In those moments, your mother not only knows best, but becomes a sort of goddess. Against the fevers, blocked noses and nettle-stung shins of childhood, she wields a mystical healing power — the ability to kiss it better, to ordain that you’ll be “right as rain” in the morning (and you always are). This relationship rests on a limitless bank of trust, the ultimate vulnerability and the ultimate faith.

But what if your mother is not worthy of it? What if, having recently emerged from a global pandemic, she is now at odds with your family doctor, and mistrusts the mysterious adults who administer jabs at hospitals? What if she now represents a gatekeeper to things that might help, or even save you, from syrupy sweet Calpol to a vaccine preventing a bout of measles that might kill you?

This is life for the children of “crunchy mums”, so called because of the hippy, molar-cracking-granola world they emerged from. They congregate on anonymous forums, on Facebook, Reddit and Mumsnet, swapping advice on raising a child under the radar of mainstream medicine. One mother asks for tips on how to lie to doctors about her children not having had their vaccines. Another’s 17-year-old daughter begs her for the Covid jab; she is told to coax her out of her mainstream-media brainwashing and push “homeopathic prophylaxis” instead. “All the protection, none of the risk,” the comment says. Another woman asks how to treat her four-year-old with meningitis, whom she refuses to take to hospital. “Is this necessary?” she says of heading straight to A&E. “I am over Covid politics.”

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On a different forum, a mother worries about the prevalence of measles in her son’s school; he is not vaccinated. “Stay confident in your decisions. Don’t let fear manipulate you,” comes the soothing reply. In one nannying forum, a woman tells of a mum who refuses to let her daughter carry an Epipen despite being fatally allergic to bananas. Instead, a “homeopathic salt” is kept in the house for emergencies. Another posts a picture of her three-year-old’s teeth — or what remains of them; they are all but completely decayed thanks to the misguidance of a “holistic dentist”. The mother now wants to do “what’s best” for her toddler, to relieve her pain, but it seems a little too late.

The Crunchy Mum phenomenon might appear, to most observers, as utter selfishness masquerading as care. This is certainly how I see one such “TikTok influencer” whose sister-in-law writes a warning post on Reddit exposing her for making videos about her “amazing and perfect” home births, assisted by an Amish midwife with “no official medical training”. Her fifth child, we are told, was delivered in a traumatic episode involving life-threatening pre-eclampsia and an admission to hospital — but the influencer “absolutely will not disclose” these facts to her followers, denying having had life-saving mainstream medical treatment to continue pushing her all-natural brand.

Spending a little time on these message boards, one gets the impression that these women — and it is almost exclusively women — are motivated not by selfishness, but by a surfeit of paranoid love. A couple of seams run through the discourse. The first is a hangover from woo-woo communal and natural-living circles of the Sixties and Seventies; it is all about lentils, flax seeds and coconut oil. This is where a lot of Crunchy Mums seem to start; after all, what can be so wrong with raising your child in the bosom of Mother Nature? There is an organic feminist flavour to it all, slightly witchy, vaguely empowering and ultimately quite harmless.

But the second seam is where the problems begin. It seems unlikely that the alt-Right homesteader mentality can coexist so comfortably with the dippy softness of the sandal-wearing Mother Earth sisterhood, but that confluence, the coaxing from concerned mother to anti-Big State freedom fighter, is at the heart of Crunchy Mum ideology. A few weeks or months among aluminium-deodorant-dodging acolytes online sends you hurtling down a pipeline of classic tropes — a distrust of Big Pharma, an aversion to vaccines, a suspicion of mainstream education.

There is a distinct hierarchy to these forums, where even quotidian questions are met with a barrage of replies which jostle to be the most extreme, the most radically sage. Mothers out-do each other with “well actually” correctives informing forum-lurkers that, in fact, you might be killing your child with radioactivity from baby monitors, seed oils or whatever else. Women bond over how they are shunned by other mothers at the school gates; they delight in the digital garrison they have formed, the spite of it all. If children see their mothers as a sort of magician, a healing goddess, then the cultists see themselves as the chosen ones.

