Vaccine conversations -Am I a truth suppressor?

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Yesterday I published this article from Ash Cunningham in response to my article about Vaccine hesitancy and vaccine denial which Ash had prior sight of. I don’t want to prolong a debate but I did think it might be helpful to clarify one thing from the conversation and that might in turn help us to draw out some further lessons.

Ash’s primary concern is that fear of conspiracy theories/anti-vaxxers will lead to a refusal by those concerned to take the vaccine will lead to us refusing to report on and investigate possible side effects concerning the vaccine. Ash specifically aligns me with this fear and potential suppression of evidence.

The point here is that there clearly needs to be a large study done to assess the potential effects of the vaccine on menstruation. Dave worries that this would lend credibility to anti-vaxxers, no matter the results, and especially if the results showed there to be negative side effects.”

It’s this point that is important and I don’t want readers to come away with a wrong impression here. So to be 100% clear

I support research into potential side effects and I support sharing the results. I am not in the slightest bit worried that doing this would lend credibility to anti-vaxxers. That suggestion plays no part in my argument whatsoever.

I support careful and transparent research because I personally take medication for asthma meaning that unsurprisingly I have a vested interest in seeing the highest standards put into testing, double checking and clearly advising on any potential risks or side affects with medication.

Whether or not in this specific case there is a need for further investigation I’m not qualified to answer. There is the challenge of correlation when mass vaccinating a population. What those deciding whether or not further studies will be considering is whether or not the instances of reports of changes to cycles has disproportionately changed in relation to the normal experience of women. If 30,000 women are reporting a possible side affect, then that is roughly 0.1% of those vaccinated, so comparison figures would be needed for those unvaccinated and for a normal year without other factors such as the lockdown with its potential impact. If there are indications that it may significantly different then that should be looked at and particularly urgently as the vaccine is introduced to younger teenagers.

There are three aspects to such a study. The first is the level at which people report such a symptom. It would perhaps be helpful generally for everyone participating in the programme to be asked to log back any experienced side effects over a few months. This might function similarly to the ZOE COVID app which logs disease symptoms. 

Secondly, we would have to look at whether or not there are specific aspects of the treatment that are likely to affect periods, for example by disrupting hormones.

Thirdly, it is important to know not just the probability of a side effect but the actual risk nature.  The fear of course is that a side effect proves long term, debilitating, reducing fertility and even life threatening.

Ash helpfully points us to the problems with drug trials where according to author Caroline Criado Perez:

“When women are included in trials at all, they tend to be tested in the earlier follicular phase of their menstrual cycle, when hormone levels are at their lowest – i.e. when they are superficially most like men.”

Caroline Criado Perez, Invisible Women (2019), 204.

Getting drug trials right from the beginning matters. Following up on reports matters.

The evidence that I don’t take the position of suppressing truth for the greater good is found in my previous articles.  Writing on vaccination for children, I said. 

“It’s important to be clear that there are side effects and some of them are potentially serious including blood clotting (AZ) and myocarditis (Pfizer).”

Similarly in the article Ash responds to I give quite full list of reported and feared side effects. I’m not shy of naming them. I go on to say:

“As you read through the list, you will realise that some of those concerns have a level of legitimacy, they are based on evidence and reason. Others are a lot less credible and associated with an anti-vax conspiracy theory movement. So how do we respond to these concerns?”

My article specifically acknowledges that there are concerns based in reason and evidence and those not. I also argue that we should take time to respond to those concerns. In fact I went on to say that:

“You see, in the end, when it comes to our concern for the well-being of someone refusing the vaccine then it doesn’t really matter whether or not their concerns are legitimate or rational. In a sense they are all genuine concerns and they all have the same affect. The result is that some people don’t get the jab.  It doesn’t matter if you are not receiving the jab because you are worried about receiving the mark of the beast or because you are terrified of needles, the outcome is the same.”

In other words, what we do, true for those responsible for rolling out a vaccine programme, true for those in pastoral ministry, is that we listen to concerns, we check them for evidence. We treat worried people seriously and then we respond appropriately. That was indeed a point I made strongly in the initial article. Of course, it would play into the hands of anti-vaxxer conspiracy theorists if evety person who expressed concern or reported a side effect was dismissed.

But that’s the point. We distinguish between the anti-vaxxer, the concerned person experiencing or alerted to a side effect and the well meaning evangelical leader making a different point entirely. To challenge public figures, leaders, journalists and pastors on how we communicate in public and to call for care in that communication is not to silence or fail to listen to those with genuine concerns.

Ash says:

The alternative would require some line-drawing, if we are not to investigate serious effects of the vaccine on women’s periods then should we also not tell them that the needle might hurt lest we scare the poor dears away? The whole deal seems controlling at worst, condescending at best.

Well, yes it would be controlling and condescending. If that was what was being proposed.  In fact, I raised the example in the original article and said:

“To help on this, let me pick up on perhaps the least controversial of examples. I have a friend who is extremely fearful of injection needles.  They are very reluctant to go and get any vaccine.  Now, if I told them that they were being silly because injections never hurt, then I would be lying. Injections do hurt, and for some people more than others.  Yet, equally unhelpful for them would be a news media saturated with people recounting horror stories of how much their injection hurt then that would not help them. They needed the truth that needles hurt to be put into perspective.”

