As justifiably proud as Canadians are about their health care system, carping about our experiences with medicine is a national pastime, too. Presented with a novel technology under today’s unusual conditions, it is unsurprising that some of the same old frustrations and complaints take on new relevance.
Doctors routinely know more than they let on, and they sometimes know less than they pretend to. They act this way because they need us to trust them—which is ironic, because whenever patients suss it out, it breeds distrust.
Sometimes in their role as prescribers our doctors can do little more than be our best guessers: Let’s try this drug at this dose, and if that doesn’t work or the side-effects are too disagreeable, we’ll go with that one at this. It can make us feel like we’re data points as much as we’re patients.
Many of us have witnessed friends or family members endure adverse reactions to medications that were approved in the usual timeframe without the same degree of urgency that surrounds the COVID vaccines. Some medications fall into disfavour once new risks are discovered. Some medications get prescribed regularly despite our knowing how damaging they can be because they represent our best available options, making additional drugs necessary to counteract their more deleterious effects. You might know someone who lost someone on account of how their meds for one ailment contributed to some unrelated terminal condition.
These kinds of stories may be reckoned anecdotal when tallied in the aggregate, but they’re the sorts of anecdotes everybody has. And what about the tons of money involved in the pharmaceutical and medical industries? It’s another something that adds to people’s distrust. We can all agree we are definitely very grateful for everything our doctors, nurses, technicians, surgeons, and therapists do for us ordinarily, and on occasion, extraordinarily. We’re all aware of the rigorous training they undergo and the sacrifices they make on our behalf. That we have so many elderly people so vulnerable to COVID is a testament to how impressive our medicines and medical practitioners are.
Still, even if many of the concerns detailed above are not directly pertinent to the discussion of the new vaccines, they all contribute to the uncertainty regarding how much trust the art of medicine deserves in comparison with how much we usually give it—a question that weighs heavily when suddenly embracing some fantastic innovation in desperate times.
People have concerns, for instance, about what kinds of immune system reactions this new technology might trigger, or what other unexpected side-effects or long-term risks it might entail. Accompanying the rollout of first few doses of the vaccine in mid/late December there were some incongruities in the footage, and of course, some reports of allergic reactions among some recipients, but not enough to cause a panic. Trusting that the results of the trials are reliable with respect to the general safety of the vaccines—something I am not disputing—it is nonetheless understandable why people might wonder how unexpected long-term adverse consequences could be ruled out given the time frame in which trials were conducted.
I know that they have assured us there will not be any. But we also know how complex the human body is, and that scientists are constantly making new discoveries about how it works. The sciences on which these technologies are based are not yet perfect and complete in their knowledge. That is why well-funded research remains ongoing.
In the end, for all but anyone who is genuinely knowledgeable in all of the relevant sciences, accepting that the vaccines are safe and effective is something that can only be taken on trust. Everyone must exercise their own judgment and heed their conscience. It certainly is not my place to tell anyone who and what to trust, what to do or not. I don’t possess the relevant expertise to know for certain; that much is certain.
Every now and then I hear someone in the media telling people who are unsure to “get educated.” The Internet is now full of diagrams and animations offering explanations of how mRNA vaccines work in a nutshell. Some of the cartoons I’ve seen are almost as fun as episodes of Schoolhouse Rock!
The very same people in the news media will summarily dismiss the opinions of anyone who isn’t a scientific expert or medical professional. This means, however, that the very people they tell to get educated could not possibly be expected to get meaningfully educated by the standards they apply for what it means to be educated.
Meanwhile, the news anchors themselves haven’t completed postdocs in the biological sciences, either. Neither have our political leaders. For the overwhelming majority of people, the instruction to “get educated” can amount to little more than “learn to trust us.”
In higher education, where I work, we’re all now getting used to teaching via Zoom, but I don’t expect anyone to provide non-experts with the untold hours of online remedial to advanced and specialized instruction in the relevant sciences that would be required for people to obtain an understanding of the new vaccines, their mechanisms and risks, sophisticated enough to qualify as truly educated. That’s before getting to the necessary hands-on laboratory experience. So, we’re stuck with trust. Pretending otherwise is disingenuous.
Laypeople have fair questions like: “Why do the many people who have already recovered naturally from the virus need the vaccine?” and “If the Ontario government wants to provide people with only one dose but the manufacturer says you need two, whose science am I supposed to trust?”
Read the third article of Convivium's COVID-19 series: Travis Smith argues reassurances about vaccine safety will convince only some of the people some of the time.
I am confident there are straightforward answers to everyone’s questions. However, treating people who have honest questions derisively, as if they’re superstitious dummies beholden to “myths” who just have to get their facts straight by deferring to supercilious fact-checkers, is apt to cement resistance rather than dissolve it. Unless people possess expertise in the relevant sciences, they are left being asked to take those who address their questions and concerns at their word. Of course, this may explain the general impatience we see with people’s questions. Medical professionals have long experience watching patients who think they know better fail to follow their explicit instructions and best advice—by not completing a full regimen of antibiotics, for example. But then again, remember when we learned that the over-prescription of antibiotics has had negative consequences for human health, too?
In the 21st century, we all have enough experience with glitchy new technologies full of bugs needing patches and fixes. It is not “anti-science” to be prudent about new technologies, especially under conditions of great anxiety, stress, uncertainty, confusion, hardship, and vulnerability. When it comes to environmental concerns, for instance, a precautionary attitude is often advocated.
Under the present circumstances, I do not see how it can be called unreasonable if somebody wants to take a let’s-wait-and-see attitude toward this latest innovation—especially since it fits the definition of something extremely invasive. This is not a hat you could theoretically take on or off. That said, people who plan to hold off may find themselves wondering how feasible it is to draw a line if what we’re presented with presently is not merely a single novel preventative for a singular new ailment, but rather the instauration of a wondrous new regimen of routinized injections for countless conditions. If so, then refusing to participate might put you in the same position as someone in the mid-1990s who thought they could opt out of email indefinitely.