I’ve been fairly confused by the popularity in the US of remaining unvaccinated, in the face of seemingly a non-negligible, relatively immediate personal chance of death or intense illness. And due to the bubbliness of society, I don’t actually seem to know unvaccinated people to ask about it. So in the recent covid survey I ran, I asked people who hadn’t had covid (and thus for whom I didn’t have more pressing questions) whether they were vaccinated, and if not why not. (Note though that these people are 20-40 years old, so not at huge risk of death.)

Their responses:

  1. I don’t think I need it, I don’t think covid is a big deal, I don’t think the vaccine works and the more the government/media pushes it the more I don’t want to ever get it. It should be a private decision between someone and their doctor, not Joe Biden and CNN saying comply or be kicked out of society.

  2. I still dont trust the information and safety claims made by the crooked FDA and CDC. Needs more research and study.

  3. I had a scary vaccine reaction previously.

  4. I am only 32 years old and in decent health so I think I would be fine if I caught COVID. It has almost been two years since the pandemic started and I haven’t gotten sick besides some minor colds. I would rather rely on natural immunity instead of the vaccine.

  5. dont want one

  6. Other health issues where my Doctor wants me to wait to get vaccinated.

  7. I think it is poison at worst and ineffective at best. Also the way the pushed it came off like a homeless man trying to lure me into an ally. The vaccine issue has made me lose 100% trust and faith in media and government i do not believe or trust anything from them anymore

  8. I have anxiety problems and other health issues.

  9. I’m actually scheduled to get a vaccination, I’m simply waiting for my appointment date.

  10. The places where the vaccination is available are always crowded and I am somewhat afraid of being outdoors or indoors in large crowds for too long these days.

  11. I am extremely skeptical of this “vaccine”, which has been proven ineffective (vaccinated people keep getting it, and what’s with all of the boosters?!) and has caused too many deaths and/or serious health issues/emergencies. I’ll take my chances on Covid any day over a “vaccine” that magically appeared from 8+ pharmaceutical companies in such an astonishingly short time. That is unheard of, and there is no way to know what is really in it, and what kind of problems those who are ignorant and fearful enough to get it will face later on down the road (that is, if they don’t die from the “vaccinations” themselves. The fact that the government has bribed, coerced, and is trying to FORCE everyone to get this “vaccine” is unprecedented, and quite frankly terrifying and sinister to me. I will NEVER allow a forced injection of god knows what into my own body, as that is wrong in every way there is. Vaccines allegedly keep those who get them safe from contracting whatever it is the vaccine is made for, so why would it be anyone’s business whether or not someone else is vaccinated? The Let’s Go Brandon administration and the dumbocrats that were fearmongering before the administration was even in place have done this by design. Spread fear, mistrust, and divisiveness, and lock people down to isolate them and make them suspicious and fearful of one another. Divide and conquer, because the fascist wannabe communists know that it is the only way to indulge their scummy self-serving agendas. United we stand.

  12. For health reasons.

  13. I’m not at high risk, so I don’t need it immediately. Waiting to see how effective it is.

  14. I don’t think it’s efficient…the prospect of being jabbed by endless boosters doesn’t appeal to me

  15. I’ve never had covid.

  16. I don’t trust the vaccine and have not have gotten covid since the pandemic started. Plus all of the misinformation surrounding covid, from the news media to social media sites. I just don’t know what to believe anymore but I feel that not getting vaccinated is the best option for me.

  17. I am still skeptical of the vaccine since people are still catching covid and its variants

  18. It doesn’t stop the transmission, or stop you from getting covid. I am at low risk anyways.

  19. I am at very low risk of infection as I do not work and wouldn’t accept any non-remote work. I also do not have any friends or family in the state where I moved to last year and I do not drink so I don’t go out to bars or events, or even restaurants.

  20. I simply have no trust in the big pharmacy and little more in the government. Throw in the fact that the vaccine was created too quickly and while it claims to have lowered infection rates and the severity of COVID-19, I’ve known several people who have been infected and they were fully vaccinated. In addition, I’ve seen many news articles reporting the same. Why should I receive a vaccine that provides such weak protection?

  21. Transportation and access. If a pill form or some self-administering option were available, I would.

  22. I don’t trust it.

  23. I have chosen not to take the vaccine

  24. Because I think its the Governments agenda to start killing people. I don’t trust Big Pharma or the Government. Also, people still get covid with the vaccine, seems like a waste of time.

  25. I live in Ohio, kinda wanna die. Also, it doesnt even dent the new variants; you still ge tit.

  26. do not trust them

  27. Because I believe that the vaccine is part of a either depopulation plan, or a tracking device. Either way there is no logical reason to get it.

