CMDA's The Point

Responsibility and Freedom in the Time of COVID

September 8, 2021
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by Steven Willing, MD

In a weekly column on Sunday, August 29, Evangelical attorney David French declared “It’s Time to Stop Rationalizing and Enabling Evangelical Vaccine Rejection.”

Is that really a thing, you may ask?

There certainly is some evidence for that. Among those who have already been vaccinated against COVID-19, white Evangelicals trail the national average by 10 percent. A significant difference, but not a dramatic difference. In fact, the majority are vaccinated, according to this tweet displayed in the article.

But last Friday, the National Religious Broadcasters (NRB) fired Senior Vice President of Communications Daniel Darling after he appeared on MSNBC’s “Morning Joe” to explain his own reasons for getting vaccinated and to address common concerns among the vaccine hesitant. According to the NRB, Mr. Darling violated their official policy of “neutrality” on the matter. (How one could be “neutral” about a simple and safe intervention that can save millions of lives is puzzling, at best).

This isn’t a new thing. In 2020, Gabe Lyons’s national Q Conference—normally a serious event spearheaded by some of the top thinkers in conservative Christianity—offered a prime speaking platform to discredited long-time antivaxxer Robert F. Kennedy, Jr.

In his column, French maintains,

Christian vaccine refusal not only rejects self-care, it enhances risks to innocent and vulnerable neighbors.”

Citing the attempts of some to invoke religious liberty as cover for refusing the vaccine, French regards this as an abuse of the principle on several levels. He references biblical mandates to care for ourselves and to care for others, and he implies an element of dishonesty:

And let’s be honest and clear. The majority of Christians seeking religious exemptions are using religion as a mere pretext for their real concern—be it fear of the shot or the simple desire to do what they want.”

He concludes:

Sound judgment should help us separate lies from truth and tell us that no argument for liberty should trump our responsibility to spare our nation and our neighbors and finally take the vaccine.”

French is an analyst who generally goes the extra mile to understand other points of view, and for doing so gets attacked from both left and right. I usually agree with him. This time around, though, he may be taking it a bit far.

Scientifically, it’s really difficult to make a case that people who choose not to be vaccinated increase the peril to anyone else over any realistic time frame.

Since early 2020, numerous restrictions were implemented to contain the pandemic that seemed to involve little consideration of their long-term benefit. It was clear from the beginning that SARS-Cov2 would never be eliminated. This has been doubly true since the delta variant became dominant. Even nations that were initially successful in limiting the spread are now seeing exponential growth, as in Japan or Australia. The only path to ending the pandemic was by “herd” immunity, either by infection, vaccination or some combination.

But since the disease can never be contained, then no one is permanently safe from infection. Even vaccinated individuals, it has been demonstrated, can contract and spread the virus. The vaccine is freely and readily available to everyone in the U.S. Almost all of the risk of hospitalization and death is borne by those who are not vaccinated. While it might be clear to French, it is not self-evident that the unvaccinated are a threat to anyone except each other.

There are two categories who may have good reason not to be vaccinated. The first is that rare adult with a contraindication. However, he/she remains permanently at risk no matter what happens. The second would be the entire population under 12 years old. In their case, the risk of death or serious illness, while real, is extremely low. (A third category could be those who survived a documented infection, but that is rarely counted as a reason).

The terror of even a single case can lead to rather extreme behavior. A divorced Chicago-area mother reportedly lost custody of her 11-year-old son after telling the judge she would not get the COVID vaccine. Presumably, the judge thought she represented too great a danger to her child. Through August of this year, only 361 children under 18 have died from COVID nationwide. That is fewer than die from suffocation or drowning, and less than one-tenth the number that die from motor vehicle accidents. To the extent her vaccine decision represented a threat to her child, it was trivial. It’s probably safer than taking him boating or swimming. The world has never been, and never will be, totally safe.

[Author’s note: CMDA has come out in support of vaccines and against coercion.]

The substance of their objections remains the crux of the matter. If the things resisters believe were true, their choice would be both rational and moral.

