Throughout the pandemic, our nation has consistently been at or near the top of the tree for COVID-19 infections and deaths worldwide. This is not a ranking we should take pride in.
Even now, most of our economic competitors are dealing with the pandemic far better than we are. And that’s despite the USA having access to as great a supply of the incredibly safe and life-saving COVID-19 vaccines as any country on Earth. The problems we continue to face relate to how a large proportion of Americans are behaving, driven by misinformation and exacerbated by atrocious leadership. It is no surprise to see that COVID-19 deaths have been much higher all year in counties where Republican voters are concentrated than ones where Democrats live. That’s because vaccine uptake tracks with how people vote, and in turn where they go for their news about the pandemic.
We will soon see a new surge of infections, hospitalizations and deaths driven by the upcoming holiday travel and winter weather factors that so badly affected America in the same period last year. By the end of January, perhaps as many as 150,000 more people who are alive today will be dead from COVID-19 — and the vast majority of them will be not be vaccinated. An unvaccinated American is now about 11-times more likely to die of COVID-19 than one who is vaccine protected. And almost all deaths of vaccinated people involve folks over about 65 and/or with serious medical conditions. Colin Powell was a particularly sad example.
What we face this winter is an entirely avoidable tragedy. Had everyone been vaccinated this past summer, when enough supplies became available, the U.S. pandemic could have been stopped cold. But this never happened. Anyone who thinks it’s now all over should look at what’s going on in Britain, where a laissez-faire attitude is driving infection rates back up. What’s happening there is what we will soon see in the USA, if nothing changes for the better, soon.
The key problem America faces is distrust about vaccine safety and efficacy. To scientists like me, and the many colleagues I interact with, this was at first hard to understand. We’re completely confident in the data we have seen emerge in the scientific literature over the past 18 months, data that we routinely help interpret for the science journalists who consult us and then transmit accurate facts to the public. We also trust government databases, such as the CDC’s, because much the same information is present on similar sites worldwide. It’s a global pandemic, after all. In short, the COVID-19 vaccines work superbly well, and they are extremely safe. It’s why we, our families and friends, accepted and have benefitted from them. In our worlds, the vaccines are not controversial. And in the past, Americans used to embrace, even clamor for, vaccines – against polio, against smallpox, against all too often lethal childhood infections. There is no science-based reason to reject the COVID-19 vaccines, and so many reasons to use them. But over 75 million Americans still won’t use what can save their lives.
People are of course free to reject vaccines. It is not illegal to take serious and even fatal risks about your health, however ill-advised that may be. But the unvaccinated are now our greatest reservoir of infection. As such they are predominantly responsible for spreading the virus and keeping the pandemic going. The vaccines remain highly effective at keeping people out of the ICUs and, worse, the morgues, although a third dose is now recommended to improve their performance. Most new infections involve unvaccinated people spreading the virus to their unvaccinated contacts. Within a household, the risk of an unvaccinated person passing along an infection is significantly greater than for someone who is fully vaccinated. On an individual level, spreading an infection can cause serious harm, particularly to old, unhealthy and vulnerable people. That’s selfish. From a wider perspective, the infections occurring predominantly in the unvaccinated population continue to disrupt American life – they cause economic damage, supply-chain shortages and social unrest. By reducing the nation’s economic competitiveness with countries that have far better controlled their pandemics, the unvaccinated are being unpatriotic – and that’s un-American.
Some people are simply nervous about the COVID-19 vaccines – people who can be called “vaccine-hesitant.” Making accurate information available and answering reasonable questions can help persuade them that the strong benefits of vaccination hugely outweighs the very slight risks. Vaccine-familiar scientists and public health specialists do this all, whether on an individual basis or in group chats. It’s part of our duties to the society that supports our work.