  28. I am hesitant because of the possible side effects long-term because not much is known about it.

  29. I don’t see the benefit since I am not really at risk from covid.

  30. It’s against my religion.

  31. I don’t need a covid vaccination.

  32. I’m concerned about possible serious side effects from the vaccine that may show up some time down the road.

  33. Normally, I would consider it, but the talk of forced mandates has really soured me to it. I dont believe in taking away people’s health freedoms like that. I think it’s an insane intursion on civil liberties, and I fear if we all just accept it, we will become like Australia

  34. I only leave the house once or twice a week so it never really felt necessary to me.

The biggest themes mentioned here seem to be distrust or hostility regarding the government and media and their various pro-vaccination pressurings, and the impression that the vaccine doesn’t work. (I wonder how much that one is relative to an expectation of ‘very occasional breakthrough cases’ that one might also trace to someone’s questionable communication choices.) An unspoken theme is arguably being in possession of relatively little information (like, what’s going on with the person who is still waiting to find out if the vaccines are effective? And do people just not know that the vaccine reduces the downside of covid, even if it is still possible to get it? Or do all of these people know things I don’t?).

I wonder if much good could be done in this kind of situation with some kind of clearly independent and apolitical personal policy research institution, who prioritized being trustworthy and accurate. Like, I don’t trust the government or media especially either on this, but I and people I do trust have a decent amount of research capacity and familiarity with things like academic papers, so we arguably have an unusually good shot at figuring out the situation without having to make reference to the government or media much (assuming there aren’t more intense conspiracies afoot, in which case we will end up dead or tracking-deviced, I suppose). If I wasn’t in such a position, I feel like I’d pay a decent amount for someone to think about such things for me. I guess this is related to the service that doctors are meant to provide, though the thing I imagine would look very different to real doctors in practice.

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It doesn't feel hard for me to understand. People have been lied to in various ways over the course of the pandemic and some of them were either severely harmed by lookdown policies or had their friends severely harmed.

The establishment lost a lot of credibility for saying that it was okay to demonstrate unmasked in the BLM protests right after lookdown and then afterward telling people that wearing a mask outdoors is very important. 

I have a friend who explained her being unvaccinated with three of her friends committing suicide during the lockdown. While it's not rational behavior given that vaccines and lockdown are two different issues, I find her position understandable, such experiences polarize people. 

People lost jobs and businesses and faced serious hardship because of lockdown policies.

An unspoken theme is arguably being in possession of relatively little information (like, what’s going on with the person who is still waiting to find out if the vaccines are effective? And do people just not know that the vaccine reduces the downside of covid, even if it is still possible to get it? Or do all of these people know things I don’t?).

Those people know that the establishment tells them those things, but lack the ability to tell which of the claims from the establishment are actually true, so they are effectively in the possession of relatively little information.

I wonder if much good could be done in this kind of situation with some kind of clearly independent and apolitical personal policy research institution, who prioritized being trustworthy and accurate.

In a climate where people lie and censor to get people to do what they want you can't be apolitical and independent. You will take stances that get people to attack you politically.

If I wasn’t in such a position, I feel like I’d pay a decent amount for someone to think about such things for me. 

Normal people who get operations are not willing to pay to get information about which hospital is best at doing a given operation. After Hanson, a lot of health decisions are made around showing that one cares and not through a good analysis of the available information.

"It doesn't feel hard for me to understand."

I don't see how your explanations relate to the explanations of the people who gave their answers to this (small) survey. So you have a thesis and some anecdotes and personal impressions, but how do you justify the certainty?

Also,

"The establishment lost a lot of credibility for saying that it was okay to demonstrate unmasked in the BLM protests right after lookdown and then afterward telling people that wearing a mask outdoors is very important. "

Who is this "establishment", seemingly speaking with one voice and understood by "those people" to be a coherent unit? Do you suggest those people do not get vaccinated because former potus Trump, who is proud of having been responsible for fast vaccine development afaik, eroded trust in what institutions say by lying frequently?

I don't see how your explanations relate to the explanations of the people who gave their answers to this (small) survey. 

A few of the answers do mention mistrust of establishment organizations from CNN, CDC, FDA, and others. Plenty of the other explanation note lack of trust as a key reason. 

Who is this "establishment", seemingly speaking with one voice and understood by "those people" to be a coherent unit?

If that's a genuine question, maybe start with reading Chomsky's Manufacturing Consent. 

I noticed an emotional shift in myself after mandates were put in place. Before hand my mood around the vaccine was pride at scientific civilisation and eagerness to join in. Afterwards anti-domination instincts kicked and I could not help feeling resentment that my vaccination had given the bullies what they wanted even though it was still in my best interest.

One potential explanation is needle phobia, and people invent rationalizations on top of this. I don't find it prima facie implausible that people strongly dislike violations of their bodily autonomy. This is, after all, the reason why we have laws against non-consensual touching and sexual assault. 

