From 2022:
"How could an MIT-educated, well-meaning, rational (hopefully), Massachusetts-born, Democrat who works in public health still not have a Covid vaccine?...
Thus began a long, fraught, journey into the world of Covid science, data and policy. A journey that started months and months ago and slowly grew into what is now something of an obsession. While much of the world has moved on, I’m still here reading Covid preprint papers, following epidemiologists on Twitter, looking at Our World In Data graphs, etc. I’ve become one of those people...
I’m an American, but I live in South Africa. This put me in a relatively unique situation early in the vaccine rollout. I could simply be a bystander.
South Africa—like all of Africa—had to wait for everyone in the first world to get their shots before we’d be given any. And when we finally got vaccines, we prioritized the old, healthcare workers, and immunocompromised. I wasn’t eligible to get a shot until mid-July, 2021, more than 6 months after the vaccines were distributed to much of the developed world.
During this period I mostly waited and watched.
And a lot happened!
The Delta variant tore through India and spread to the rest of the world. Covid policy, and later vaccination policy created a fierce political divide in the US and much of Europe. Things went from “cutting in line to get the shot” to “here’s $100 to get the shot” to “get the shot or lose your job” in a surprisingly brief period of time. In a country that still had a 5% vaccination rate, the path to mandate was hard to imagine, but impossible to ignore.
We also learned a lot about Covid and the vaccines.
With Covid, it became clear that the impact of the disease was highly stratified. If you were old and/or sick, Covid was really scary, and if you were young and healthy it was relatively mild. I studied CDC mortality statistics, trying to figure out the chances that I—a 39-year-old who runs 5 miles a day—might die from Covid. I never got an exact answer but it was clear Covid was far less likely to kill me than a heart attack, and was perhaps on par with getting murdered.1 I’d never worried about heart attacks and murder before, so it didn’t seem rational to worry about Covid. So I stopped.
I then applied the same exercise to my wife—similar to me—and two healthy children—whose odds of dying were orders of magnitudes lower than ours. For kids Covid was as dangerous as the flu—again, something I hadn’t ever worried about except as a mild inconvenience. I concluded our family was already safe enough from the disease and did not feel compelled to vaccinate for our own health.
So we were ok. But what about vaccinating to stop the spread and protect those around me?
Well, around this time, we also started seeing evidence that the vaccine protection against infection was waning pretty quickly. About a month after I became eligible for my shot, a paper came out of Israel indicating that vaccine effectiveness against infection dropped to 50 or 60% after 6 months. And on top of that we saw evidence that vaccinated people carry equal viral loads and spread the disease as much (though for a shorter duration) as unvaccinated people.
I concluded that there was a benefit to being vaccinated to protect those around me, but that it might be short-lived—or require boosting—to stay above a compelling threshold. And also that I could likely do just as much to protect those around me by continuing to only see people outside, wear a mask, etc.
The other thing that became clear during this time was that Covid would become endemic. That is—we would not be able to stop its spread, and would have to learn to live with it in our lives. This meant that most of the measures we were taking weren’t stopping people from getting the disease, they were just delaying it. If getting vaccinated meant I could prevent a Covid illness, that was pretty compelling. But if it only meant pushing the illness back a few months, that was a bit less remarkable. Still beneficial—by spreading the strain on health systems or allowing more time for new treatments to come out—just not nearly as much.
These factors created a backdrop where I could see that getting vaccinated meant stepping onto a treadmill of sorts. A treadmill that didn’t have any clear stopping criteria. The immunity would go, but the virus would stay. And to continue to be a responsible citizen I’d have to keep topping up my immunity.
Still, so what? Unless the vaccines were harmful, there was still no reason not to get vaccinated. And the vaccines were safe, right?
And the simple answer is “yes”. If I wasn’t worried about Covid then I should also not be worried about the vaccine. Yes, there were some rare side effects—some of which were quite serious—but these appeared to be less common than the serious problems associated with Covid itself. Statistically, the vaccines looked less dangerous than the disease.
But that seed of doubt lingered in the back of my mind. From what we knew, the vaccines were safe, but how much did we know? Did we have a complete picture of what the vaccines did, or were we standing on top of an iceberg with lots of information still lurking underneath?
What I could say definitively is we didn’t know everything. We’d been wrong about the vaccine effectiveness that was quoted when the shots were first released. There was no clinical trial data for boosters. The trials for kids were underpowered to demonstrate true risk/benefit from the intervention. And so on.
Did our lack of complete information mean the vaccines were bad? Of course not. Did it mean there was a chance the vaccines were bad? Maybe.
I tried to think about other times in history where it took a long time to learn that something was bad for us. Smoking and lung cancer. Asbestos. X-Rays and other cancers. I wondered, if the vaccine made people 1% more likely to develop cancer or heart problems sometime later in life, how long would it take to figure that out? I decided the answer was probably quite a while. I decided to wait.
