Relentless propaganda against public health measures no doubt contributes to erosion of trust. However, that mistrust may also be fueled by the sorry state of health insurance in this country and the deep inequities in health care — at a minimum, this could make people more vulnerable to misinformation. Research on the unvaccinated by KFF from this September showed the most powerful predictor of who remained unvaccinated was not age, politics, race, income or location, but the lack of health insurance.
The Covid States team shared with me more than a thousand comments from unvaccinated people who were surveyed. Scrolling through them, I noticed a lot more fear than certainty. There was the very, very rare “it’s a hoax” and “it’s a gene therapy,” but most of it was a version of: I’m not sure it’s safe. Was it developed too fast? Do we know enough? There was also a lot of fear of side effects, worries about lack of Food and Drug Administration approval and about yet-undiscovered dangers.
Their surveys also show that only about 12 percent of the unvaccinated said they did not think they’d benefit from a vaccine: so, only about 4 percent of the national population.
In law, “dying declarations” are given special considerations because the prospect of death can help remove the motivation to deceive or to bluster. The testimony we’ve seen from unvaccinated people in their last days with Covid, sometimes voiced directly by them from their hospital beds, gets at some of the core truths of vaccine hesitancy. They are pictures of confusion, not conviction.
One woman who documented her final days on TikTok described being uncertain about side effects, being worried about lack of F.D.A. approval, and waiting to go with her family to get the shot — until it was too late.
Or consider Josie and Tom Burko, married parents who died from Covid within days of each other, leaving behind an 8-year-old daughter. They hadn’t taken the pandemic lightly. They were “100 percent pro-vaccination,” a close friend told The Oregonian afterward, but Josie reportedly had a heart murmur and chronic diabetes and worried about an adverse reaction. Tom reportedly had muscular atrophy, and similar worries. Afraid, they had not yet gotten vaccinated.
It’s easy to say that all these people should have been more informed or sought advice from a medical provider, except that many have no health care provider. As of 2015, one quarter of the population in the United States had no primary health care provider to turn to for trusted advice.