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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