Link goes to an article on AI prediction?
posted by Ziabatsu at 3:17 PM on June 10 [3 favorites]

For example, clearly conveying risks can help: The 1-in-500 death rate from measles far outweighs the extraordinarily rare serious vaccine side effects.

This argument is ridiculous because, first of all, they'll say the death rate from measles is massively overblown and also the frequency of serious side effects from vaccines is massively under-reported.

Do you know what works? Mandatory vaccinations with exemptions for medical reasons and not personal or religious reasons.

This article falls for the same thing that (generally speaking) Economics does, that people are rational actors. Generally, people are not.
posted by tclark at 3:22 PM on June 10 [53 favorites]

Flagged. The link does not match the description.

Either the link or the description would make a great post!
posted by justsomebodythatyouusedtoknow at 3:26 PM on June 10 [1 favorite]

I think the link was meant to go this url:

https://theconversation.com/game-theory-explains-why-reasonable-parents-make-vaccine-choices-that-fuel-outbreaks-256975
posted by Reverend John at 3:33 PM on June 10 [5 favorites]

I feel that they left out two factors:

1. The culture war which has demonized vaccines as “woke,” spread and enabled by grifters like Alex Jones and RFK Jr.

2. We are a long way past when measles, polio, and similar diseases regularly left families with dead children. Years of safety taught them not to fear and to be contemptuous of the experts who got caught up in #1.
posted by GenjiandProust at 3:58 PM on June 10 [28 favorites]

This is a textbook case of public good and the free-rider problem.

There are benefits and risks to vaccination. If everyone (well, enough people to stop transmission) vaccinates then diseases can't spread and people aren't at risk of those diseases. So you benefit from the actions of others and they benefit from your action - you can't spread disease to them

But there is a cost to vaccination - that of side effects (including anxiety). The cost is one that you bear yourself, for the benefit of others. Hence there's a personal motivation to free ride.

Here's the stable state:
1 - It's best for everyone if everyone vaccinates
2 - It's best for me if everyone else vaccinates and I don't
3 - I make a decision for my benefit not to vaccinate
4 - Other people make the same decision, vaccination levels drop and everyone suffers

This is a collective action problem. The solution to this is for people to see themselves as part of the collective, as part of society, as someone who can affect their neighbours, and equally being affected by their neighbours. This hinges upon social trust and mutual respect.

And guess what - there's a really high correlation between measures of social trust and vaccination rates. Both are high in the Nordics, East Asia, and Oceana; both are lower in the US and other more corrupt countries.
posted by happyinmotion at 4:02 PM on June 10 [31 favorites]

Game theory reveals that vaccine hesitancy is not a moral failure

Nope. Being a free rider (about something good anyway) is still very much a moral failure.
posted by GCU Sweet and Full of Grace at 4:06 PM on June 10 [49 favorites]

This is a collective action problem. The solution to this is for people to see themselves as part of the collective, as part of society,

Another solution is to take the people who don't wanna get vaccinated and use as much violence as is necessary to hold them still while you vaccinate them against their will.
posted by GCU Sweet and Full of Grace at 4:07 PM on June 10 [1 favorite]

The 1-in-500 death rate from measles far outweighs the extraordinarily rare serious vaccine side effects.

One problem with this reasoning is that the death rate from measles is only applicable if I get measles and I'm not guaranteed to get measles. OTOH, if I get a vaccine, I am guaranteed to have gotten the vaccine.

If I have 1 chance in 100 of dying of the disease Lurgi and 1 chance in 10,000 of contracting it in the first place, and the vaccine results in death 1 time in 750,000, then there's a personal case to be made for not taking the vaccine.

(This was actually the case for smallpox vaccine, which was fairly unsafe by modern standards. The last smallpox death in the US was 1949. From 1959 to 1968, the smallpox vaccine was responsible for nearly 70 deaths. You were more likely to die from the vaccine than from smallpox)
posted by It's Never Lurgi at 4:10 PM on June 10 [7 favorites]

Sorry to be a tab challenged fumble fingered mouser clickeroo. Thanks BB.

I have not followed the article links deeply but it does seem like the incredibly ingrained mis-information subcultures need to be addressed and approaches like "you ignorant idiots" is counterproductive (although occasionally satisfying:-) and the authors are at least thinking about viable approaches. And I love game theory - Go John von Neumann!
posted by sammyo at 5:40 PM on June 10 [1 favorite]

We don't have a problem of adults making the decision not to get vaccinated—we have a problem of adults denying their children the right to be vaccinated. Children cannot opt out of life-saving preventative treatment, because they do not have full agency.

