By Maja Graso and Kevin Bardosh.
Societies have long deployed creative tools of deviance control. People whose recklessness risked their collective’s well-being or threatened the dominant power structures were often sanctioned. So when C19 vaccines became widely available, many viewed those who remained unvaccinated as a threat worthy of blame, discrimination, and punishment.
The dominant social frame of modern public health is, after all, a shared responsibility in the best interests of the whole society. Our actions often impact others, so if a person can reduce the chain of transmission and lower their own chances of requiring scarce medical care, the argument is that they have a moral duty to do so; they should get vaccinated.
But social sanctions are not always proportional to the threat. Sometimes, an individual or a group are blamed for matters not entirely in their control. If blame is unjustified, it may be better understood as a form of scapegoating; a fear-based reaction that emerges in situations of deep, intolerable uncertainty.
To be sure, identifying a point after which any threat – including that posed by C19 or the unvaccinated – becomes dangerous enough to justify blame cannot be answered with only scientific inquiry. This process is imperfect and subject to multiple perspectives, evolving knowledge, political considerations, malleable definitions, and competing value systems.
In some ways, it may be easier to answer the opposite; when is the blame inappropriate or subject to exaggerated identification of threats?
The general public and experts are prone to severe risk over- or under-estimation, and risk miscalibration was a major issue of contention during the C19 pandemic. While some people underestimated C19 risks, many have exaggerated them substantially. For instance, the Franklin Templeton-Gallup Economics of Recovery Study showed that 35% of US adults in late 2020 believed an infection had a 50% chance of hospitalization. The correct estimate provided by the same study was 1-5%, which was a general range that did not account for variability in risk due to age or comorbidities (e.g., in 2021, an individual 85+ years of age had 95 times greater chances of hospitalization and 8,700 times greater chance of dying of C19, than a 5 – 17-year old).
As C19 has been and continues to be a politically contentious issue in the USA, variations in people’s perceptions of its risks are closely linked to their political ideology. In general, liberals display greater concern regarding C19 and exhibit higher compliance with restrictions. However, they are also more prone to overestimating the risks associated with C19.
Any risk miscalibration – especially if severe and uncorrected – has consequences, including the social construction of deviance. We examined whether the animosity towards the unvaccinated could be considered another instance of deviance control or a reaction stemming from a flawed perception of risks.
How did we do our studies?
In early 2022, we conducted three experimental vignette-based studies with online participants from the United States (one pre-test and two full studies). We created several characters of various profiles.
For each character, we only manipulated their vaccination status (e.g., vaccinated, unvaccinated, unvaccinated but recovered). Participants then rated each character’s responsibility for straining the healthcare system, prolonging the pandemic, and undermining public health efforts.
Character descriptions challenged the obvious culpability of the unvaccinated. For instance, participants assessed a fit 28-year-old named Steve who, due to his low risk, was unlikely to strain the healthcare system himself. Steve got C19 six months ago, around the time when vaccines became available to him, and he recovered fully. Because the unvaccinated Steve could still potentially transmit the virus, we compared him against his counterpart, who got vaccinated six months ago and has no intention of getting a booster. Viewing the unvaccinated-recovered Steve as more blameworthy supports the scapegoating explanation for bias against the unvaccinated, as the benefits of both vaccines and prior infection wane.
Overall, we observed that people blamed the unvaccinated characters (including unvaccinated-recovered) more than the vaccinated ones for the pandemic outcomes, despite information that would cast doubt on such blame. In line with representative sample-based research, we also observed that people, on average, overestimated C19 risks. Finally, liberal individuals were far more likely to blame unvaccinated individuals than conservatives.
What are the implications of our study?
Our study was just one attempt to understand the reasons behind the animosities towards the unvaccinated during C19. Such sentiments played an important role in creating public support for the various vaccine mandates and passport policies that emerged in 2021. We focused on reactions to the unvaccinated as one of many potentially disruptive consequences of risk over-estimation on social cohesion.
We invite additional interdisciplinary contributions to examine different contributors to risk misperception and create more flexible, less divisive response strategies. Sensible risk response is a function of what information is known and available, but equally importantly, what is known, but not cognitively available.
Overestimation may have resulted from well-intentioned efforts to counter misinformation downplaying the severity of the C19 threat and to ensure consistent messaging essential for inspiring collective action. However, if a situation is more intricate, consistency might only be achieved through vast simplification, where action-congruent information is disseminated, and the known action-incongruent information is not. For instance, constant announcements of all cases, deaths, and threats of long covid made highly negative information cognitively available. What was missing were details about comorbidities, implications of unprecedented testing, or information challenging the attribution of post-C19 symptoms to long covid.
Erroneous, partially presented information can lead people to refuse or dismiss C19 vaccines that would benefit them, and it can lead others to shame non-compliant individuals when that is not appropriate. It can also create a public debate that is not well-attuned to a reasoned evaluation of the risks and benefits of vaccines and natural immunity, and that does not consider age-based risk profiles – as we see with C19 booster mandates for young people in the United States.
We invite readers, especially the media and scientific community, to correct all misinformation, regardless of whether it over- or under-estimates C19 risk or C19 vaccine effectiveness. All uncorrected errors can further amplify misplaced beliefs, and through social division, create all sorts of spin-off effects: mistrust, cognitive dissonance, preference falsification, and misappropriation of resources.
Our findings also highlight the influence of political ideology on scapegoating within the C19 context. While conservative media and politicians have been responsible for spreading misinformation that undermined the benefits of vaccines, there is evidence that liberal outlets have also contributed to misinformation, albeit in a different direction, and themselves participated in fostering ideological divisions (Examples 1, 2 3, 4, and 5).
Public health is a shared good that requires transparency, an educated public, and well-earned trust in experts who, through their diverse disciplines, are able to reveal each other’s oversights. Consumers of medical information deserve accurate information, for misguided, runaway misperceptions of risk can never serve as the bedrock for sustained trust, regardless of their origins.
Authors: Maja Graso1, Karl Aquino2, Fan Xuan Chen3, Kevin Bardosh4,5
1Department of Management, University of Otago; Faculty of Social and Behavioural Sciences, University of Groningen, Netherlands
2Department of Marketing and Decision Sciences, University of British Columbia, Canada
3Department of Psychology, University of Illinois at Urbana Champaign, USA
4Department of Environmental & Occupational Health Sciences, University of Washington, USA
5Edinburgh Medical School, University of Edinburgh, UK
Competing interests: None declared.