This theory has the advantage that it explains why people seem less skeptical of government coercion for other things. My sense is also that I find relatively little resistance to the idea that we should take emergency-approved medication if we're hospitalized with COVID-19.

Wikipedia states,

It is estimated that at least 10% of American adults have a fear of needles, and it is likely that the actual number is larger, as the most severe cases are never documented due to the tendency of the sufferer to avoid all medical treatment. The diagnosis criteria for BII phobias are stricter, with an estimated 3-4% prevalence in the general population, and this also includes blood-related phobias.

Prevalence of fear of needles has been increasing, with two studies showing an increase among children from 25% in 1995 to 65% in 2012 (for those born after 1999). Augusta University professor Amy Baxter attributes this increase to an increase in administration of booster shots around the age of 5, which is old enough to remember and young enough to be more likely to result in formation of a phobia.

As for myself, I find it somewhat disturbing to be stabbed with a needle. I can cope with vaccines, but in the few instances in my life in which I needed to draw blood, or have a drug administered intravenously, I remember feeling extremely queasy. It's overall not a fun time.

Nobody in the post's quoted survey results mentioned needle phobia or gives any indication they have a fear of needles. Is that not evidence that needle phobia isn't the cause?

Perhaps it’s embarrassing for people to talk about. In my experience, people aren’t always honest about their true motives. In fact, in many cases my starting assumption is that people will actively be dishonest by trying to invent a reason that sounds noble when the true motive is mundane and kind of ugly.

Maybe my point is easier to see if you imagine how the justification “I’m afraid of needles” would fare in a public debate. The answer will be, “Just get over it you big baby. That’s not a reason to risk killing people by spreading the virus.”

The poll was anonymous and was not inviting debate.

my starting assumption is that people will actively be dishonest by trying to invent a reason that sounds noble when the true motive is mundane and kind of ugly

This sounds like a good way to disregard all stated reasons all the time. I can only see it being a valuable heuristic if you first have some other reason to believe the true motive.

The poll was anonymous and was not inviting debate.

Even still, people are prone to self-deception. You may be interested in this book, which argues that self-deception is very normal. In a multitude of areas of life (from education to religion) people often tell themselves and others that they're doing things because of reason X, when reason Y fits the evidence a lot better.

Ask yourself whether a poll asking why people appreciate modern art would provide a lot of insight into why people view modern art. Or a poll asking people why they donate to charity. At the very least, many of the replies will probably leave out one of their true motives, such as wanting to look benevolent to others in the case of charity.

It's worse than that. "Self deception" implies that you know what the real answer is and then deceive yourself to believe otherwise. You still have to figure out what the right answer is, and while people are obviously going to be more willing to look for and accept self flattering answers, such motivated cognition isn't necessary in order to ruin the idea of anonymous polls being fountains of truth.

If you see a lion and feel fear, it's easy to figure out that you're probably afraid that it's going to eat you. If the lion is in a cage at the zoo, then seemingly no explanation works so you say "I guess I just have a[n irrational] fear of lions".

Similarly, if you feel fear when a doctor pulls out a needle, you have to figure out why that is. "Because I don't trust the guy with a needle" is a pretty straight forward explanation, and sorta by definition true. You're not going to get "Because I have a fear of needles" unless the person decides that their fear can't be justified.

This sounds like a good way to disregard all stated reasons all the time. I can only see it being a valuable heuristic if you first have some other reason to believe the true motive.

I agree, but I presented evidence to the contrary. Wikipedia said that 10% of adults have needle phobia, and added "it is likely that the actual number is larger". Even if not strictly the main reason why people avoid the vaccine, it seems probable that it plays some role.

If it were merely a matter of distrusting social institutions, we would need an explanation of why people seem to have no problem trusting those same social institutions in other circumstances, including other medicine that they're prescribed. Almost every single time a new vaccine is introduced on the market, there are a lot of people who oppose it. Therefore this phenomenon seems unlikely to merely be the result of a perception of rushed vaccine trials or something similar.

#21's response that "If a pill form was available... I would" might be related to needle phobia, although not explicitly stated.

There is anxiety in there. That could stand for needle phobia.

Needle phobia wouldn't explain a gap between covid vaccines and other vaccinations, correct?

Are you referring to specific vaccinations? Most vaccines are administered when people are small children, and thus have no choice in the matter. The flu vaccine is routinely taken by only about 50% of the population, which is less than the Covid vaccine.

Huh, interesting point. Do we know what's happening with blood draws, or pre-travel vaccinations?

How does your theory explain cross-country differences in vaccination rates?

I'm not sure, but it's clear that some cultures have more collectivist norms, which translates into more social pressure for people to get the shot, even if they don't like it privately.