So to amend what GCU Sweet and Full of Grace said, we should take the parents who deny their children life-saving preventative treatment and use the full power of the state to stop them from abusing their kids.
posted by Just the one swan, actually at 5:41 PM on June 10 [14 favorites]

Either one trusts the science or one doesn't. Science isn't perfect, but it's the best thing we have. If you can't work with that, you're stupid in my book.

The gods and faith only heal people in mythology.
posted by JustSayNoDawg at 5:44 PM on June 10 [8 favorites]

This can’t be just “a predictable phenomenon explained by game theory” or there would be zero change in vaccination rates over time.

I feel like we plowed this field during COVID and this is till a problem of individuals being unwilling to do what’s right for the health of the collective. Not a math problem, a human thinking problem:
posted by Miko at 5:49 PM on June 10 [19 favorites]

I have no evidence to support this but I believe deep in my heart you'll find a much higher rate of non-vaccination amongst Americans who don't return their shopping carts vs those that do.
posted by turbowombat at 6:00 PM on June 10 [14 favorites]

I'm with Miko, the variability of this over time means that, sure, there might be a baseline free-rider problem, but it's not, like, The Problem. Mennonite communities aren't extra free-ridey than others, their vaccination rates come from elsewhere.
posted by BungaDunga at 6:09 PM on June 10 [7 favorites]

(not that Mennonites are the Problem but that they're an example of obvious cultural factors that are vastly more important)
posted by BungaDunga at 6:10 PM on June 10 [3 favorites]

What percentage of kids not being vaccinated is due to parents not having health insurance and not being able to afford a doctor,
and/or not being able to take time off work to take their kid to the doctor?

I feel like free community outreach vaccination clinics - at schools, at shopping centres - might help bring numbers up.

One thing Australia is trying recently is letting appropriately trained staff at pharmacies do vaccinations in case getting a doctor's appointment is a barrier.
posted by chariot pulled by cassowaries at 6:20 PM on June 10 [4 favorites]

It's interesting to read this after having read Katelyn Jetelina's What I'm Learning from MAHA. She is a public health worker that is currently working to have open conversations with people in the MAHA movement in order to improve communication, and hopefully eventually reduce vaccine hesitancy. She's had a couple of posts about it, and I think it's worth reading them. There are people who think she's a traitor for doing this kind of outreach, but we aren't going to get out of this hole unless someone does.
posted by rednikki at 6:21 PM on June 10 [14 favorites]

My parents didn't fully vaccinate me, not because they were anti-vaxxers, but because they were busy and disorganised and neglectful.

When I was young enough that I could get vaccines at the local baby health clinic where all parents had regular "well baby" checkups, I got those vaccines -

but as soon as it was required to book a Dr's appointment (which was free! but extra fuss and hassle!) they stopped bothering because it was too much effort.

I had to have catch up vaccines in my 20s.

Research shows that while there are people who don't vaccinate because they are hardcore antivaxxers, or because they are worried about the (very small!) risks of vaccination, there are also some people who don't vaccinate because of logistical barriers, and anything that can make getting kids (and adults!) vaccinated as simple, easy and frictionless as possible increases vaccination rates.
posted by chariot pulled by cassowaries at 6:25 PM on June 10 [10 favorites]

I'd love to see vaccinations being rolled out at preschools, kindergartens, primary schools - and you only get to opt out if you have a genuine medical issue that makes it unsafe, as proved by a letter from an appropriately qualified health professional.
posted by chariot pulled by cassowaries at 6:30 PM on June 10 [6 favorites]

One good initiative I saw: my age cohort needed a top up measles booster, because even those of us fully vaccinated as children had our immunity wane by the time we were age 19/20/21,

so the state public health department (in Australia) sent nurses in caravans to universities to offer students measles boosters on the spot. No appointments, no waiting, just walk in right that moment and done (unless there was someone ahead of you in the queue, but the van was at the university for a solid 5 day week.) And all completely free of charge.
posted by chariot pulled by cassowaries at 6:34 PM on June 10 [6 favorites]

I definitely had vaccinations at primary school and intermediate school in NZ in the 1990s. MMR and polio are the two I remember lining up for.
posted by poxandplague at 7:14 PM on June 10 [1 favorite]

Here in Canada, the outbreaks are hitting Mennonite and similar Anabaptist communities the hardest.

If there's any group of people in North American to whom individualistic game-theory calculations least apply, it'd be them.

Like... you could argue that the numbers would be similar if everyone was a free-floating entity making self-maximizing rational choices, but when you look at the actual dynamics, that's not what's happening here. If the numbers predicted by game theory match the numbers being produced by social pressures in a tight-knit community in this case, it's a mere coincidence.
posted by clawsoon at 7:15 PM on June 10 [7 favorites]

Vaccines have caused serious problems.