A large national survey from the U.S. Census Bureau found the following to be the most common reasons for not getting or planning to get the COVID-19 vaccine:

  • Concerned about possible side effects
  • Plan to wait and see if it is safe
  • Don’t trust COVID-19 vaccines
  • Don’t trust the government

Respondents were allowed multiple answers, and about one-half were concerned of side effects while about one-third just didn’t trust the vaccine. Nothing is ever perfectly safe, including vaccines. As professionals, we understand the known risks of COVID-19 vastly outweigh the theoretical hazards of the vaccine. But if a layperson doesn’t know or believe that, it wouldn’t be fair to frame his/her reluctance as callous indifference to the welfare of others.

I have seen little or no evidence for a cohort which accepts the evidence but refuses vaccination purely as a defiant expression of personal liberty. Possibly. But if they do exist, French understates the case. Either they would be unashamedly selfish free-riders, or they would be totally nuts.

Vaccine resisters succumb to the same cognitive pitfalls that afflict everyone else.

Albert Einstein thought Vladimir Lenin was the hope of humanity. Arthur Conan Doyle believed fairies were real. Kary Mullis, recipient of the 1993 Nobel Prize in chemistry, claimed to have been abducted by aliens. Owing to ubiquitous and unavoidable pitfalls in human cognition, very smart people can fall for very foolish things. It may even get worse the smarter one is, leading to what science writers have dubbed the “Nobel disease.”

In another recent survey, vaccine acceptance increased along with increasing education, until one hits the PhD threshold. It turns out that PhDs are more resistant than those with high school or less, and three times more resistant than those with master’s degrees. Obviously, if this were a matter of knowing more, it would be reflected in the group most competent to judge: MDs and DOs. Vaccine acceptance among physicians, not surprisingly, runs north of 95 percent.

Some vaccine resisters may feel we are being condescending, but succumbing to deception isn’t a fatal flaw, it’s human. It happens to all of us, like the geniuses I referenced. The easiest targets are those convinced they cannot be deceived. Better to be condescended to than spend the last few hours of one’s life on a ventilator in intensive care, surrounded by grieving family.

Never underestimate the power behind purveyors of mass disinformation. The deceivers and the deceived occupy different moral categories.

If your 90-year-old grandmother were suckered out of her savings by a con artist, would you berate her for squandering your inheritance? While my metaphor might be a bit hyperbolic for clarity, the vast majority of the vaccine resistant are in a similar straight.

The antivaccination movement was thriving long before anyone had heard of COVID, propelled by a tiny number of highly vocal and aggressive troublemakers. It was widely known that certain people would be against a COVID vaccine—before one even existed. When a position is predetermined, you can be certain it’s not being decided on the evidence.

While it’s common to lump all vaccine resisters into an “antivaxxer” box, there are at least two categories of people involved: the millions who have not been vaccinated for whatever reason, and the much smaller group of people responsible for propagating the disinformation. The number actually producing disinformation is miniscule, but their impact is amplified exponentially via social media, particularly YouTube. In one recent investigation, a mere 12 individuals—“The Disinformation Dozen”—were found to be responsible for 65 percent of the anti-vaccine propaganda on social media.

Other moral considerations are at stake here.

There’s quite a wide gulf between an anxious patient confused by conflicting messages and a militant activist on a crusade against vaccination. To the first we owe compassion and concern. The second is another matter. Their failure is the most ancient and destructive of all—the sin of pride. Intellectual pride, specifically, is overconfidence in own’s own intelligence leading to unwarranted certainty. Take it from a former insider. Writing for StatNews, Craig Idlebrook described his own descent into the antivaccination world, the mindset it created and how he eventually broke free.

