Understanding Covid-19 Vaccine Hesitancy

Covid-19 Vaccine Hesitancy:

The Causes &

Consequences of Risk (mis)assessment

  • In Australia, if infected with Covid-19 we have a 1 in 82 chance of dying (Sept ’21 data).
  • Should we survive, up to 40% of us will experience long-term health effects from Covid-19. 
  • The long-term effects of Covid-19 include: Breathlessness, hearing and eyesight problems, Chronic-Fatigue symptoms, muscle weakness, pulmonary scarring, and organ damage (including kidney, heart and brain damage).
  • Documented mental health problems post-infection include struggling to think clearly (brain ‘fog’), depression, anxiety, and trauma symptoms.

Overview

There are a wide variety of reactions to COVID-19 pandemic ranging from fear and mistrust, to anger and denial, to grief, concern, and acceptance.

Sadly, we are all faced with the dichotomous forced-choice to either be vaccinated or to risk becoming infected with COVID-19 at some point. In addition, many employers are now also requiring their employees to vaccinate in order to keep working. Understandably, certain people can feel particularly ‘stuck’ or triggered by situations such as these, which seem to involve a ‘forced-choice’.

With the increase in cases of COVID-19 and the ever-growing spread of misinformation (and disinformation) across the internet, it is important to inform yourself with clear and reliable information concerning decisions around the COVID-19 vaccine.

The aim of this page is to deepen your knowledge about the facts concerning the vaccine, including the risks (vs benefits), the longer-term outcomes (of Covid-19 vs being vaccinated), and the consequences of risk (mis)assessment should you choose to not get vaccinated.

It is also hoped that the information here will help you (and your loved ones) be more discerning and better able to understand the various psychological and behavioural reactions to COVID-19 vaccine information.

The information here was last updated Sept 18th 2021. Links to all figures discussed will take you to the official pages where you can get real-time data, should you require it. 

Warning: These statistics are Sobering

Before we begin, it must be emphasized that the presentation of the following data is not to diminish the experiences of people who have lost lives due to vaccinations, or who may have had side effects due to having been vaccinated. If you are grieving the loss of someone because of this pandemic (regardless of the cause), or if you are struggling with vaccine side effects – or from side effects from Covid-19 – it is important that you consider getting professional support. All Australians are eligible for up to 20 Medicare rebates for psychology sessions (this also applies to Telehealth sessions). You can find out more about Medicare Rebates and Telehealth, here.

Risk of Death 

The following information was last updated on Sept 18th 2021:

  • Infected Australians have a 1 in 82 chance of dying from Covid-19 (official Data, here)
  • Yet, the number of deaths from the AstraZenica vaccine is less than 1 in 1 million (i,e., 9 deaths per 10.8 million doses, Data Source here).
  • So far, there are no deaths reported for Pfizer.

Nevertheless, based on this official data, we are 12,000 times more likely to die from COVID-19 than the AstraZenica vaccine (i.e., ‘1 in 82 is 12,195 times more than ‘1 in 1 million’).

Because infections are spreading so rapidly, if left unvaccinated, the likelihood of being infected with Covid-19 increases over time.

Sadly, of those who do survive, many will also be left with long-term side effects called ‘long covid’. We now know that even mild cases of Covid-19 can cause long-lasting symptoms.

Side Effects

Covid-19 vs Vaccine

As with any medication, certain people may experience side effects. Side effects are not kept secret. Rather, this information (like the leaflet that comes with any medication that we are prescribed) is always publicly available.

Whereas the side effects from Covid-19 affect up to 40% of people and may be permanent (this will be discussed later), most of the reported side effects from the Covid-19 vaccines are short-term and typically pass within a few days.

It is well-known that most of us are horrendous at calculating our own personal ‘risk’, accurately. Therefore, the data presented below come from the Australian Therapeutic Goods Administration’s COVID-19 Vaccine Weekly Safety Report. This report contains the most up to date information in Australia (Weekly reports are available, here).

According to the TGA’s Covid-19 Vaccine Weekly Safety Report dated 12-09-2021:

  • Approximately 22.8 million doses of Covid-19 vaccines have been administered in Australia.
  • The number of blood clotting side effects from the 10.8 million AstraZenica doses was 134 (which is less than 1 in 80,500).
  • Side-effects for Pfizer are slightly lower than for AstraZenica, but until recently, Pfizer has been in limited supply.

Importantly, when compared with the risks of blood clotting from other common behaviours, the risks of blood-clotting side effects from the vaccine are extremely low. To put it into perspective, compare the risks of blood clotting from AstraZenica (1 in 80,500) with the risks of blood clotting from other behaviours many people commonly engage in:

  • Flying: The incidence of Deep Vein Thrombosis (DVT) is 1 in 1,000, but this increases up to threefold on flights longer than three hours.
  • Contraceptive Pill: Women who take the contraceptive pill (1 in 1000 risk)
  • Tobacco smokers: Many more health risks than side effects from any vaccine
  • Obesity: People who are obese are more than twice as likely to develop a thrombus (blood clot in the leg) compared with people with a healthy weight.

Given everybody’s lifestyles and medical histories are different (e.g., some people may regularly smoke, may drink alcohol, may be obese, or may have pre-existing medical conditions that may / may not require a concoction of medications), questions regarding how any medication may affect your health should ultimately always involve a discussion with your trusted GP. Nevertheless, the above comparisons certainly put the risks of AstraZenica side effects into perspective.

Finally, consider the risks of blood clotting if you become infected with Covid-19: 

Clearly, the risks for blood clotting from a Covid-19 infection (and its long term symptoms) are far greater than the risks from either of the vaccines. 

