inquiries. The latter may be more accepting of meaningful discourse, so here I am, trying to have a conversation with a vaccine-doubter.
The world is in the grip of a global pandemic that any living human being had never personally experienced. Thus far, humanity was clinging to hope, and I would often hear random comments about how people were exasperated at the slow pace of developing a vaccine. Finally, now when the vaccine is available, I am surprised at how many people show reluctance about receiving it.
It is difficult to convince people to prevent an illness before it happens or to treat an asymptomatic illness. Symptoms lead to compliance with the treatment. For example, many people will not take their blood pressure or diabetes medications simply because of the lack of symptoms. Still, they will take abundant over-the-counter pills for minor symptoms. If you have a heart attack, you or another person will call the ambulance, and within a matter of minutes, you will be wheeled into a cath lab, and a cardiologist will be opening your coronary vessel. On the other hand, you may have a large tumor growing in your chest for months, but you will not notice it unless if it becomes symptomatic. As an oncologist, it is very routine for my patients to criticize their primary care physicians for “missing” the diagnosis until it’s too late. I tell them that it is the nature of cancer because it is a silent killer. Similarly, it is difficult to “sell” the idea of vaccination since the vaccine-doubter will think to themselves, “I feel fine! Why do I need the vaccine? Maybe I might not get the disease in the first place.”
As a vaccine-doubter, you may have many questions, such as whether it is a “plot” to inject the masses to control their bodies or to change their DNA or achieve some other concocted ulterior motive. Why doesn’t that thought cross your mind when you are admitted to the hospital with shortness of breath, and the doctors are giving you antibiotics or diuretics? That is partly because currently you are asymptomatic and have time to think, but the moment you get sick, you do not want a delay of a single moment in getting the treatment. Isn’t that a form of hypocrisy?
I grew up in the northern part of Pakistan. After a peaceful childhood, I had to see my beautiful region go through turmoil due to the spillage of the conflict between the USA and the Taliban. As a medical student, I was involved in the campaign to vaccinate children against polio, which was eradicated in the rest of the world but still an emerging threat in that region. Doctors and nurses were putting their lives in jeopardy by knocking on each door. It was hard to convince the locals that the free-of-cost oral drops vials we brought with us were for their own good. They brought intuitive concerns that perhaps the same “foreigners” bombing their villages were sending us with vials of poison labeled in the English language. We, the local doctors, did our best to convince them otherwise and asked them to put their blind trust in us. Many parents did and allowed us to administer the vaccine to their children. A few years later, Osama Bin Laden was found and killed in the same region. It turned out that a local Pakistani doctor was a key person who gave the CIA the information that led to the successful operation. While it was great news for the rest of the world but for the doctors of that region, it was a major blow to the trust that we had tried to build for so many years with the public. “See! We told you that the doctors are not our well-wishers, they are with the foreigners, they speak their language and wear their clothes and now they bring their medicines to give to our children and sweet talk us into giving poison to our kids!”
Indeed, sometimes the doctors may not always be right, but those instances are rare. A couple of decades ago, Hemophilia patients acquired AIDS from products and blood transfusions. Initially, doctors did not know that the HIV virus was being transmitted by the products they were administering to the patients. Many hemophilia patients carried a stigma and lost their lives because of this. The doctors later had nothing less than symptoms of PTSD riddled with a feeling of guilt that their treatments actually were the cause of death for their patients. There are lessons to be learned from incidents like this, but for every inadvertent adverse event like that, there are examples of hundreds and thousands of instances when new treatments were successful without any unforeseen downsides.
A scientific achievement can never have success on its own unless if it has acceptance in the social context by the masses. I think that the concerns brought forward by the vaccine-doubters cannot be dismissed as ignorance, and it is hard to convince people. As a physician, it is not uncommon that I see a patient become indecisive and anxious about various treatment decisions facing them. I don’t shy away from asking them to put their faith in me as their physician at moments like this. There is a simple strategy that makes the decision-making relatively easier, and that is to think of each patient as your own family member and recommend to them what you would want done if they were your own mother or grandfather. When presented this way, it usually goes very well with the patient, and a bond of trust is built, which ends up in successful care for the patient.
I would say the same thing to a vaccine-doubter. If I am being vaccinated myself as a health care worker and if I agree to vaccinate my children, please trust me that you should do the same.
Farhan S. Imran is a hematology-oncology physician.
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