Why refusing the COVID vaccine could be bad decision-making. And what to do about it.

Science tells us that vaccines are safe and effective, and that by getting vaccinated we can save lives. Scientists have the data to prove it. You’d think this would be enough to convince everyone.


But it’s not.


What’s wrong with people? Why do they think that not getting vaccinated is a good idea? Are they unintelligent? Closed-minded? Unwilling to see the truth?


If only. Actually, it’s worse. These people… they’re only human. Like the rest of us.


We all love a good story.


A major reason people aren’t following the data when it comes to the COVID vaccine is the same reason all of us make bad decisions from time to time: our human brains are naturally inclined to interpret the world in terms of memorable stories and personal experiences, not in terms of numbers. Ever buy a product, see a particular doctor, or travel to a particular destination because someone told you a great story about their experiences with these things? Sure you did. It’s what humans do.


We carry only some personal experiences and stories in our heads, but data tells us so much more. Data captures the experiences of hundreds, thousands, even millions of people. That’s upwards of millions of stories. That’s a lot of information. Wouldn’t we all like as much information as possible when making our decisions? In theory, yes, of course we would. Ignoring important information when we make choices can hurt us and the human race.


But unfortunately, data is boring. Here, I’ll prove it. Think of a number. Any number.


Boring.


Now think of another number.


Still boring.


Now think of the movie Star Wars.


Not boring.


Stories are memorable; data is not. Because data doesn’t tell stories in an interesting way, we don’t process or remember it very well, and we don’t conjure it up when it’s time to make a choice. I mean, think about it… “95% effective” isn’t as exciting to hear as “My 72-year-old mom got vaccinated and she’s totally fine, and now I can go visit her and hug her, finally, for the first time in months! Boy do I miss her! And her lasagna!” Or “No one in my family believed the virus was real. We never wore masks and we refused to get vaccinated. My dad died of COVID three days ago and now my mom is sick too. We’re all devastated. My dad was my best friend and now he’s gone. I wish we’d all gotten the vaccine.” These stories are easier to remember. That’s why we rely on them when we make our decisions. It’s a very human thing to do. (Ever wonder why gossip can ruin entire lives even when it’s not true? Gossip is interesting and memorable.)


But sometimes relying on stories as evidence, rather than relying on data, can hurt us and the human race. I work with data all the time. A huge part of my job is working with statistics. Even I ignore the data when I shouldn’t. Like when I bought that waffle maker. I read one review about how great it was, and that story was enough. I didn’t pay attention to the high proportion of people who bought the waffle maker and had serious issues with the ceramic plates. I should have done the math. Those ceramic plates suck. That waffle maker was a waste of money.


Now imagine making a decision about COVID the same way. Wait… you don’t think that’s what we do? Think again.


We’re not all treated equally.


There are a number of different stories floating around that explain why people aren’t getting vaccinated. I’m not saying these stories are lies; these are very real personal experiences, and some are backed by data. For instance, when African Americans say they’re reluctant to get vaccinated because they don’t trust public health officials, I believe it. They have reason not to trust. The stories are powerful and tragic: the Tuskegee Syphilis Study was no small thing, and neither was the story of Henrietta Lacks. Add to these the painful personal experiences of many minorities who’ve gotten shafted while trying to get decent health care. Anyone in their shoes would believe that the system is rigged against them.


The data also supports systemic racism and classism in health care. Rigorous research has been done to show this.


But the data is also leading us to another conclusion: if African Americans don’t get vaccinated, they’ll suffer even more. How much more? Let’s think this through. A recent study by the American Heart Association showed that Black and Hispanic people have made up nearly 60% of COVID-19 hospitalizations in the United States. In North Carolina as an example, as of the end of January, whites make up 82% of those vaccinated while blacks make up 11%, even though blacks make up 22% of the total population. Vaccine effectiveness is anywhere between ~85-95%, give or take. Altogether, this paints a specific picture: if things keep going this way, by the time this pandemic is over, more minorities could lose their lives to COVID than whites, and a lot of COVID illnesses among minorities could be prevented if more people relied on the data.


But relying on data is so hard to do. Humans see the world through the lens of stories, not numbers. And percentage points aren’t emotional, so what they tell us doesn’t stick. And because data doesn’t stick, it’s less likely to make an impact.