Vaccine Myths Busted

Long Term Effects: Vaccines

You may have heard the false claim that: “we do not have enough long-term data about the Covid-19 vaccines!”

This is a dangerous myth based on some very incorrect information about vaccine development and testing research. This piece of misinformation is unnecessarily causing fear that may drive people to make life-threatening decisions. It also overlooks how vaccines work on the immune system (which operates extremely quickly, to keep us safe). This will be discussed later, but first – let’s examine the facts:

We rarely ever have over 6 months of safety data on any vaccine before it is released to the public (in fact, the average time is typically 1.5 months).

  • A major study looking at all FDA-approved vaccines between 1 January 1996 and 31 December 2015 (57 Vaccines in total) found that the average (i.e., median) safety follow-up of all FDA-approved vaccines was just 5 months (View this research here.)

Yet, with the Covid-19 vaccines, Pfizer’s phase-three trial of its COVID-19 vaccine ran for approximately four months (here) and AstraZeneca’s ran approximately six months (here). Both timeframes fall within the same range as the 57 FDA-approved vaccines that were examined in the study discussed above.

  • In Australia, we have over 6 months of data from the 3.4 million people surveyed since Feb 2021 (this Data is released monthly and is publicly available, here).
  • Across the World, we have now passed 18months since the first dose and almost 6 billion doses have been administered Worldwide (Data Source here).

Therefore, we have more long-term data on the COVID-19 vaccines than any other vaccine in history.

This myth is BUSTED (!)

Inflated Death Statistics

Although the total number of confirmed deaths across both AstraZenica and Pfizer is 9 in 22.8 million doses (which is less than 1 death per 2.5 million doses), you may hear some people misquote this information. For example, people skeptical of the TGA’s classification of these deaths argue that there is a ‘cover-up’ by the TGA and that the true number of deaths should be the ‘535’ figure.

This may be because in the Weekly Safety report the TGA state that “So far, the TGA has found that 9 reports of deaths were linked to immunisation from 535 reports received and reviewed”. However, even when we re-run the analysis using the ‘535’ figure as the number of deaths (i.e., 535 deaths from 22.8 million doses), we are still much safer to get vaccinated than to remain unvaccinated, even when the deaths rejected by the TGA are included in these calculations.

To illustrate this: At the time of writing, the risk of dying from Covid-19 in Australia is 1 in 82, whereas the risk of dying from the vaccine based on the 22.8 million doses administered in Australia (using the ‘535’ figure) is 1 in 42,616. The math calculations are as follows: Risk of death using the ‘535’ figure based on the number of doses given is 22,800,000 / 535 = 42,616 (or ‘1 in 42,616’).

Based on this higher death rate figure, it is still over 500 times safer to get the vaccine (the math calculations are as follows: 42,616 / 82 = 519). In other words, we are still 519 times more likely to die from Covid-19 than any vaccine, when using this figure. Perhaps the official data should be expressed this way (?).

Please note: The presentation of the data above is not to diminish the experiences of people who have lost lives or who have had side effects due to having been vaccinated. If you are grieving the loss of someone who has been lost to during this pandemic (regardless of the cause), or if you have struggled with vaccine side effects – or from side effects from Covid-19 – it is important that you consider getting professional support. All Australians are eligible for up to 20 Medicare rebates for psychology sessions (this also applies to Telehealth sessions). You can find out more about Medicare Rebates and Telehealth, here.

Immune system

mRNA Vaccines & the Immune System

Researchers have been studying and working on developing mRNA vaccines for decades (for flu, Zika, rabies, and cytomegalovirus) and more recently, mRNA medicines have been used to trigger the immune system by Cancer Researchers to target specific cancer cells (multiple sources: here).

mRNA vaccines work by triggering an immune response, by teaching our cells how to make a piece of protein that triggers an immune response inside our bodies. This immune response, which produces antibodies, is what protects us from becoming infected if the real virus enters our bodies.

Our Immune System is our first line of defense against germs entering the body. It responds very quickly. For instance, bacteria that have entered the skin through even a small wound are detected within a few hours (source: here).

Because mRNA vaccines work on the immune system, any side-effects we may experience will also happen very quickly. Thus, rather than experiencing side effects months or years after receiving the vaccine, we know that the most common time period for onset of any serious symptoms is within the first 30 days after vaccination.

In other words, any side effects will be experienced soon after the vaccine (within weeks, not within years) and this is because mRNA vaccines work on the immune system, which (because it functions to protect us) works very quickly.

However, in contrast to the vaccine side effects (which are rare, and they pass over time), if Covid-19 has beaten the body’s immune system there are often negative long-term side effects even when our infection is mild. These negative long-term effects are referred to as ‘long covid’.

Long term side effects from Covid-19: ‘Long-Covid’

Sadly, many who are lucky enough to survive a Covid-19 infection, are likely to suffer long-term side effects (‘long-covid’). Unfortunately, there are still many ‘unknowns’ about how to treat these side effects and whether they can be completely resolved. In other words, Covid-19 may cause permanent damage to various physical systems.

For instance, a recent study of over 1100 French Covid-19 survivors found that over a quarter of participants were still experiencing 3 or more symptoms 6 months after recovering from Covid-19 (!).