This anxious-but-smug fatalism is nowhere clearer than in the big-ticket forums of Crunchy Mum culture: the autism boards. Here, mothers advise one another on “detoxing” their children through natural methods, which promise to see “autism characteristics improving or going away completely”. This process involves overhauling the diet, introducing supplements, and for some reason getting chiropractors involved. You must junk pesticides, preservatives and artificial colours. And give your child Epsom salt baths. One mother reassures another that her five-year-old has “lost” his autism diagnosis by cutting out “gluten and casein”. When the original poster expresses concern that this strict diet would remove some of the greatest pleasures from her little boy’s life, she is scolded: “The changes you make now can impact the rest of his life.”

The link between “alternative medicine” and obsessions with autism is not new. In 1998, Andrew Wakefield, a former physician, published a study in respected medical journal The Lancet linking the MMR jab to autism. Though the research was based on a study of only 12 children, it quickly became accepted that gastrointestinal inflammation from the vaccine caused developmental disorders. It sparked the first major wave of what would become a global and recurring anti-vax movement. The paper was ultimately discredited — The Lancet retracted it in 2010 — and Wakefield was disgraced. The fable is by now so familiar, but nonetheless many parents are still determined to believe it.

Why? The appeal of this theory is that it gives parents a sense of control, which saves them from the bleak uncertainty of genetic fate while conferring blame on those who didn’t try “hard enough”. There is great comfort in the belief that the destiny of the person you love most in the world is not random, but in fact entirely dependent on the sacrifices you are willing to make for them. You are determined to face censure from your community, to smilingly nurse them through bouts of mumps and rubella, to become the heroine of your own family story, to save them. If anything, the controversy of your beliefs only burnishes your heroism.

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There are significant spiritual overtones to this martyred maternity. Crunchy Mums represent a slippage between real and mystical lives; they are the modern continuation of a medieval thought system which held that left-handed children represented something sinistra, devilish, and that harsh correctives could drive the dark out. In one forum, this connection is taken to an extreme in the context of — what else? — the Covid vaccine: “Don’t take it under any circumstances,” a mother says. “The mark of the beast is an unforgivable sin and you will get grievous sores all over your body… Plus the shot changes your DNA — writing lucifer (shot contains luciferace) [sic] all over it. Hell is not worth it. Plus the definition of pharmacia is spells, witchcraft, potions. [The] Bible WARNS against witchcraft and seeking such things.” This is worth unpacking. Luciferase is a family of proteins that, from the Latin, bear light (produce photons) — so are used as bioluminescent markers. These harmless, useful proteins are used in a variety of common medical applications, but not the Covid vaccine. That this woman has combined fundamental medical misunderstanding with earnest spiritual sentiment crowns her Crunchy Mum to end all Crunchy Mums.

Groomed by others to leap from well-meaning woo-woo to paranoid extremism, Crunchy Mums are a growing army. But it is one thing asking how to make soap out of your own breast milk, and quite another to give your baby botulism. These children are living the same embattled lives as those who, centuries earlier, would have grimaced through back-room exorcisms, huffing the acrid smell of burning sage from the local warty witch, getting leg cramp from sitting in a salt circle until your deformity is cured. And for the mothers, the same ancient affliction: guilt, overwhelming love — you will and must do anything to save your child. But what if rather than saving them, you’re condemning them?

“Djokovic Crowned Anti-vaccine Hero after US Open Win,” howled the title of an internal report. It continued: “The optics of Djokovic, whose vaccine opposition barred him from competing in the 2022 US Open, returning to and winning the Moderna-sponsored competition bolsters anti-vaccine claims that vaccines — and mandates — are unnecessary.”

The report rated news surrounding Djokovic as “high-risk”, noting that “vaccine opponents are celebrating” the tennis champion and that some on social media “mockingly point out that Moderna is a US Open sponsor”. Other alerts, produced by a partnership blending marketing executives with former FBI and Secret Service analysts, also cited concerns around drug industry profits as a source of misinformation.

Far from viral deception, much of the content flagged by Moderna as “misinformation” and a supposed danger to public health was nothing of the sort, it was legitimate discussion of vaccine-related issues. But the Moderna misinformation reports, reported here for the first time, reveal what the pharmaceutical company is willing to do to shape public discourse around its marquee product. And, even affect policy-making.

