Optimism of the Vaccine, Pessimism of the Will

How do you convince people who don't think Covid is a big deal to get vaccinated?

Thanks for reading and, as always, please email or comment if there’s anything in the post that inspires you to do so. As always, if you’re reading this because someone forwarded it to you or you clicked a link, please subscribe.

There appear to be stark partisan, regional, and cultural disparities in vaccination rates. If you look at Bloomberg’s vaccine tracker, you see a few things. New Englanders love getting vaccinated, people in the Deep South and Mountain West do not. After an initial rollout where several large states that contain about a third of the population (Florida, Texas, New York, and California) were roughly grouped together in vaccination levels, New York and California have started to break out.

While this may not doom America’s overall Covid response , it would be better if more people get vaccinated, if for no other reason than to protect themselves and those around them, putting aside concerns about mutations and variants.

This is where public policy matters, but in large swathes of the country, policy that could encourage vaccinations appears to be ineffective, if not being actively hostile, to the goal of higher vaccination rates — especially where it’s most needed.

There is now universal vaccine eligibility. Adults in all 50 states and Washington, D.C. can now get vaccines regardless of their health or occupational status. Even in places where there is high vaccine uptake, like New York City, walk-in vaccines are available. While there are always individual logistical issues with vaccinations, now it is the case that if you want a vaccine, you can get one.

These vaccines are safe, they are effective, they almost certainly stop the spread of Covid along with dramatically decreasing one’s risk of hospitalization or death even if they get infected. So why not get one? Well, maybe you don’t think Covid is a big deal in the first place. For you or really for anyone else.

And that’s what many Republicans think.

The data

There’s a ton of polling data to this effect. For instance, Democrats have (inaccurate) views about the chance of hospitalization upon getting Covid.

But Democrats also have more accurate views than Republicans on the overall risk of Covid compared to other causes of death like car accidents, as well as whether Covid can be spread asymptomatically.

So it’s not surprising that through February, about twice as many Democrats as Republicans said Covid was “a major threat to the health of the U.S. population.”

Why get the vaccine?

Well one reason could be that your state government isn’t just making it easy for you to do so but is actively pushing you to do so. Either by mandates, instituting vaccine passports, or by conditioning statewide restriction loosening on vaccine rates, among other metrics.

In reality, policy seems to be moving in the opposite direction of where one might think. States with lower vaccination rates seem to be loosening restrictions or might not really have any at all. States with high vaccination rates or specific municipalities are maintaining restrictions that may not be strictly scientifically justified. There will be no masklessness in Brookline, nor dancing in D.C.

In other countries with successful mass vaccination campaigns, things worked the other way. In the United Kingdom and Israel, over 50% of the population have received at least one dose of a vaccine, and those campaigns were undertaken amidst rather severe restrictions that are starting to be liberalized.

The U.S. has 51 Covid polices and they’re hardly consistent with each other or the situation on the ground. Big, conservative-led states like Texas and Florida have few restrictions and relatively low vaccination rates. Florida’s political leadership’s distaste for any Covid restrictions has extended to trying to ban “vaccine passports,” the idea that businesses could condition customer access on being vaccinated.

In short, the most advanced form of the conservative worldview on Covid is not so much that people shouldn’t get vaccinated or that vaccinations are bad, but that it should be entirely voluntaristic.

Not only should there be no mandate for vaccines, this line of thought goes, there shouldn’t be much encouragement, publicly or privately to do so. Policy will be loosened at the most rapid pace possible and if you want a vaccine, you should get one, but it’s not really anyone’s business.

The other policy: persuasion

When Republican House members and Senators who are medical professionals made an ad to encourage their constituents to get vaccinated, they hewed to advice that spin doctors like Frank Luntz gave them. Kansas Senator Roger Marshall wore a lab coat because "we've found is if we put on our white coat, it literally moves the needle.” Republicans are far more likely to trust their doctors than government officials, so if government officials have to get the lab coat out of the closet, so be it.

But towards the end of the ad, Wyoming senator John Barrasso says that he “looks forward to the freedom that I along with my loved ones will regain once the vast majority of Americans are vaccinated.” While his freedom to dance at weddings in Washington, D.C. may be dependent on higher vaccination rates, his freedoms in Wyoming are greatly restored despite it and Idaho having the lowest vaccination rates west of the Mississippi.

The video ends with Marshall saying that he hopes Americans will get the vaccine so “we can throw away our masks and live life as free as we did before.” But Marshall’s constituents already are free: Kansas’s state mask mandate was overturned by its Republican legislature and its largest county is letting its mask mandate expire, while less populated counties are turning down vaccine shipments.

Several blue states have announced future dates for restriction loosening based on projections of case counts falling and vaccination uptake increasing. In New York, many businesses will be allowed to fully reopen on May 19 — and will be able to ignore distancing requirements if customers show proof of vaccination or a negative test. In California, restrictions will lift on June 15 conditional on vaccine supply and low hospitalization rates.

The irony is that people in the Northeast probably need the fewest inducements to get vaccinated in terms of policy change, while the Deep South and Mountain West need the most and are getting the least.

But politicians are people too, and leaders in these Republican-dominated states either agree that Covid poses little threat to their state’s health or know that their population does and it’s not worth it to push back against that. And if that’s the case, no amount of slickly produced and intelligently crafted videos will move the needle much.