Trying to understand vaccine resistance

by Emrys Westacott

Upton Sinclair famously remarked that “it is difficult to get a man to understand something when his salary depends on his not understanding it.” It is easy to imagine the sort of scenario that illustrates his point. A drug company rep works to increase how often a certain drug is prescribed, putting aside any worries that it is addictive. A video game designer seeks to increase the number of hours young players spend hooked on a game, not thinking about the impact this might have on their education.

Yet the current situation in the US regarding vaccine hesitancy–or, more accurately, vaccine resistance–seems to offer some striking examples that call Sinclair’s claim into question. A number of states, including New York State, have mandated vaccinations against covid for health care workers. Those who refuse to get the vaccine face termination. Some of these workers have nevertheless chosen to forfeit their jobs, income, and benefits rather than be vaccinated. Their salary depends on them not allowing their judgement to be influenced by the anti-vaxxers; yet they appear to have fallen under the influence just the same.

The situation is still fluid. The deadline for compliance by workers in hospitals and nursing homes in New York State was October 7, but a federal judge ruled on October 12 that the state had to grant exemptions to workers who claimed to have religious reasons for not getting the vaccine. Moreover, it should be said that many of those who had held out against getting the vaccine eventually complied at the last minute rather than lose their jobs. Nevertheless, according to one well-grounded report, almost 34,000 NYS health care workers were fired or furloughed, resigned or retired because they were not willing to be vaccinated. This number includes 8,600 hospital employees, over 4,000 who work in nursing homes, and about 20,500 home care workers.[1]

Many of these, particularly home care workers, are paid close to minimum wage and may easily be able to find alternative employment at a similar or even better rate of pay. But qualified nurses are in a very different category. The average salary of a registered nurse in New York State is over $89,000 per year[2]; the average salary of a licensed nurse is close to $53,000.[3] Giving up such salaries and the accompanying benefits represents a significant sacrifice, especially if it also means that one is no longer able to continue working in one’s chosen profession without moving to another state.

It is easy to fall into the trap of assuming that almost everyone who refuses to be vaccinated is simply the dupe of Fox News and other media who continually spread suspicion and distrust regarding the covid vaccines, In an excellent article in the New York Times, Zeynep Tufekci documents how many different factors can play into a person’s decision not to be vaccinated.[4] The vaccine resistant include, for instance:

  • those with medical conditions (e.g. diabetes) who fear the vaccine will trigger an adverse reaction;
  • those who live in remote rural areas where access to health care is very limited;
  • pregnant women and breastfeeding mothers who are afraid that that the vaccine will affect their babies;
  • people who oppose vaccination on principle: e.g. on religious grounds;
  • people who are afraid of needles (which some research suggests is responsible for 16% of adults not getting vaccinated);
  • African Americans, native Americans, and other minorities who distrust government and the health care system because of the well-documented history of discrimination and mistreatment. (In New York City, only 49% of adult African Americans are fully vaccinated, compared to 77% of adults for the city as a whole.)

For all that, one can hardly doubt that it is the politicization of the issue by the likes of Fox News commentator Tucker Carlson that has done most to create an environment in which, according to recent polls, 18% of men, 20% of Republicans, and 24% of white evangelical Protestants say they will never get the vaccine.[5]

One should not exaggerate the degree of resistance. In many cases, mandates have been very effective. United Airlines, Tyson Foods, and New York City schools, for instance, all imposed mandates, and vaccination rates among their employees are now over 90%.[6] Nevertheless, it is hard not to be somewhat perplexed by the tens of thousands who make the opposite choice. The choice is especially bewildering in the case of health care professionals who from their training are familiar with the science behind vaccinations and from their experience are likely to be familiar with the devastating effects of the covid virus. After all, what is at stake in this case may be much more than just their salary.

Speaking generally, there are two ways to try to understand this sort of phenomenon. One way is to seek to get inside the heads of the individuals. Exactly what are they thinking, and what are their reasons? Here one can expect to encounter anecdotes (many apocryphal, some true but probably not representative), doubtful statistics, generalized distrust of government, and occasionally absurd notions (e.g. the vaccine is a way for the government to implant a microchip in each person in order to exercise control over them).

The other way is to approach the issue in a more systemic way. Here the question is not so much why some particular individual believes x, but why certain patterns of thinking take hold, or at least find a foothold, in a given society at a certain time. To this kind of question there will never be a simple answer. In the present case, for instance, one can reasonably enough point to the huge influence of Fox News and other media–now including social media, which has a sort of multiplier effect–that around the clock feed their audience a steady diet of right wing perspectives, conspiracy theories, and disinformation. But then one can ask, further, why is Fox News so popular. (In August, 94 of the top 100 cable news programs were broadcast by Fox.[7]) It isn’t enough to simply say, using a powerful metaphor from Bob Dylan, that “the pellets of poison are flooding their waters.” One then has to ask why the water is being poisoned, and why people drink it without noticing that is has been poisoned.

The first of these questions is perhaps easier to answer. As Thomas Frank persuasively argued in What’s the Matter with Kansas? conservative forces in the U.S., particularly the Republican party, have for many years successfully pursued a strategy of getting voters to focus on issues that might broadly be described as “cultural”– abortion; capital punishment; gun control; immigration; affirmative action; patriotism; etc.–in order to win power, which they then use to advance the interests of the wealthiest individuals and corporations through tax cuts, anti-union laws, anti-environmentalist laws, etc.. This may not be a complete answer; there is also, for instance, the obvious fact that right wing punditry is highly profitable. But it certainly seems to explain quite a lot. Witness the way that Donald Trump, who clearly didn’t give a hoot about abortion himself, secured the votes of so many anti-abortionists by promising to seat anti-abortion justices on the supreme court–justices who also happen to be decidedly on the side of capital against labor.

The second question–why so many people readily consume ideas that are contrary to their own interests, is a hardy perennial in left-wing circles. It is the problem of explaining “false consciousness,” to use the Marxist term for this phenomenon. In the present case of people who prefer to quit their jobs rather than be vaccinated, there is the further question of why they are embracing ideas that run contrary to the best available science and empirical data.

A conventional Marxist account would place most emphasis on the material conditions that underlie ways of thinking. Marx, for instance, argued that suffering, impoverished people embraced religion because it promised in the next world the sort of happiness they desired but could not attain in this world. But that sort of analysis doesn’t seem to apply to the case of vaccination resistance. What does seem to be true, though, is that for many of those who refuse to be vaccinated, the issue is bound up with other matters, particularly one’s general attitude towards governmental authority. And skepticism towards government, which is certainly inflamed daily by right-wing media, is at the heart of an ideological package that is individualistic rather than communitarian–my freedom to say no outweighs everyone else’s desire to be safe. To that extent it reflects and perpetuates values that in other contexts (e.g. environmental concerns; tax codes; worker safety regulations) align with the interests of what, for want of a better term, we may still call the ruling class.

[1] David Robison, “NY Covid-19 vaccine mandate reduced healthcare workforce by 3%.” Iohud. Oct. 14. 2021

[2] US Bureau of Labor Statistics


[4] Zeynep Tufekci, “The Unvaccinated May Not Be Who You Think,” NYT, Oct 15, 2021

[5] Robert Hart, “By the numbers: Who’s refusing covid vaccines–and why,” Forbes, Sept. 5, 2021.

[6] Andrea Hsu, “Faced with losing their jobs, even the most hesitant are getting vaccinated,” NPR, Oct. 7, 2021.

[7] Mark Joyella, “Fox News nearly sweeeps top 100 highest-rated cable broadcasts in August,” Forbes, Aug 31, 2021.