Moderna did incredibly well out of the pandemic. It was shot from a fledgling biotech firm to a household name, having created one of the most effective vaccines during the outbreak. The mRNA Covid-19 vaccine catapulted the company to a $100 billion valuation and minted five new billionaires, including the chief executive, Stéphane Bancel, its chairman, Noubar Afeyan, co-founder Robert Langer, president Stephen Hoge, and Timothy Springer, a Harvard Medical School professor and early investor.

But as demand for its vaccinations has diminished, inevitably, so too have its earnings. This year, its only marketable product lies unused and the company has recorded steep losses. Moderna has also been forced to pay royalty payments to NIAID, the US government agency that helped produce the basic research that underpins the mRNA vaccine technology. As a result, in January, Bancel announced a price hike of up to $130 a dose, far higher than the $15-26 for American federal contracts, according to the Wall Street Journal. “We’re expecting a 90% reduction in demand,” Bancel said, when he was asked to defend the decision. “As you can see, we’re losing economies of scale.”

With its profits evaporating, Moderna embarked on a flashy new marketing campaign that features a child chasing a red string that transforms into a ribbon, which the narrator explains is an mRNA strand that could unlock cures for all types of diseases. And its latest television advert depicts the company’s coronavirus vaccine as emblematic of a healthy lifestyle. Over some cool music, the narrator says, “make vaccination against Covid-19 a part of your health routine: Spikevax that body”.

The most important thing for Moderna is that people keep having their jabs. Smart ads are part of that. But more important is to push back aggressively against any prevailing anti-vax narrative and engage where possible in any discussions around vaccine policy. That’s where the Moderna disinformation department comes in.

Behind the scenes, the marketing arm of the company has been working with former law enforcement officials and public health officials to monitor and influence vaccine policy. Key to this is a drug industry-funded NGO called Public Good Projects. According to documents we have seen, PGP works closely with social media platforms, government agencies and news websites to confront the “root cause of vaccine hesitancy” by rapidly identifying and “shutting down misinformation”. A network of 45,000 healthcare professionals are given talking points “and advice on how to respond when vaccine misinformation goes mainstream”, according to an email from Moderna.

Moderna’s disinformation arm is perpetuating the public discourse wars that have been raging since early in the pandemic, aimed at shutting down anything that might undermine Covid-19-related policies, including lockdowns and efforts to encourage mass vaccinations. These documents provide a new window into the process that has roiled speech debates over the last three years.

With PGP, Moderna is monitoring a huge range of mainstream outlets, as well as unconventional ones, such as the Steam online gaming community and Medium. Meanwhile, Moderna also retains Talkwalker which uses its “Blue Silk” artificial intelligence to monitor vaccine-related conversations across 150 million websites in nearly 200 countries. Discussions around “competitor” issues, including discussions of Pfizer are flagged as well as vaccine hesitancy.

Their monitoring team includes Moderna’s global intelligence division, which is run by Nikki Rutman, who spent nearly 20 years as an analyst with the Federal Bureau of Investigation. Rutman was working from the FBI’s Boston office during the COVID-19 effort known as “Operation Warp Speed”, which involved the FBI conducting weekly cybersecurity meetings with the Boston headquartered Moderna. She is among many former law enforcement agents now with the vaccine maker. The involvement of former law enforcement reflects a wider trend in the misinformation-space, as the Department of Homeland Security and FBI have increasingly leaned on social media platforms to shape content decisions as a national security issue.

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The reports issued by the department, which are circulated around staff, include colour-coded warnings about the severity of various anti-vaccine narratives. The high and medium alerts include explanations of the news source and why it matters, followed by a listing of “low-risk narratives we are monitoring” that “don’t currently warrant any action”. If and when a response is needed, “our team will notify the appropriate stakeholders with recommendations”.

