A Tale of Two [Unvaxed] Women
We needed to find a new plumber. I called around. The first business that seemed willing to clean our boiler and replace a problematic hose spigot had availability soon. Before settling on a date, I remembered to ask the woman answering the company’s phone–let’s call her, Mary–a non-plumbing question: Will the plumber who comes into our house to work on the boiler for a few hours be fully vaccinated?
That inquiry took us to a place I hadn’t prepared to enter while finding the right vocabulary to explain our garden issue. Indeed, Mary’s unwelcome answer brought us into one of those difficult conversations we all dread these days. Here’s my best memory of how it unfolded:
Mary: I can’t guarantee that the plumber would be fully vaccinated.
Me: Are SOME of your company’s plumbers fully vaccinated?
Mary: We don’t require our staff to be vaccinated. The owner can’t force them. We’re not legally allowed to do that.
Me: Absolutely. But, the owner doesn’t have to keep paying people’s salaries if they won’t get vaccinated. That’s not forcing, that’s just his legal right to hire whoever he wants to hire. He’s got that freedom.
Mary: He won’t require it.
Me: But, are ANY of the plumbers who work for you vaccinated?
Me: Hmm. In that case, I’ll probably wait to use your services until after the pandemic is over.
I sensed that Mary was struggling to refrain from going into a political tirade about how Democrats and scientists were lying to Americans, and the vaccine would make people magnetic or sterile or digitally trackable or . . .
A normal person would have ended the conversation there. But I’m not a normal person. Suddenly, this conversation offered new possibilities for engaging with someone outside my usual social circle. The anthropologist in me was activated. I forged on.
Me: My husband and I are both vaccinated, but this aggressive Delta variant is now causing some mild, breakthrough cases that people might pass on without knowing. Since we have young grandchildren who can’t yet get the vaccine, and we’ll soon see them, we’re being extra-cautious.
Now the citizen in me was activated. Reckless, I plunged ahead.
Me: Meanwhile, since only the unvaccinated are dying from Covid now, you might want to recommend that your plumbers get vaccinated–not only to protect themselves, but also your customers.
Mary: We won’t do that.
Re-enter the anthropologist.
Me: Ah. [Pause.] Out of curiosity, I’m wondering why you don’t urge them to get the vaccine.
Mary: All our plumbers are very healthy and have great immune systems. They won’t get sick.
Me: Oh, that’s wonderful that they’re so healthy. [Pause.] Still, I keep seeing videos of people in the hospital with Covid, on ventilators, who said exactly that. This Delta variant seems to be extra-contagious and is getting so many people sick who had strong immune systems. The vaccine is a great way to protect your plumbers.
Mary: My husband and I don’t believe in the vaccine. We’re not vaccinated, and we don’t want our employees to get the vaccine, either.
Me: Really? Why’s that?
Mary: [Hangs up.]
So much for my long-honed interviewing skills. I’d have to grade myself an “F.”
But I’m never one to take failure lightly. The anthropologist in me wanted to call back and see if I could gently persuade Mary to explain her opposition to a vaccine that has so much overwhelming scientific evidence supporting its efficacy. Exactly what unfounded fears had grabbed Mary’s imagination? Who, or what, was her source of information? Why did she trust that source?
Still, the plumbing issues beckoned. Rather than re-engaging with Mary–trying to conduct instant phone ethnography that was, undoubtedly, doomed–I sighed and returned to an inventory of plumbers recommended on a neighborhood list-serv.
Phone call #2 produced an outcome at once similar, and worlds apart.
The woman answering the phone of the second business I rung up–let’s call her, Carol–offered a complicated reply that invited a conversation. Here’s what I remember of the non-plumbing portion of our exchange.
Me: Will the plumber who comes into our house to work for a few hours be fully vaccinated?
Carol: Probably, yes.
Me: Ah, that’s great. My husband and I are, too. But since we have young grandchildren who can’t be vaccinated yet, we’re being extra-cautious. Are all your plumbers fully vaccinated, then?
Carol: All but one. But, I can make sure that the one who isn’t vaccinated isn’t the one who comes to work in your house.