I thought about writing this when the vaccine trials were wrapping up, but was slow, and by the time I had it ready, I saw SSC say the overwhelming majority of people in this sphere were vaccinated so I figured it would be a waste of time.

I didn't get one of the three vaccines available in the USA, if I were in a higher risk demographic/lifestyle/less lazy, I would have made the radvac. I would be willing to get novavax or soberana. I have no needle anxiety (if it's relevant). I have studied this stuff on my own since well before the pandemic and am decent enough in the lab that I could probably do a lot of the work of making a recombinant vaccine with the correct equipment

I tried the inside view/outside view method of forecasting and am satisfied with the result.

Some things I view as the outside view: -early years of mass vaccination campaigns are usually associated with disasters (1850-70s cowpox campaign, cutter/wyeth during polio, swine flu in the 70s, pandemrix in 2009, many others) -the FDA is bad at evaluating new technology (they approve things that shouldn't be, and block things they shouldn't); as an example, it took five years to pull thalidomide. -vaccines are safe drugs not because of anything inherent to the class, but due to the stringent standards to which they're usually held

I saw nothing inside this situation which gave me unusual confidence about this particular mass vaccination campaign. I did see an apparent relaxation of the stringent standards usually applied to vaccine approvals.

I figured I'd wait a month, and if anything unforseen happened, I'd wait another month, looking for signs of toxicity of the payload, toxic vehicle effects, OAS, ADE, and more data on the estimated risk to me from catching covid. I saw the j&j pause for VITT, the pfizer data on 'it has more of an antibody response than we expected', then later the aspiration studies, the legislation making it hard to get side effects compensated (if it were safe, there would be the opposite, and people with visible side effects would be celebrated as heroes), the pulling of medical licenses of doctors who were public about the side effect risks...eventually I was just out, I'm not expecting data on booster #4 to persuade me to start the potentially multi year course of treatment for a pandemic that may be mutating away from them or winding down.

My standard for 'this vaccine is safe enough' is 'more safe than the windrawn limerix vaccine', which was pulled in part due to a 1/25000 probability of cardiac issues, and in part due to lack of success in the market (I'd have taken it). I'd view something with a side effect profile as bad or worse than that as unacceptable to me. I believe that there is enough data suggesting that the side effect profile of most of these is at least that bad, and that the true safety state is obscured by rigid suppression of negative information in the western world. I know it isn't great, and assess that it's probably worse than it looks.

I have plenty of reasons which have strengthened my opinion that not getting one of the three available shots was the correct decision, though I have some doubts about my laziness about making the radvac.

All in all, I'm not expecting to change my opinion, or regret my decision. I fully expect governments to back off the mandates and for side effects to get just as much public attention as the cancers SV40 contamination of 1960s polio vaccines caused, meaning zero.

I'd love for someone to tell me why my reasoning sucks, I'll freely admit that I'm probably overly conservative about side effect risk, but for my demographic and lifestyle (I haven't caught any of the strains yet and don't expect to), I think that conservative approach makes sense.

My attempt at why your reasoning sucks:

"My standard for 'this vaccine is safe enough' is 'more safe than the windrawn limerix vaccine', which was pulled in part due to a 1/25000 probability of cardiac issues, and in part due to lack of success in the market (I'd have taken it). I'd view something with a side effect profile as bad or worse than that as unacceptable to me. "

This implies a way less than 1/30,000 risk of actual death from the vaccine. I don't think that anyone looking forward from May 2021 who had not yet gotten covid could reasonably predict less than a 1/30,000 lifetime risk of death from the pandemic if they resume normal behavior. And the odds, even for a young woman in their twenties, would probably still be higher than 1/100,000 for death from covid looking forward from that point than, even if she never resumed normal life.

The relative risks of bad things less than death are similarly lopsided, and it is unlikely there is a death rate for healthy young adults from the vaccines of more than 100k hiding in the data. At the 1/40,000 rate, if it existed, it would show up as unusually high summer 2021 age specific excess mortality rates.

But that is a long way around to say: you can't do a cost benefit calculation by only putting in the numbers on one side of the column. Come up with explicit numbers for the benefits of the vaccine, and put them in your explanation of why you think it is a bad idea to get it.

Thank you for taking a shot, unfortunately, I'm not moved.

My answer to your argument is that risk to me of damage from covid must be multiplied by probability of getting covid before being compared to the side effect risk of getting the vaccine as a healthy person.

If I thought that number was high enough to drive action, I'd have made the radvac and taken it by now. I tracked microcovids early in the pandemic, but my habits haven't changed, and my risk profile was extremely low (lockdowns did not affect my life much, so I'm an unusual case, there were lengthy periods in 2020 and 2021 where my risk was 'zero' rather than 'effectively zero'). If you're assuming that the probability of getting an infectious exposure is 1, then the vaccines and NPIs will all look much better.