You might find my choice to remain unvaccinated a selfish act. To some extent it was. Part of me felt guilty about not “doing my part” to protect those around me. I was torn. But, looking at the balance of evidence—I could live with myself. In life we constantly balance our selfish desires with the global good. If I were completely selfless, I’d be vegan, get rid of my car, and donate all my extra money to people with less than me. In the balance of selfish things I do every day, and the data as I understood it, I did not feel my decision to remain unvaccinated was wildly out of line with my own moral compass.
Still, my wife and I revisited the prospect of getting the shot regularly. But it was easier to put off the decision another day, another week, and so on than to take action. Perhaps, if we were less lazy we would have gotten it earlier.
And then we got Covid. And the picture changed again...
In my province, they didn’t recommend getting the shot within three months of a Covid infection, so I now had more time to think about the decision. Also, I now had some degree of future protection from the disease (a.k.a. natural immunity).
Now natural immunity is another funny topic with Covid. No one can seem to agree how much protection you get from it. Policies in some places—including most of the US—ignore natural immunity entirely. And yet, simultaneously, much of Europe includes it in the definition of “fully vaccinated” in terms of their restrictions—at least for some period of time after infection. This apparent lack of consensus seemed odd, so I found myself digging into the evidence.
Sadly, the evidence was just as confusing.
One study that came out of Israel in August claimed that previously infected people were 27 times less likely to get infected and 9 times less likely to be hospitalized than vaccinated people. But then, many other papers claimed that vaccines produced “a more consistent, and higher-titer initial antibody response”—whatever that meant. Then in November the CDC published a study that found the complete opposite of the Israel data: infected people were 5 times more likely to be hospitalized with Covid than the vaccinated. Huh?!
My background is in engineering and computer science. I’ve been a practicing software developer for 15 years and done my fair share of data science in my career. But I’m not a biologist. Making sense of these papers was slow-going.
So, I thought, “Well, I’ll do what I normally do in other fields—I’ll just look to the experts to tell me what the answer is.”
Unfortunately, the experts didn’t agree either!
Instead, the experts seemed to say whatever supported their own previously-held positions. Experts who favored vaccination loved the CDC study. Experts who thought Covid policy had become too extreme hated it. It was enough to make my head explode. How can we not know these things? How is there not consensus?
I went deep on this topic, trying to form as unbiased an opinion as I could based on reading as many papers and conflicting opinions as I could. My conclusion after many, many hours of research was that my natural immunity was at least as good as any vaccine.2 Probably far better than one dose of J&J. Maybe not as good as two doses of Moderna. Either way, I was now as “protected” and as “safe to society” as anyone who’d been vaccinated.
The other conclusion I drew from this exercise was that our information ecosystem was pretty broken. I had tried to get an answer to what I thought was a simple question—”How protective is natural immunity vs vaccination?”—and found it to be a deep and complex rabbit hole of evidence and opinions. I also observed a serious disconnect between how confident people were and the body of contradictory evidence. To borrow a term from Wait But Why, everyone was operating in the Arrogant Zone.
The simplest answer was: we aren’t sure! But everyone was talking as if they knew everything, despite equally-credentialed people across the aisle saying the polar opposite. I had thought being scientifically-minded meant continually questioning consensus opinions with new information, but here things had turned on their head. Science was being used to affirm our previously-held beliefs, rather than help us see truth.
As I continued down the Covid rabbit hole, what did become clear is that I had to “correct for bias” in everything I read about Covid. I would see a study and immediately think “Ah the New York Times is gonna love that one”. Or another one and think “The Brownstone Institute is gonna be all over this”. Media outlets that I had trusted my whole life morphed into these predictable propaganda machines, amplifying the information they liked and ignoring the information they didn’t. I realized that to see the whole picture I had to follow a wide group of sources with a broad range of opinions and draw my own conclusions.
I also realized that almost no one around me was doing anything like what I was doing. Instead most people were living in an ideological echo chamber, certain that it represented the truth. I don’t blame people for this—getting a broad view takes a lot more time and effort—but it was troubling that this was the position we had gotten ourselves into.
What also became clear to me is that the downstream effects of these Covid information echo-chambers was having a big impact on policy and public opinion.
Here again, my position in South Africa provided a unique perspective into the things that started happening elsewhere in the world. Specifically, the politicization and polarization of all things pandemic, from masks to lockdowns to vaccines to mandates.
As I said, I’m American and most of my friends are still in the US. What became striking was how different the conversations I was having in South Africa were from the conversations people were having in the US...
