It is hard to describe what it feels to hear someone you think you know intimately start to make conspiracy theories about the vaccines and pandemic. It is too overwhelming and jarring to grasp everything in one sitting. You go through phases. First you clutch at straws. It could be a bad joke or misunderstood. You then enter a state of disorienting anger and frustrated remonstration. After that, you can finally cool down. You may feel a deep sadness inside, knowing that this person is putting their lives at risk.
Even in countries where the majority of people don't have internet access, cable TV or shock jocks on commercial radio, there are still some who hold the most bizarre theories about the pandemic. Common instinct is to dismiss those who espouse conspiracies and to consign them to the victims claimed by WhatsApp groups or disinformation. Although these things are true, vaccine hesitancy can be a sign of larger failures. All people who are wary about vaccines, from Khartoum and Kansas, have one thing in common: their distrust in the state. We will continue to channel our frustrations at individuals, without understanding why they lost trust in us.
People can be so distrustful that they will trust any source of information, even the government. My birthplace, Sudan, has less than 1% of its population fully vaccinated. Ventilators are even more rare than vaccines. Similar stories are told in other African countries. People will often abandon everything to get free shots, and go to hospitals based on rumours that vaccines are available. For many, however, these rare and lifesaving vaccines seem a bit too good to be true.
Two members of my family were very vulnerable when the first shipment of vaccines arrived in Sudan. It was because of a rumour that there was an electrical shortage and vaccines could not be stored properly. This would have caused them to reject the vaccines and made their lives miserable. We tried to convince them that even if this were true, the worst scenario was that the shots would not be effective and could prove fatal. All of our efforts proved futile. But I held on to those straws in my hands, hoping that when the first shots were administered, and no harm was reported by anyone, my relatives would be able to come around. Their excuses were ready. According to me, the new batch was rejected by western countries who sent them the vaccines to Africa in order for good PR and not to throw them away.
Although it sounds completely insane, this is actually the exact opposite. The state is not a source of good or freewill in countries like Sudan. The government is an extractive entity that does not exist to serve citizens but to rob them of their money and then charge them for their day. Corruption is rampant. It can be as simple as bribing your way through traffic violations to forcing you to use private hospitals, because government cronies own medical technology. You can thrive in spite the state. This is evident in the government communication. Officials communicate with the public to either scold them, or spread propaganda. In Egypt, doctors who disagreed with the government's account of the pandemic were detained while oxygen tanks were running out in Cairo's intensive care units.
How can you convince someone that Covid vaccines are free and effective? The idea that vaccines are a sudden outburst of generosity and competence is a common misconception. Because political systems don't have to be completely authoritarian in order to support exploitative and dishonest governments that breed distrust, suspicion is easy to sow. If you are in the US, you might suspect that there is a hidden profit motive behind Covid vaccinations. The US has extreme political resistance to public healthcare funding, a hugely profitable pharmaceutical and healthcare industry that spends $306m (221m), lobbying, and an exorbitant and unregulated pricing for everything, from flu shots to holding your child after birth. If you were born in the UK, you might question the government's assurances that the vaccine was rigorously tested. After seeing high-ranking officials create pandemic policies, drag the nation along through lockdowns and U-turns they didn't follow, it is possible to doubt whether the vaccine was actually tested.
State failure breeds paranoia. People turn to personal vigilance when their trust in the government is broken. Poorly regulated media, which sell lies, increase this climate of uncertainty and fear. For example, in the UK, a misleading report claiming that vaccine trials were being stopped for ethnic minorities was corrected by a footnote.
Vaccine rejection doesnt happen in a vacuum. It is easier to dismiss hesitancy or conspiracies and call them unhinged behavior. However, it makes us less anxious by unreasonful displays from rational people. There are many vaccine-reticent people. They are not necessarily selfish, misanthropic, or stubborn. Just as the pandemic exposed the weaknesses in our public and economic health systems, so too has vaccine hesitancy highlighted the weakening bonds between states and their citizens. While there are no simple solutions to dealing with people who believe in conspiracy theories or falsehoods, it is worth looking at the systems that have lost trust.
