Vaccine decisions require critical thinking, not sound bites

Now that the test positivity rate and safety signals have tipped the scales in favour of the National Advisory Committee on Immunization (NACI) with respect to its position on vaccines, perhaps we can approach the rest of the pandemic with more reasoned and productive discourse.

The rallying cry at the beginning of the pandemic was that we would be “guided by science” in our decision-making. More than a year later, two lessons have become apparent. One, science is a process that requires time that is not always available before decisions need to be made in the midst of a crisis. Two, science does not make decisions. People make decisions, and many things influence the decisions they make.

NACI’s job is to make “recommendations for the use of vaccines currently or newly approved for use in humans in Canada.” The role of the Public Health Agency of Canada (PHAC) is to “focus on preventing disease and injuries, responding to public health threats, promoting good physical and mental health, and providing information to support informed decision making.” PHAC has a much broader role, so its decision-making is influenced by much broader considerations.

When faced with contradictory messages, I employed critical thinking and reasoning to make a personal decision. My decision to wait for an mRNA vaccine was not due to “vaccine shopping.” Characterizing the behaviour of people who chose to wait in this manner is part of the problem.

I listened to PHAC’s “first vaccine, best vaccine” sound bite, read NACI’s recommendations and decided to give more weight to NACI’s view in the choice of vaccine because that is their main focus.

When parents and teachers think about teaching critical thinking and reasoning, we sometimes forget that if we truly empower our children and students to employ these skills, they may come to different conclusions from each other and us. If we could learn to see this type of diversity as a strength and respond by asking relevant, respectful questions, we would all benefit.

Research has looked at the “important role that language, discourse and argumentation play in both the personal and social construction of scientific knowledge” for some time, as academics Christine Chin and Jonathan Osborne put it in 2008, and questioning skills are an important part of this process. As the two wrote, “the formulation of a good question is a creative act, and at the heart of what doing science is all about.”

If instead of delivering the “best vaccine = first vaccine” message, the leaders and experts who have been so visible during this pandemic had modelled what productive language, discourse and argumentation looked like, more people would have been better equipped to weigh the different messages and make a reasonable decision for themselves. Instead, many are feeling mislead.

Recently, I came across the phrase “expert opinion without data” in an article in the Los Angeles Times describing how COVID-19 vaccines are affecting mammograms and what to do about it.

Since much of the expert opinion being offered around the pandemic response is “without data” or “with early data,” the role of language, discourse and argumentation among experts is more important than ever. Sound bites don’t help.