In order to understand the current controversies about access to the COVID-19 vaccine, we need to reflect on how we got here. The virus is called COVID-19 because it emerged in December of 2019 in Wuhan, China. The pandemic hit Europe and Iran with fury, and arrived in the U.S. by February 2020. In order to try to contain the virus, we largely shut down society with restrictions on travel, closure of schools, and the closure of many businesses other than essential ones. As we watched news stories from New York City, where refrigerator trucks were used to store corpses because the morgues had been overwhelmed – we health care workers feared for our own lives.

There were those who said that shutting down the economy will take a toll on the most economically vulnerable in society. And that a prolonged shutting down of schools would be bad for kids. They were right about those things. Yet we virology-curious wanted to beat down the virus. There were those, such as Jay Bhattacharya, at the time a health economist on the faculty of Stanford Medicine, now the Director of the National Institutes of Health, who argued against lockdowns. He was an author on the Great Barrington Declaration, which recommended allowing the virus to spread among the healthy and protecting the elderly. It was modeled on the approach taken by Sweden, which is a relatively equitable society. I don’t think that would have worked in the U.S. As it was, the way COVID played out in the U.S. was this: If you had the means and could work from home on your laptop, cool. If you were a wage worker, and you had to show up on the job to support your family, and your elders lived with you – they got the virus, too. This was the reason that we witnessed the class and racial disparities in COVID infections and deaths that we saw in 2020. In Hawaiʻ i, the Micronesians endured much sickness and death.

During 2020, we were told that the usual vaccine development process takes years, so we had to rely on so-called “non-pharmaceutical interventions” such as social distancing and mask-wearing. Under Operation Warp Speed, however, the first Trump administration spent over $12 billion to make mRNA vaccines available by December 2020. We were all eager to receive our two doses of vaccine at the time, relieved that (once vaccinated) we would not end up on a ventilator.

We labored under the public health messaging in early 2021 that once a significant majority of the population (was it 70%? 80%?) was vaccinated – we would then achieve “herd immunity” – the idea that when a sufficient proportion was vaccinated, the virus would not be able to find enough susceptible people to which to spread, and the pandemic would sputter out. We public health cheerleader-types found it mysterious that there were people who would decline to be vaccinated. Our impression was that these people were not only endangering themselves, but that they were also keeping society from beating down the pandemic.

Vaccine refusal preceded COVID-19, of course. A milestone in anti-vaccine history was the publication in The Lancet in 1998 by Andrew Wakefield and colleagues of a case series that purported to link the measles-mumps-rubella vaccine (MMR) and autism. Based upon a sample of twelve children, the report has been debunked and was finally retracted by The Lancet in 2010. Found to have committed “serious professional misconduct,” Wakefield lost his license to practice medicine in the U.K. Subsequent studies involving hundreds of thousands of children have not found an association between the MMR vaccine and autism.

Robert F. Kennedy, Jr., the current U.S. Secretary of Health has been a long-time proponent of the position that vaccines cause autism. He said so during his Senate confirmation hearings in January, and he has pledged to reveal the cause of autism in September.

But back to the COVID........

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