“I take a breath and try to remember that perspective, that feeling of being so sure I was right and that almost all of modern science was wrong. I’m often angry at my friend and others like them who refuse to get vaccinated against Covid-19, but then I have to remind myself that I am no better than they are.” [emphasis added]

Intellectual pride is the downfall of many. But how do we know we are not the proud ones? From that there is no easy escape, for there is a kernel of pride within every single one of us. So, the first response would be transparency. We may be proud, but that doesn’t make us wrong. The second is more practical. All other things being equal, it is humility to accept the professional judgment of the vast majority of experts, and arrogance to assert they are wrong, especially without any professional expertise in the subject. Quite simply, the militant dissenter bears a far greater burden of proof.

But there is something else at stake that is profoundly consequential. In leading people to reject potentially life-saving treatment, the activist lures many to their own demise. The unnecessary deaths caused by antivaccination activists from measles numbered in the tens or hundreds. Unnecessary deaths in the time of COVID are measured in the tens of thousands. To be pro-life is to oppose antivaccination propagandists the same way we have opposed the abortion lobby: with truth, passion, courage and conviction. Let people make their own decision, yes. But let them choose free of deception, for a decision made under false assumptions is hardly free.

Steven Willing, MD

About Steven Willing, MD

Dr. Steven Willing received his medical degree from the Medical College of Georgia, and then he completed an internship in pediatrics from the University of Virginia, a residency in diagnostic radiology at the Medical College of Georgia and a fellowship in neuroradiology at the University of Alabama at Birmingham. Dr. Willing spent 20 years in academic medicine at the University of Louisville, the University of Alabama at Birmingham and Indiana University, followed by 11 years in private practice. During his academic career, Dr. Willing published more than 50 papers in the areas of radiology, informatics and management, and he authored the Atlas of Neuroradiology. He currently practices pediatric neuroradiology at Childrens of Alabama, while serving as a consultant in radiology at Tenwek Hospital in Kenya, a visiting scholar with Reasons to Believe and an Adjunct Professor of Divinity at Regent University. Dr. Willing is the author of Superbia: The Perils of Pride. The Power of Humility and The Top Ten Myths of the Sexual Revolution. His personal blog on science apologetics, “The Soggy Spaniel,” may be found at www.swilling.com.

15 Comments

  1. Avatar Carl Vander Kooi M.D. on September 18, 2021 at 12:12 pm

    The author listed four reasons why some are not choosing vaccination. The first three come under the same category. This is a new technology. What are any long term effects? Why did this technology fail in the two Phase 1 trials for influenza? How long will the protection last? (3rd or more boosters may be necessary. In Israel the present report is 39% protective from break through infection after 6 months). Some find it morally objectionable because of the use of aborted fetus cells.
    Regarding the fourth category, I know of at least 5 things an official government spokesperson said to not to be true, including three times they later admitted that they knew what they said was not true. I also have problems with the counting of cases and mortality. It seems a different criterion is used for deaths and morbidity post vaccination than counted for the infection. The US government has ignored “natural immunity”, in spite of multiple world wide reports, including both patient data and labratory detection of specific immunity

    • Avatar Amy Heneisen on November 4, 2021 at 9:21 pm

      Thank you for your concise description of additional reasons why people are choosing to forego this inoculation. I share your concerns.

  2. Avatar Kirk A. Milhoan, MD, PhD on November 4, 2021 at 6:06 pm

    As a pediatrician/pediatric cardiologist who has received every vaccine ever required by the military including Anthrax and Small Pox (including this years flu vaccine), the examples given for why people may be hesitant to receiving the current options was not a very complete list. Maybe it is because I also have a PhD. Maybe it is because I have already have had COVID and have IgG and T-Cell immunity. Maybe it is because I have watched as I care for over 200 people with early treatment and have watched none (0%) of those who had COVID early in 2020 come down with Delta in 2021, whereas I watched 75% of those completely vaccinated become infected. Maybe I am concerned about coercion or enticement for vaccines still under EUA. Maybe it is because I have looked at risks known and theoretical and have trusted my natural immunity just as I have trusted my natural immunity to chicken pox and did not get a booster when my titers were reassuring. As I discuss vaccine issues in my community I am running into much more hesitancy for all of the traditional vaccines that I advocate for children, from parents who have been uncomfortable with the push to vaccinate healthy children who’s risk is clearly much less than influenza. This is a tragic consequence. Pushing a vaccine that is not really necessary in children and very leaky in adults is driving many families to reconsider all vaccines that have a proven track record for benefits and risks. I am seriously considering parting ways with CMDA after 25 years of membership. I am very disappointed with CMDA following a narrative rather than being willing to honestly discuss real issues surrounding this vaccine.