Me: Thank you, I appreciate that. [Pause.] Out of curiosity, is your boss encouraging that plumber to get the vaccine, to protect himself and your customers?
Carol: Actually, he’s already gotten the first shot. He just hasn’t gotten the second one yet.
Me: Oh, great.
Carol: Yeah, our boss is very big on the vaccine. He’s encouraged everyone in the company to get it. I’m the only one who hasn’t!
Me: Oh. [Pause.] Well, since you won’t be coming to work in my house, that’s not a problem for me. [Pause.] But, would you mind me asking why you haven’t gotten it, if your boss is encouraging you?
Carol: I’ve heard there are a lot of bad side effects. Did you have any bad side effects after your shots?
Me: Well, after my second shot, I was tired for a few hours, and the spot on my arm where I got the shot hurt a lot for about a day. But, really, it was no big deal. I’d much rather have a sore arm than die from Covid!
Carol: Oh! [Giggles, pauses a few seconds.] But, I have underlying conditions, and that’s what makes me very nervous about the vaccine.
Me: Ah, I can see that would make you nervous. Have you discussed your situation with your doctor?
Carol: No, I haven’t. I’m just reading stuff on social media.
Me: Maybe your doctor might have more information about whether your condition would make you a good candidate for the vaccine — whether it would be safe for you.
Carol: I guess so. But, I had [pauses] cancer some years ago, and I wouldn’t want the vaccine to bring that back. That was a nightmare. The treatment was so awful. And, the vaccine’s so new, no one knows what it will do, years later.
Me: I hear you. My husband was actually in treatment for cancer the past year, and his oncologist urged him to get the shot as soon as possible. He got it very early. I was online every day for a few hours, starting in January, looking for an appointment for him.
Carol: Wow, really?
Me: Yes. My husband got the first shot as soon as he could. Even though he’s now completely recovered from his cancer, now that booster shots are available, he’s going to get that third shot as soon as he’s eligible. His doctor thinks that’s a good idea.
Carol: Oh, yeah?
Me: Yeah. Because all the available scientific evidence shows that if you have a history of cancer, your symptoms may be much worse if you come down with Covid.
Carol: I didn’t know that.
Me: Yes, there’s a list of underlying medical conditions that make you more vulnerable to catching Covid, and suffering more, if you do. Cancer is one of them. Diabetes and asthma and obesity are some others. That’s why people with those underlying conditions were being urged to get the vaccine early on, before other people.
Carol: Hmm. You sound very knowledgeable. [Pauses.] Maybe I should consider it.
Me: Just this morning, my husband was almost in tears when he read a profile of an ER doctor in Los Angeles who is so, so frustrated with her Covid patients. None of them was vaccinated, and now, many of them are dying. As a doctor, she wants to do everything she can to help people survive, and she can’t believe that people are refusing to get vaccinated, since the vaccine pretty much guarantees that, even if you come down with Covid, it’ll probably be mild, and you won’t end up in the hospital and won’t die from it. Just about everyone in the hospital with Covid now is unvaccinated.
Carol: Where did your husband read that story?
Me: I think he said it was in the Los Angeles Times. If you like, I can ask him and maybe send you the link.
Carol: Oh, yes, please, I’d like to read that.
Me: Sure, I’ll send that to you as soon as I can.
We scheduled our plumbing appointment and Carol dictated her e-mail address so I could send her that newspaper article link. A few minutes after ending the conversation, Carol called back to double-check our street address. But first, she said, “I haven’t gotten that link yet. Are you still going to send it?”
I reassured her I would, then told her some updated statistics about Covid’s ravages that I’d read in the past few minutes. Carol eagerly resumed our conversation.
Carol: You sound so knowledgeable. I’ve enjoyed talking with you.
Me: Thank you. Same here! I do spend a lot of time every day reading updates, since the pandemic has taken such a toll.
Carol: I think I need to stop looking at social media and stop listening to people telling me not to get the vaccine.
Me: I know there’s a lot of claims out there about how the vaccine is unproven or dangerous. But, there’s definitely a lot of scientific evidence now that shows that the vaccine is super-safe and super-effective to keep you from dying from Covid. So far, something like 200 million Americans have gotten the vaccine, and no one has died from it. But we’ve had over 600,000 deaths from Covid.