The smallness of these interactions stayed with me. The casual way in which there were clear “sides” to this thing. In which it was obviously “right” to be on one side, and that the people who felt differently were somehow conspiracists, crazy, and worthy of mockery. The casualness of it all was the most striking.
I’ve seen this “othering” before in various forms. I’ve been a part of many conversations—some in the workplace—where it was perfectly acceptable to casually mock and dismiss anyone who supported Donald Trump. I wondered what it would be like to be a Trump supporter in a place like that. Whether you’d try to defend your position. Whether you’d keep silent. Or whether you’d eventually be shunned and forced out. And suddenly I was getting a taste of it. Vaccine status had become a “safe” place to mock and shame our fellow people.
Was this ok?
In South Africa our vaccination rate slowly climbed to 20%, then 30% of the population, but the vaccinated remained a minority. Most of my personal network was vaccinated, but the national picture was still quite different. And my interactions were quite different. Everyone was respectful. No one made assumptions. No one has shamed me. If my status comes up, it’s usually a level-headed and nuanced conversation. I’ve never had any of these “othering” experiences that became commonplace with the people in the west.
Something clearly different was happening in America. For reasons that were clearly not just about public health.
It didn’t sit well.
As time went by, I became increasingly confused by what appeared to be a growing divergence between science, common sense, and policy.
On the science side, the effectiveness of vaccines against infection continued to wane. The vaccines continued to do great at preventing hospitalizations and deaths, but there was now no doubt that they weren’t going to contain the spread. Countries with 80 or 90% of their adult populations vaccinated saw their largest waves ever. Israel redefined “fully vaccinated” to mean three shots instead of two, and people started talking about doing the same in Europe and the US. Natural immunity also waned over time, but appeared to last longer than vaccines.3
I looked at the global picture and thought, well it’s clear that the vaccines aren’t stopping the spread of disease. It looks like getting vaccinated is moving towards becoming more of a personal health decision than a public health necessity. So maybe mandates are no longer required? Or perhaps at a minimum we’ll recognize natural immunity is at least as good as these vaccines?
Oh you sweet summer child. This perspective turned out to be hopelessly naive.
Instead, mandates continued to be pushed, harder and harder, and with more and more tenuous logical reasoning. I became ineligible to enter Canada—my wife’s home-country—due to my vaccination status. I can no longer dine in many of the most popular cities in the US. The goal of pandemic policy seemed to have changed from “stop the virus at all cost” to “increase vaccination rates at all cost,” and so a policy that increased vaccination that was deemed “successful” even if it didn’t really…well…stop the virus.
And there was a cost. Thousands of people were losing their jobs. Hospitals were hurt by staff shortages in part because they had fired healthcare workers—people who risked their lives and got Covid early in the pandemic, but whose natural immunity wasn’t recognized. Students were being kicked out of universities. Long-tenured, celebrated doctors and professors were fired from their jobs.
The gap between policy and common sense didn’t just apply to vaccines. Mask policies in many places became a circus. People would put on their masks for 30 seconds walking through a restaurant, only to dine unmasked for 2 hours, and somehow everyone accepted this was helping. The US masked kids, often as young as 2, despite this being against WHO recommendations, and being based on a very tenuous base of circumstantial evidence. Did we have any idea what harm that was doing?
The decoupling of evidence from policy and public opinion created a fierce rift in society. It also created a group of people—people like me—who paid attention to the science and saw just how much our trusted institutions were getting wrong. This erosion of public trust will take a long, long time to repair.
I tried having conversations about this with people around me—people who were very smart, highly educated, and generally open and liberal-minded—and was consistently met with fierce resistance.
Usually we disagreed about the facts. How effective the vaccines were, how risky they were, whether it mattered if you were old, young, infected, etc. Fact-based disagreements were tricky because—like I found on the topic of natural immunity—the evidence base was overwhelmingly complex. I couldn’t bring everyone along my 100-hour research journey, and there was plenty of evidence out there to support whatever position anyone wanted to have.
What was most effective in these conversations was pointing out where there were clear differences of Covid policy globally. Pointing out that natural immunity was widely acknowledged in Europe’s Covid pass system, for example. Or that Germany and France suspended giving Moderna shots to anyone under 30 because of heart inflammation risks. But whenever I presented an opinion that diverged from most government policies the conversation became almost impossible.
I get it.
It’s pretty hard to fathom that most of the world might be operating on imperfect and incomplete information. It’s hard to believe that some random person who did some internet research has a more balanced, or nuanced position on Covid than Anthony Fauci. But Fauci sits on the edge of a complex spectrum of opinion related to Covid policy. Many equally-credentialed experts in public health and epidemiology think very differently. And there are even highly credentialed experts who believe the vaccines might be far more harmful than we believe. Somewhere in this mess lies the truth. The biggest difference between Fauci and the other experts is that Fauci has the biggest microphone.
