Recently, Covid vaccine sceptics have enjoyed a growing profile. In an article on Bari Weiss’s Substack, Vinay Prasad and John Mandrola draw attention to sudden deaths and studies which link the vaccine with myocarditis, an inflammation of the heart muscle. Reading such articles, I can say little in response; Prasad is a professor of epidemiology and Mandrola is a practicing cardiologist and their arguments seem reasonable.

But Covid vaccine sceptics will probably never convince me.

This reflects my attitude to expertise and its institutional foundations. Whilst I have followed debates about the vaccine somewhat, my knowledge is very limited. I am not a medical expert, my inability to counter the arguments of Prasad and Mandrola reflecting this. Being unacquainted with a subject, one is defenceless against a knowledgeable interlocutor. I have a friend who is a biologist and creationist. When he explains his scepticism with evolutionary theory, going into great technical detail, I cannot say a thing in retort.  

Given these deficits in my knowledge, reliance on mental shortcuts is reasonable, scholars calling these heuristics. One cannot make all one’s decisions; we have limited time and confront issues of great complexity, particularly in modern societies. Therefore, we use heuristics constantly. Currently, the vast majority of experts support vaccination programmes.  

Clearly, one cannot trust the state indiscriminately. My wife grew up in Communist Poland, the government lying habitually. Are liberal democracies different? Whilst I (and many others) would argue this, these systems being predicated on openness, such states are unworthy of unconditional trust. Within living memory, liberal democracies have endorsed lobotomies for mental illness and thalidomide for morning sickness. Recently, such states have embraced ideological positions which I consider questionable, the transgender issue involving medicine.

Why are Covid vaccines different? Aside from the rarity of scandals such as thalidomide, I have faith in the formation of expert consensuses, following years in academia. In another area in which the role of expertise has been disputed, the Brexit debate, I have some technical knowledge. Whilst Brexit experts made mistakes (see below), I think that prognoses proved sound and consensuses developed from the bottom-up.

When Covid vaccine sceptics write about the creation of consensuses, they overemphasize the role of external influences, such as the state; this makes me distrust their wider arguments. Unlike the transgender issue, this area is primarily scientific and highly salient.

In short, I have better reason to trust authorities over sceptics. Certain sceptics have impressive credentials, yet the imbalance in expert opinion is too great to ignore, particularly in an area with serious consequences. Discretion may be possible in certain areas – sometimes consensuses are less clear and authorities indicate this – but in areas in which agreement is near unanimous, I will follow official advice.

Were I to acquaint myself with the subject matter, perhaps I would change my mind. Yet such acquaintance would involve significant investment of time and/or formal training in medicine. I do not have the time and this attitude is reasonable. No one can undertake all their own investigations and, in most cases, reliance on heuristics is permissible. In most areas of their lives, sceptics use heuristics, many of which rest on technical expertise.

But if I and others have such faith in institutions and little intention of engaging with this issue, how can we be sure that, were there problems with the vaccine, sufficient opposition would develop?

This concerns the quality of our institutions. Despite my broader confidence, public institutions have challenges. To function optimally, institutions must be places in which dissenting views can be aired without fear. For this reason, liberal democracies have better safety records than dictatorships.

The atmosphere around the vaccine should concern us. Whilst some censorship may be legitimate – during a pandemic, misinformation can be highly damaging – environments can become too illiberal. Aside from issues of freedom of speech, the vaccine was developed quickly and there have been previous medical scandals. Liberal atmospheres maximize the likelihood of problems being identified, even if they are, pace sceptics, smaller ones.

In some cases, this has not occurred, certain dissenters being treated unfairly. Problems are familiar; partisan divisions have extended throughout society, making dissent more difficult. Such trends affected debate about Brexit, echo chambers in elite institutions encouraging support for the disastrous People’s Vote campaign; I can see how debate about the vaccine might be impacted.

Certain vaccine experts might deny this. I cannot debate technical details, yet can emphasize that, in the great majority of domains, they are non-experts. Across fields, all of us have an interest in cultivating healthy atmospheres for the emergence of expert consensuses, this being a duty of the engaged citizen.   

Declining trust threatens our institutions. In certain regions, such as Central and Eastern Europe, it is a longstanding phenomenon and associated with negative outcomes. There is no single solution and elites must take their share of the blame – as Helen Dale notes, certain experts give poor accounts of themselves on social media – yet we must work to rebuild trust in institutions. Without it, liberal democracy cannot function.    

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"I have better reason to trust authorities over skeptics"  argumentum ad auctoritatem (appeal to authority) is a well known logical fallacy, and unwise in an era of orthodoxies enforced by brutal institutional financial menaces. Far better to adhere to nullius in verba (on the word of no one), the motto of the Royal Society, or as Deming said "In god we trust, all others must bring data"

Followed closely; the pandemic years have provided numerous clear examples of very old problems like bureaucratic reluctance to change direction even when strongly indicated - such as holding on to vaccine mandates for young in era of very low risk covid strains, the malign impacts of regulatory/institutional capture by rich corporates (eg pharma cutting-short vaccine trials without doing long term follow-up, and buying support from media and regulators to prevent dissent or contrary evidence and opinions seeing light) and high ranking individuals conspiring to corrupt scientific process (published mendacious statements dismissing Wuhan lab leak theories for political reasons) all of course abetted by Big Tech censorship.  All these and a hyper partisan media and academic landscape that constantly threaten heretics and heterodox thinkers with financial destruction has broken the truth-finding and sense-making mechanisms of our world.  Institutions do not deserve trust when dissenters are punished, that is the hallmark of religion not science. 