According to one report we have seen, Musk is deemed to be “high risk”. Specifically, a Musk video that ridiculed media and government officials who claimed the Covid-19 vaccine was “100% effective” against the virus. The report did not identify any false statements, but warned that his video highlighted the fact that “deception by health authorities and health care providers during the pandemic” would “lay the groundwork to sow distrust in credible sources on vaccine safety and effectiveness”.

Another high profile critic of Big Pharma featured in a Moderna report is Russell Brand. In September, he was flagged because some on social media suspect that he has been targeted for his “anti-vaccine beliefs”.

The report featured a video of Brand decrying pharmaceutical profits and making the claim that Moderna and Pfizer made “$1,000 of profit every second” from the pandemic. The claim is bundled into a “high-risk” alert that warns Brand’s views are “circulated in anti-vaccine spaces where he is viewed as a truth-teller and threat to authority”. Moderna further notes that Brand received support from “high-profile” figures such as Elon Musk and Tucker Carlson.

None of the reports that we have seen makes any attempt to dispute the claims made. Rather the claims are automatically deemed “misinformation” if they encourage vaccine hesitancy. We approached Moderna for comment, but they didn’t respond.

“What often flies under the banner of combating disinformation is, in this case, nothing but corporate public relations, trying to spin public narratives in directions favorable to the corporation’s interests,” said Aaron Kheriaty, a bioethicist, and fellow at the Ethics and Public Policy Center. “Does anyone really want to live under a regime where their social media feed is essentially curated by government or by multinational corporate interests that stand to profit, influencing opinion on these issues?”

This is where the line between PR and lobbying gets blurred for Moderna. It’s all very well for a company to be information gathering, and attempting to send out a positive message. But it’s quite another for it to be using that information for more problematic purposes. Of particular interest in this respect is PGP — the company at the heart of Moderna’s misinformation department.

Financed through a $1,275,000 donation from the Biotechnology and Innovation Organization, lobbyists representing Pfizer and Moderna, PGP maintains close ties to government and media. Moderna first worked closely with PGP on a programme called “Stronger” in 2021-22 in which it identified misinformation and shaped content decisions on social media. PGP was particularly well-equipped to help with this since it had backdoor access to Twitter data, known as the “firehose”, and helped Twitter formulate its pandemic-related speech policies.

We have discovered, through internal emails from Twitter, that PGP’s misinformation reporting team was frequently in contact with Todd O’Boyle, a lobbyist at Twitter, and sent him periodic Excel sheets with accounts to amplify or censor. Their intention, as we have gleaned from the emails exchanged, was not only to combat misinformation, but also to affect the content and tenor of public debate. While PGP identified some obvious falsehoods, such as claims that the vaccines contained microchips or were devised intentionally to kill patients, many tweets flagged as misinformation were simply critical of vaccine passports and other policies designed to coerce vaccination.

The relationship may have extended into the law enforcement space. Last year, Vijaya Gadde, then serving as Twitter’s general counsel, advised the Department of Homeland Security’s task force on combating misinformation on trusted fact-checking organisations. In an email to her colleagues, reported here for the first time, Gadde recommended that the government meet with PGP to decipher Covid-19 speech issues.

Moderna’s corporate intelligence and marketing team has worked closely with PGP again this year in its bid to shape the vaccine discourse as take-up drops off a cliff. The partnership expanded again in October with an official training programme, developed by Moderna and PGP, alongside the American Board of Internal Medicine, to help healthcare workers identify medical misinformation. The online course, called the “Infodemic Training Program”, represents an official partnership between biopharma and the NGO world. But none of PGP’s recent work with Moderna is disclosed on its website or in the Infodemic Training Program. PGP did not respond to requests for comment.

As the pandemic abates, Moderna is, if anything, ratcheting up its surveillance operation, with a keen interest in anything relating to policies designed to coerce vaccination. In particular, the company is closely tracking elected officials and recently passed laws in Arkansas and Texas which restricted vaccine mandates.

“Politicians attempting to ban COVID-19 mandates — or at least claiming to — signals growing resistance to COVID-19 mitigations,” reads one of the Moderna alerts. Given the company avoided publicly commenting on the mandate debate, this is revelatory.