Long-term Covid-19 symptoms include:

  • Unexplained symptoms and skepticism from peers (often leading to emotional isolation and risk of anxiety & depression, here)
  • Breathlessness caused by pulmonary scarring (Source: here)
  • Muscle weakness and joint pain (Source: here)
  • Brain ‘fog’ & Chronic Fatigue-like symptoms (Sources: here and here)
  • Heart, brain, and other organ damage (Sources: here and here)
  • Depression, Anxiety and Post-Traumatic Stress Disorder are common long-term consequences of ‘long covid’ (Source: here)

The first Australian study looking at the long-term effects of COVID-19 has published interim results. It found 40 per cent of the people in the study had persistent symptoms two months after infection (Source: here).

One study of COVID-19 patients who were followed for up to 9 months after illness found that approximately 30% reported persistent symptoms (Logue et al., 2021).

Images like the one below (which represents data from 921 participants, taken from Proal & VanElzakker, 2021) are emerging from studies of different populations worldwide, and are easily found by searching  ‘the effects of long covid’:

Long Covid

Take away messages:

  • Covid-19 can cause long-term side effects in up to 40% of people.
  • There may not be treatments available for the damage caused by Covid-19.
  • The mental health toll of long-covid can include depression, anxiety and post-traumatic stress symptoms. 
  • Some post-viral symptoms may be permanent.

Benefits of Vaccination

Vaccination has long been the most effective way to protect against infectious diseases. Although no vaccine can ever provide 100% protection, overall, we know that the outcomes for those who are fully vaccinated are far superior to those who are not, for both the primary Covid-19 infection and any ‘long-covid’ symptoms.

Vaccine Reality Check: Even if fully vaccinated, we can still become infected with Covid-19 (eg, here). But the symptoms are generally more mild and your health outcomes are far greater if you are vaccinated (here). In other words, vaccination not only reduces the risk of infection and severe symptoms, but significantly cuts the odds of experiencing long-term effects if you’re one of the few who experience a breakthrough infection (here).

Below are some of the benefits of the Covid-19 vaccine (Note. We are not ‘Fully vaccinated’ until 2 weeks after we receive our second dose):

  • Even after a single dose, we are less likely to require emergency hospitalization if we contract Covid-19 (here).
  • Unvaccinated people who already had COVID-19 are more than 2 times as likely than fully vaccinated people to get COVID-19 again (Source).
  • When fully vaccinated, we are over 80% less likely to be infected (here), and the severity of infections are more mild (here).
  • When enough people in the community are vaccinated, it slows down the spread of disease (here).
  • Fewer transmissions mean fewer mutations: Because viruses mutate each time they are passed on, newer strains may emerge over time. This is one reason we will need a ‘booster shot’ (i.e., the faster we are all vaccinated, the faster we can stop the spread because fewer transmissions mean fewer mutations).
  • Vaccination is not just about protecting you it is about protecting everyone (particularly your loved ones and the vulnerable people in your community such as your parents, the ageing, and people who are immunocompromised).
  • The sooner we are vaccinated, the sooner we can resume normal activities and reduce the social and psychological burden that we are all experiencing.

Yet, despite these benefits – why are small numbers of people still ‘unsure’ about (or ‘resistant’ to) the longer-term benefits of being protected with a vaccine?

Vaccine Hesitancy: The Causes

The Psychology of Fear, Anger and Denial

Nobody wants a Pandemic. Aside from the growing numbers of deaths, the social and psychological burdens caused by the restrictive nature of lockdowns combined with the uncertainty of Governments (who often appear to be in panic-mode themselves), and the burden of misinformation and News ‘sensationalism’ across the internet, are immense.

However, these pressures affect people very differently. Here are some reasons why: 

Echo Chambers

Unfortunately, the internet is not what it appears to be. Due to algorithms designed to ‘test’ and learn about our online behaviour (primarily for marketing purposes, because that is where the big money is) we are each carefully ‘fed’ a unique version of the internet whereby any content that we ‘click’ on or ‘like’ then shapes all future content that we are likely to see.

This creates a phenomenon known as an ‘echo chamber’ whereby what we see is becomes filtered in very narrowed in ways that cut us off from information outside of the things that we typically ‘click’ on. This creates a ‘bubble’ or a bias in the information we are exposed to (e.g., we will see more of the ‘same’ information, and we will see more of the ‘feeds’ of like-minded peers than people who we know but who do not share our views).

This is easy to spot – on YouTube, algorithms ‘suggest’ videos that we might like to watch: Click on a few videos of ‘dogs chasing balls’, and soon we will be ‘fed’ videos about ‘dogs and balls’. For instance, machine-learning algorithms may suggest videos about Dogs (dog food, dog fights, dog clothes etc…). And we may also be ‘fed’ suggestions to watch videos about Balls (Football, Soccer, Basketball etc…). We may also start to see advertising about ‘Dog Toys’ or ‘Pet Shops’ appear across other apps and webpages that we use.

This is not new. However, this process is the same process that fuels misinformation across social media.  When we ‘like’ a friend’s MEME or post, we are more likely to be ‘fed’ similar posts by that person (and similar posts from similar people / interest groups). In this way, we are ‘fed’ a version of the internet that is hugely influenced (but also constrained) by our own past browsing behaviour.  This can create many Cognitive Biases (discussed later).

Whereas previously believing the earth is flat or that Bill Gates wanted to microchip the entire world would have been very socially isolating … now social media can instantly find us thousands of like-minded people who are eager to reinforce and exacerbate our misguided views.

Due to sophisticated machine-learning algorithms if we search for ‘dogs playing with balls’ we will see an increase in suggestions for similar content:

Echo Chambers & YouTube algorithms

Misinformation & Disinformation:

Most people who use the internet do not know the difference between Misinformation and Disinformation. Yet, we are exposed to both on a near daily basis.