What if we heard a painful story about a young African American couple, newlyweds with a two-year-old son? And what if the husband refused to get vaccinated while the wife got vaccinated against her husband’s hopes? And what if we heard that the husband died of COVID while the wife survived, only to care for their child alone? Maybe then the importance of getting vaccinated would stick in our memories. And maybe then more people would be open to getting a vaccine.


I don’t want to hear that story. I don’t want to hear it because I don’t want it to happen. And this is what I’m afraid of. Stories like this are more likely to come true when they aren’t already part of our conversations. Unless we hear tragic stories where not getting vaccinated leads to death, and where getting vaccinated is a heroic act, we won’t remember the information we need in order to make the right choices.


We love the hero.


There are other stories that conflict with the data, stories that seem to be winning. Imagine this story. A young mother, following the advice of her child’s doctor, gets her son vaccinated for measles, mumps, and rubella (the MMR vaccine). Sometime after his vaccination, the son shows symptoms of autism. The mother, distressed, goes online to get educated and comes across information linking autism to vaccines. Everything changes. She puts her son on a special diet. She gives him supplements and puts him through a detox regimen to rid his body of metals and candida. And just like that, his symptoms improve.


It’s a powerful story with all the important parts. A protagonist (the mom), faced with a tragedy (her son’s autism), beats the odds and the establishment (antagonist) and finds a real cure. She goes on to speak out about the harms of vaccines so others don’t experience what she and her son went through (she’s a hero). It’s straightforward, emotional, and memorable. It sticks.


This is Jenny McCarthy’s story, and I am not here to doubt that this is her experience. But it is one experience. A powerful one, but only one. Meanwhile, MMR vaccines have saved the lives of over 20 million other people on the planet. Twenty million is a big number, but it’s a number, not a story, which means it’s harder for the human brain to process it, remember it, and then recall it when it’s time to make a decision about the COVID vaccine. When I heard Jenny McCarthy’s story for the first time, even I started having doubts about vaccinations. It was compelling, and I am drawn to stories where big pharmaceutical companies are the bad guy. But I’m very familiar with the laws of probability, so I could catch myself before getting carried away. Most people don’t think about statistical principles throughout their days (understandably). We can’t fault ourselves for relying on stories. We’re only human.


But in case you haven’t noticed, human tendencies can be self-destructive. Not just for us as individuals, but for our families and communities too. No need to be tough on ourselves. But we might want to try a different way.


I’d like to think that people who reject anti-vaxx arguments are thinking about the laws of probability, but it’s likely that they’re not. They’re likely basing their judgments on other things, like on the fact that Jenny McCarthy is bucking the norm, which many of us don’t like. Or that she’s criticizing what many mothers have decided to do, which many of us don’t like. Or that she’s used her sex appeal to make a living, which many of us don’t equate with medical expertise.


There’s nothing inherently inaccurate in beliefs that buck the norm, or that contradict what many of us do, or that come from people who aren’t formally trained. In fact, to keep an open and scientific mind means actually hearing anti-vaxxers out, at least to where we’d want to test their beliefs scientifically. Fortunately, we don’t have to do much work to accomplish that: a lot of data already exists that contradicts what anti-vaxxers believe. Maybe anti-vaxxers don’t notice it. Maybe they dismiss it. I don’t know what’s going on in their heads so I can’t say for sure. But something is going on.


We value our experiences.


Here’s another type of story. Many health care workers who have been testing and treating people with COVID have themselves felt perfectly fine. Perhaps they were asymptomatic carriers at one point. Maybe they never caught the bug at all. Day after day, as they headed to work where they treated patient after patient with COVID, they had to feel lucky that they felt healthy. Not all health care workers had this experience: some lost their own lives or have gotten their family members sick. But many have been symptom-free.


That personal experience of being exposed to COVID day after day and not feeling sick is a powerful and memorable one. I mean… imagine what those early days were like: hours caring for patients in rough shape because of a new, scary, and dangerous disease. Day after day they probably left work wondering, “Is this the day I’m going to catch the virus? Is this the day I’m going to infect my family?” And imagine that day after day, nothing happens. Months later and still no symptoms.


It’s a powerful experience, so powerful and memorable that it takes center stage in peoples’ minds as they decide whether or not to get vaccinated. If nothing’s happened yet, it probably won’t happen in the future. Right?