It had become clear to me that we were spinning into a weirder and weirder place at faster and faster speeds with our Covid policies.
And then came Omicron.
And if pandemic policy had already become decoupled from science and common sense, Omicron put this divergence into hyperdrive.
Once again being in South Africa provided a unique perspective into what was going on with the pandemic. Where historically living here was like living four or five months in the past, now all of the sudden I was living in the future! We went through Omicron first and were weeks ahead of the rest of the world in terms of what the impact would be.
And Omicron turned the balance of pandemic policy upside-down in every way.
First, it was impossible to contain. It spread like wildfire and tore through populations regardless of what measures were put in place. Vaxxed? Previously infected? Masked? Don’t matter. Omicron finds you.
Second, it was much more mild. And I know that as of the time of this writing (January 4, 2022), some people don’t feel ready to admit that to be true even though it is getting more and more impossible to ignore. In South Africa—now on the downward slope of our Omicron wave—the “peak” of deaths has been only 1/10th as big as previous waves.
Third, it largely evades vaccines. Many of Omicron’s mutations are in the spike protein that is used by the vaccines to confer immunity. It appears the changes substantially reduce the effectiveness of the vaccines against infection to levels bordering on zero just a few months after the shot.4
So now we have an impossible-to-stop virus that looks a lot like the common cold. And we have a heavy-handed global mitigation strategy based on vaccination that does very little to stop it. Surely, I thought, we will now see that these policies, and especially vaccine mandates, do not make any logical sense?
Fool me once, shame on you. Fool me twice, shame on me.
Instead, the mandate train kept right on coming. Universities started mandating boosters for healthy 20-year-olds. Kenya announced—two days before Christmas—that all airplane travelers would require vaccination to enter or exit the country. Because… the variant that evades vaccines was spreading. Kenya’s policy change forced us to cancel our planned holiday trip with less than two-weeks’ notice. In a fun twist of irony, the policies rolled out the same day I got my yellow fever vaccine for the trip.
The public opinion train steamed on as well. As cruise ships, parties, and weddings of fully-vaxxed, often boosted, people created massive spreading events, people continued to celebrate their cities’ vaccine mandates on Instagram, shame the unvaccinated on Twitter, and grow the ever-increasing divide among us.
Here in South Africa, we had all-but declared the pandemic over. The day after Kenya mandated vaccination for air travel, South Africa issued a remarkable update to its Covid guidelines. No more contact tracing. No more isolation or testing of Covid contacts. No more need to isolate even if you test positive for Covid, as long as you weren’t sick. And no different treatments for vaccinated or unvaccinated people. The government acknowledged what is now obvious: this virus is here to stay, it’s not that bad anymore, and we need to live with it and get back to our lives.
I was shocked. Not because I disagreed with the changes, but because I didn’t think the government would be willing to do something that would be so obviously controversial. I was never more proud to be in South Africa than I was at that moment.
And then just a few days later, they rolled back the guidelines. Citing “media, stakeholders and public enquiries”, they decided to take more time for comments...
You might be wondering, well why not just get the shot?...
I do genuinely believe that given my previous infection the risk/benefit of the vaccine is negative. That is—I think it is more likely to do harm than good. And I believe that any good it will do is temporary, and futile in the long term.
The overwhelmingly likely outcome is that the vaccine would do just what the virus did: maybe inconvenience me for a day or so, and then I’d be on with my life. Rationally, isn’t that worth being able to live “normally” again?
Yes. That would be worth it. But the issue is no longer the vaccine. The problem is the precedent.
I don’t believe it’s ok to live in a world in which medical procedures can be forced onto people without an impenetrable foundation of evidence to support them. And I’m just not seeing that from where I stand.
The world I want to live in is a world where we make and enforce rational, evidence-based policies based on the good of the population. A world in which we defer some autonmy to individuals to make their own decisions regarding their health, and don’t keep them from going out to dinner or getting on an airplane if we disagree with them.
I’d also like to live in a world where we stop shaming “the other”, and I’ve decided that one way I can do that is by declaring myself as part of “the other”.
Earlier I didn’t take the shot because I wasn’t sure it was good for me. But now? Now I’m not taking the shot because I’m taking a stand.
I’m taking a stand because if people like me don’t stand up against what’s going on in the world right now then things will only get harder and weirder and scarier for other people like me. I’m worried that if we don’t get off this path soon, it’s going to get harder and harder to turn back. And I don’t want to see where that ends up."
Clearly, doing your own research means watching YouTube videos.
This is like left wingers who won't get married until gay marriage becomes legal where they live. But of course that is brave and stunning and this is disgusting.
Addendum: I still saw people mock and shame the unvaccinated and gloat over them dying in late 2023, so