  3. Avatar John V Spencer on November 4, 2021 at 8:01 pm

    Are these injections even vaccines? If not, to call them such is disinformation. This author has totally missed that point. In January of this year the definition of vaccine was changed and then updated again in July. This is a new, unproven and likely dangerous technology promoted by the CDC and WHO,which are rife with pro-abortion atheistic staff and leadership. They cannot and should not be trusted. They have a history of using and promoting vaccines made from aborted fetal cell lines. This is not a new problem but has been a problem somewhat hidden beneath the surface. It would help to look at the history of other vaccine developments. One OPV trial was stopped after one death. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782271/#:~:text=The%20first%20inactivated%20polio%20vaccine,the%20United%20States%5B13%5D.) We are looking at more deaths from this new inoculation than all previous vaccines combined. The people supporting these RNA and DNA instruction set inoculations are the same people suppressing inexpensive safe treatments causing many deaths. If you have any risk factors and have early covid, get early treatment and avoid the hospital.

    • Avatar Amy Heneisen on November 4, 2021 at 9:19 pm

      Thank you, John, for your points. I agree wholeheartedly.

    • Avatar Keith Anderson, MD on November 4, 2021 at 10:21 pm

      I don’t know if Mr. Spencer is a doctor or not. Let us hope that he is not. He is sadly the purveyor of the very misinformation that the article warned against. He appears to be sadly misinformed but has apparently been the victim of other individuals who have in turn propagated misinformation.

    • Avatar Steven Willing on November 5, 2021 at 10:05 am

      Virtually nothing in that response is actually true.

    • Avatar Mark Spencer MD on December 25, 2021 at 1:59 pm

      I am sad to see that the CMDA allowed the author to call you a liar without addressing any of the points you made and declined to publish your response to Anderson despite his ad hominem argument also without any references to support his attack.
      And to the rest of you and to address Anderson’s slur, John is a board-certified family physician, proud graduate of the University of Washington School of Medicine, class of 79. While i, his brother and also an MD, don’t share some of his conclusions about the utility of the COVID vaccines, I don’t like to see people allowed to denigrate him in this forum and not have him allowed to make a response.

      • Avatar Steven Willing on December 31, 2021 at 6:07 pm

        Saying someone is wrong is not calling them a liar, but that is a common fallacy.

  4. Avatar Norman Mallory PA-C on November 4, 2021 at 9:39 pm

    This article by Dr.Willing is so incredibly disappointing, and frankly, offensive. I am not an anti-vaxxer. I just happen to disagree with him. I also am not vaccine-hesitant: that term (which seems to be the current most popular secular label) would seem to imply I am still making up my mind or I am scared. I am neither; I have just decided against it based on my assessment of what I have determined to be true.
    in looking through Dr.Willing’s article, I have to get to the second to last sentence before I find one that I agree with and that is to “Let people make their own decision”. I wish though, that I could actually live that out. In my home state of Maine our governor has taken that right away, and I soon will not be allowed to practice medicine here.

  5. Avatar Daniel DeCook, MD on November 5, 2021 at 11:19 am

    Thank you for this thoughtful commentary, and for the link to the essay by Mr French. I am grateful for the (appropriate) position CMDA has taken on Covid-19 generally, and on vaccines specifically.

    I would like to disagree (gently) with the first bold-pointed paragraph, however. I think the collective choices of many to refuse vaccination was in fact closely linked to the most recent surge in Covid-19, as perhaps best represented by the close parallels geographically of the incidence of vaccination and the incidence of Covid-19 cases. True, other forces were certainly also implicated (cessation of mask mandates, resumption of group gatherings, etc). But it is the collective result of sufficient numbers of people to be vaccinated that is most closely tied to the surge.

