Misinformation stoked vaccine hesitancy — facts may require vaccine passports

When John Snow convinced officials to remove the handle of London’s Broad Street pump in 1854, making it impossible to draw water, he immediately stopped a local outbreak of Cholera. People who had been fearful and had left their homes and abandoned their businesses returned to their lives.

However, despite Snow’s theory that untreated sewage dumped into the river Thames or into cesspools near town wells could contaminate the water supply and lead to a rapid spread of disease, officials thought this was nonsense. They refused to do anything to clean-up cesspools and sewers and the wider Cholera epidemic continued to spread.

Fast forward to 2021, and we are in the midst of a coronavirus pandemic that waxes and wanes according to adherence to public health measures designed to check its spread. We also have cesspools — darker corners of the internet that infect through the ubiquitous algorithms that serve up misinformation into our everyday lives, so effectively that we often cannot see it for what it is. This is the “infodemic” that we have been battling in our online spaces in parallel to the real-life virus that makes our physical spaces so dangerous.

As a Senate Judiciary Committee convened this week for a hearing on how algorithms contribute to misinformation, we had another tool available to us: COVID vaccines. However, it is emerging that uptake of these vaccines is also unlikely to be uniform, just as the burden of COVID-19 is not, and may be drastically affected by events such as reports of side-effects, that are then amplified and misshapen by those driving the infodemic. 

Part of the issue is that those who decline an offer to be vaccinated may do so, not out of a true free choice, but because they have been exposed to a high level of targeted misinformation designed to create societal splits rather than facilitate real choice, or to protect health. Given the political polarization of the pandemic response, it is likely that those with proposed and indeed existing vaccine certificates or passports verifying their status as a vaccine-taker are likely also to be people in favor of movement restrictions, or lockdowns, masking and physical distancing.

This fundamental dysfunction in society, where we are driven to see complex problems as having simple solutions, where you are with or against my point of view, does not set us up well to tackle this burgeoning issue. The red mist of the contrived grievance of disagreement is not a solution to the infodemic where people are effectively corralled towards certain binary choices. But for many, these choices have become the dominant issue. If you win, I lose.

These are Snow’s cesspools writ large in modern society. Dealing with infodemic is equally, if not more important in determining how we emerge out of this pandemic. And we have been slow to react, even as infectious algorithms became so widespread in their dangerousness even before the coronavirus pandemic hit. Just look at recent elections in the U.S., U.K. and India.

In places where personal liberty is revered and considered to be a fundamental plank of a free society, we must also remember the most vulnerable, especially those who have no choice but to take whatever work they can get in these constrained times. Government has a duty to protect them from harm from those who can unwittingly spread COVID-19 rapidly and even asymptomatically.

Personal liberty is treasured, but so is the right to stay uninfected, out of hospital and alive. Can we balance freedom of choice with a duty to protect others from harm from the very choices we make? How do we square this circle, ensuring that people can be confident that those who they are being asked to share space with in public on a bus, in the workplace, or in a theatre are taking action to protect themselves and their fellow-humans from COVID-19 risks?

One way we could innovate to both protect personal liberties those who have declined the vaccine balancing their rights against the most vulnerable and concerned could be to limit access to certain places to particular times, where you must have a validated vaccine certificate in order to access those premises. This then helps those who need a better sense of security that risks are being managed in more vigorous ways for them to take part more fully in everyday life. At other times, there may be no requirement for vaccine certification, but there will be continued requirements for public health measures such as masking and physical distancing to protect those working in these environments. Complete denial of access to services to those who do not possess valid vaccine passports of certifications is likely to deepen any polarization and sense of grievance even further.

This is a conundrum that isn’t going away soon and there may yet be challenges to come. Aside from the strategic chess battle that continues between the virus variants and the technological public health measures taken to counter them, it is the behavior of individuals, groups and societies that will enable us to take part in a fuller life again.

There is freedom in choosing to take a vaccine or not. Even if the multi-tentacled reach of social media algorithms means that people have been exposed to a relentless diet of anti-vaccine content, we cannot escape the meaning of this choice. There are consequences that come with this. If you choose not to take a vaccine, then you are also choosing not to play your part in protecting others around you. It follows that it may be proportional to curtail other choices available to those who choose not to take a vaccine, to help protect the wider community’s right not to become infected.

Striking this balance will continue to be challenging. And we need to be prepared that this challenge will still be in play in 2022 and beyond.

Dr. Sarb Johal is a clinical psychologist and author of Steady: A Guide to Better Mental Health Through and Beyond the Coronavirus Pandemic. He helped shape New Zealand’s COVID-19 communications campaign.