'We didn’t see enough honest, critical and nuanced discussion'

A Q&A on the unintended consequences of vaccine mandates with Canadian author and social scientist Kevin Bardosh

Police break up the trucker protest earlier today in Ottawa. Photo by Scott Olson/Getty Images

It has been a long and tense week for many in this country, and certainly for those in the capital. As police break up the protest in Ottawa, and we head into another weekend, with the possibility of more demonstrations, it’s a good time to pull back and contemplate the issue that sparked such unrest in the first place.

Until several weeks ago, there was very little public discussion and debate about vaccine mandates. An international group of academics had already recognized this and were putting the finishing touches on a paper on the topic when the big rigs rolled out of Vancouver in late January.

That paper, “The Unintended Consequences of COVID-19 Vaccine Policy: Why Mandates, Passports, and Segregated Lockdowns May Cause more Harm than Good,” was published as a pre-print on February 1. It surveys 13 potential unintended consequences of vaccine policy, in the areas of behavioural psychology, political and legal effects, socioeconomics, and the integrity of science and public health.

I spoke with the Canadian lead author of the paper Kevin Bardosh last night. He’s an author, an affiliate assistant professor at the University of Washington’s School of Public Health, and an honourary lecturer at the Edinburgh Medical School at the University of Edinburgh.

Here, Bardosh walks me through his group’s findings — and shares insights on why vaccine policy has become such an explosive issue.

You published this paper before the trucker convoy had become an international story. What was the impetus for pursuing this line of inquiry?

We saw this discourse on social media that’s very polarizing. It comes out of the lockdown discussions and it’s really cemented over the last two years. Where you have, on the one hand, people who are very supportive of the vaccination mandates, saying horrible things, like, “If you are not vaccinated, you should lose your job.” And: “We should maybe take kids away from their parents if their parents are not vaccinated.” Very drastic statements. Then on the other hand, people having what I would consider as pre-2020 public health norms: informed consent, the notion of proportionality [i.e. the benefits of a public health intervention should outweigh the harms], and putting human rights at the centre of public health. Which I think has really taken quite a nosedive during this pandemic, and I hope that we can build that up once the dust settles.

So, all of us have a background in anti-stigma approaches to public health. My whole raison d’être in the last fifteen years has been: How can we include a broad range of people in public health programs, and make them more equitable, through community participation? I think all of us share what we consider a normative approach, that’s been eroded over the pandemic.

For the purposes of this paper, how have you defined vaccine policy?

It’s been a little tricky because obviously there’s a huge number of different types of policies. But I do think they share this common core, which is the mandate approach. On the one hand, mandates for international travel, for access to employment, for access to schooling. And then also the passports systems. Which is completely new. We’ve never even really heard of passports for going to get a coffee or a muffin in New York City, for example. Or where you’re allowed to order, but if you sit down, you have to show your vaccination certificate. Then of course — and this is goes back to what really got us together as a group — what we were seeing in Europe, especially Austria and Germany. This whole notion that we’re going to actually restrict people’s freedoms based on their vaccination status, to the point where they cannot even leave their homes. This is the segregated lockdowns. So, a lot of different policies, but they do share a common root.

Part of it is also this idea that we need to have one hundred percent of people vaccinated against Covid. That’s the implicit assumption. I have yet to see very convincing arguments, that actually engage with the state of evidence, that argue for the necessity of that. Especially considering what we lay out in the paper. Which is that when you are forcing people to get vaccinated, you are using social capital. The government and public health is using social capital to force people to get jabbed. Is that really worth it?

We’re thinking very specifically about Covid, here. If we were talking about a different pathogen, and we were talking about different vaccines — if they had better efficacy on transmission — and also the age distribution of mortality was different, then there would be a different discussion around the ethics of mandates.

The paper lays out four different domains of study — behavioural psychology, political and legal effects, socioeconomics, and integrity of science and public health — and 13 potential unintended consequences of vaccine policy. What is your main argument on why we need to examine these unintended consequences?

With all of the pandemic mitigation measures that we’ve had, we should have been engaging more on unintended consequences. Thinking holistically about the societal effects of lockdowns, mask mandates in school et cetera. It’s been a very polarizing conversation. These particular areas in the paper come out of our background as social scientists engaged in medicine. Part of our role is to critique the biomedicalization of life that the medical profession brings to the table when they are thinking about how to control disease. There’s one focus: “Covid. How do we reduce Covid? How are we tracking that? With our epidemiological data.” Very narrowly defined goals. But we are humans, we are very complicated.

When you’re talking about a public health intervention, like receiving a vaccine, it’s very difficult to simplify the multitude of reasons why people will get vaccinated or won’t get vaccinated. Often there’s a simplification around this issue. In the media, but also in the academic discourse. But when you get down to actual human motivation, it’s incredibly complicated. A lot of the people that I know myself who are not vaccinated, of these areas [that our group studied], maybe four or five or six of them would be very strong reasons for why they are not vaccinated. We’re trying to come to terms with that complexity.

This information feels really new. I haven’t seen this all laid out in one place before.

That was our motivation. To try to open up the conversation. Another motivation was the way the media has talked about vaccine hesitancy, for the last year especially. We tried to provide something to get beyond this dehumanized, stigmatizing, scapegoating discourse.

Let’s pull a few threads from the paper. One of the potential unintended consequences of vaccine policy is cognitive dissonance, or psychological stress from the perception of contradictory information. This really resonated for me. What are a couple of the areas of incomplete or misleading information from health authorities or the media that your team observed?