Not really. COVID doesn’t stop itself before infecting someone to say, “We’ve passed this guy up already; we should pass him up again.” This is not how COVID works. And with new strains appearing, our past experiences with the virus aren’t really a good gauge of future ones. A better way to go would be to think about the data, specifically the rates of transmission, the rates of mutation, and the rates of serious illness. Wait… what are those rates again? I can’t tell you, because I can’t remember. And that’s my point.


We connect the wrong dots.


Rates, percentages, statistics… they’re hard to conjure up. But that rough day at work, followed by months of being symptom-free? Totally easy to recall. What we remember shapes how we predict the future. How we predict the future shapes the choices we make. If we think we won’t get COVID because we haven’t gotten it already, then we’re going to decide to not get vaccinated. But if we thought about the data, we’d be going another way. We’d be getting the vaccine.


There’s more to this story. Some health care workers have also expressed doubt about the vaccine’s effectiveness because the vaccine was developed so quickly. Maybe health care workers know too much. They know what’s typical as far as vaccine development goes, so when a vaccine is developed so quickly, something might seem a bit “off.”


But the effectiveness of a vaccine isn’t determined by how long it takes to develop. Its effectiveness is measured by data collected in clinical trials, data that’s analyzed systematically and objectively. But who can remember the results of those trials? It’s easier to remember that one time, years ago, when AIDS happened, and how we still don’t have a vaccine for HIV, even as scientists work hard to develop one. I honestly can’t recall one virus for which a vaccine has been developed as quickly as it was developed for COVID.


When we hear stories, we connect dots to form conclusions like “speed in vaccine development is related to ineffectiveness.” The actual data doesn’t make that connection. Our memory, coupled with our need for closure, does.


Meanwhile our health care workers aren’t getting vaccinated. Which means many of us who care about others the most, and need vaccines the most, are going to suffer more – and cause more suffering.


Don’t stop short when making decisions.


Scientists can parade data around all day long to showcase the effectiveness of the COVID vaccine. But a lot of people don’t make decisions based on data. At least not naturally. It’s more natural for us to recall stories and to put more weight on the stories we remember than on data we can’t recall or don’t know.


Does this mean that relying on memorable stories to predict outcomes and make decisions is a bad idea? Yeah, sometimes it does. Why? Because good decisions require good information, and the more quality information you have, the better. Unfortunately, the human brain pushes us to stop short. The human brain wants efficiency. It feels satisfied having a story to hang onto, a story that feels good enough to shape our futures around.


Our human tendencies have gotten us far, but just look around… they’ve also been kind of a problem. Stories are great, but why give in to natural tendencies and stop short in our information-gathering? Our choices dictate our individual and collective futures. If your choice is whether to have toast or oatmeal for breakfast, then ok, maybe you don’t need to do a lot of research. Maybe you can rely on a memory of that one time last week when the oatmeal just didn’t do it for you. But when it comes to getting vaccinated… that’s a different story. That’s not something to be taken lightly. You want good information. You want enough of it. Why? Because you want to minimize risk and uncertainty and increase your chances of doing the right thing.


Human beings say one thing and do another. We’re not necessarily hypocrites; inconsistency is part of what we are. You and I can sit here together calmly, and we can rationally agree that no good decision is made hastily, and that you can’t make good decisions with insufficient information.


But when we’re in the throes of an actual decision, all that goes out the window. The autopilot kicks in. And suddenly we’re thinking about “that one time when…” or the news story about that “one guy who…” or our neighbor who experienced something “you wouldn’t believe!” And then we go off and make serious life choices based on these stories.


Don’t stop short. Don’t move too fast. Don’t make up your mind just yet. It’s ok to not be sure, if even just for a little while, until you’re just a little more certain.


And don’t be afraid of data. Or try not to be. Statistics class sucked in high school, but it’s as important a life skill as financial budgeting or eating a well-balanced diet. If you don’t think in terms of probability you’re going to set yourself up to draw the wrong conclusions. And make the wrong decisions.


In short, fear the virus, but don’t fear the numbers. It’s our fear of numbers that gets us into our messes. It’s a respect for the numbers that can get us out.


To learn more about the science behind these perspectives, learn about the availability heuristic here, how stories reinforce memory here, and about how our memories can fail us here. And to learn about biases that can happen when you neglect the laws of probability, look here.

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