“You have a greater chance of being in a car accident on the way to getting this vaccine than you have of having a problem from this vaccine. But that’s not how people view risk.” — Paul Offit, vaccine expert at Philadelphia Children’s Hospital.
Maybe it is because I do not seem to have a gambling gene in my body. Maybe it is because I have studied the math. But every day in the news I see instances of people “betting against the house” and losing against the coronavirus.
All of those fabulous buildings in Las Vegas are paid for out of the human self-deception of betting against the odds and losing to “the house.” Few people seem to admit leaving Vegas significantly poorer, but the aggregate economics of gaming are plain to see when you cruise down the Strip. “The house” has a small probabilistic edge on every game, and that edge gets magnified many times over by the Law of Large Numbers, first articulated by Bernoulli and Poisson in the 18th and 19th centuries (and largely from them trying to understand gambling at that).  The law’s application reaches far beyond Las Vegas, however.
I get it that gambling also has a lot of entertainment and fantasy value, which makes the risk “worth the price of admission” for many small bettors. I have frugal friends who would (pre-Covid) regularly take only the price of two movie tickets plus refreshments to the nearby riverboat casinos (which makes for a decent evening’s slot machine pot these days). But what is the value of betting against the germ theory of disease, the exponential math of coronavirus “virulence,” and the massive prevention-versus-side-effect risk imbalance of vaccines?
Deaths from coronavirus still regularly approach 5000 per week and hospitalizations are trending up again, but the distribution of the Johnson and Johnson vaccine was stopped because of only six “adjacent” deaths (not even proven as cause-effect) out of nearly seven million doses administered and a blot clot risk rate lower than that of common birth control pills. And don’t forget the far-higher risk of blood clots from getting Covid itself. Paul Offit likely gets it right, as quoted above. The person-on-the-street’s view of risk is often different from the math nerd’s. “The house” here is not science, but rather Nature/God and biology of virulence. The virus “knows the math” better than most Americans right now and holds the statistical edge as surely as do the Vegas casinos.
I do not like categories for divvying up an explanation for “vaccine hesitancy” here. I prefer vectors, those invisible forces that have both direction and magnitude. Like the counteracting forces that act on a bridge structure, the mental vectors in real life can be multiply simultaneous and act in slightly different directions to take us to new places, some of them not good. People can “live” in more than one anti-vaccine “vector” at different magnitudes at the same time. Here are some of the anti-vaccine vectors I see in the Covid fight:
“God will protect me.” There are enough correlative factors to make this often appear true. Mormons rarely die from drunk driving. Mennonites suffer few gun deaths. However, bringing in the dreaded economist’s ceteris paribus (“all other things being equal”), this is another bet against the house. Religious believers of every stripe have found their prayers to be spared hospitalization or death from Covid unanswered. Most of those infections and deaths appear to have been tragically, but probabilistically, random. Some activities and pre-existing conditions are high risk, but you may still escape infection. Or, the dice (or “God’s will”) may land wrong for you. But then, based on the title of this blog, I would say that, wouldn’t I?
Digging one step deeper on the religious faith question, the half-million-plus documented “excess American deaths” over the past year, and over 2.5 million deaths worldwide, raise for religious believers a critical question of theodicy (the “justice of God”). Pray tell, what is the “divine purpose” of all of those coronavirus-related deaths? I do not intend to dump on religion here, but if you have reasoned out that your God let half a million people die of Covid in the U.S. because they didn’t pray as well as you do, I am suggesting that you have another think coming. Feel free to comment below.
“My family uses natural means to stay healthy.” This vector is often related to religion. The vaccine is frequently portrayed in the Christian press as “unnatural” and the spawn of evil science using stem cells from long-ago aborted fetuses. Folk remedies, and the scientifically-excessive consumption of certain vitamins and other supplements, are preferred alternatives to “unnatural” science. But outside of this particular debate, “science” and its created children infuse the lives, often unrecognized, of every American in every aspect of daily life. The 1950s polio vaccines were not “natural,” but I and virtually every other kid in that era took both the Salk vaccine shot and the later Sabin vaccine sugar cube, and we conquered polio. Would today’s vaccine skeptics have allowed this to happen?