Misinformation is: misleading information created or shared without the intent to manipulate people. An example would be sharing a rumour or meme that a celebrity died, before finding out that it was false. This happens daily on social media via memes, posts, and videos on Facebook, Twitter & YouTube.

Then we have disinformation: Disinformation refers to deliberate attempts to confuse or manipulate people with dishonest information. This can happen overtly (e.g., Donald Trump is a primary example of someone who has been caught out many times for spreading both misinformation and disinformation), but this can also happen covertly via coordinated attempts across multiple ‘fake’ social media accounts through the use of automated systems, called ‘bots’ (eg, Search on Google for ‘Twitter + bots + COVID’ and see how widespread this actually is. You can view the results for this search, here).

However, it is important to understand that disinformation can turn into misinformation when spread by unwitting readers who believe the material, which they then share to trusted friends and wider shared social networks. This then becomes part of the feedback loop that becomes amplified within the Echo Chambers of the individual’s online user experience (discussed above).

These forces (i.e., Echo Chambers, Misinformation, and Dis-information), in combination with the complex financial and political agendas of News companies, Advertisers, and Mass Media (who all pay top dollar to be part of our ‘feed’) leads to a second problem: Cognitive biases.

Cognitive Biases

Cognitive Biases  

Humans are not perfect – our brains have been shaped by evolutionary pressures to favour speed and efficiency over accuracy. With this, comes many shortcomings and errors in perception. The most common types of these errors are referred to by Psychologists as ‘Cognitive Biases’.

Cognitive Biases are ‘errors in perception’ that result from the reality our brains create by taking mental shortcuts to simplify information processing and to provide us with answers FAST.

There are literally dozens of types of cognitive biases. In people who are experiencing depression or anxiety, people often display common cognitive distortions including ‘catastrophizing’, ‘personalising’, ‘overgeneralizing’ (all common in depression) and ‘what iffing’, ‘mind reading’, ‘emotional reasoning’, and ‘predicting the future’ (all common to both depression and anxiety).

In terms of COVID-19 and the enormous job we all have of trying to process the ever-growing mass of information, there are also many other cognitive biases at work (there are in fact several dozen – too many to list).

However, below are four cognitive biases (with examples) to demonstrate how they interact and shape our perception and behaviours around about Covid-19. As you read the following examples, think about how these biases are triggered by information you may be exposed to in your online experiences:

#1: Availability Heuristic

This is our tendency to use only information that comes to mind quickly and easily when making decisions about the future (this often happens without our awareness).

When making a decision, the availability heuristic feels like it is making our choice easier… However, the availability heuristic challenges our ability to judge accurately the probability of certain events, as our memories may not be realistic models for forecasting future outcomes. Although many of us do this in small amounts, think about how ‘clouded’ and influenced your decisions might be if they are based on just the information that you can most easily bring to mind (!). In terms of COVID-19 vaccine information, you may spot this bias in people who are ‘stuck’ on thinking about the times in which other vaccines have cause side effects or medical complications (vs the facts supported by official data such as those presented here, for instance).

#2: Confirmation Bias

The confirmation bias describes our underlying tendency to notice, focus on, and give greater credence to evidence that fits with our existing beliefs. People often do this with emotions like fear and anxiety (e.g., ‘I feel anxious, therefore something bad will happen’).

The biggest downside to this bias is that it leads us to ignore information that discredits our previously held views (even when these views are simply wrong!). In the context of COVID-19, this bias can lead a person to ignore the copious research and evidence underscoring the value of vaccines, and instead focus on any evidence that supports what they believe in order to feel better about their decision. The Confirmation Bias is a form of ‘mental filter’ that is also shared by people who are experiencing psychosis (and is common across many other mental health difficulties).

#3: The Illusion of Explanatory Depth (aka: ‘Dunning–Kruger effect’)

“Do you know how COVID-19 vaccines work?” People often falsely believe that they understand more about the world than they actually do. They overestimate how much they know about inherently complex and ostensibly simple phenomena. It is not until they are actually asked to explain a concept that they come face to face with their limited understanding of it (their gaps in knowledge).

Regarding COVID-19 vaccine information, if a person believes they possess the knowledge of experts, then there is little reason for them to update their beliefs in response to an expert opinion. However, we can often gently reveal this illusion by asking: ‘can you please explain how COVID-19 vaccines work’?

This also extends to the ‘research’ that people ‘claim’ they may have done – whereas in fact learning how to do medical research correctly requires years of methodical study, a nuanced understanding of research design and statistics, and thousands of hours of practice (and often post-graduate university studies, such as the completion of a PhD).

The phenomena that people with low ability tend to overestimate their own ability is called the ‘Dunning-Kruger effect’ and it has been demonstrated across many areas of life ranging from driving ability to sporting performance to aptitude / intelligence. Regarding Covid-19 vaccine hesitancy and assessing ‘risk’, people risk taking their own lives into their own hands by overestimating their capacity to sift through disinformation and misinformation, while also being able to conduct high-level medical research and arrive at trustworthy conclusions (despite no prior medical training, or formal research experience).

#4: Cognitive dissonance

Cognitive dissonance is the uncomfortable threat-based feeling that occurs whenever we experience conflicting thoughts or behaviour. In order to ease our discomfort, we are driven to either change our behaviour or change our belief system.

With Covid-19, we are faced with a forced-choice to vaccinate or to risk being infected and this can be uncomfortable for many people (for many reasons, discussed later). Yet, this can often result in the reluctance to accept expert medical and scientific findings (or to seek ways to refute / deny the best medical advice) because the discomfort we feel about having to make this ‘forced-choice’ creates too much psychological discomfort.

