Where do we go from here?

I remember listening to a podcast by JBP, where it was an auditory version of the essay, Needle Points by Norman Doidge. He untangled the mystery of vaccine hesitancy through the archaic brain circuit called the Behavioral Immune System (BIS).(1) It is described as a set of behaviors expressed by an individual as a prophylaxis against infectious disease.(1,2) According to Inhorn and Brown, infectious diseases has been estimated to be responsible for most of human deaths than all other causes combined.(3) As our ancestors evolved over time, this psychological mechanism most likely evolved with them; while we are aware of threats that are identifiable by our five senses, infectious diseases poses a threat that is unidentifiable.

The activation of our BIS triggers responses such as disgust, fear, avoidance, stigma, and prejudice to avoid pathogenic diseases exhibited by connoting cues.(1,2) For example, we are well aware of contaminated foods that smell eerie and we are inexplicably disgusted by it; we are then fearful of the contaminated food because ingesting it would cause harm to the body and therefore cause avoidance. It is no different than seeing another human that is exhibiting signs of sickness such as: coughing, sneezing, physical signs of abnormalities associated with pathogenic diseases, and more. This may lead to stigmatization and prejudice against certain groups of people that causes ethnocentrism and xenophobia; This has been demonstrated through studies explaining in-group preferences versus out-group preferences such as immigration of ethnic minorities.(4,5,6) This was no exception for Canadians that were of Chinese descent, reported by the CTV news as early as January 27, 2021 where they experienced vitriol, vilification, and physical abuse.(7,8)

Norman describing the BIS in the vaccine hesitant can be demonstrated by a study of older chinese adults, aged 65 and older, in Hong Kong describing their perception of the vaccine: lack of trust in the vaccine due to novelty, Adverse Events Following Infection (AEFI), poor long term effectiveness, risk being in contact with health care workers, lack of trust in government, and dislike of injecting an attenuated version of the virus into their body. Meanwhile, proponents of vaccination shared the opposite: trust in vaccines, medical health experts, government, and historical success of vaccines.(9) Similarly, this was experienced in Canada between the vaccinated and unvaccinated. (10) However, this created a division within our society with increased tribalism between the unvaccinated and vaccinated - creating discourse that heightened moral vigilance (11) and conformity (12) between the in-group, vaccinated, and the out-group, unvaccinated.

It did not matter whether or not the out-group that questioned mandated vaccinations and passports versus real Canadians that were against all types of vaccines, they were lumped under the same out-group. This led to some of the worst characteristics of Canadians to be summoned during a time where the BIS was heightened due to the pandemic. For example, Bob Hepburn from Toronto Star wrote an article titled “Time to call out nasty, hate-filled anti-vaxxers.” (13) Moreover, Durham Radio News reported a survey from Nanos Research suggesting an overwhelmingly amount of Canadians support banning the unvaccinated from sporting events and indoor restaurants. (14) Even the Prime Minister of Canada was involved inciting hatred towards the unvaccinated calling them “racist and misogynistic extremists.” (15)

On the other hand, the Freedom Convoy protest that occupied Ottawa was in response to the authoritarianism enacted by government to mandate vaccination and vaccine passports that would ultimately segregate the unvaccinated from participating in society. (16) Anecdotally, the protest was nothing more than Canadians gathered around after several months of isolation and enjoying each others companies and a group effort against mandated vaccines and passports. In fact I had conversations with the Toronto police. Civility was demonstrated on both sides. Discussions and debates can be welcomed as to whether this was appropriate or not, but in the end, it heightened the discourse between the unvaccinated and vaccinated.

The discourse is still very real. I regrettably downloaded twitter as an attempt to keep up-to-date with research studies on the bivalent vaccine. However, my feed was filled with “tweets”, as they call it with these:

I am uncertain as to how Canadians feel about each other between the unvaccinated and vaccinated; despite the mounting evidence of the failure of lockdowns, community wide masking, and vaccinations in reduction of transmission, severity of illness and mortality (caveat: who is at risk, who benefits most from vaccination, who is at risk for higher AEFI due to lack of benefits outweighing consequences?). What can we do right now as a society to heal the divisiveness that we all experienced and are experiencing right now? How do we instill compassion and empathy for each other again? More importantly, how do we build trust again with educational, health, and governmental institutions that have enacted policies that were unscientific and divisive towards Canadians? I’ll leave this quote here from Needle Points by Norman Doidge:

“One needn’t agree with the decisions or actions of the vaccine hesitant in order to learn something from them and about them, and about society as a whole. They pay attention to, and are vigilant about, different issues than the vaccinated, and have strong feelings about the people and institutions involved in our public health—particularly politicians, the drug regulatory process, and pharmaceutical companies. For many, vaccine hesitancy is not simply about the vaccines; it’s about the absence of faith in the wider systems that brought us the vaccines. “Public health moves at the speed of trust,” notes physician and author Rishi Manchanda. If we want our public health system to function better—safer, swifter, in ways that more effectively safeguard the lives and livelihoods of all citizens—it must be rooted not in coercion but in confidence, and not only among the majority.”(1)

P.S. I think further research should focus on how the past two years may have affected Canadian culture, as this may be an important role in how we progress. We must all feel proud to be Canadian despite what has happened.