Even the Vatican’s conservative Pontifical Academy for Life declared in 2005 and reaffirmed in 2017 that in the absence of alternatives, Catholics could, in good conscience, receive vaccines made using historical human fetal cell lines. And a reminder that famed natural foods advocate Euell Gibbons died at age 64 of a heart condition. “The house” favors the scientists in this one.
“Owning the libs.” The Trump administration spurred a still-running series of crazy “loyalty tests” throughout the coronavirus crisis as a badge of fealty, requiring adherents to “believe because it is absurd,” and apparently just to try to get a rise out of people on the other side of the political spectrum (and more cash contributions). From initially dismissing the severity of the virus itself, to declining to take simple mitigations, on to ingesting discredited medicine, the political theater continues stronger than ever. Ironically, both President Trump and his faithful sycophant, Florida Governor Rick DeSantis, both received their vaccine shots in private, even while downplaying coronavirus risks to their followers. If this is you, then you are being played for a sucker.
Conspiracy believers. Overlapping heavily with the above group, the anti-vaccine movement has always been driven by believers in often-outlandish conspiracies, too numerous to mention here. Any hard evidence aimed at striking down a particular erroneous belief is seen as further proof that the “deep state” is further conspiring against them. There is no way to “logic out” a conspiracy theorist. But they will “lose the bet” in the long run.
Risk perception problems. All of us have problems at times in rationally evaluating risks. We underestimate the danger of “risks we know,” such as driving in bad weather, and overestimate the risks of things with which we have little experience, such as spiders. In terms of the Covid vaccine, the intentional action of being injected with a vaccine is perceived by many, if not most people, as a higher risk than the more passive action of exposing yourself to Covid. Severe illness or death from Covid remains, for most people, something that happens to someone else (until it doesn’t), while the shot is something that clearly happens to me.
The quote from Paul Offit that opened this post sums it up well. When it comes to measurable risks, the risk of known harm from any of the vaccines remains several orders of magnitude less than the numerous risks you take on daily, especially the risk of long-term harm or death if you are infected with the coronavirus.  Out of a random sample of one million Americans, over 160 will die this week from all causes, which makes it is difficult to filter vaccine-caused deaths from vaccine-adjacent deaths (those happening within several days of an injection). As the chart above showed, however, we can see the overall Covid “excess deaths” quite clearly when 2020 is paired against weekly deaths over the past several years.
I received the two-dose Moderna vaccine with a one-day flu-like reaction, not much worse than the reaction to my last shingles vaccine shot (you really do not want to get shingles either), but I would have taken the Johnson and Johnson shot if it had been offered earlier. Let’s put the apparent risk of the Johnson and Johnson shot this way: Out of every million readers of this blog (a little joke there) all of you except one will be virtually guaranteed to avoid serious illness or death from Covid if you received the J&J shot. More importantly to society as a whole, you are all far less likely to pass it on to other, more vulnerable people. But one of you out of that million may get very sick or even die. If you do not like those odds, do not go out driving in your car today, or ever again, or fly, or drink alcohol, or own a gun, or cross the street during rush hour. Million-to-one odds are common daily bets for all of us.
Essentially, what we call “vaccine hesitancy” is a brain misfire. Your survival instinct is reacting incorrectly to a threat for which it has not been programmed to assess very accurately. Your biological ancestors knew nothing of future math work of Bernoulli and Poisson, and you may have struggled with that statistics course yourself. But please, don’t flunk that class again. Get the shot.
- The roulette wheel has one “extra” slot, the dealer draws last in Blackjack, and slot machines pay out in net slightly less than the money going in. All of these yield the sufficiently lucrative probabilistic edge to “the house” (unless you are a famous ex-investor in Atlantic City casinos).
- One “order of magnitude” is a power of ten. A reduction of three orders of magnitude drops the odds by 1000 times. The vaccines exceed that risk reduction by even more powers of ten than that.
- Kids, can you say Fecundity?
- Betting your life on “The Truth”
- When innumeracy kills
- What’s past is prologue – vectors into the future
- Believe because it is absurd?
- Theodicy in 1000 words
- The probability of “Deep State” and other conspiracies
- Avenging angels and the Coronavirus
For additional posts on probability, volition and ethics, follow the Dice icon back or forward where it appears.