For example, imagine a parent who hears about the effectiveness of vaccines, but who may also worry about a risk of harm to their child. In order to eliminate the dissonance that they feel about having to make a decision they do not want to make, they may decide that ‘vaccines do not work’ .

This would be an example of making a decision, in an attempt to resolve / reduce cognitive dissonance. When we do this, it often also leads to use many other biases discussed above to justify our position.

Although all biases lead us to adopt incorrect conclusions, choosing to believe them makes us feel better about our choices. This applies specifically to choosing to not vaccinate, when the reason is purely to reduce immediate feelings of anxiety about receiving the vaccine. Sadly, this leads to yet another common error (Emotional Reasoning): ‘I feel good about my choice, therefore I am correct’.

Brain Scan Research: Findings From Neuropsychology

Although it may not surprise you to hear that people often discount evidence that contradicts their firmly held beliefs, you may be surprised to learn just how powerful (and reactive) these processes can be.

Sometimes, exposure to counterevidence may even inadvertently increase our confidence that our most cherished beliefs are true (!).

Researchers are now beginning to understand the neural mechanisms involved in maintaining a belief—even in the face of counterevidence. A recent fMRI brain scan study presented participants with information that challenged their previously held political views, to see what affect this had on their brains.

Results (presented below) highlight just how much emotion is intertwined with belief-change resistance. When we are presented information that challenges beliefs we hold strongly, there is more activation in the parts of the brain that are correspond with negative threat-based emotions (the Amygdala and limbic system), and self-identity (the Default Mode Network).

Essentially, this means that when we identify with something (and worse, when we over-identify with it) we become biologically motivated to GUARD and PROTECT it, as if it is ‘ours’. This also extends to our beliefs. 

This is especially true for views that we arrive at via information that we have actively sought (even if this information is based on misinformation). Unfortunately, the more we invest in developing / supporting a particular viewpoint, the more we become biologically motivated to protect it.

In combination with cognitive biases, the desire to protect / defend our beliefs can push us to the extremes of these beliefs, even if the rationales for these beliefs can become absurd (and can lead us to experiencing anxiety, denial, and conspiracy beliefs). These processes are also common in psychosis (and many other mental health difficulties).

If interested, you can read the entire study here (an external link).

Denial & Conspiracy Beliefs

A Sophisticated Protective Mechanism

Denial is a form of emotional minimization and avoidance. It occurs when we refuse to accept reality or facts. Denial temporarily reduces anxiety-producing thoughts and feelings related to internal conflicts and outer stressors, because by blocking external events or circumstances from our minds, we do not have to deal with the emotional affects.

Denial is a complex protective mechanism that attempts to ‘help’ us to avoid painful feelings or events. Denial is one of the most common subconscious defence mechanisms and is common to both trauma and people who hold conspiracy beliefs.

‘Conspiracy beliefs’ meet important primal psychological needs such as ‘the need for security’, ‘the need for freedom of choice’, and ‘the need for control’. Sadly, people who do not know how to meet these needs (which includes being able to self-soothe well, and to reassure one’s self when anxious, angry, or distressed) are often those who are the most susceptible to relying on defense mechanisms, denial, or turning to conspiracy beliefs to restore the subjective ‘sense’ of security, choice, and/or control.

Denial can be rewarding, which (like online echo chambers) creates a feedback mechanism that reinforces the denial. For example, a person who lacks security and control may feel relieved if they are led to believe that they possess knowledge that other people do not have (i.e., this leads to tunnel-vision in seeking information that supports the conspiracy belief).

Ok – so what are the origins of these insecurities?

Risk Factors: Childhood Insecurity & Adversity

Attachment Experiences

We know from decades of attachment research that early experiences between a child and its primary caregivers can directly affect brain development. This is because the quality of the ‘bond’ between children and their caregivers (i.e., especially within the first 7 years of life) shapes their capacity for emotional regulation, their view of Self and others, and their general sense of Safety in the world. These factors are well-known to effect our brain’s development and our early attachment experiences can continue to influence us across our lifespans. 

Because our early Attachment experiences strongly shape how we develop (or do not develop) emotionally into adult hood, Attachment strongly influences the partners we choose, how well we self-soothe, how we cope with setbacks and adversity, and how ‘safe’ we feel in this world. Thus, our early attachment experiences either are an asset, or a vulnerability.

For example, a parenting style that is warm, nurturing, engaged, and supportive, will typically foster the development of a more resilient child than (say) a parenting style that is authoritarian, coercive, cold and punishing. Over time, these prior experiences directly relate to how we perceive ‘safety’ as adults, and how we learn to meet our needs for ‘security’, ‘autonomy’ and ‘control’.

Not only is it true that Attachment science is one of the most researched and well-understood areas within psychology, but the effects of our childhood are so far-reaching and are so fundamental to the development of our psyche that researchers can even predict (with high accuracy) our attachment style based on the contents of our dreams, alone. If interested, I strongly recommend reading the article I have written about attachment, here.

In terms of belief in Conspiracy, a common misconception is that people who are more likely to hold conspiracy beliefs are simply ‘uneducated’ or ‘stupid’. However, recent Attachment research has found that people who are higher in attachment anxiety are more likely to show a tendency to endorse conspiracy beliefs. Importantly, this finding held true even among highly prolific academic workers (i.e., people that many of us would otherwise consider ‘highly educated’).

Attachment

Perceptions of Control, Punishment & Coercion

Sadly, we know that pandemic and associated social distancing measures may contribute to heightened fear experiences. This can cause viewing others as ‘potential threats’ or in us viewing ourselves as being potentially ‘dangerous’ to others (Schimmenti et al., 2020). Understandably, this can lead to an increase in paranoia and conspiratorial thinking (Larsen et al., 2020). But who is at greatest risk?