I do think that there’s a risk of correlation becoming causation in the example Ash cites and despite his dismissiveness of this point, yes it does matter. We are dealing with a fundamental principle in terms of the presentation of evidence. To be sure, if a scientist, doctor, lawyer or pastor were to spot a correlation, then they would be extremely unwise to ignore it. The problem comes when we simply smash the correlating evidence together and present it as seemingly linked. Indeed, the irony is that the BBC’s sticking together of reports risks leading to a presumption of cause in our minds, whether or not it is there.

The specific correlation/cause question here is whether news item 2 -reported changes to menstruation is leading to vaccine hesitancy among care workers. The reasoning seems to be as follows

  • There seem to be concerns about care workers not taking the vaccine
  • The majority of care workers are women
  • Some women are reporting a possible side effect from vaccination
  • Therefore, this side effect is a significant cause of vaccine hesitancy among care workers

Well, whilst more studies might be needed to see if the reported menstruation changes are caused by the vaccine, it is actually a bit easier to check potential cause and effect in terms of possible hesitancy here. That’s what we do when we see a possible correlation, we chase it up, we check it out.

As I mentioned in the first article, the vast majority of people in the UK have assessed evidence and got the vaccine, male and female.  The numbers from each gender are fairly evenly matched and if anything the gap in younger generations appears to have been weighted towards male hesitancy.

So, it’s worth being aware to the reasons why people might be reluctant to receive the jab where that hesitancy exists.  The best way to do that is to ask them – much better dare I say than us white middle class men deciding for them in our debates on our social media platforms.

Ash rightly highlights that the care sector is predominantly female but that does not mean that those hesitant to take the jab are hesitant because of one very recently reported concern, indeed one that rightly or wrongly doesn’t seem to have broken through and dominated.

I think it is worth noting that those within the Care sector also include many who are low paid, many from a variety of ethnic minority backgrounds and many whose experience of authority has not been great. There are also many from religious backgrounds too and paying attention to the narratives there is important not because a suspicion of authority is unreasonable -for many who have experienced the delights of our immigration and asylum system it is understandable.  But as I said, the only sure fire way of knowing what causes vaccine hesitancy is to talk to the hesitant. In the same way, for pastors to know what is concerning their congregation about particular decisions is to ask them.

As for the care sector, I cannot think of any worse a response than telling them that they are going to lose their jobs if they don’t do what they are told. We are already seeing the result of the Government’s heavy handed approach to jobs with shortages in other areas. However, it matters because we do want to see them vaccinated. There are benefits both to themselves and to those they care for from this.

So, I do believe that we should investigate, and we share all the facts truthfully.  At the same time, the primary point I was making in the previous article is that how we present things and context matters. That we need to take care in such things.

Indeed, here I think we have a helpful case study.  It’s clear from my articles that I don’t think we should control or suppress. Nor, do I think that the evidence from Faithroots is that I’m one for moral pragmatism. After all it would be strange wouldn’t it to think that the guy who is morally pragmatic to the point of wanting a cover up has actually given the person who disagrees with him free space on his blog? Some cover up! Some suppression!

I’m sure that Ash gets that and isn’t seeking to personally accuse. Rather, there is a level of hyperbole and personal focus in his description of me and my position that is a tactic sometimes used in debate, it’s part of the rough and tumble of the fray if you like. There are risks with such a strategy of course but at least in the context we are alert to what it is.

At the same time, through the knock about stuff, Ash is making a serious point that challenges me too. The risk is that without careful patient explaining (and even with it) that this is where my concerns and words might lead, just as I’m concerned about where his concerns may lead. The point cuts both ways. That’s how we learn and move forward as iron sharpens iron and so I’m thankful for his contribution.

The point though is the context.  And that really comes to the heart of my argument. My point in the previous article, as much as anything was that we need to be alert to the environment we are working in on social media where sadly there have been the two extremes polluting the discourse. On the one side we had the anti-vax/COVID deniers but there is the other extreme too which seems to believe that anything less than full and permanent lockdown is evidence that our governments are trying to kill us with the virus.  That polarisation and the agendas behind it doesn’t make healthy conversation easy but it doesn’t make it impossible either. 

That’s why we need to be careful in our conversation. It’s all about being alert to all those different narratives flying around.. Here’s the thing, the points Ash raised in his article are relevant regardless of whether or not there is a resulting vaccine hesitancy. They matter enough for us to not want them to get lost in some other unhelpful debate. You see it matters that women are properly listened to by doctors, that they don’t have to traipse around for years until they get listened to by a consultant who takes them seriously (assuming that does happen), that they can rely on medication to have been carefully and properly assessed.

It matters that they can know that they can walk home safely or exercise during a lockdown without the fear of a van driving up slowly beside them and it matters that they don’t have to worry about whether a policeman approaching them is acting legitimately or using his office as a pretext to inflict sexual violence.

The available evidence suggests that this specific issue isn’t a driver for vaccine hesitancy. It appears that the only correlation was the placing of two news stories side by side. But just because women are weighing up all the risks and making an informed decision to be vaccinated doesn’t mean that the issues raised about women, their health care, their saftey and their value goes away.

That’s why not conflating stories together on the basis of possible correlation actually matters because sometimes the stories are worth hearing in their own right.

So, keep the conversation going. Be alert to the experiences and concerns of people with the vaccine and be alert to the narrative we are swimming in. Seek truth and speak the truth in love. This applies of course beyond COVID.   

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