Dear Anti-Vaxxer,


Last week, I shared how I’d received my first dose of the AZ vaccine. This prompted an anti-vaxxer to write me an email. It contained strong, heartfelt arguments, as well as a smorgasbord of horrors. It made me pause. My career is centred around health, so if this is the discussion, I have to recognize and address it. That means being open to other perspectives.

First things first:
We all have the same priority: to keep our loved ones healthy and safe. As long as we’re all starting with this agenda in mind, everything else is just a question of how.

I also want to acknowledge a couple of my own biases:

I have faith in science
This sounds like a paradox but it’s not. I take a lot on trust because I have to. Any one of the important discussion points around covid or vaccines could easily take up an entire academic career. It’s impossible for any one person to understand it all deeply. So, we have to put a certain amount of trust in people. All of us do that; it’s just a question of whom—and what standards we apply to them.

Even as I wrote this article, I had to look up—or verify—multiple details, from the lab reproducibility of embryonic cell lines to the most current data on vaccine risk factors. This isn’t so that I can claim expertise; merely to prevent being conspicuously ignorant about anything important.

It would take a lot to change my mind
When I began to examine the resources that were shared with me, I realized that I don’t always dig this deeply. Especially not on things that I already agree with. So, there is a bit of a bias in place. I think that if we tug the thread on just about anything, we’ll find some negative information as well.

The depth of my scrutiny is based on skepticism
When I began to examine the resources that the anti-vaxxer shared with me, I realized that I don’t always dig this deeply. Especially not on things that I already agree with. So, there is a bit of a bias in place. I think that if we tug the thread on just about anything, we’ll find some negative information as well.

That might extend to how some of our favourite possessions or works of art came to be. Blood diamonds, sweatshop sneakers, misogyny in Silicon Valley, and terrible moments within the private lives of our personal heroes all come to mind.

Good things can have ugly aspects and bad things can have terrific qualities. Life isn’t binary.

Getting started
With my biases up front and centre, if not out of the way, you can understand how I can think about this stuff. The email I received contained at least a dozen claims. Rather than going through them one-by-one, I started by asking one question:

What is the highest quality of evidence provided?
That’s the question. I could send you 10 citations. Or 1,000. But what if the BEST evidence I have sucks? What if I tell you that a secret Wizard bestowed this knowledge on me before disappearing forever? If that’s the best I’ve got, it’s going to be downhill from there. You don’t need to read the rest of my citations.

Of course, the lowest quality of evidence says something too. It speaks to the cutoff point for criticism. If every bit of evidence someone sends is carefully vetted, that’s a good sign; it shows high standards and good critical thinking. If quality is low, it shows a lack of discernment.

These are standards that we need to hold ourselves too. They’re not just for the people we disagree with.

So… Since I’m on Team Science, I refer to the classic Hierarchy of Evidence:

The Hierarchy of Evidence is essential for understanding information about vaccines.

I made a list of the documents included in the email from the anti-vaxxer. Everything I received in the email lived on the lowest tier of the hierarchy—even when it looked official or sciency (or scary).

What if you don’t trust science?
Some anti-vaxxers find the entire scientific community suspect. This adds a wrinkle. It reduces our ability to discuss existing research—or even agree on how to assess reality. But can we still have an intelligent discussion? Absolutely. We just need to establish the ground rules.

Guideline 1: Quality of evidence still matters
If we were to create a hierarchy of not-so scientific thinking, the bottom tier would be 3rd hand information (or lower). The best information should be easy to verify and extremely difficult to fake.

If you are actively fact-finding, then document those finds clearly. If you are vaccine-hesitant and collecting information, determine a high standard of proof.

“My best friend’s sister’s boyfriend’s brother’s girlfriend heard from this guy who knows this kid who’s going with a girl who saw Ferris pass-out at 31 Flavors last night. I guess it’s pretty serious.”

Simone from Ferris Bueller’s Day Off is delightful. But maybe not a source for high-quality information.