People who have had the fortune of nurturing, secure early attachment experiences, are more likely to trust in authority figures—whether they be people from the medical profession, government figures or epidemiologists—and therefore understand (vs resist) the reasoning behind lockdown measures and the need for vaccinations. Thus, rather than seeing those measures as punishing or as part of a conspiracy against them (and/or society), they can adapt to the challenges of the Covid-19 situation with (relative) ease.

However, for many adults with unresolved childhood attachment wounds (which include abuses of trust by powerful adults who did very harmful things to them), any situation that triggers either the need for ‘safety’, ‘security’ or ‘control’ may be experienced as deeply disturbing / triggering particularly if these ‘unresolved themes’ featured in their early childhood experiences with significant caregivers.

As a result, feelings of powerlessness, disillusionment and mistrust in authorities manifesting as conspiracy beliefs could in fact be construed as an understandable self-protective safety strategy (rather than being simply discounted as ‘irrational’, even if it is difficult to make sense of the reasoning or logic of a particular conspiracy belief).

This is much like a trauma reaction (‘it’s happening again!’), and this is completely understandable. For example: how we are currently confronted with a dichotomous choice either to choose between vaccines or to be infected by a potentially life-threatening virus during this global pandemic, on the backdrop of Covid-19 lockdowns, can all ‘feel’ punitive and uncaring; much like an authoritarian parenting style can feel harsh, restrictive, and inflexible.

In addition, for those of us who breach mask-wearing requirements and/or stay-at-home-orders, there is the ever-present threat of financial ramifications (fines / court appearances). Any of these situations could understandably trigger unresolved adverse childhood experiences of ‘social safeness’, ‘control’, ‘authority’, ‘freedom’, ‘safety’, ‘powerlessness’ or ‘trust’.

Early Attachment experiences can create vulnerabilities that can be triggered by atypical situations such as these, and this can lead to the development of conspiracy beliefs as a protective mechanism among vulnerable (and wounded) people. For people who have had regular and ongoing adverse childhood experiences, such as authoritarian parents and/or emotionally absent caregivers, the result of unresolved attachment wounds can become a significant scar that affects a person’s sense of social ‘safety’, an inability to self-soothe, and being perpetually stuck in primal threat-based pattern of attack, avoid or shutdown when triggered.

Instead of being able to appreciate the public safety implications, certain people (particularly those abusive experiences with parents and/or people in authority) are more likely than others to become ‘triggered’ and this can breed threat-based resistance that seduces the brain into using Cognitive Biases as a coping strategy. This is no-one’s fault, it is simply how we are wired. But it is our responsibility to learn about our own make-ups, so that we can heal ourselves from the influences of our past and respond to unpredictable, ever-changing situations (like the pandemic) with flexibility.

Toxic Parenting Styles

We are all faced with a choice to either ‘be vaccinated’ against or ‘risk becoming infected’ with a virus that nobody wants. Yet, we did not choose this.

Equally, we did not choose our parents or families or our early childhood attachment traumas. If we become easily triggered by themes that relate to ‘safety’ or ‘control’, it is our responsibility to look at our own childhood experiences of these themes.

For example, consider how the following parenting styles might make you feel if you were a 10-year-old child. How safe would you feel? How much choice and control would you feel?

  • Demanding compliance / obedience without question (children must listen and agree no matter what).
  • Disciplining via punishment (e.g., Being punished for having feelings vs receiving emotional support)
  • Parents who constantly put their needs ahead of the child’s, such as parents who withhold love when their children are not meeting their expectations.
  • Parents who believe in total control over their children, both behaviorally and psychologically. Kids are expected to obey parents without question (e.g., they use “Because I said so” to explain limits).
  • Parents who punish out of anger (thereby teach emotional dysregulation vs teaching how to self-regulate).
  • Parents who force the child to choose between two aversive choices (e.g., “either you can a ‘smack’ or you can miss out!”)
  • Parents who belittle or ignore their children’s emotions, behavior, or activities (do not show interest in their child) or who do not set limits or boundaries.
  • ‘Tough love’ (cold, non-nurturing and harsh parenting, including strict rules and/or impossibly high standards).
  • Do not allow independence. One-way communication (Children’s opinions / emotions are not heard or allowed)
  • Controlling or over-protective parenting (rigid and inflexible)

Events in early childhood can create significant vulnerabilities that can leave certain people open to being highly triggered by the uncertainty of the current global pandemic. Unresolved triggers can lead to threat-based conclusions, which are experienced as an aversive situation requiring our immediate attention. This gives rise to the Cognitive Biases (previously discussed) which favour speed over accuracy, to help us resolve how we are feeling.

We also need to keep in mind that so many of our beliefs and actions are ‘shaped’ by not just the past, but also amplified by our online experiences. The internet is cleverly designed to manipulate people for financial and political reasons (via sophisticated machine-learning algorithms that give rise to Echo Chambers) in ways that exploit ancient psychological weaknesses (i.e., processes that favour speed over accuracy and which give rise to Cognitive Biases). It is not our fault, but it is our responsibility to do something about it – to learn about ourselves, our biases, and to heal our wounds so that we can feel empowered by the choices that we make.

Unresolved Traumas & Lived Experience

Another understandable source for vaccine hesitancy is when we have lived experience (by either witnessing someone close to us or by having direct experience) of instances where medical advice – or care – was incorrect or even harmful.