P.S. #2 Don't carry around CO2 moniters. This is unscientific. No, Covid is not a leading cause of death.

1. Doidge N. Needle Points. Tablet Magazine.com. Published October 27, 2021. Accessed September 25, 2022. https://www.tabletmag.com/sections/science/articles/needle-points-vaccinations-chapter-one
   

2. Schaller M. The Behavioral Immune System. 2nd ed. In D. M. Buss; 2016
   

3. Inhorn MC, Brown PJ. The anthropology of infectious disease. Annual Review of Anthropology. 1990;19:89-117. https://www.annualreviews.org/doi/abs/10.1146/annurev.an.19.100190.000513
   

4. Aaroe L, Peterson MB, Arceneaux K. The Behavioral Immune System Shapes Political Intuitions: Why and How Individual Differences in Disgust Sensitivity Underlie Opposition to Immigration. American Political Science Review. 2017;111(2):277-294. DOI: https://doi.org/10.1017/S0003055416000770
   

5. Navarette CD, Fessler DMT, Eng SJ. Elevated ethnocentrism in the first trimester of pregnancy. Evolution and Human Behavior. 2007;28:60-65. doi:10.1016/j.evolhumbehav.2006.06.002
   

6. Faulkner J, Schaller M, Park JH, Duncan LA. Evolved Disease-Avoidance Mechanisms and Contemporary Xenophobic Attitudes. Group Processes and Intergroup Relations. 2004;7(4):333-353. DOI: 10.1177/1368430204046142
   

7. Neustaeter B. ‘Raise your voice’: Campaign targets anti-Asian racism heightened amid COVID-19 in Canada. CTVnews.ca. Published January 27, 2021. Accessed september 25, 2022. https://www.ctvnews.ca/health/coronavirus/raise-your-voice-campaign-targets-anti-asian-racism-heightened-amid-covid-19-in-canada-1.5283974
   

8. Chinese Canadian National Council. Timeline of recent anti-Asian incidents. https://www.covidracism.ca/timeline
   

9. Siu JYM, Cao Y, Shum DHK. Perceptions of hesitancy toward COVID-19 vaccination in older Chinese adults in Hong Kong: a qualitative study. BMC Geriatrics. 2022;22:2-16. https://doi.org/10.1186/s12877-022-03000-y
   

10. Tasker JP. Meet the unvaccinated: Why some Canadians still haven’t had the shot. CBC.ca Published July 25, 2021. Accessed September 25, 2022. https://www.cbc.ca/news/politics/meet-the-unvaccinated-why-some-canadians-haven-t-had-a-shot-1.6115270
    

11. Murray DR, Kerry N, Gervais WM. On Disease an Deontology: Multiple Tests of the Influence of Disease Threat on Moral Vigilance. Social Psychological and Personality Science. 2017:10(1):1-16.doi: https://doi.org/10.1177/1948550617733518
    

12. Wu BP, Chang L. The social impact of pathogen threat: How disease salience influences conformity. Personality and Individual Differences. 2012;53:50-54
    

13. Hepburn B. Time to call out nasty, hate-filled anti-vaxxers. Thestar.com. Published January 27, 2022. Accessed September 25, 2022. https://www.thestar.com/opinion/star-columnists/2022/01/27/time-to-call-out-nasty-hate-filled-anti-vaxxers.html
    

14. Durham Radio News. Majority of Canadians support banning unvaccinated from indoor dining, sporting events: survey. Published August 5, 2021. Accessed September 25, 2022. https://www.durhamradionews.com/archives/143234
    

15. Naylor D. Trudeau calls the unvaccinated racist and misogynistic extremists. Westernstandard.news. Published December 29, 2021. Accessed September 25, 2022. https://www.westernstandard.news/news/trudeau-calls-the-unvaccinated-racist-and-misogynistic-extremists/article_a3bacece-2e14-5b8c-bf37-eddd672205f3.html
    

16. Raymond T. Majority of Ottawa residents oppose ‘Freedom Convoy’ protest, poll finds. Ctvnews.ca. Updated February 8, 2022. Accessed September 25,2022. https://ottawa.ctvnews.ca/majority-of-ottawa-residents-oppose-freedom-convoy-protest-poll-finds-1.5771778