Guideline 2: You don’t need to trust scientists in order to think scientifically
Start with a hypothesis. Then tell us what we’d expect to see if the hypothesis is true. Tell us what would disprove your hypothesis. Explain what would make your research unimpeachable. Wherever possible, speak in probabilities instead of binaries. If you’ve made mistakes in past, explain how you will avoid making those same mistakes again. Scientific thinking has great humility. It is ready to change when new information becomes available.

Let’s say that you believe that certain musical notes will interact with vitamin D supplements and cause tiny bicycles to grow out of people’s heads. Or sometimes unicycles. How would you show that? In what percentage of subjects would you expect to see that change?

You’d probably find people who claim a positive diagnosis and then find a way to clearly verify what they’re saying. I’d recommend at least a dozen. A couple of dodgy claims won’t do it.

No matter what, you’ll want to have enough evidence to potentially change minds. If I felt like I had a burning piece of information that ran counter to popular opinion, I’d really try to work from the perspective of a skeptical reader. I need to respect their perspective and intelligence—even if I don’t agree with their conclusions. If not, what’s the point of doing any kind of outreach?

Guideline 3: Show off your expertise
There were a few claims in the email that were pretty big red flags. They all followed this format:

Scientific term + negative outcome (no explanation of mechanism)

You can’t just use a term causatively; you have to be able to explain the mechanism. For example, if you say that the mRNA in vaccines will change your DNA, you’ll need to explain the conventional understanding first (saying mRNA will change your DNA is like saying eating soy protein will turn your muscles into soy). Demonstrating your grasp of the subject builds confidence in the reader. That, in turn, sets up your ability to explain why a specific use-case is different.

While we’re at it, you may also want to explain what DNA might be altered via this mechanism, if there’s a predictable effect, and how you’d test it.

On a statistical note, if you are listing the risk factors of a vaccine as a deterrent, you have an ethical responsibility to contextualize them. For example, the risk of a blood clot from covid is about 8 times higher than from taking the AZ vaccine. However, the data is still coming in—which is a thing that scientists tend to say. If you have other data, you have a responsibility to organize it in a trustworthy way and then share it.

Optical illusion: stare at the centre of the Healing Grid and the edges will repair themselves
Even what we see with our own eyes is subject to variation. Just stare in the centre of Ryota Kanai’s optical illusion, Healing Grid, and you’ll see the edges begin to repair themselves.

Guideline 4: Keep it consistent
If you don’t believe doctors that say vaccines are good, why should I believe doctors that say vaccines are bad? What makes your doctors different—other than that they agree with you? As above, exceptions and contradictions demand an a very high standard of evidence.

Guideline 5: Keep it simple
While life can certainly be complex, the simplest explanation tends to be the correct one. If a theory requires billions of dollars and 100,000s of people coordinating their efforts in perfect lockstep, that’s an awfully big reach. How many flawlessly-executed days were there at the last place you worked?

People struggle to keep secrets. Corporate espionage is common. Video evidence is everywhere. A lack of high-quality evidence is not something to casually ignore. You really have to deliver on this one. Unverifiable anecdotes and strong opinions are not enough.

Guideline 6: Be kind
This is a tough time for all of us. You want good things for people. You don’t want to see unnecessary loss of life, health, or freedom. So, please choose your words and actions intentionally. If you’re wrong about this, you’re going to wind up working in the opposite direction and increase both sickness and fear.

Most of us just want health and freedom—for ourselves and our loved ones. And if you are in the small minority that wants to increase disease, death, and fear… Well, you are probably looking for—or already in—a hate group.

If you want to be a trusted source for others, I hope that you will hold yourself to high standards for evidence, thinking, and—above all else—compassion.

On my end, I have literal skin in the game; I’ve been vaccinated. So has my wife, my mom, and many other people close to me. We have all weighed the risk—assessed by sources we trust—and made the call. I hope you wish us well.

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