Consider the Cutter incident:

In April 1955 more than 200 000 children in five Western and mid-Western USA states received a polio vaccine in which the process of inactivating the live virus proved to be defective. Within days there were reports of paralysis and within a month the first mass vaccination programme against polio had to be abandoned. Subsequent investigations revealed that the vaccine, manufactured by the California-based family firm of Cutter Laboratories, had caused 40 000 cases of polio, leaving 200 children with varying degrees of paralysis and killing 10.
Paul Offit, paediatrician and prominent advocate of vaccination, sets the `Cutter incident' in the context of the struggle of medical science against polio and other infectious diseases over the course of the 20th century. He reminds us that, within a decade of Karl Landsteiner's identification of the polio virus in 1908, an epidemic in New York killed 2400 people (mostly children) and left thousands more with a life-long disability. In the 1950s, summer outbreaks in the USA caused tens of thousands of cases, leaving hundreds paralysed or dead. `Second only to the atomic bomb', polio was `the thing that Americans feared the most'.
Offit provides a gripping account of how the `March of Dimes', inspired in part by President Franklin D Roosevelt's personal experience of polio, raised funds for research and focused national attention on the disease. He profiles leading figures, notably Jonas Salk and Albert Sabin —brilliant, egotistical and flawed characters—pioneers in vaccine development and as scientific celebrities, and notorious for their bitter personal rivalry.
Offit offers a balanced judgement on both the Cutter incident and on the Salk and Sabin vaccines. Reviewing failures in the manufacturing and inspection processes, he exonerates Salk from blame and concludes that `the federal government, through its vaccine regulatory agency... was in the best position to avoid the Cutter tragedy'. Three larger companies produced safe polio vaccines according to Salk's protocol for inactivating the virus with formaldehyde. The lack of experience and expertise at Cutter Laboratories, undetected by the inspectors, caused the disaster.
While acknowledging Salk's mean-spiritedness towards colleagues, Offit believes that in denying him a Nobel prize, history has dealt harshly with a man who was `the first to do many things' that have contributed to the virtual eradication of polio in the USA. The Cutter incident led to the replacement of Salk's formaldehyde-treated vaccine with Sabin's attenuated strain. Though Sabin's vaccine had the advantages of being administered orally and of fostering wider `contact immunity', it could also be re-activated by passage through the gut, resulting in occasional cases of polio (still causing paralysis in six to eight children every year in the 1980s and 1990s, when a modified Salk vaccine was re-introduced). As Offit observes, `ironically, the Cutter incident—by creating the perception among scientists and the public that Salk's vaccine was dangerous —led in part to the development of a polio vaccine that was more dangerous'.

posted by jamjam at 7:18 PM on June 10 [2 favorites]

Another solution is to take the people who don't wanna get vaccinated and use as much violence as is necessary to hold them still while you vaccinate them against their will.

That only works if everyone else agrees that they are in it together, against those people.
posted by atoxyl at 7:20 PM on June 10 [1 favorite]

The article describes what happens if everyone is a self-interested actor who believes the science and has a finely honed sense of the relative risks.

My impression is that lack of vaccination has mostly been happening in communities where trust in science and the government is low, understanding of the relative risks is poor, and community cohesion generally outweighs self-interest.
posted by clawsoon at 7:24 PM on June 10 [7 favorites]

Like...

The death of his daughter, Peter told me, was God’s will. God created measles. God allowed the disease to take his daughter’s life. “Everybody has to die,” he said. Peter’s eyes closed, and he struggled to continue talking.

...those aren't the words of a self-interested rationally-calculating game-theory actor.
posted by clawsoon at 7:28 PM on June 10 [32 favorites]

This can’t be just “a predictable phenomenon explained by game theory” or there would be zero change in vaccination rates over time.


Game theory absolutely can have unstable or "knife-edge" equilibria. This is compounded by other exogenous changes. It's not hard to make a simple model where an exogenous 1 percent decrease in the average personal benefit people assign to getting vaccinated (say due to slightly decreased trust in the scientific establishment) leads to far, far more than a 1 percent decrease in vaccination rates.
posted by yaj at 7:59 PM on June 10 [7 favorites]

yaj: Game theory absolutely can have unstable or "knife-edge" equilibria.

