I would like to share an extract from A State of Fear: How the UK government weaponised fear during the Covid-19 pandemic.
The Covid-19 vaccine is in the not-mainstream-news this week, since a Pfizer executive admitted in a European Parliament hearing that their vaccine was not trialled to stop transmission. This was known at the time, you will find it in black and white in official documents. And yet people were told that the vaccine did stop transmission. And that they were selfish if they were not vaccinated. They were refuseniks who should be punished. As Rob Roos MEP, who posed the question to Pfizer has pointed out, getting vaccinated to save lives was a lie. At best, it was an unevidenced hope.
This chapter is a little more generous to the vaccine than I would have liked, and a little less critical about the transmission issue. The book passed through two fact-checkers as well as an editor and publisher and compromises were made. Considering it was written at the end of 2020 and early 2021 I am satisfied it holds up well, although very sad that my foreboding about scapegoating the unvaccinated was accurate.
The vaccine programme appears to be the Happy Ending to the Horrible Story of the Covid-19 pandemic. But I am cautious. Not because I am ‘anti-vax’, but because I have observed that this stage of the story is also being written in the language of emotional manipulation and coercive control.
Some of the vaccine messaging is optimistic, proud and forward-looking. Some is straight from the behavioural science handbook. The message ‘Impfen = Freiheit’ which translates as ‘Vaccination = Freedom’ was projected on a TV tower in Düsseldorf, Germany. Proud optimism or blatant propaganda?
The term ‘vaccine hesitancy’ is now used to describe the attitude of people who have decided not to get vaccinated. It implies a slight pathologisation, that those reluctant to have a vaccine may have some sort of mental condition, rather than be making an individual choice based on risk analysis and rational preferences. It is designed to denigrate the vaccine sceptic, to make them look a bit silly. It also implies the ‘hesitation’ is just a step towards the inevitable, part of the process – come on dear, we’ll get you over that hump and you’ll have your vaccination in the end. Surely an ad hominem attack is less ethical and robustly persuasive than evidence would be?
Some of the language around Covid vaccines ticks the boxes of Biderman’s ‘Chart of Coercion’ (p142–3). In December 2020, the NHS published a document for health professionals called Optimising Vaccination Roll Out – Dos and Don’ts for all messaging, documents and “communications” in the widest sense.
Although I talked about the possible propaganda aimed at encouraging vaccine take up in BAME communities in Chapter 8, ‘Controlled spontaneity and propaganda’, this messaging is a broader departure from the public health language for the wider population. Certain recommended phrases are emotionally manipulative in a way that would affect informed consent. For instance, ‘normality can only return for you and others, with your vaccination’ and ‘if you want to be able to do what you want, then having the vaccine is the fastest and safest way to achieving this’. Why can normality only return after vaccination? If you do not get vaccinated is the message that you prevent everyone else getting back to normality?
I discussed it with psychologist Gary Sidley, who said this ‘fits the definition of blackmail’ although ‘the blatant nature of it is a little surprising’. Public health expert and doctor Jackie Cassell agreed that the document contains ‘pretty extreme language’ and that ‘the whole approach is very much from the SPI-B playbook’.
Cassell was deeply uncomfortable about this extreme language. ‘I can’t imagine how a doctor could use these arguments,’ she said. ‘Using peer norms as a direct form of persuasion is not something that comes readily to doctors and we don’t speak that language. It goes against our professional training. A vaccine is a medical intervention and people have to consent to it. I wouldn’t use the arguments in this document in these ways.’I wondered why the language was so at odds with how doctors are trained to work, and she responded that ‘it brings up some interesting disciplinary perspectives, if not fault lines. The behavioural scientists and nudgers occupy a very different space. They are thinking like psychology- trained advertisers, like they are trying to get us to buy fashion or whatever. Asking health professionals to use this kind of language could be profoundly damaging to the trust in government and health services.’
The coercive language in this NHS document shows how integral the behavioural psychology approach now is. This is also apparent in the recruitment of new behavioural science roles in the NHS, Public Health England and various government departments in recent months and years. And not everyone in public health agrees with it. If behavioural psychology is here to stay then it’s clear that, at the very least, the different disciplines need greater synergy to ensure that reflective thought about ethics and informed consent is not a thing of the past.
On the world stage, politicians as well as representatives of the WHO, United Nations, Gavi (the Vaccine Alliance) and the World Economic Forum have all parroted the same phrase: ‘No one is safe until everyone is safe’. Language is being coordinated – but by whom? The phrase is literally not true: if you have the vaccine, you have the protection it confers.
Boris Johnson announced on 25 March 2021 that ‘there is going to be a role for vaccine certification’. He justified the imposition of Covid certificates that might allow businesses to bar unvaccinated customers by saying that the public ‘want me as prime minister to take all the action I can to protect them’. The Sun duly ran the headline ‘No Jab, No Pint’.
There’s a feeling after a year of restrictions that people will do anything to ‘get back to normal’. But declaring your health status to use businesses and services has never been normal. The introduction of a health status ID to access products and services will cross a rubicon.
Some people are now overly anxious about other people’s immune status. In fact, the constant requirement for reassurance, through certificates and checkpoints, could actually ‘end up promoting fear and anxiety that are not proportionate to the perils involved’, according to Robert Dingwall, sociologist and government advisor.
