Question: One of the top executives where I work has stated that we need to be sympathetic to people’s reasons for opting not to get vaccinated. He stated that he knows someone who died one week after vaccination, and that this person died as a direct result of the vaccination. I hear a lot of anecdotal stories to this effect. Is there any truth to them? If so, what is the cost/benefit for someone who believes they can do a good job of protecting their own health and doesn’t want to risk putting something they don’t trust into their body?

Answer: Whew, there’s a lot to this question!  First off, I agree that we need to be empathetic with people who are vaccine hesitant (caveat coming).  Unvaccinated people are not a monolith (Figures 1 and 2) and there is a substantial proportion who are likely to get vaccinated with the right nudges, information, and support.  This piece from Ed Yong in The Atlantic last week does an admirable job describing how, as Ed Yong writes in his related twitter thread, “Anti-vaxxers have successfully sown distrust in vaccines… but also in *unvaccinated people*. They’ve created the illusion that everyone unvaccinated is aligned with them, which isn’t true, and is making those folks harder to reach.”  Enter the aforementioned caveat– My empathy ends with people who are truly anti-vax, sowing deadly lies and harming us all.  In fact, many of the anti-vax stories circulating online are about vaccines and death, which are driving misinformation and vaccine skepticism. To be clear, when it comes to COVID vaccinations and death, there is no causal link (see CDC statement, copied below).  The causal link is instead between COVID infection and death!  When it comes to communication, messages focused on the effectiveness of vaccines at preventing hospitalization and death seem to resonate with the largest share of the “wait and see” vaccine hesitant crowd.  So if you do have a conversation with your executive, sharing information that vaccines are nearly 100% effective at preventing hospitalization and death may help.  And so will empathy… because throwing facts and figures at someone will not sway them.  This NY Times tutorial gives some helpful advice, as does this previous Q&A of 2/2/21.

CDC— Reports of death after COVID-19 vaccination are rare. More than 342 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through July 26, 2021. During this time, VAERS received 6,340 reports of death (0.0019%) among people who received a COVID-19 vaccine. FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem. A review of available clinical information, including death certificates, autopsy, and medical records, has not established a causal link to COVID-19 vaccines. However, recent reports indicate a plausible causal relationship between the J&J/Janssen COVID-19 Vaccine and TTS, a rare and serious adverse event—blood clots with low platelets—which has caused deaths.

Figure 1. Proportion of Adults by Vaccination Status over Time (Kaiser Family Foundation)

Figure 2. Demographic Characteristics of Unvaccinated (from Kaiser Family Foundation)