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Harry Rakowski: We can’t shame people out of their vaccine hesitancy

Commentary

Democracy is all about allowing citizens to enjoy enshrined freedoms of choice and freedom of movement.

China rapidly curtailed the initial outbreak of COVID-19 infection by isolating Wuhan and imposing harsh penalties for disobedience. Facial recognition and closed circuit cameras were and still are routinely used to track people’s movements and compliance with government will. Communist and other authoritarian countries encourage people to monitor and disclose unwelcome behaviour by friends and neighbours. They can force their will on their population. Canada is very different, we will have to convince people to be vaccinated.

Mass vaccination is essential to curtailing the devastating effects of COVID-19 to our personal health, the health care system, our economy and our national psyche. We routinely accept that if you want to drive you have to pass a test and get a licence. You also have to wear a seatbelt since it clearly saves lives. Children have to be schooled and get a basic education. You don’t have the freedom to sell illegal or dangerous products, unless of course they are taxed by the government like cigarettes. You do however retain the freedom to make personal medical decisions.

The World Health Organization estimates that vaccines prevent 2-3 million deaths a year by protecting people from dying of hepatitis, measles, diphtheria, cervical cancer, pneumonia, tetanus, polio, diphtheria and whooping cough.

There is an important difference between vaccine hesitancy and extreme vaccine deniers. Vaccine deniers believe no vaccine is safe, that paediatric vaccination causes autism, that vaccines will change your DNA and that toxic additives cause more long term harm than any exaggerated benefits of vaccination. The lack of any true scientific basis for these claims doesn’t shake their belief. They are highly unlikely to accept vaccination for COVID-19.

The shaming and blaming of those uncertain about vaccination only makes their refusal more entrenched.

Vaccine hesitancy is much more common and has many more superficially reasonable arguments.

The largest group who are hesitant are those whose political views colour their decision to decline vaccination. Up to 40 percent of Republicans indicate they will decline vaccination, especially older white men. The polarization of the last U.S. election makes them underestimate the risks of infection just as many Democrats may overestimate what is truly a considerable risk.

The higher risk for people of colour, essential workers and those in a lower economic class makes many older white men feel less at risk. The shaming and blaming of those uncertain about vaccination only makes their refusal more entrenched. Their hesitancy can best be overcome by those they respect continuing to emphasize the benefits of vaccination. Unfortunately it often won’t come from sensible words from Dr. Anthony Fauci whom they see as someone restricting their freedoms.

In Canada there is much less political polarization but it still exists.

Hesitancy by people of colour distrustful of government and religious groups uncertain of benefit or convinced that God alone will protect them has been blunted by wise words from peer groups, trusted physicians and counsellors.

There is also a divide based on age and personal risk. In Israel, over 90% of those over 60 have accepted vaccination and 99% of those above 90. In Canada those over 60 aren’t vaccine hesitant. They know their risk and want to reduce it as quickly as possible. Their fury is directed at the inept procurement of vaccines and the resulting need for a 16-week delay between shots.

Many younger, healthy people reasonably believe that if infected they are highly unlikely to die and question why they should take any risk of vaccination. This concern is magnified by the hyping of rare complications, fear of needles and the belief that natural treatments rather than vaccines from mistrusted big Pharma are the answer.

Our population is becoming less vulnerable as more at-risk individuals are protected. That protection may wane if we wait too long between shots, but for now mortality from COVID-19 is well below 1 percent. What needs to be emphasized is that with the dominance of variants of concern, becoming infected conveys a higher risk of bad outcome even for young and healthy people. Many will also have months long symptoms of fatigue and sensory abnormalities that limit quality of life.

While Canada may not have formal vaccine passports, many restrictions will be imposed on those not vaccinated.

We need to reach about a 70 percent level of vaccination to achieve relative herd immunity. Otherwise we will continue to have a reservoir of unvaccinated people that can get infected with newer variants not yet widely circulating that could pierce vaccine immunity for others. Vaccines have not yet been approved for children under 16 who represent more than 20 percent of the population. We therefore have to convince many hesitant younger people that our future safety depends on their compliance for the benefit of others, even if they are not fearful for themselves.

Those vaccine hesitant also need to see a benefit beyond disease prevention. While Canada may not have formal vaccine passports, many restrictions will be imposed on those not vaccinated. The ability to travel to other countries, enter the workplace, cruise, fly, enjoy indoor venues, and to have others feel safe in their presence will all rely on vaccination.