Once the over-50s and vulnerable categories have been vaccinated, 98% of the risk of death and 80 to 85% of the risk of serious illness will have been eliminated. On that basis, the vaccine programme is a success for at-risk individuals and for society as a whole. So, what would the point of Covid certificates be? After all, the only thing that matters is your own immune status. If you are vaccinated, you are protected. If someone is not vaccinated next to you at the bar, it will not matter because you are vaccinated.
The push for certification is reminiscent of yet another behavioural science strategy. The kinds of people who populate the advisory panels close to government are very risk-averse. They are focused on the importance of vaccination, and ‘forcing’ their view of good health on to us, and perhaps dismissive of ethical and social considerations. Allowing private businesses to discriminate against the unvaccinated allows the government to avoid mandating vaccinations, but at the same time makes it impossible for people to go about their normal lives without vaccination. It is a form of coercion.
I asked Dingwall if he thought this push for vaccine certificates is a behavioural psychology ‘nudge’. ‘It’s a nudge for low-risk groups, once the high-risk groups have been vaccinated’, he said. ‘Perhaps the worry is about vaccination uptake among younger people. But why not cross that bridge if we come to it? Public health should not be about bullying people, it should be about advising them.’ Jackie Cassell also had reservations about certification: ‘Vaccines tap into our relationships with personhood and state. I hate the idea of biosecurity. We don’t have a passport for measles because, by and large, we have a fantastic vaccination scheme and uptake. Biosecurity won’t make people get vaccinated, feel safe, or have confidence in government and the NHS.’
Is this a case of the government capitalising on disaster? Matt Hancock said in September 2019 that the government was ‘looking very seriously’ at making vaccinations mandatory for school pupils. Is Covid-19 being used as the excuse to usher in a change that the government already wanted? He said at the time that ‘when the state provides services to people then it’s a two-way street – you’ve got to take your responsibilities, too’. But this is autocratic thinking in disguise, where ‘responsibility’ means doing what you are told. He said he thought that ‘the public would back us’. I think that would have been unlikely at the time, as it would have been a huge change for the British socially, ethically and legally. But there’s nothing like a pandemic for shifting the dial on mandatory vaccines. Indeed, in March 2021, Hancock announced that the government was looking at making Covid-19 vaccines mandatory for care workers, to the consternation of unions who attacked the plans as ‘heavy-handed’ and ‘authoritarian’.
During the epidemic, public opinion polls functioned like crystal balls, allowing us to gaze at the plans of politicians. While polls are ostensibly supposed to tell the government what we think, they are quite useful for telling us what the government wants us to think and what it wants to do next. And when the results are revealed to us they guide us, through social conformity and the herding instinct, into a preference we never knew we held. As Peter Hitchens said, ‘Opinion polls are a device for influencing public opinion, not a device for measuring it. Crack that, and it all makes sense.’ In an IPSOS MORI report, David Halpern made a similar comment: ‘In a world of behavioural economics, public opinion surveys are themselves a “nudge” – a signal to both policymakers and our fellow citizens about what’s acceptable and what’s not.’
On 30 September 2020 YouGov asked, ‘Once a vaccine has been found, would you support or oppose the government making it compulsory for everyone to receive a vaccination against the coronavirus?’The options allowed you to support, oppose or select ‘don’t know’. That question was a fairly clear indication of the government’s direction of travel at a time when emergency authorisation of a vaccine had not even been granted in the UK. The next question hinted harder at the desired destination: ‘And once a vaccine has been found, would you support or oppose the government prosecuting and fining people who do not get a vaccination against the coronavirus?’ Before the vaccine had been authorised, long before we would know whether the vaccine interrupted transmission of the virus (that is still not certain at the time of writing) the government was checking to see whether the public would support fines for not having the vaccine.
Just as Hancock’s pre-epidemic enthusiasm for mandating vaccines mirrors his post-epidemic interest, might the government’s flip-flopping on vaccine passports also align with a previous inclination for such schemes? The European Union published a Roadmap For The Implementation Of Actions By The European Commission Based On TheCommission Communication And The Council Recommendation On Strengthening Cooperation Against Vaccine Preventable Diseases which proposed countering vaccine hesitancy, and the development of a common EU vaccination card between 2019 and 2021, to be followed by a ‘vaccination card/ passport for EU citizens’ that is ‘compatible with electronic immunisation information systems and recognised for use across borders’ by 2022. Well, that seems to be remarkably on schedule.
Fear has created a morality play where heavy-handed discussions about society-wide vaccine mandates and Covid certificates, or vaccine passports, are privileged over personal responsibility and risk. Does your Happy Ending involve personal responsibility or state mandates? In the desperate desire to end the Horrible Story of the Covid-19 pandemic we are rushing towards a conclusion without being certain enough of our values.
The minister entrusted with reviewing the use of Covid certificates is Michael Gove. As he once said, ‘Once powers are yielded to the state at moments of crisis or emergency, it’s very rarely the case that the state hands them back.’ It will be interesting to see whether the spirit of those words influences the review.
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Author Laura Dodsworth