Current concerns about vaccine harms seem to have a lot of signal in data; most clearly in excess death figures for New Zealand where covid, flu and RSV deaths were near zero due to effective zero-covid lock-downs from 2020 till end of 2021, and yet in 2021 excess deaths jumped by about 400 per million above the 2020 baseline in the 6 months after the vaccine programs started in Q1 2021 prior to covid becoming widespread in December 2021.   The temporal correlation pointing to covid vaccination as the cause of these excess deaths is powerful in the absence of other reasonable explanations.  And with a natural experimental 'control' population test of 5 million and 2000 extra deaths it is not a small number to be dismissed.

Hopefully the argument will be resolved scientifically over next few years, but it will be politically very difficult battle given large number of powerful people and corporations with reputations and fortunes on the line.

My general heuristic is that the higher the stakes (especially for personal and societal survival), the more you need to check the expert consensus (especially for softer sciences such as medicine, sociology, and economics). Examples where expert opinion should be checked (and is or was probably wrong or misguided): cryonics, certain pandemic mitigation strategies, aging research, geoengineering. Examples where expert opinion probably shouldn't be checked very often by non-experts: brain surgery, bridge building, rocket engineering, archeological excavation.

If you go for brain surgery, check the error rates of different doctors that might operate you and taking actions so that you get operated by a doctor with a low error rate seems to be pretty valuable. You probably also should get opinions from experts that aren't brain surgeons about whether the surgery in itself makes sense.

Bridges build today are often more expensive, take longer to build and are more ugly than those build 70 years ago. Moses wasn't an architect but was good at building bridges.

Elon Musk wasn't an expert at rocket engineering before starting SpaceX. He seems to do pretty well. 

I was referring to how docs do brain surgery (e.g., infection prevention procedures, what instruments are used, where incisions are made, etcetera) rather than error rates or second opinions. I highly doubt that many non-experts (even a very motivated brain cancer patient) could successfully determine the appropriateness of specific surgical techniques for brain surgery. And since brain cancer is rare, it's low stakes from a societal or even a personal survival point of view (although, it will become high stakes if you'll live a lot longer than the current lifespan).

Nah, bridges (see other reply) and rockets aren't high stakes enough to be worth worrying about.

China is a big one for this. Large numbers of experts, including many non-pundits, have been widely forecasting China's imminent demise on 3 separate occasions over the last 1.5 years (disclaimer: if you look closely you'll see that many of them were being vague and had way too much plausible deniability to consider it a "forecast", and I only used the word "forecast" above because many were vaguely acting like they were forecasting).

What kind of demise are you referring to?

fall 2021: banking system collapse due to evergrande
spring 2022: covid overruns healthcare system, causing mass graves and widespread system failure
winter 2022: covid overruns healthcare system, causing mass graves and widespread system failure

To be fair, I was a little too harsh on the third time, since many people and most china watchers were very fatigued by then with the ubiquitous plausibly deniable claims of imminent catastrophe in China which didn't come to pass at all the first two times. Then when there actually were videos popping up of piles of bodybags, everyone got confused. The first two times were pretty strong evidence that experts of all kinds were popping up all over the place making way overconfident predictions of China's imminent demise. I don't know whether those predictions persuaded many intelligence agencies or wall street analyst firms, but many people in open source intelligence got bamboozled and started wising up by the third time. I heard that the worst of it was on twitter (alot of respected china watchers apparently tweet), but I've never used or trusted twitter so I'm not the right person to ask about how bad it got there.

It's a tricky situation. As soon as Hong Kong relaxed its pandemic strategy, excess deaths exploded. Since China followed a similar (and even stricter) pandemic strategy, it seemed inevitable that the same thing would happen (all things being equal) and millions would die with many more millions becoming hospitalized. But all things might not be equal; the circulating strains of covid in China might be less lethal than when Hong Kong relaxed its own pandemic strategy. So, it could go either way.

The real problem here is that China is playing Russian roulette; rather than using more effective vaccines and respirators, its using less effective vaccines and poorly-performing masks instead. The expert consensus seems to correctly identity the vaccine problem but still mostly ignores the mask/respirator issue, as they've done throughout the pandemic.

The examples you give seem to be divided more according to richness & rapidity of feedback loops, as well as ease of credit assignment rather than how impactful the work is to society. Cryonics seems about as important as bridge building. If we kept failing at bridge building, many would die.

Bridge building is nowhere near as important as cryonics (or more appropriately, "brain preservation" technology which may not involved cryonics at all), because brain preservation tech has the potential to save hundreds of millions and possibly billions of people from certain death. Even if you disagree, it is still potentially important for personal survival way more than bridge building.