I'm willing to concede that I might be underestimating the risk of covid to me. Once I make that concession though, I would then need to be convinced not to a) make the radvac or b) seek access to one of the vaccines I view as having a nicer side effect profile (novavax, soberana, some others, I'll likely get sanofi-gsk when it releases). So even if I accept your argument that I should have some sort of vaccine, I'm far from sold on the ones readily available in the USA.

I haven't gotten any of the strains, so my approach has worked out thus far.

I mean if your risk was zero, and you don't care about the downsides of having a risk of zero, go for it. Though I suspect there are mortality risks in being that isolated that are on the order of 1/30,000 a year too.

Also, if you want to get a different vaccine, go for it. My wife's boyfriend got his first two as sinopharm, just get an extra shot or two, and the inactivated vaccines are probably as strong as the mrna, with a more established technology.

Also if you are socially interacting with people in closed spaces more than maybe once a month, I suspect your odds of getting some exposed to some form of covid sooner or later are still probably close to 1.

the FDA is bad at evaluating new technology (they approve things that shouldn't be, and block things they shouldn't); as an example, it took five years to pull thalidomide.

The FDA never approved thalidomide, so that doesn't seem like an applicable example?

if it were safe, there would be the opposite, and people with visible side effects would be celebrated as heroes

I'm not sure that I follow the logic here. Are you taking the "safe" condition to mean that we would know exactly when some side effects are due to the vaccine, and when they are just coincidental (so there would never be any arguments over that)?

Strictly speaking, thalidomide was only authorized for some testing in the US and never received full approval, but there were thalidomide babies born in the US. There are plenty of examples of drugs and devices which were approved and later pulled. My favorite story in recent memory is the 'Essure' device, which was only pulled after a pressure campaign by facebook mom groups (you know, the kinds of purveyors of medical misinformation who get censored for antivax misinformation)

A more articulate thing to say on the second point would would be as follows: The US government passed laws to ensure that damages would absolutely never be paid out for a 'false positive' vaccine injury, likely at the expense of 'true positives' not getting justice, a better approach would be something loose like the paycheck protection program (which was gamed), where the standards for getting a payout for a vaccine injury are low enough that people considering taking the drug are fully confident that if they have medical bills due to side effects, the government will cover them. At present, I believe the opposite, and anecdotally, I know someone who had a heart attack within a week and a half of his shot; his medical bills are in the process of slowly destroying his life.

The presence of socialized medicine in other countries and the us military I think explains part of the higher vax rates in those places. If a socialized health system or the military medical system tells you to take something, it is implied that they have ownership of future medical problems related to it.

The presence of socialized medicine in other countries and the us military I think explains part of the higher vax rates in those places.

Germany has the same number of first vaccination doses as the US does but more people with two or three doses. California has more people who received the first vaccine dose than Germany does. Within the US Alabama has the lowest vaccination rate and is at the same time one of the most conservative states. Vermont is a very blue state and has the highest vaccination rate.

While there will certainly be some people for whom not having access to free healthcare services for vaccine side effects is a major issue but it doesn't seem to explain the pattern. To me, trust in the establishment seems a more likely explanation. 

When I write it out like this it doesn't seem insightful at all, but basically people are doing a cost/benefit analysis with different inputs. A lot of the objections boil down to "it doesn't seem worth it to me", which can be broken down into (1) "there isn't enough upside" and (2) there's too much downside. This isn't exhaustive but the reasons given are mostly about:

Insufficient upside:

  • Don't trust that it will protect from getting COVID (no/low personal upside)
  • Already at low risk (no/low personal upside)
  • Don't trust that it will prevent transmitting COVID (no/low altruistic upside)
  • Don't really care that much about living anyway

Too much downside:

  • Receiving vaccines is unpleasant (needle phobia)
  • The (normal, expected) side effects are unpleasant
  • Traveling to get the vaccine is hard or aversive
  • There are too many people at the vaccine site and you're afraid
  • Getting an appointment is hard or aversive
  • The vaccine is actively dangerous (serious side effects, death/depopulation, tracking devices), or could be (too many unknowns)
  • Bowing to the vaccine mandate is a slippery slope to totalitarianism
  • Social cost to bowing to the vaccine mandate (tribalism)

IIRC old people are mostly getting the vaccine regardless of tribe, because their risk is potentially very high and they feel that viscerally. My upside was very high because I was in a semi-self-imposed prison and because if I didn't get vaccinated no one would let me hang out with them, and my downside was low (among other things, I'm not afraid of needles, and even if heart inflammation side effects are a thing, I have no relevant risk factors).