And aren't there also some three-state game theory setups where condition A leads to B which leads to C which leads back to A in an endless loop? I feel like I've read about that in prisoner's dilemma games with mixed populations of cooperators, defectors, and tit-for-tat-ors. Cooperators allow defectors to take over, defectors allow tit-for-tat-ors to take over, tit-for-tat-ors allow cooperators to take over, etc.
posted by clawsoon at 8:15 PM on June 10 [2 favorites]

From above:

I feel like we plowed this field during COVID and this is till a problem

I see what you did there!
posted by Theophrastus Johnson at 8:22 PM on June 10 [4 favorites]

By an interesting coincidence, 1955 is also the year of the first recorded outbreak of chronic fatigue syndrome/myalgic encephalomyelitis among 300 nurses and other hospital workers in Great Britain, several months after the Cutter incident:

Background and Objectives: Controversy exists over whether myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an organic disease or a psychosomatic illness. ME/CFS usually occurs as sporadic cases, but epidemics (outbreaks) have occurred worldwide. Myalgic encephalomyelitis was named to describe an outbreak affecting the lymphatic, muscular, and nervous systems that closed the Royal Free hospital for three months in 1955. Fifteen years later, two psychiatrists concluded that epidemic hysteria was the likely cause. ME/CFS research studies show multiple pathophysiological differences between patients and controls and a possible etiological role for infectious organisms, but the belief that ME/CFS is psychosomatic is widespread and has been specifically supported by the epidemic hysteria hypothesis for the Royal Free outbreak. Our objective was to obtain accounts from ex-Royal Free hospital staff who personally experienced the 1955 outbreak and evaluate evidence for it being an infectious illness versus epidemic hysteria. Materials and Methods: Statements in the newsletters of two organizations for staff who had worked at the Royal Free hospital invited anyone who had experienced the 1955 Royal Free outbreak to contact the authors. Accounts of the outbreak from telephone interviews and letters were evaluated against the “epidemic hysteria hypothesis” paper and original medical staff reports. Results: Twenty-seven ex-Royal Free hospital staff, including six who had developed ME, provided descriptions typical of an infectious illness affecting the lymphatic, muscular, and nervous systems, and were not consistent with epidemic hysteria. Conclusions: The 1955 Royal Free hospital epidemic of myalgic encephalomyelitis was an organic infectious disease, not psychogenic epidemic hysteria.

And note the final paragraph of my earlier quote about the Cutter incident:

The Cutter incident led to the replacement of Salk's formaldehyde-treated vaccine with Sabin's attenuated strain. Though Sabin's vaccine had the advantages of being administered orally and of fostering wider `contact immunity', it could also be re-activated by passage through the gut, resulting in occasional cases of polio (still causing paralysis in six to eight children every year in the 1980s and 1990s, when a modified Salk vaccine was re-introduced). As Offit observes, `ironically, the Cutter incident—by creating the perception among scientists and the public that Salk's vaccine was dangerous —led in part to the development of a polio vaccine that was more dangerous

Contact immunity means that the children vaccinated with those earlier versions of the Sabin vaccine could infect other people they came in contact with with the attenuated strain that constituted the vaccine, making them immune as well, and making them capable of passing the vaccine strain to others too, of course.

Does this mean that CFS/ME is caused by attenuated vaccine strains of polio, first the strain behind the Cutter incident and later by circulating strains of the even more attenuated earlier Sabin vaccine? I don’t know, but the resemblance of Post Polio Syndrome to CFS/ME has been remarked upon in past versions of the Wikipedia article on PPS, though I haven’t checked the current one.
posted by jamjam at 8:22 PM on June 10 [2 favorites]

Circulating vaccine derived poliovirus still causes occasional polio outbreaks in countries where oral polio vaccine is used so I’d think we would notice if it were circulating enough to cause other things?
posted by atoxyl at 8:34 PM on June 10 [2 favorites]

The US hasn't used the live polio vaccine since... 2000, and the EU since 2002.
posted by BungaDunga at 8:36 PM on June 10 [3 favorites]

Yeah it has nothing to do with game theory. People generally do what they are told by the people they trust. It's just that more and more people are putting their trust in people who turn out to be wackos. Sometimes they trust them because they are wackos!
posted by being_quiet at 9:03 PM on June 10 [10 favorites]

Does this mean that CFS/ME is caused by attenuated vaccine strains of polio, first the strain behind the Cutter incident and later by circulating strains of the even more attenuated earlier Sabin vaccine?