One of them was the public announcements about mandatory vaccination. The WHO’s head of immunization, the Biden administration, and most other governments said that they were not going to mandate vaccinations. They created an expectation and then they switched and changed policy. I think that’s a huge source of anger and frustration for people.

Another issue would the efficacy of the vaccines on transmission. I was watching, looking at the data out of Israel and the U.K., two countries that were early out of the gate in vaccination and had really great real-time data that they were collecting. I was looking at this data, and I was watching the news out of the U.S. mid 2021, where the CDC and the Biden administration are saying, “This is going to stop transmission. Once you get vaccinated, you don’t need to worry, you’re not going to get Covid.” And I am like, “This is not true. And they must know it’s not true.” But yet they are using this to increase vaccination rates. I have a problem with that. I have a problem with being dishonest, or telling white lies, or not being completely frank with the public, even if you think it’s better for them. For me, that’s not a foundation of a liberal democracy.

The third one — and there’s lots of other ones — but the third one especially in the United States and in Canada was this denial of acquired immunity, or natural immunity. And the politicization, this notion that this was some sort of right-wing conspiracy. So, people who had Covid in 2020, if they were intelligent people and they looked at the scientific data, they might think, “Yeah, I don’t need to get vaccinated. Or, maybe I’ll get one vaccine.” But if they wanted to, let’s say, keep working as a professor at a university, they had to get two vaccines or else they were fired. There was no notion that that would be problematic. I’ve spoken to professors who have been let go, or have had to deal with this, and there is very little compassion towards them from their colleagues. It’s just like, “Why don’t you get vaccinated?” But for those individuals, it’s a matter of principle, it has to do with their political psychology.

This is also what the pandemic I think, for me, has blown a hole in. Which is this whole notion of the Liberals, and the Democrats, being a pro-science party. And the Conservatives, or the Republicans, being the anti-science party. For me personally, that was a narrative I grew up with. I’ve seen it blow up over the past two years.

You’ve also touched on stigma, and in the paper you explore how political leaders have actively blamed the unvaccinated for the continuation of the pandemic, stress on hospitals, new variants, and the necessity of lockdowns, masks, and school closures. You draw attention to Justin Trudeau’s rhetoric. What were your findings there?

Justin Trudeau obviously had some pretty inflammatory statements along those lines. Which is ironic, given his stance on supposedly supporting human rights, minority groups, the right to protest.

Emmanuel Macron in France very deliberately said, “Our approach is to piss off the unvaccinated.” That gets back to this notion of proportionality. If your goal in a public health program is to make people’s lives miserable, or difficult, is that informed consent? Is that an appropriate or ethical response? I wouldn’t think so. It’s draconian and coercive.

Political polarization was another area of research. What are the risks of this global backlash that we’re seeing against these mandates?

The people who are passionately opposed to the mandates, it’s quite an eclectic group of people. It is across the political spectrum. Although there’s this narrative that it’s right-wing, it perhaps is that those groups are more vocal, or more able to mobilize themselves in a more visible way. But it is a cross section of society that are opposed to it.

It is absolutely going to be driving anti-vaccination sentiment into the future. There’s no question about that. If you look at the most popular book on Amazon over the Christmas holidays, it was Robert Kennedy’s The Real Anthony Fauci.

I also am very concerned about countries where we didn’t have an anti-vaccination movement, or a strong one — for example different places in Africa — and what the impact will be of having access to news from the States or Europe, where people are very angry about the scientific transparency of the Covid vaccines.

There is also a question about where we are going from now in terms of pandemic policy. The next time there’s a variant, are we all going to shut down again and mandate vaccinations again? We’ve created a normative biosecurity state response that’s very forceful. I think there are some fundamental questions about the infringement on human rights and civil liberties that need to be talked about more truthfully.

What’s the response been to your paper so far?

The paper has been downloaded something like nine thousand times and the abstract has been viewed thirty-five thousand times — in two weeks — so it’s obviously a hot topic. There was one article recently in The Australian, which is a pretty mainstream newspaper. There have been some individuals or groups that have cited it in letters to employers, making the case that the mandates are no longer proportionate.

Apart from that, I would say it’s been somewhat ignored, at least within the main public health institutions and by mainstream public health folks. I think this is one of the worrying things that I see possibly coming out of the pandemic. Because all of these organizations supported these mandates. They supported these policies. So now to go back and say, “Well, actually, that wasn’t necessarily a great approach” — that’s very threatening. I’ve spoken to colleagues who have critical perspectives and have felt very reluctant to share them throughout the pandemic, because of this group mentality. All of the universities, all of the public health departments, have mandated these vaccines, so to come out and be critical of them, you’re ruffling people’s feathers.

That was another motivation to write the paper. We didn’t see enough honest, and critical, and nuanced discussion about this.

Having just studied this issue, what’s it been like for you watching the trucker protests play out?

It’s quite amazing, actually. It started as we were finishing the paper. We were predicting something like this. I didn’t think it would come out of Canada. I’m Canadian. I’m living in the States, and I also have Hungarian citizenship. So, I was following Europe and North America quite closely. I didn’t see it come out of Canada, that’s for sure. It was quite surprising.

Again, it reinforces the simplified narrative that we’ve been telling ourselves about society, and politics. I think all the old categories don’t really make sense anymore. The people that I know in Canada who have gone to the protests, just for the day and whatnot, these are typically progressive Liberals, or individuals who lost their job, who have been harmed by these policies.

The Emergencies Act has been invoked. These people are protesting because of an infringement on their rights, because of emergency mandates. And then you are going to one-up them and call in a further state of emergency? I think it’s going to polarize the discussion even more.

This interview has been edited and condensed.