But looking at it like this, I actually find it hard to fault people whose cost/benefit analysis came out the other way. All of the downsides make sense to me as things that would deter me from getting the vaccine (I don't believe that the vaccine is actively dangerous in expectation, but if I believed that were true, it would definitely deter me). In conclusion, ¯\_(ツ)_/¯

May I add one downside? Vaccines are expensive and ultimately paid by the community.

I've heard on at least 3 different occasions people around me arguing that the unvaccinated were unconscious of how costly it would be if they ended up hospitalized. It upsets me that it never seems to dawn on them that vaccines are not free.

Even if the government has already bought the doses, taking one justifies that spending, and incentivizes them to buy more.

So it seems this is an argument you would endorse. If so, would you add some numbers for the costs of vaccination vs non-vaccination?

Thanks for categorizing and summarizing respondents' concerns, I found it valuable.

Not trusting authorities seems like a really critical one, and is a reason I'm not sure that, as bad as they have proven to be, publicly shouting about how bad the FDA and CDC are is net-positive.

What's the point of being silent about the failures of FDA and CDC? The silence will not convince anyone.

If fewer people get vaccinated because we loudly point to failures, the point would be to have more people vaccinated. There is a reasonable argument that the price of silence is too high, and that it's better that people die due to not getting vaccinated so that we all see more clearly that the institution is broken, but as I said, I'm note sure it's a net positive.

People who do not vaccinate now are not making this decision because you point out failures.

They can point out failures themselves and do it too.

That completely ignores the social dynamics behind knowledge sharing and creation - there's a lot of work on this related to how information and misinformation spreads among the public.

There are way more balanced discussion in EU compared to US, see https://world.hey.com/dhh/after-two-weeks-with-no-covid-restrictions-in-denmark-923dd9a2 or google “why norway does not recommend child vaccination”. Overall data demonstrate vaccination doesn’t slow spread and approx around ~40 years of age there is a flip in risks - you have higher chance of complications from vaccines than from COVID if you are younger. I believe it shall be personal choice which everyone weight for themselves and I am particularly concerned about “booster” philosophy - if you architect the systems which shall be re-build every 3-4 months you would be asked to go back to drawing boards to address longevity of the system. I don’t see that ask being projected into pharmaceutical companies. Also you are framing discussion negatively from the title, why people vaccinate voluntarily will be example of negative framing in other directions, more balanced and suitable for rational community discussion would be more balanced about pros and cons.

Why did these vaccines produce close to 1000 cases of heart and pericardium inflammation in young men while flu vaccines do not?

What if we make covid vaccines with older technology, the way we make flu vaccines. This is not being done. No one can choose older tech vaccines over newer tech vaccines. 

It is being done, search for inactivated vaccines in https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker . I seem to recall there's a tiny, tiny, tiny chance of some viruses not being inactive, so I don't see an advantage. Also, all the adverse reactions of an mRNA vaccine seem to be related to the configuration of the spike protein they produce because it is very similar to the virus' spike protein, and an inactivated virus vaccine has the actual spike protein, so no gain there either. It is an alternative, though.

Also, there's no "free lunch" in this pandemic: either one accepts the risks associated with infection without a vaccine, or the risks associated with a vaccine, or sacrifices contact with fellow humans. In that calculation, the more information one has, the better off one is. It would be nice to see more funding in personalized recommendations (i.e. better prior determination of someone's propensity to permanent or deadly side effects to the virus'and the vaccine), but making health recommendations is very regulated and carries high liability.

I don't see an advantage

A potential advantage of inactivated virus vaccine is that it can raise antibodies for all viral proteins and not just a subunit of the spike protein, which would make it harder for future strains to evade the immunity. I think this is also the model implicitly behind this claim that natural immunity (from being infected with the real virus) is stronger than the immunity gained from subunit (eg mRNA) vaccines. (I make no claim that that study is reliable, and just on priors it probably should be ignored.)

When I've asked my Red Tribe friends their thoughts about the vaccines, they've generally given similar answers to your survey how they don't trust the government, media, big pharma, etc. But I think the main underlying reason is just signaling which tribe they belong to. Early in the pandemic, Trump's messaging was that covid was no big deal, just the flu, it will go away soon, etc. and this became the party line. For relatively young, healthy people, choosing to get the vaccine might be seen as disloyal to the tribe. So when they weighed these social costs against the seemingly negligible risk of death or serious illness, they chose their social identity over getting vaccinated. And as Matthew Barnett mentioned, they could easily come up with plausible sounding rationalizations like the ones from your survey.

... and the impression that the vaccine doesn’t work. (I wonder how much that one is relative to an expectation of ‘very occasional breakthrough cases’ that one might also trace to someone’s questionable communication choices.)