The Royal Free outbreak is certainly the best known, but there were plenty of outbreaks before 1955 (including outbreaks associated with polio itself before the vaccine, e.g. in Los Angeles). It is unlikely that CFS/ME is caused by one particular infectious agent, as it clearly is something that affects some percentage of people who have mono, Covid, and other infections as well.
posted by ssg at 9:05 PM on June 10 [7 favorites]

“letting appropriately trained staff at pharmacies do vaccinations”

I’ve been getting vaccinated at the pharmacy inside my nearest grocery for years! Often drop-in! Very handy!
posted by clew at 9:47 PM on June 10 [4 favorites]

I’m bugged by this phrasing:

“Game theory reveals that vaccine hesitancy is not a moral failure, but simply the predictable outcome of a system in which individual and collective incentives aren’t properly aligned.”

Individual and collective incentives being different is when morality comes into play, by my definition.
posted by clew at 9:51 PM on June 10 [8 favorites]

For example, clearly conveying risks can help: The 1-in-500 death rate from measles far outweighs the extraordinarily rare serious vaccine side effects.

This has been conveyed to me clearly and quite effectively repeatedly - it's not as if people aren't trying this approach. Part of me can't shake the feeling that people who still don't understand this at this point, don't want to understand it.

Then again, most people have shit intuitions about maths, especially probabilities (Kahneman discusses many experiments showing this in Thinking Fast and Slow). Me certainly included. (Probabilities always my weakest area in maths). And the only reason, why I "understand" the relative risks of vaccines vs measles is that I have come to know and accept this about myself and I am willing to let myself be guided by external sources.

But a lot of people have made bad experiences with being guided by external sources. They feel they have been deceived and manipulated too often, and that the only thing they can trust is their own gut. Personally, I don't think that this sort of person is actually any less susceptible to outside manipulation than everyone else, but still, I get why one would cling to this idea about "trusting your guts".

I'm convinced that ultimately this isn't a problem about information or cognitive abilities, but one about trust, and that makes it a lot harder to solve.
posted by sohalt at 9:57 PM on June 10 [2 favorites]

If I have 1 chance in 100 of dying of the disease Lurgi and 1 chance in 10,000 of contracting it in the first place, and the vaccine results in death 1 time in 750,000, then there's a personal case to be made for not taking the vaccine.

Public health is not about best choices, it’s about practical choices. Not to pick on anyone, these sorts of examples are the kind of accidentally irrational thinking the authors are making a heart felt attempt to destigmatize, to start the practical work of actually just saving lives and decreasing suffering.

The example might be true if you acted alone in a population of 100% susceptible people. But even then,… humans are notoriously poor probabilistic thinkers.

If the example was true we also wouldn’t need bona fide Epidemiologists with fancy maths to tell us anything about it. Herd immunity at 95% for Measles wouldn’t exist. Measles would just be an independent coin flip for each person.

However… probabilistic thinking does not lend itself to intuition. You can’t expect to win the lottery yet someone does. Intuition is what I think we’re talking about when we say “rational” thinker: that there’s some intuition embedded in an individual’s mind that lets an individual synthesize information into a practical and reasonable decision. In reality, rate of infection drops quickly as susceptible population drops. These are called compartmental models. People make careers developing compartmental models.

As said above, people are not informed rational actors, because they’re neither rational nor informed. They’re probably not even authentic actors (I was taught the “Problem of Neglect” is that people view the exact same outcome fundamentally differently if they acted to get it versus when they didn’t: it’s “better” to not act versus not act if the outcome is negative… we aren’t aware inaction is an action).

I think the authors have more clandestine intentions than they let on: to destigmatize the susceptible population and help more people. It’s shocking we’re debating the near eradication of polio. We got close only because Sabin’s contact immunity, we’ll eradicate it only with Salk. We can certainly discuss what went wrong with some batches and why some individuals must be free riders truly for their own health. But it’s bizarre to use smallpox and polio as examples causing suffering when their net good is so good we can’t really even compare the harm to the harm of still having the diseases unchecked. I think that’s the sort of anecdotal thinking the authors are trying to destigmatize for the practical reason of inoculating against.
posted by rubatan at 12:26 AM on June 11 [13 favorites]

A few haphazard thoughts -

This piece is sort of strange because it partially includes a nod toward health communication (which is field that uses scientific inquiry to figure out What Works to use communication to change health behaviors), but then shifts over to talking about how we just need to communicate risk clearly. Which is ridiculous, because the field of health communication is all about the fact that it's so much more complicated than just patiently explaining facts to people, which often is worse than doing nothing.

I think about smoking often, because two strategies that were successful at reducing smoking rates were a) dramatically increasing the social and economic costs of smoking, and b) massive communication campaigns about how tobacco companies are out to manipulate young people. It sure as hell wasn't clearly explaining the risks of smoking.