It will be important to not overly restrict those who are vaccinated with excessive quarantines and restrictions based on the minimal chance of harbouring infection. A major benefit that will overcome hesitancy will be the ability to take off masks to enjoy outdoor activities and to increase congregation. People desperately want to resume a better quality of life and vaccination is the way to do so.

We can’t force people to be vaccinated just because it is to the benefit of society. We don’t shame or exclude people who are obese, unfit, smoke or don’t exercise, even though their unhealthy behaviour taxes our health care system. Overcoming vaccine hesitancy in a democracy will take patience, honest information about the risk-benefit of choices and the advice of trusted friends and advisors. Some people will overcome their fear for altruistic reasons and others because the alternative is less attractive.

We greatly value our freedom of choice even if those choices seem unwise to many. Those who are vaccine hesitant need to be convinced that with vaccination they will enhance their freedom to be both healthier and free.

Harry Rakowski

Dr. Harry Rakowski is an academic, Toronto cardiologist, and commentator.

Sean Speer: The ten-year anniversary of a crazy 24 hours

Commentary

Yesterday marked the ten-year anniversary of the craziest and most memorable 24 hours of my professional career.

A bit of context: At the time I was on leave from my job as a policy advisor in the Prime Minister’s Office and working on the Conservative Party of Canada’s 2011 election campaign. It was my first time on a national campaign. It was an exhilarating yet stressful experience.

The campaign started in earnest on March 26 following a non-confidence vote in Parliament and was set for 37 days with the election itself falling on Monday, May 2.

As it unfolded, the campaign’s main political issues became Stephen Harper’s appeal for a Conservative majority government to pre-empt the prospect of a Liberal-NDP-Bloc Québécois coalition and Jack Layton and the NDP’s unexpected surge in Quebec. The policy debate was generally less developed. It amounted to a ballot question about which party was best placed to manage the ongoing economic recovery in the aftermath of the 2008-09 global financial crisis.

My role was focused, in broad terms, on public policy. I contributed to the party’s platform, wrote speeches and produced policy backgrounders, answered surveys from stakeholder groups, fact-checked press releases and talking points, and responded to queries from the party leader and rest of the team traveling with him. I was basically a jack-of-all-trades. The work and its urgency never seemed to slow down.

By the beginning of May, election day was finally in clear focus. Although the outcome wasn’t guaranteed, polling consistently showed the Conservative Party was out-in-front and likely to win re-election. Whether it would be enough to secure a majority government – the first for a Conservative Party in nearly a quarter century – was yet to be determined.

As of May 1, most staff in the national campaign office had cleared out. It was the final day before mass voting and there wasn’t much left for national campaign staff to do. People were encouraged to head out into different ridings to stump for candidates in a final, pre-election blitz.

I remained back in the campaign headquarters with a small skeleton crew to deal with any last-minute policy issues and be on stand-by if Mr. Harper or the team had any questions. But it was a slow day, and we were able to wrap up around dinner time.

That night I planned to relax, have a few drinks, and get some well-deserved sleep. Early in the evening, I exchanged with the senior team who were at a final stop in Abbotsford before traveling with Mr. Harper to Calgary to await the election results the next day. Everything seemed under control.

That, however, didn’t last long. As I sat on my couch and flipped through the channels, something unexpectedly significant happened. News began to emerge around 10PM that a group of Navy Seals had executed an operation, code-named Operation Neptune Spear, to kill Osama bin Laden in a compound in Pakistan.

This was big deal. As the terrorist mastermind behind the 9/11 attacks, bin Laden had been the highest Al Qaeda target for nearly a decade. The lack of progress tracking his whereabouts and bringing him to justice was a source of great frustration for America and its allies. It cast a pall over U.S. political life and was a disconcerting reminder that terrorists with radical ideas, significant means, and sophisticated know-how could carry out damaging attacks on free societies and get away with it.

This wasn’t just an American story either. Not only had the Canadian Armed Forces served with great honour and distinction in Afghanistan including some of the most dangerous theatres such as Kandahar province, but 24 Canadian citizens were also killed in the 9/11 attacks.

(Canadian citizen, Ron DiFrancesco, whose office was on the 84th floor of the South Tower of the World Trade Center, managed to make the harrowing journey out of the building before it collapsed. He’s believed to be the last person to make it out of the building alive, and the US 9/11 commission report says he was one of only four people to escape who were working above the 81st floor.)

The killing of bin Laden must therefore be seen as more than just an effort on the part of the American government to neutralize an ongoing threat to its homeland. It was also a moment of justice and closure for other countries like Canada whose citizens had given their lives in the global war on terror.