I didn't follow this part. What is "questionable communication choices" referring to? And how is it related either to someone's expectations around breakthrough cases or their impressions of vaccine effectiveness?

Is this about what media sources they're exposed to? (It seems like that's probably not what you meant by "communication choices", but I'm having trouble coming up with other hypotheses.)

Not totally confident, but I think what Katja meant is that the media/government used the phrase "very occasional breakthrough cases" when they turn out to be more than 'very occasional'. That, like many things, was a questionable communication choice.

Yeah, I meant that early on in the vaccinations, officialish-seeming articles said or implied that breakthrough cases were very rare (even calling them 'breakthrough cases', to my ear, sounds like they are sort of more unexpected than they should be, but perhaps that's just what such things are always called). That seemed false at the time even, before later iterations of covid made it more blatantly so.  I think it was probably motivated partly by desire to convince people that the vaccine was very good, rather than just error, which I think is questionable behavior.

Ah, got it. Thanks!

Reminds me a bit of how it feels to have social media pressure to share political content on nonpolitical channels. It’s a relatively small ask compared to the enormity of the issue. Yet it feels disproportionately obnoxious to have it demanded of you over and over again.

In fact, in the face of such pressures, it makes sense to bypass fielding such requests individually, and have a policy of ignoring requests to share.

Likewise, if you have that reaction to being asked to do various unpleasant and inconvenient things by the government - things that are physical impositions, hurt, and cost you money - then you might make a policy for yourself of resisting all such impositions, regardless of the rationale.

I know that it was frustrations like this that originally got me interested in the EA/LW communities. Here was a group of people trying to find a more systematic way of separating effective ways to help from ineffective ones, and that gave me permission to say no to nonsense.

Pure speculation, but I wonder if people in the anti-vax cluster will develop a demand to create their own version of a rationality and EA movement? I imagine the originators would be religious family types, hard workers, who are frustrated with the symbolic nonsense on their own team but also have stridently different values from liberals. They’d create some sort of vision and institutions to build and transmit knowledge about how to create the brand of conservative nationalism that they actually want to live in.

There are a couple of Poe's law candidates in that list, but if anyone here knows (or is) a smart sincere covid vaccine conspiracy theorist, I'd like to know how they reconcile a) their belief in the level of coordination and competence and sheer power required to pull off that kind of conspiracy, with b) their apparent belief that they have some chance of defending themselves against the conspirators by refusing the vaccine. 

Do they think that ~all world governments and their respective health bureaucracies are working together on this plot in secret, or that there is some shadowy group behind the scenes that has managed to dupe all of those same people? If I thought either option was plausible, I can only assume I'd also think that resistance was futile.

I know quite a few very bright people who basically buy the conspiracy angle. I can speak to this a little bit.

A common theme I hear in many of these theories is that people have (supposedly) been getting trained for compliance. It's not about getting overpowered as much as hacked. The "slowly boiling a frog" metaphor shows up often enough to be notable.

The suggestion is something like… all these bigwigs pulling the strings underestimated some combo of (a) tech that gets the word out, (b) people's ability to recognize patterns like this, and (c) people's willingness to take a stand even at great personal cost.

So it's not that refusing the vaccine is mysteriously possible. It's that compliance with the vaccine, and support of vaccine mandates and passports, is part of totalitarian creep.

The question of why people who are smart enough to orchestrate something on this scale would be dumb enough to overlook these factors isn't really raised. It's often brushed aside with a tone along the lines of "Whatever. We see what they're doing. We're going to stand up against tyranny!"

It's worth noting that such circles have a lot more cases of people with adverse reactions to both the vaccine and the bureaucracy surrounding it than what I hear amongst rationalists. Months of crippling pain or inability to walk, kids having serious heart conditions, etc. Not minor issues. And without really trying to listen in for them I've heard maybe a few dozen cases of people being turned away from reporting these issues because "the vaccines are safe & effective" and therefore these problems can't possibly come from the vaccines donchyaknow. And yet at the same time, when these people go to the hospital because their reaction gets too severe, the staff often acknowledge that yep, this is just a thing with these vaccines.

So it doesn't take too many stories like this to affirm that official authorities are just not to be trusted on this. Whatever is truly motivating them sure isn't truth and transparency. Often the narrative spun in these circles is that the core motive is profit, mostly for the vaccine companies. Hence suppression of ivermectin, for instance.

(Some folk like those at Rebel Wisdom have pointed out that the financial incentives go both ways. If ivermectin were a miracle drug, insurance companies would be all over that. So why don't the incentives in that direction dominate? I basically don't hear this point discussed at all in these circles.)