Lastly: people have spent the last 40 years exposed to straight-up manipulative misinformation about vaccines, in a movement that has its origins in outright fraud; and it's become a powerful personal and tribal identity. It's hard to push against that with the normal tools. I don't know where we go from here but it's very bad.
posted by entropone at 4:40 AM on June 11 [8 favorites]

Game theory reveals that vaccine hesitancy is not a moral failure,

Did someone just look up the wikipedia page for game theory? Game theory cannot tell you what is and is not a moral failure.
posted by MisantropicPainforest at 6:01 AM on June 11 [10 favorites]

I’m wondering if that “not a moral failure” depends on “virtue ethics” (AIUI, the technical name for believing that there are good people and bad people and what good people want to do isn’t bad.) I think there are *versions* of that that don’t allow *everything* to the good people, but historically they seem to allow quite a lot.
posted by clew at 6:55 AM on June 11 [1 favorite]

I am so f.ing tired of the "scientists must rebuild trust" narrative.

No. First, the public must trust science. Full stop.

Second, uninformed conspiracy theorists need to be called out for what they are, and denied a platform. We need to stop sowing irrational, factless mistrust. That's all. Stop overlooking the obvious.

The "cutter incident" is not a failure of vaccines, nor is it an example of vaccine harm. It is a failure of product manufacturing, just like a salmonella outbreak including death is a failure of food production, not food itself.
posted by Dashy at 7:09 AM on June 11 [11 favorites]

Does this mean that CFS/ME is caused by attenuated vaccine strains of polio...

This is a near perfect example of the kind of "intellectual hubris" that gets a person started on the crank-to-conspiracist pathway that is, among many other factors, clearly contributing to the rise of anti-science and RFK/MAHA nonsense.

Polio and its vaccines are among the most studied phenomena in the history of medicine and public health. The number of people who have spent their entire lives studying them in detail and with rigor, after spending the first half of their lives training to become sufficiently expert to do so, is staggering. What does this mean?

It means that any "novel" thought a random person might have will, with near 100% certainty, (a) not be novel, (b) already have been studied, or (c) be so clearly contradicted by other evidence and mechanisms (of which the idea-haver is of course unaware, because you'd have to spend half your life training to know) that it cannot be studied in any meaningful way. In this specific case we already have people in this thread pointing out that CFS/ME is complex enough that it cannot be explained by a single viral cause.

To be clear what's dangerous here isn't the "novel idea" - that's great! What's dangerous is failing to take the next step: if I had this idea, probably 1000 other people who - and this is the hard part - know more about this than I do - also did. What did they do with that idea? Because again, 99.999% of the time the answer is "they rejected it because they know something about epidemiology that I don't" or "they did a study 50 years ago that disproved it." But instead of that we go from an "interesting coincidence" to vaguely casting doubts on the polio vaccine and by association all vaccination campaigns and next thing you know you've got parents refusing the measles vaccine because they "heard vaccine side effects weren't studied thoroughly."
posted by range at 7:11 AM on June 11 [14 favorites]

I am so f.ing tired of the "scientists must rebuild trust" narrative.

No. First, the public must trust science. Full stop.

So there's nothing anyone can do until that happens spontaneously?
posted by straight at 7:17 AM on June 11 [1 favorite]

I'm a scientist. Trained, taxpayer funded lab, have trainees and state of the art tools at my disposal.

What do you want me to spend my time and resources on?

Moving forward,, new science, new cures and knowledge and tech?

Or standing still, handholding conspiracy theorists, contemplating naval lint, re"proving" well established results, on your dime?
posted by Dashy at 7:27 AM on June 11 [6 favorites]

Rednikki's link deserves its own fpp. The most infuriating part to me, and on reflection the most important, is this:

One public health colleague said, “Sure, do what you need to do, but please don’t kill someone else.”

That didn’t land well, and one MAHA person said, “Just saying that will lose so much ground [in trust].”

And I'm tearing my hair out because how can you tell me not to say what is so obviously and importantly true?

Because it doesn't work. Because many (most?) people simply can't recognize and own up to such a serious moral failure on their part and repent. Certainly not when the accusation comes from a perceived enemy.

Maybe they can do it when led to see it by someone they trust. But the trust comes first. Either that, or a gun. And right now Donald Trump and RFK have the guns.
posted by straight at 7:34 AM on June 11 [2 favorites]

What do you want me to spend my time and resources on?


I don't think "scientists must rebuild trust" means literally every scientist should stop working in their field and become a communications specialist instead.

But health communications is a science and we need communications scientists to study what actually works and we need to pay attention to and use their findings.
posted by straight at 7:47 AM on June 11 [4 favorites]

What scientists need is a public that will stand up and say "we trust you, go do your thing"

That's missing badly.