It makes sense (even from an evolutionary perspective) that after the disappointment (or even trauma) of a negative experience, that someone would learn to be cautious and on-guard about accepting help in the future if previous experiences of help were not ‘helpful’ (or were even harmful).

Unfortunately, unresolved past traumas can affect us by feeding into present day (and future) triggering situations. We can develop protective defenses that (although they are trying to do their best to protect us) can sometimes prevent us from making important decisions that we need to make to receive the help that we need.

If this resonates for you (or for someone you know), it may be useful to consider working with a trauma-informed Clinical Psychologist in order to help you process the pains of your past so that you are no longer triggered by the present.

Trauma - Gabor Mate

‘Force-Choice’: Mandatory Vaccination 

Many employers and industries now require that their workers be fully vaccinated by a certain date, else they cannot continue working.  In addition, once we all return to life after lockdowns, many businesses will require, from their patrons, evidence of vaccination. Again, if you are someone with a traumatic childhood involving a parenting style that demanded compliance, these requirements may feel coercive (and may trigger issues some people have around ‘control’).

However, most people who take issue with these new requirements fail to appreciate that healthcare employees Australia-wide have always been required to have their vaccination records up-to-date before they can work in a hospital / health care setting. This has been the case for decades.

For example, besides the Covid-19 Vaccine, NSW Health requires ALL HEALTHCARE WORKERS to be vaccinated (with up-to-date booster shots) and/or screened for the following diseases: diphtheria, tetanus and pertussis, hepatitis B, measles, mumps, rubella, varicella, tuberculosis and influenza.

This has never been about ‘control’. Rather, this is to help minimise the risk of transmission of vaccine-preventable diseases to the public (i.e., YOU!). Again, this has been the case for decades. (If you are interested, you can read a document by NSW Health which outlines all of the infectious diseases that its health workers must be screened for, here).

Thank about this: Would you want to be treated by a doctor who may have diphtheria, tetanus and pertussis, hepatitis B, measles, mumps, rubella, varicella, tuberculosis and influenza… and/or Covid-19 ?

Death: The Risk of Denial

There have been many convoluted changes to the official Covid-19 recommendations and quite frankly, the public health messages have often been quite confusing. In addition, Australia’s vaccine rollout has been painfully slow and health messages around this have also been convoluted. But, this must not detract from the facts (already discussed).

Sadly, there will remain people who do not have access to quality information or who are so polarized in their cognitive biases that they are not helped by simply hearing the facts alone. Again:

  • We risk becoming infected with Covid-19 should we choose to not get vaccinated
  • The likelihood of long-Covid is as high as 40%

Given Covid-19 kills 1 in 82 Australians (according to cumulative deaths data, accessed Sept 18th 2021), once we have achieved 70-80% vaccination in the population, one thing is very clear:

  • Once the lockdowns lift and we all resume our usual activities, those who have not been vaccinated will be at the greatest risk of infection since the start of the Pandemic.  

For some people, denial may ‘feel’ like it provides ‘certainty in uncertain times’. However, the only certainty that denial ensures is risking becoming infected with Covid-19. Unfortunately, this will inadvertently lead to further uncertainty (because the risk of ‘long-covid’ is an outcome for which there are no effective treatments).

There are many reports of Covid-19 ‘skeptics’ who unfortunately fall victims to their own denial. For example, Mohammed Shaar (a Muslim preacher and natural healer), had spent weeks preaching that Covid-19 vaccines were ineffective and that the pandemic was a myth. Yet, he became infected with Covid-19 in late August 2021 (Source here).

Shockingly, one of his devoted followers (likely in denial himself) suggested that he drink hot water with ‘lemon’ to treat his Covid-19 infection (!).

Similarly, in September 2021 a TikTok personality (who was charged after speaking at an anti-lockdown protest in July) found himself in hospital with COVID-19. If interested, you can read that story in full, here.

Unfortunately, for certain people the consequences of denial can be fatal:

“Their last dying words are, ‘This can’t be happening. It’s not real.’ And when they should be [spending time]… Facetiming their families, they’re filled with anger and hatred.”

This quote is from Emergency Nurse Jodi Doering, who in 2020 went public about Covid-19 patients who tragically were still in denial even as they are dying:

Summary

  • We are all faced with a ‘forced-choice’ to either get vaccinated or risk being infected (and risk ‘long-covid’ symptoms)
  • This can trigger for many people, for many reasons. However, most people overlook the impact of unresolved past adverse childhood experiences, which often related to our relationships with our primary caregivers (i.e., unmet Attachment needs).
  • The human brain has been shaped by evolution to react to threats very quickly (for survival) which results in us making decisions that favour speed over accuracy.
  • Unfortunately, this leads to a range of Cognitive Biases.
  • The information we are all exposed to is both politically and financially influenced (which is particularly true for News information).
  • All of our online experiences are constantly being ‘shaped’ by AI algorithms that ‘feed’ us a unique version of the internet that is heavily influenced by our own private browsing styles.
  • This results in Echo Chambers, which give us an unrealistic and an unbalanced ‘sample’ of the internet. This feeds Cognitive Biases, because it can lead us to false information and a ‘skewed’ version of all possible views, whereby we are more likely to see content and people’s views that are like our own. Remember: there is big money in ‘user retention’ (and no money in loosing users / viewers who leave a social media page because nothing they see interests them).
  • Sadly, many people have experienced (or have seen others experience) examples of help not being ‘helpful’. Often, these previous experiences can leave a scar – like a trauma does.
  • Unfortunately, unresolved past traumas can affect us by feeding into present day (and future) triggering situations.
  • It may be useful to consider working with a trauma-informed Clinical Psychologist in order to help you process the pains of your past so that you are no longer triggered by the present.
  • Although denial may ‘feel’ like it provides certainty, sadly, the truth is that denial ensures being infected with Covid-19, which will inadvertently ensure ultimate uncertainty (because the risk of ‘long-covid’ is an outcome for which there are currently no effective treatments).