Occasionally some folk grant that maybe there's no conspiracy but more like an opportunistic power grab. I tend to lean in this direction myself: Moloch-like "conspiracy" by egregores (what my family has long called "conspiracy by stupidity") followed with a chaser of Rao-sociopaths. Although most folk who go in this kind of direction that I've heard seem to assume that "the elite" are awfully coordinated even in their opportunism. Usually with Bill Gates and/or Fauci in cahoots with the vaccine companies and "big tech" and a few other key players. I don't hear too many recognizing the multipolar nature of the Egregoric Wars. I guess it's easier to visualize corrupt villains than hyperobjects.

But even so, the conclusion is usually the same: "Going along with it and not speaking up against it is being complicit in something Bad™." Insert allusions to early Nazi popularity prior to WWII. And it's possible to resist because the goal isn't actually to force everyone to get vaccinated: it's to make everyone compliant.

[+][comment deleted]6mo 1

One way of thinking about mutually held exclusive beliefs in general is that in these instances, the person’s map cannot reconcile to a terrain but maps don’t need to.

You'd have an easier time getting an answer to your question if you came at it from a perspective of improving epistemics overall instead of looking for one tiny specific answer. You're automatically assuming your reasonable sounding understanding is correct and focused on finding reasons why the other people's reasonable sounding, yet different understandings are wrong. I don't believe that will get you a lot of information.

You'll know more about why people believe X and why X is wrong by just trying to become more knowledgeable on X ~X and a variety of related issues as a whole.

The question I would ask is whether the marginal utility of a dollar spent in convincing this long tail of people is actually worth it, compared to other uses of the money. It's obvious that some of us needed no convincing at all, we were just desperate for a vaccine. Other people were ok with getting vaccinated if it were easy or convenient. Some must have been on the fence or mildly against it, but could be convinced with some nudging (see vaccine lotteries and other interventions). So now you have a minority that is stubbornly against getting vaccinated. Let's say it's 10% of the people, and perhaps you could convince one in five of those people at some cost. Now you have 8% of the population who won't get vaccinated, and you spent a significant amount of money or resources on going from 10% down to 8%.  Are the public health gains significant enough to warrant the expenditure? Is there anything else with more impact that you could have done instead?

In US, the number of unvaccinated is closer to 30%. This is no long tail. 

I threw 10% there as an example of a target that you might convince with some intervention. By "long tail" I don't mean a small number of people, a long tail can be 50% of a distribution. I am using the term to refer to the reasons they don't get vaccinated. The post mentions 34 distinct responses, so if one were to optimize for impact then the idea would be to identify the most "nudgeable" class, evaluate the cost/benefit of the nudge, etc. Sorry if I wasn't clear enough in my original comment.

Right, I did misunderstand. I thought you were proposing taking 10% and trying to convince some of them who can be convinced. But the value of that is decreasing every day now. Half the population has already been infected at least once and recovered which is probably equivalent to vaccination.

I had always been very pro-vaccination. Both me and my kid were fully vaccinated on the standard schedule. The situation around COVID vaccines prompted me to think critically about vaccines in general for the first time.

In absence of vaccines, how many serious diseases a human body was supposed to have seen throughout its life? Probably one or two, then you'd mostly be dead.

With our usual vaccination schedule, we now routinely prime our immune system against twelve diseases, if I'm not mistaken. Plus now COVID. As an engineer, I would be extremely worried if I did something like this to a legacy system. Yet we seem to only look at each vaccine in isolation and short term, and approve based on absence of visible side effects.

Take the difficulty in tracing side effects of COVID vaccines. For all the attention, good information is very hard to find, because it is genuinely difficult to produce. Now imagine same level of difficulty, plus no attention - because when was the last time anybody worried about side effects of a flu shot? 

And that is before we mention politics, mandates, and trust in institutions.

For context, I did take the original COVID vaccine. 

In absence of vaccines, how many serious diseases a human body was supposed to have seen throughout its life? Probably one or two, then you'd mostly be dead.

Why would you expect historical people to die after getting sick twice when modern people get sick all the time and usually recover without treatment (from colds / flu)?

I would expect that modern people get sick less often than people >100 years ago due to improvements in sanitation, nutrition and housing density.

Just chiming in to say that you're very, very wrong about prevalence of minor and major disease throughout human history. For an obvious comparison, look at wild animals, which contract multiple minor infections a year, and often suffer from several fairly major ones chronically - which was typical for pre-modern humans as well.

In absence of vaccines, how many serious diseases a human body was supposed to have seen throughout its life? Probably one or two, then you'd mostly be dead.

I don't understand where this assumption is coming from (both in terms of "one or two" specifically, and that there should be any particular number in the first place).

With our usual vaccination schedule, we now routinely prime our immune system against twelve diseases

Is the idea here that all vaccines have the same fixed risk level, regardless of what it's vaccinating against, whereas non-serious disases have a lower risk level? And most of the twelve diseases are not in the "serious" category?