We have lots of leaders and scientists and public people doing their job. We also have lots of air time devoted to cranks and conspiracy theories and the public who believe them. The fight currently is between scientific leaders, and cranks, and somehow the net outcome is "scientists have to rebuild trust".

I mean, wt actual f? If that's the conclusion, the cranks won. Goalposts successfully moved. Big step backwards, congratulations to the "both sides" media.

We do not have a public that shouts the cranks down. That is what we need. Not more scientific leadership.
posted by Dashy at 7:56 AM on June 11 [5 favorites]

We do not have a public that shouts the cranks down.

That was one subtle effect of the pandemic, loss of bubbler conversations. I recall numerous chats where the conspiracy guy was not shouted down but eyerolled down. Can't argue with'em but can shame bad ideas occasionally. (*** NOT the person but the bad idea)
posted by sammyo at 8:10 AM on June 11 [2 favorites]

That didn’t land well, and one MAHA person said, “Just saying that will lose so much ground [in trust].”

I just told a student that two plus two equals four!

(scoffs) We need for you to recant that.
posted by flabdablet at 8:17 AM on June 11 [1 favorite]

the frequency of serious side effects from vaccines is massively under-reported.
Could you provide documentation, please?
posted by theora55 at 8:21 AM on June 11 [3 favorites]

We do not have a public that shouts the cranks down. That is what we need.

But Brawndo's got what plants crave!
posted by flabdablet at 8:27 AM on June 11 [1 favorite]

What scientists need is a public that will stand up and say "we trust you, go do your thing"
We do not have a public that shouts the cranks down. That is what we need. Not more scientific leadership.

I agree we don't have that. So now what? I don't know where/how to get it
posted by straight at 9:07 AM on June 11 [2 favorites]

You had to go back to 1955 for that serious trouble with vaccines. Science is better, medicine is better. This is where regulation is a benefit.

Currently, vaccination is highly politicized, much of it quite intentionally, ro polarization and votes. Lately, I'm really mindful of good faith vs. bad faith and it feel like bad faith is winning. And the press is so intimidated they report all sides, no matter how spurious.

My kid got vaxxed. It was so great not to deal with chicken pox, not to fear the childhood diseases. I'm delighted to be safer from shingles and, as a side effect, to have fewer outbreaks of herpes. Vaccines are a blessing and I'll keep advocating for them and against stupidity.

Post title - Chef's kiss.
posted by theora55 at 9:12 AM on June 11 [7 favorites]

I have one suggestion for changing the conversation that might bring it into the realm of shared responsibility for the communities we live in: Kill the phrase "herd immunity." People don't like to think of themselves in terms of being a "herd." The appropriate phrase is "community immunity." If enough people in the community get vaccinated, you have protected the community from that particular disease.

And since the advent of the Covid-19 vaccines, it's become clear that many vaccines do NOT provide immunity, they provide protection from serious illness, which is seriously important, but will not enable "community immunity." Distinguishing the selfish reason for getting vaccinated for flu or Covid-19, or a host of other viruses, -- that I won't get seriously ill from that particular virus -- and the public good reason for getting vaccinated for polio/measles/rubella, is an important part of this conversation that doesn't happen because raising the concept that not all vaccines provide immunity is anathema to public health officials. "It confuses the conversation," to be accurate about what protection a vaccination will or won't provide.
posted by drossdragon at 9:27 AM on June 11 [2 favorites]

No. First, the public must trust science. Full stop.

I disagree, as a scientist.

Science is not inherently moral. Science has been used to perpetrate terrible abuses, especially to vulnerable people. Science is a process that relies on good-faith skepticism, not faith!

Scientific institutions should benefit the public, and should be trustworthy, but institutions that conduct science largely occupy positions of extreme privilege in society and should work to ensure public benefit, public trust, and to be trustworthy.
posted by entropone at 9:37 AM on June 11 [3 favorites]

In 1990 or thereabouts, I got my MMR.

I gave it no thought for decades after. Then RFK Jr. caused the first few outbreaks of measles, and then my wife got pregnant. So I did exactly what game theory advised: asked my doctor and got a booster.

So long as measles stayed suppressed, I didn't think about whether or not my MMR took. Then it started spreading again, and then we conceived, and I did the math. Asked for an immune titer, and got a booster. So I played this game theory issue implicitly.

Other parents going antivax because the rest of us do try to maintain herd immunity? Not the same thing, in my view.
posted by ocschwar at 10:59 AM on June 11

And since the advent of the Covid-19 vaccines, it's become clear that many vaccines do NOT provide immunity, they provide protection from serious illness, which is seriously important, but will not enable "community immunity.”