Afterword / Postscript

The goal of this webpage was to present in the most accessible (but impactful) ways:

  • Simple facts about the vaccine
  • To weigh up the pros and cons of vaccination (vs no vaccination), and
  • To examine the psychological processes involved in vaccine hesitancy, misinformation, and denial.

Although these are huge topics (and I surely wanted to write more) I assume that because most people ‘scan’ vs read webpages, that any further depth or detail would have been unnecessary.

For instance, I omitted any discussion of the religious / ethical issues around vaccine development, and instead direct interested readers to the following peer-reviewed article.

Second, I also omitted any discussion about potentially dangerous experimental drugs like Ivermectin, because the FDA, the Royal Australian Collage of GPs, and the TGA are all quite clear about it already (e.g., here, here, here & here). Essentially, Ivermectin is not FDA approved, it is not an anti viral medicine, it is toxic at high doses. The science and claims about it (that many people still misquote) were discredited in March 2021 which led to the journal “Frontiers in Pharmacology” removing the manuscript. Their official published statement was: “Frontiers takes no position on the efficacy of Ivermectin as a treatment of patients with COVID-19, however, we do take a very firm stance against unbalanced or unsupported scientific conclusions.”

Until we actually have a large body of credible peer-reviewed research, consider echo chambers, misinformation & disinformation, and unresolved anxieties about vaccination as the main reasons behind any hype around Ivermectin (and any other experimental ‘solution’). 

Long-Covid in Breakthrough Cases: 

I continue to have a professional interest in the data on ‘breakthrough cases’ and also ‘long-covid in breakthrough cases’, because these are contemporary issues that will affect us all in the post-pandemic future. But at the time of writing, these topics are currently at the ‘edge’ of our best medical data and more research needs to be done. Although these topics (again) exceed both the scope and the aims of this webpage, I direct interested readers to the following pieces (of which there are many more):

  1. A 2021 research paper that discusses how the human body harbors many viruses which are normally kept at bay by healthy immune systems. It discusses the possibility that what we are observing in long-covid ‘could’ actually be largely the result of Covid-19 breaking down our defenses to viruses for which many of us are already carriers (such as CMV, HSV-1, VZV, HHV-7, HPV, RNA and EPV, to name a few).
  2. An opinion piece in the New Yorker, by an assistant professor and practicing physician that weighs in on our current findings of ‘breakthrough cases’ and what this means about the efficacy of vaccines. It also discusses how the concept of breakthrough cases is misleading.  It is an interesting and well-researched piece. (If the concept of ‘breakthrough cases’ is new to you, know that the evidence that vaccines prevent severe Covid-19 remains both clear and encouraging with less severe outbreaks and fewer people requiring hospitalization.)

Finally, although I endeavor to keep this page current (particularly in terms of the statistics around ‘risk of death if unvaccinated’ and also the side effects from the vaccines using official Australian data), in case I have not updated these figures for some time – links to the official pages have been provided throughout this article so that the latest information can be easily accessed anytime.

If you (or a loved one) are struggling to understand the official Covid-19 vaccine facts and information, I recommend discussing any concerns you may have with a trusted GP or Psychologist. If you are feeling anxious or are noticing a decline in your mental health because of the current Covid-19 situation, a Clinical Psychologist should be high on your list of effective strategies. 

Equally, the presentation of the data in this article is not to diminish the experiences of people who have lost lives or who have had side effects due to having been vaccinated. If you are grieving the loss of someone who has been lost to during this pandemic (regardless of the cause), or if you are struggling with vaccine side effects – or from side effects from Covid-19 – it is important that you consider getting professional support.

With a GP’s referral and Mental Health Treatment Plan, all Australians are eligible for up to 20 Medicare rebates for psychology sessions (this also applies to Telehealth sessions). You can find out more about Medicare Rebates and Telehealth, here.

Further Resources:

Useful external websites & links:

The Dunning–Kruger Effect (brief animation):

A list of Cognitive Biases from Decision Lab

(Evidenced-based behavioural science applied to how people make decisions)

https://thedecisionlab.com/biases-index

Echo Chambers (Animation):

https://www.youtube.com/watch?v=Se20RoB331w

Echo Chambers (Peer-reviewed paper)

https://www.pnas.org/content/118/9/e2023301118

The Great Hack (Documentary):

A documentary about how our online behaviour is used by corporations to ‘feed’ us specific information designed to influence our behaviour. It uses the Facebook–Cambridge Analytica data scandal as an example of how our internet use still continues to be curated and manipulated by marketers today.

Digital Media Literacy

Digital Media Literacy’s Animations:

https://www.youtube.com/playlist?list=PLpQQipWcxwt9NUsBX4KpO4PwHMilgzEh1

Digital Media Literacy’s Articles:

https://edu.gcfglobal.org/en/digital-media-literacy/

Sam Harris: “A Contagion of Bad Ideas: A Conversation with Eric Topol”  (July 24th 2021)

In this episode of the podcast, Sam Harris (neuroscientist) speaks with Eric Topol about vaccine hesitancy and related misinformation. Eric Topol is a Professor of Molecular Medicine, and Executive Vice-President of Scripps Research. As a researcher, he has published over 1200 peer-reviewed articles, with more than 290,000 citations, elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine.

https://samharris.org/podcasts/256-contagion-bad-ideas/