As for its immediate implications in the late evening of May 1, it’s worth pointing out that while we were in the final hours of an election campaign, Mr. Harper was still Canada’s Prime Minister and as such had, at least in theory, access to the capacities and functions of the federal government in order to carry out his responsibilities. It’s a basic feature of the Westminster model that the governing party continues to effectively govern until a post-election transition.

This was generally less of an issue in the 2011 federal campaign, but it mattered a great deal incidentally in the subsequent 2015 campaign during which the Canadian government finalized and announced its involvement in the Trans-Pacific Partnership trade agreement. During that campaign, as Mr. Harper criss-crossed the country to announce Conservative Party platform commitments and hold party rallies, he remained in regular contact with political staff, public servants (including the lead trade negotiators) and the cabinet to get ongoing updates and provide instructions on our negotiating position.

It also mattered in the late hours of May 1, 2011. As leaks started to be reported in mainstream American media, it became obvious that there were major implications for Canada. It was one of those unique moments in modern history that needed to be marked. The prime minister needed to issue a statement.

Yet it was challenging to get much information from government officials. The problem was two-fold: first, we were on the eve of an election so there may have been some trepidation on the part of public servants to get too involved in a high-profile issue that could conceivably have some impact on the election outcome; and second, it was late on a Sunday night and many people had gone to sleep. U.S. President Barack Obama’s public address didn’t even begin until 11:35PM.

I was in regular contact with the team traveling with the prime minister and in touch with colleagues who had stayed back in the Prime Minister’s Office during the campaign and public servants in the Privy Council Office. We were trying to understand what had happened, who was involved, and if bin Laden and other high-profile terrorists were killed or captured.

It seems sort of surreal in hindsight but most of the information that I was able to accumulate and pass onto the team with the prime minister was mostly drawn from Fox News and other American media outlets whose reporting on the raid and its successful execution was moving much faster than what we were able to obtain from our own sources.

Eventually, with some intelligence from the public service and our own news consumption, we were able to piece together a statement on behalf of the prime minister acknowledging the successful outcome of the raid, the role of Canada’s military in breaking up Al Qaeda’s networks in Afghanistan and those Canadians whose lives had been touched by its terrorism.

It was written in some haste and with fast-evolving information, but in hindsight the prime minister’s statement reflected the right mix of soberness for those who had sacrificed and defiance for those who would threaten our way of life. Mr. Harper had a significant hand in drafting the statement. He delivered it in an empty hangar at the Abbotsford airport in the early hours of May 2.

That evening’s frantic emails and phone calls were a fitting capstone to the entire campaign experience. I finally got to bed much later than I had initially planned.

The next day was election day. I drove out to riding of Glengarry-Prescott-Russell, just east of Ottawa, where the incumbent Conservative MP Pierre Lemieux was running in his third election. I went to help out but admittedly didn’t make much of a contribution. I was burnt out and distracted by the unknown election result.

I went for dinner to mark the end of the campaign and accept the futility of worrying about it much anymore. It was ultimately in Canadians’ hands.

Later that night a group of us who hadn’t joined the senior team in Calgary got together in a bar in Ottawa to watch the results. The riding-by-riding returns played on televisions across the bar. They started in Atlantic Canada and began to move westward.

Soon the number of projected Conservative seats started to bounce around the threshold for a majority government. They went up and down several times before it became clear that it was only moving up and no longer dipping below the magic number of 155 seats. We did it. The networks soon declared a Conservative majority government.

In that moment, the stress of the previous weeks just sort of washed off. It was a feeling of accomplishment that’s sort of difficult to describe. People were hugging, calling their families, and joyously celebrating. Some were even in tears.

It marked an extraordinary moment for Mr. Harper and the Conservative Party which had only been created seven years earlier. It had already won three successive elections and now its first majority government at a crucial moment in Canada’s trajectory from the depths of the global financial crisis.

It also marked the culmination of a crazy 24 hours that started with scrambling to understand what was going on northeastern Pakistan and ended with celebrations of a majority government with friends and colleagues in an Ottawa bar. It’s an experience and a set of emotions that I’ll certainly never forget. And 24 hours that will be difficult to match.

Sean Speer

Sean Speer is The Hub's Editor-at-Large. He is also a university lecturer at the University of Toronto and Carleton University, as well as a think-tank scholar and columnist. He previously served as a senior economic adviser to Prime Minister Stephen Harper....

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