A commonly heard argument for not getting vaccinated is: “I’ve been infected, I have natural immunity.” That just doesn’t cut it. Vaccine-induced protective immune responses are superior to what infection causes. In particular, many people who had mild “at-home” Covid-19 probably has only very weak immunity against another infection, and aren’t likely to know that. As many as 25% of Britons who tested positive for COVID-19 never developed any antibodies at all. You can easily fool yourself into thinking you’re protected when you’re really not. But when you’re vaccinated, you KNOW you’re protected. Also, infection-induced antibodies are strongly boosted by vaccination, so even if you were definitely infected, why not get the extra protection? One vaccine dose is enough in this context. It’s not just about you, it’s about the people you interact with. Vaccines protect populations, particularly those who are most at risk of dying a nasty death.
Unfortunately, there are also Americans who are beyond our capacity to now help – the “vaccine-resistant.” The mindsets of these people are rooted in conspiracy theories – they are as likely to reject vaccines as they are to believe that the “Washington Elite” kidnaps children for sex trafficking; that 9/11 was a Mossad/CIA plot; that “Jewish space lasers” are an actual thing. If QAnon is your primary information source, it’s not surprising that you believe that the COVID-19 vaccines turn you into human magnets, cause you to transmit mysterious fertility-destroying rays to nearby women, or make you able to breathe under water (I just made that last one up, but wouldn’t be surprised if it were out there somewhere on the internet…). The role played by misinformation is well understood and efforts are being made to counter it.
There is blame to assign for the continuation of the pandemic, and the unnecessary excess deaths in Republican-voting parts of the country. Those most guilty for this American carnage are the peddlers of misinformation who spread toxic fake news about vaccines on social media or, worse, from their political bully pulpits. Word has spread on social media is that the COVID-19 vaccines have already killed 150,000 Americans. That’s a lie. A few deaths can, unfortunately, be directly attributed to these vaccines; some cases are still being investigated but the final total is likely to be fewer than 10. And that’s after vaccinating over 200 million people. To put the vaccine fatalities into further perspective, the widely used over the counter pain-killer Paracetamol (Acetaminophen) kills several hundred Americans every year. And around 7,500 Americans a year die as a result of taking common anti-inflammatory drugs, including Aspirin. The medical intervention that’s 100% safe to every user has yet to be invented; approvals are based on the benefit-to-risk ratio. COVID-19 has itself now killed over 750,000 of us.
Where does this kind of pandemic misinformation come from, and who spreads it? One source is white nationalists. Jewish and minority populations have been targeted in an effort to stop them taking vaccines. This is evil perpetrated in pursuit of a perverse agenda. But, more often, misinformation is rooted in the profit motive. There are grifters around, and they fool people into forking over their money. Trashing vaccines is profitable for those who peddle quack “alternative remedies.” Let’s consider ivermectin. That drug has no role to play in preventing or treating COVID-19. It is as useless as hydroxychloroquine. It’s now widespread use is squarely rooted in misinformation and outright lies – and a lot of people make a lot of money by selling ivermectin and hydroxychloroquine on the internet, including pharmacists. That’s blood money, as relying on these ineffective drugs instead of effective vaccines can kill you. In what universe is it appropriate for lay-people to tell doctors how to treat a lethal viral infection? And yet this now happens a lot in hospitals, with lawsuits filed to try to force ICU physicians to give dying patients ivermectin and/or hydroxychloroquine. That’s as absurd as telling a pilot to taxi backwards down the runway as you’ve read on Facebook that it’s safer to take off that way. Or demanding that your builder use beeswax and aluminum foil to construct your new carport, as you saw this done on YouTube. But, seriously, the disrespect we are now seeing for multi-year medical qualifications is staggering. If this pattern of behavior continues, real long-term damage could be caused to the doctor-patient relationship.