This attitude is borne out in a report from October 5, which flags an Elon Musk message on X that elaborates on the billionaire’s opposition to mandates. Musk expressed outrage at the “demand that people *must* take the vaccine and multiple boosters,” adding that, until the courts overturned the Biden employer mandate, “SpaceX and many other companies would have been forced to fire anyone who refused to get vaccinated.”

The report notes: “Musk has one of the largest platforms in the world—literally and figuratively. He increasingly uses that platform to elevate fringe vaccine opponents and conspiracy theorists.”

But despite the growing backlash against social media censorship, the network of fact-checking nonprofits has grown at an industrial pace, providing opaque opportunities for private and public interests to take subtle control over the public discourse. Such sophistication in blending public-health messaging and corporate advertising should concern anyone with an interest in how government controls free speech.

“This is an interesting peek behind the disinformation industry, what it actually does,” said Kheriaty, the bioethicist. ”It’s about controlling a narrative, controlling the flow of information, controlling how people think about public policy, like the vaccine mandate, and how people think about a particular product that a corporation is profiting from,” he added. “It’s deeply disturbing.”

This may be the work of the anarchist far-left. It may be the work of the libertarian Right. It may — though less plausibly — have been painted by ordinary apolitical people infuriated by President Emmanuel Macron’s decision to ban all fun and long-distance travel for unvaccinated citizens from Monday.

All three of these groups, along with many other angry citizens, were represented in the protests against the “passe sanitaire” (health pass) on Saturday, which attracted over 200,000 people to 150 demonstrations in French towns and cities last Saturday.

Politics goes to the street more rapidly in France than other democracies — but protests during the late July-August holiday season are very unusual. And the numbers have doubled since they kicked off three weeks ago. Further protests are expected this weekend.

The political and social geology of the gatherings is equally bizarre. There are anarchists. There are fundamentalist Catholics. There are dotty conspiracy theorists. There are priggish anti-vaccine fanatics, some of whom attacked and destroyed a stall in front of a pharmacy offering free Covid tests on Saturday’s march in Montpellier. There is the anti-capitalist hard-Left, which believes the pandemic was invented by “Big pharma” to sell vaccines. There is anti-Semitic ultra-right — some of them holding banners which read simply “qui?” or “who?”. The intended message is that “you-know-who” (ie the Jews) are somehow responsible for the pandemic.

There is the rump of the anti-Macron Gilets Jaunes movement of 2018-9, which has little support and no clear aims but is keen to latch on to any protest against the President. And there are also many hundreds of moderate-seeming, apolitical people. Many are young. Many come in family groups. Some are anti-vaccine. Others detest the idea of health passes restricting personal freedoms or creating separate categories of French people: the government-approved “fully-jabbed” and the unvaccinated and “unclean”.

In Caen, Mélanie, a primary school teacher in her thirties, said: “I’m vaccinated. I’ve never protested before. I’m not interested in politics. But I can’t accept a segregated society. This is supposed to be the country which invented human rights.”

In Paris there were four separate marches to accommodate the different points of view. In other towns and cities, habitual enemies walked together in condemnation of Macron and the French parliament which approved the health pass last week.

Some amendments were accepted during the emergency debate but the broad thrust of Macron’s policy passed both houses of parliament. To travel long distances or to visit a café, restaurant, cinema or museum from next Monday you must be able to show a code proving one of three things: you are fully vaccinated; you have recovered from Covid; or you recently tested negative. All health and care workers must be vaccinated by 15 September or risk suspension or dismissal.

Similar, though more limited, “vaccine passports” have been introduced in other EU countries, as well as in New York City. But the French pass is the most comprehensive in Europe. Macron argues that it rewards those who put aside individual or selfish concerns to protect themselves and others – a classic example of “fraternité”, one of the three principles proclaimed by the French Republic.

Opponents say that the pass contravenes the principle of “liberté” or freedom of individual choice; or that it offends against the principle of “égalité” because it divides the French into first and second-class citizens.

These allegations – and the suggestion that Macron is somehow turning France into a dictatorship – – fell flat on their face yesterday. The Conseil Constitutionnel, which fulfils some of duties of the US Supreme court, approved the pass with a couple of relatively minor tweaks.