Carol: Wow, really? [Pauses.] I think I’ll get it soon.
Me: That sounds like a good decision for you.
Carol: Yeah, I’m sure I’ll get it, now.
On the surface, the two women I spoke with share a lot of demographic characteristics. They’re both white. They both sounded within about 10-15 years of each other (I’d say, in their 40s to 50s). They’re both part of the working class. From a variety of speech styles and other markers, I’d guess they both stopped their formal education after high school. They’re both native English speakers. They’re both American. And they’ve both resisted getting the vaccine to protect themselves, their families, and their communities against Covid-19.
But, that’s where the similarities end. Together, Mary and Carol occupy two distinct points on the non-vaccinated spectrum in the U.S.
To put the contrast at its starkest . . .
Mary opposes the vaccine for political reasons; Carol opposes it for personal reasons.
Mary is angry about the vaccine; Carol is afraid of it.
Mary is sure in her decision; Carol is uncertain about hers.
Mary refuses to listen to counter-evidence that would challenge her decision; Carol is willing, even eager to listen to counter-evidence that might impel her to rethink her decision.
What does this tale of two women tell us about the people who have yet to get a free vaccine in the U.S. against COVID-19, despite incredible effectiveness and widespread availability? True, they’re only a sample of two. I can hardly claim that’s a scientifically representative group. But between them, these two women cover a lot of fascinating territory that I think is important, and instructive.
I draw some admittedly big lessons from my conversations with those two plumbing company receptionists. At the ethnographic level:
- The “vaccine-hesitant” are not a single, homogeneous block. They include a variety of people who have arrived at their caution–or refusal–from a variety of subject positions.
- If Mary and Carol offer strikingly different reasons for rejecting the Covid vaccine, they still do not represent the full range of reasons. Notably . . .
- Some undocumented immigrants remain nervous about deportation, in case they have to show an ID at a vaccine clinic (as with some in the Cape Verdean community I research in Rhode Island);
- Some blue-collar laborers work such long hours that they don’t find time or energy to go get a shot (as with the Stanley Steemer employee who came to clean our carpet earlier this spring, pre-Delta);
- Some young people find it impossible to imagine that they could die (who among us hasn’t been there?);
- Some “gig economy” workers live so precariously, from paycheck to paycheck, that they can’t risk missing a single unpaid day or two of work (why can’t the federal government address this with direct compensation?);
- Some people of color retain such deep distrust of a medical system steeped in racism that they see no reason to let down their guard now (happily, physicians and nurses of color are starting to effectively address these concerns).
- At the pragmatic (or, should I write, methodological?) level: Because “vaccine hesitancy” has many, diverse foundations, addressing it requires a multi-pronged approach.
- “Meeting people where they are” has recently become a catch phrase among some in the medical community. That pithy motto is really just a simple way of signaling that what’s needed is an army of anthropologists. Who better to plumb people’s hidden, implicit values?
- If the Biden administration were on the ball, they’d be recruiting anthropologists left and right for their medical team.
At the truly big-picture level: Education matters. Without research skills training us to evaluate the clearly false from the potentially true from the absolutely true, we are at the mercy of anything passing for “fact” that crosses our screen. Whatever the grade level, whatever the class subject, whatever the instructor’s expertise, every teacher’s first task should be to teach basic skills to evaluate evidence. The story of Mary and Carol makes it clear: our lives depend on those skills.
Meanwhile, here’s a rash prediction. This Monday, the F.D.A. is said to announce full authorization of the Pfizer vaccine. For some of the under-informed and mis-led Carols of the world ruled by a troubling combination of fear, misinformation, and eagerness for reliable advice founded in facts that regularly evade them, that authorization should provide some assurance that may motivate them to roll up their sleeves for their first shot. In short, I anticipate an enormous wave of new vaccine doses in the coming week or two, as several dams of hesitation break.
And, a wish. Maybe, just maybe, as the Marys of the world watch more people they know and even love die needlessly of Covid, at least a few of them may find some face-saving cover in the F.D.A. move and finally decide to go for a shot. After all, joining the pro-life camp of the vaccinated will confer the ultimate freedom.