    And hence, my disagreement is that while each individual choice (to not be vaccinated) may have little force on the incidence of Covid-19 cases, wen one makes that choice (or simply, silently, fails to make the choice to be vaccinated), they are, in fact, associated with the collective effect that choice has. And that, morally, leaves one implicated in the fall-out from the surge. It is rather like silently watching the Jews be deported, or the babies be aborted; it was not enough to say at least one wasn’t in favor of it. No, in those circumstances, and in this circumstances, Christians should be leading from the front, doing the thing that is most expressive of the “Love Thy Neighbor” command.

  6. Avatar Janet E. Patin, MD on November 7, 2021 at 12:36 pm

    “Scientifically, it’s really difficult to make a case that people who choose not to be vaccinated increase the peril to anyone else over any realistic time frame.”

    Is the R0 of 5-8 for the Delta variant, meaning that one infected person can spread it to 5-8 others (compared to R0 of 2.5 for the original Covid-19, and R0 of 1-2 for influenza) not an argument for significantly increased peril to others? While it is possible for the vaccinated to contract and spread Covid, it’s misleading to equate that to the risk by and for the unvaccinated. “The unvaccinated are a big highway of transmission. The vaccinated are a little side street,” per Dr. William Schaffner, ID professor at Vanderbilt.

    Let’s not muddy the waters like this. People are still dying, almost exclusively the unvaccinated, in numbers that have contributed to a nationwide shortage of nurses and MAs, burnout of physicians, and hospitals stuffed to the gills. Christ’s call to love our neighbor can be lived, and translates in this case as acknowledging then setting aside one’s concerns and doing the right thing accepting the vaccine. This peril has not passed.

  7. Avatar Larry Sears MD on November 7, 2021 at 8:24 pm

    One of the main reasons for not getting the vaccination is the natural immunity obtained from infection which has been shown in numerous well done studies to be far superior to vaccine immunity. Those who have been infected are at higher risk from the vaccine also. While the vaccine was fairly effective against the original Sars-CoV-2, it is not against the Delta variant. And it is not “safe” as noted on CDC’s website. There have been now over 18,000 deaths reported to VAERS along with other significant health issues. And this is probably an under-report. Besides the above, there are safe, cheap oral medications which have been shown in numerous studies to be effective against the virus (actually more effective now than the vaccine). I have treated hundreds of patients with HCQ and ivermectin successfully.

  8. Avatar Steven Mull MD on November 11, 2021 at 11:15 am

    Unfortunately, there is much noise on both sides of the argument. We have friends who are not antivaxers but who are anti COVID vaccine who send me all sorts of foolish articles and misinformation. On the other side, the disinformation comes from government sources saying things like masks do not help or we didn’t fund gain of function (Fauci), masks are 80% effective(Wolensky), and we are going to stop/eradicate/end the virus (Biden). The reality is that we will live with this virus like we do with the flu and the common cold. The virus has some serious complications which we as healthcare professionals have all seen and which probably explains the 95% vaccination rate for physicians. There are new medications that will likely help prevent serious complications. There are high risk groups (not most children ) who probably should get vaccinated. I do have a concern though that forcing people to be vaccinated for someone else’s good may set a poor precedent. Historically we got vaccinated to protect ourselves and a side benefit was protection for others. What happens in the future when our society decides that having a child with Down’s creates societal costs. Perhaps society will determine that humans are, via pollution and demands on the environment, a detriment. Will the government be able to force abortions in the name of the greater good?

  9. Avatar John V Spencer on December 24, 2021 at 2:29 pm

    I posted links to verify every point I made in that post above. This page monitor for this site did not want you to have those links and did not allow the post. You will have to verify those true points on your own. It will take your time but is not impossible to do. Just as atheists and agnostics should not advise you how to run your church they should also not be trusted to give you safe or true medical policy.

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