All in all, the health pass has exposed the contradictory and — somewhat teenaged — French attitudes to “the state”.

The French Etat (the “virus” on the Norman-Breton motorway bridge) is expected to be all-protecting. It is also constantly criticised for being intrusive and suffocating. Mummy, or Maman, state is expected to do the laundry; she is also criticised if she interferes in her children’s/citizen’s lives.

Another less of the health-pass protests — but not an entirely new one — is that part of the French ultra or alternative Left is now as “anti-state” as the American hard Right. In the United States, and up to a point in the UK, the politics of Covid scepticism has been a largely a Right-wing affair. In France it is more diffuse.

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I visited friends in a picturesque Breton village this week which is divided between two hostile tribes: ultra- conservative Catholic locals and green, alternative-artistic incomers. “They now agree on one thing,” my friend said. “They don’t really believe Covid exists.”

And yet and yet…

It is important to point out — as some foreign media commentary on the protests fails to point out — that the Macron health pass has already been an immense success.

Its intention is to revive the French vaccine programme, which was famously slow in January and February. It was quietly excellent from March to mid-June, but faded again as it ran into layers of the vax-shy, vax-lazy, vax-sceptical and vax-resistant.

France has long been the most anti-vaccine country in the developed world. One opinion poll last year suggested that fewer than one in two adults would seek vaccination against Covid-19. The real numbers of the willing proved much higher but they slumped in late June — as they also have in Britain.

Confronted with a Delta surge threatening a fourth Covid wave, Macron reneged on his promise not to coerce or force the French to be vaccinated. The impact was immediate, with one million people booking jabs online in the 24 hours after his announcement. Since when, well over 7 million French people have received their first vaccine, taking the total to over 44 million or 80% of the adult population. The rate of vaccination has almost doubled and shows no sign of slowing in the habitually inactive month of August.

Roland Lescure, spokesman for Macron’s party, La République en Marche (LRM) and member of parliament for French expats in North America, said: “There were 200,000 demonstrators with all kinds of motives (last Saturday). On the same day 500,000 people were vaccinated – which means 8.5m first vaccinations in the month of July. The result is not even close.”

Arguably, Macron’s decision to impose the pass — and it was largely his decision — will save hundreds of French lives.

Some of the old vaccine critics, such as the hard-left leader Jean-Luc Mélenchon and the far-right leader Marine Le Pen, now criticise the health-pass without fully supporting the protests. Centre-right and centre-left opposition parties voted in favour – but say little in pubic to support Macron’s approach. There is, after all, a presidential election next spring.

Opinion polls suggest that the health pass is broadly popular with French people. Between 60 and 70% of samples questioned by pollsters say that they approve. Only 40% (at most) say they support the protesters although 50% say they “understand them”. The Gilets Jaunes movement – with which the pass protests have been compared – attracted over 70% support in its early months.

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On the other hand, while support for the GJ’s gradually declined, support for the anti-passers — both in the polls and on the street — seems to be increasing.

They may, in part, represent a surge of anger against the on-off social restrictions of the last 18 months. No attempt to organise protests against mask-wearing or curfews has been successful in France. The anti-health pass protests have channelled months of frustration.

When Jean-Paul Sartre died in 1980 his funeral attracted a huge crowd, one man saying that he had “come to demonstrate against Sartre’s death”. Many of the non-political participants on Saturday’s marches were demonstrating — consciously or not – against Covid-19.

The sociologist Jean Viard says that a leaderless coalition of the ordinary and the politically-motivated should worry the government. “This movement is a cocktail which could prove explosive and whose boundaries are difficult to draw,” he said.

In particular, he predicted, the protests could be the harbinger of a more widespread social unrest (and not just in France) if the Covid pandemic – fuelled by new variants – drags into 2022 or beyond.

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Government ministers admit that they are surprised that the protests have not faded away and this Saturday will be an important test. Another big turnout on the first full weekend of August, even if somewhat lower than last week, will suggest that the movement is here to stay. It could grow larger in September and, potentially, damage Macron’s campaign for re-election in April.