Right-wing talk radio and TV commentators abuse their wide reach by lying about COVID-19 vaccines and therapies. They regurgitate standard tropes to spread a poisonous but highly influential agenda. What Americans choose to believe nowadays is rooted in where they obtain their news. And when that information is twisted and perverted by falsehoods, gullible people make incredibly poor choices. In short, if you believe what you see and hear on right-wing talk radio, from Fox News commentators, QAnon-linked websites or your grannie’s Facebook feed, you are much more likely to die of COVID-19 than if you rely on legitimate news sources. And we’re now seeing influential sportsmen like Aaron Rodgers amplify misinformation to their fans by regurgitating the nonsense they’ve heard on talk radio. Ironically, many talk radio hosts have now died of COVID-19, unvaccinated.
Republican state officials and congressional representatives who oppose vaccination and other common sense public health measures (mask wearing, social distancing), or who spout lies, have blood on their hands — and that blood comes from the coughed-up lung tissues of constituents who die of COVID-19. Ranting about “personal freedom” isn’t leadership, it’s pandering to the Republican base for personal political gain. In a complex, modern society, freedom is not unfettered and never has been. The Brazilian Senate recently recommended charging President Jair Bolsonaro with crimes against humanity for his pandemic policies that led to the avoidable death of so many of his citizens. Those policies resemble what we see and hear all the time in the red half of America.
Whatever you might think of vaccine mandates, they now exist and are here to stay. Fake excuses are being used to try to get around them. Some people may say that’s justified. I don’t. A culture that relies on lies and distortions is not what America should aspire to be. There are very few genuine grounds for medical exemptions, but some doctors betray their integrity by signing anything put in front of them. Stripping their licenses would stop that. Religious exemptions are an even worse opportunity for scammers to exploit. All the world’s major religious leaders have endorsed, and personally taken, the COVID-19 vaccines; they have considered and rejected morality-based objections, most of which are based on anti-vaccine misinformation. There is no fetal tissue in the authorized Pfizer and Moderna mRNA vaccines – that’s just a lie – and there’s only a tenuous connection to the Johnson & Johnson vaccine. Yes, some vaccines are tested on cell lines made from fetuses decades ago, but so are many standard drugs everyone has been taking for years. If you reject vaccination because of the fetal cell line testing issue, then you should also swear off Tylenol, Tums, Preparation H, acetaminophen, albuterol, aspirin, ibuprofen, Tylenol, Pepto Bismol, Tums, Lipitor, Senokot, Motrin, Maalox, Ex-Lax, Benadryl, Sudafed, Preparation H, Claritin, Prilosec, and Zoloft for exactly the same reason. Let’s have ethical consistency here…
A key tenet of religions is love for other people, which does not involve exposing them to a deadly virus. Religions generally teach respecting life, not embracing death. Religions are also based on ethics and morality. And yet it is now trivially easy for lay-people to become “ministers of religion” via the click of an internet button, and then sign exemption certificates for all-comers. Truly religious Americans should object to the immorality involved in how their faiths are being traduced in this shabby way. Anyone with a genuine religious objection to vaccination is now likely to receive greater scrutiny as a result of the activities of those whose motives are blatantly dishonest.
Because of the spread of misinformation and anti-vaccine propaganda, we are seeing nasty attacks on public health officials in charge of programs that safeguard the nation’s health. Not surprisingly, given the nature of the threats to themselves and their families, one consequence is resignations – plus the inability to recruit new talent. Here, the eventual outcome could be catastrophic harm to essential health-based initiatives – and even more unnecessary suffering and death. We can also expect the smearing of the COVID-19 vaccines to have a knock-on effect on childhood vaccination programs that were already under assault from the anti-vaccine zealots. In the years to come, more children will die of easily preventable infections as a result. How does behavior like this make America a better place for everyone to live?
Will America ever emerge from the COVID-19 pandemic? Probably, at some point in the years to come we can put it all behind us and return to full normality. But the more people who remain unvaccinated, the longer it will take and the more people will die in the meantime. Whether that’s a statement you agree with or not doesn’t matter, because the facts are the facts and there’s no such thing as “alternative facts”. So, you should beware if you choose to rely only on distortions disseminated by charlatans.
John P. Moore is a professor of microbiology and immunobiology at Weill Cornell Medicine.