They almost always provide some degree of immunity and reduction of transmission but sometimes it is partial or of limited duration due to the rapid mutation or immune evasive properties of the pathogen (or the limitations of the particular approach to vaccination). Protection from serious illness is what you have left when protection from (any) illness wears off. People pretend they didn’t know this pre-COVID but it’s obviously true of flu vaccines, for example. A lot of people genuinely hoped and believed for a time that COVID would not be like that but it’s not how it ended up. This does mean that true community immunity and effective eradication are not realistic for every disease with current technology, if that’s your point.

I do agree with the person upthread who pointed out that talking in terms of individual risk/benefit is not an adequate strategy because the more effectively we have controlled the disease, the less attractive the individual calculation is. It has to be understood as a community issue, and really a global issue, since the only way to take a vaccine off the menu permanently is to make sure the disease it targets goes the way of smallpox.
posted by atoxyl at 1:33 PM on June 11 [3 favorites]

I’m bugged by this phrasing:

“Game theory reveals that vaccine hesitancy is not a moral failure, but simply the predictable outcome of a system in which individual and collective incentives aren’t properly aligned.”

100% this.

Game theory explains why people who think only about their own self interest might make a certain decision. It says nothing about the morality of that decision! If you're not an objectivist, there's a good chance that thinking only of your own self-interest is a moral failure in whatever ethical tradition you adhere to.

It can be an argument that people who abstain actually do understand the risk factors, but that's a totally different issue. (Giving the number of abstainers who don't understand vaccines, and vastly overestimate the chance of side effects, I don't think that's what's going on either.)

There's a certain kind of mental short-circuit that seems to happen to some people when they analyze a decision and realize it's rational, that they then seem to think it's protected from ethical judgements.
posted by mark k at 4:07 PM on June 11 [2 favorites]

It doesn’t have too—-their own self interest is assumed into the model. You could easily construct a payoff matrix that values helping others. We would see different outcomes (and I think this is why we have had such low vaccine hestinancy in the past). But there’s no assumption of selfishness inherent to game theory.
posted by MisantropicPainforest at 4:12 PM on June 11 [1 favorite]

Even studying non human animals, we find systematic actions based on altruism as well as competition and cooperation. Spite is the quadrant that’s least agreed on IIRC. (This may be microbe specific. ‘S a while since that lecture.)
posted by clew at 4:24 PM on June 11

But there’s no assumption of selfishness inherent to game theory.

There definitely is in the payoffs used for this analysis. The individual in this model is thinking of their own rewards.

More sophisticated models (which I assume some of the links point to) end up making some individuals act out of self-interest while others act on the urge to, say, punish defectors. So you get an equilibrium where more defectors increases the odds of being punished. But would-be cheats are still acting out of self interest and whether that is a moral failing in the case of communicable diseases remains an ethical question, not a game theory problem.
posted by mark k at 4:44 PM on June 11 [1 favorite]

Kill the phrase "herd immunity." P

I often have this feeling when I see someone taking what seems to be a misinformed stance on something like vaccination: "If only we weren't using this particular term which seems to have tripped them up." But:

1) I think that's often mixing up cause and efffect. It's the misinformation sources that have seized on whatever terminology we're using and found some way to twist it.

2) It's an empirical question whether changing that terminology actually helps anyone to better understand. I can imagine better ways to communicate all day, but they've got to be tested.
posted by straight at 4:49 PM on June 11 [2 favorites]

I sometimes wonder if the Roman elite lost the trust of the people to the Christians not because their facts and science were wrong and the Christians were right, but because the people didn't trust their intentions. The more that you try to make me a slave on a giant estate, the less that I trust whatever you tell me.

As much as postdocs struggling to pay their rent don't see themselves as part of an elite, science as a whole is one of the systems of elite knowledge and power in the modern world. As people stop trusting the intentions of The System, they will also stop trusting the facts of science, not unlike late Romans. Scientists need politicians and business leaders and economists to do the right thing by the people, too, if they want to stay trusted.

...

Now... Mennonites are a bit of a special case, because the past 500 years of Mennonite history has been all about not trusting governments. Every migration - from Holland to Prussia in the 1500s, from Prussia to Russia in the 1700s, from Russia to North America in the 1900s - has been a case of trying to get as far out onto the frontier as possible so that governments would be willing to chase away nomadic peoples for them but would otherwise leave them alone. Every move has involved getting a promise from the government to leave them alone (a promise which was inevitably broken, provoking a crisis and another migration of at least part of the community). Not trusting the government is Mennonite cultural DNA by this point.
posted by clawsoon at 4:51 PM on June 11

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