On the other hand, Macron’s gamble could pay off. France is well on the way to reaching its target of first-vaccinating 50 million people over the age of 12 by the end of this month. On present trends, France should overtake the UK total of first vaccinations (covering people 18 and over) within the next two to three weeks.

The Delta wave, which hit France late, is already showing signs of fading. The health pass was always meant to be temporary. Once France reaches 52 million or so first jabs – around over 90% of over 12’s – Macron could declare it to have been hugely successful and no longer necessary. He could even hope — cautiously — to reap a Covid bonus in the elections in April.

It’s inconvenient timing, given that England has just relaxed restrictions, and the Health Secretary didn’t seem overly keen to talk about the Government’s failure to impose restrictions on travel from India for several weeks after the new variant was known to be causing havoc in south Asia. But he made one interesting point: the majority of people in Bolton and Blackburn who are in hospital with the new variant are of an age who are eligible to have the vaccine, but who have chosen not to. 

That is true. And apparently there are “growing concerns” in Downing Street that even a small number of people refusing Covid vaccines could delay the final restrictions in June. Hancock didn’t say it, but there does seem to be an attitude among some people, not just in Government, that vaccine-hesitant people have made their bed and now they need to lie in it. They’ve been offered the jab, they’ve turned it down, and it’s now their own problem.

That’s understandable. After all, the most prominent vaccine sceptics are crankish academics and Jeremy Corbyn’s brother, Piers — although Jeremy himself doesn’t seem completely on board the vaccine train either.

But while the middle-class dinner-party sceptics get the most attention, vaccine hesitancy is actually highest in other demographic groups — notably, ethnic minorities and the most deprived. While more than 90% of Britons over 50 have had at least one jab — and the British are the least vaccine-sceptical nation in the world — coverage varies widely by ethnicity. By April, people of white British or Indian heritage had over 90% take up; but people of Pakistani origin had just 78%, and black African and black Caribbean groups were down at 71% and 67% respectively.

There’s a socioeconomic difference, as well, although it’s not so pronounced. Only 87% of people in the most deprived 20% of the population were vaccinated, compared to 95% of the richest 20%.

And while it’s tempting to say that if people aren’t getting vaccinated, it’s their own fault and their own problem, it’s not entirely true. People don’t usually choose the communities they grow up in, and if you live in one where lots of people don’t trust the British establishment for whatever reason, I don’t think it’s fair to say that it’s your own fault.

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And it’s certainly not just their problem, either. Most of the population has been vaccinated, meaning that it will be increasingly hard for the virus to spread and even harder for it to kill people. But the coverage is highly uneven. People tend to live in communities full of people roughly like themselves — with similar socioeconomic and ethnic status. That means there will be lots of places in the UK with large numbers of unvaccinated people of vulnerable age.

According to Dr Adam Kucharski, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine, the future of the pandemic in the UK is likely not to be huge national outbreaks, but more localised. “It’s worth getting away from the average national coverage,” he says. “It won’t come averaged across the whole UK; it’ll be clusters.” 

And if there’s a cluster, local healthcare systems can be overwhelmed, even if the UK system as a whole has plenty of spare capacity. As we know, when Covid overwhelms healthcare systems, people die who wouldn’t otherwise have had to, and it’s not jot just Covid patients: “People who are in car accidents can’t get the care they would otherwise have had,” says  Dr Duncan Robertson, a policy researcher focusing on Covid modelling at Loughborough University. Or cancer patients, or people having heart attacks, or whatever. Plus, while the vaccines are very good, they’re not perfect: some vaccinated people will still die as a result of other people’s refusal to take the vaccine. If a very large number of people get the vaccine, a small percentage of them will die, and a small percentage of a very large number is still a large number. 

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The new variant seems to be about 50% more transmissible even than the Kent variant, which means that we need to vaccinate many more people than we would have done to achieve herd immunity, and that it will spread much more quickly around susceptible people than earlier variants did.

It’s worth remembering that, on one level, this is a good problem to have, and the UK is still in an amazingly strong situation. And although the Indian variant has thrown a bit of a spanner in the works, it’s still time to start thinking seriously about when we start donating vaccines in large numbers to the rest of the world — not just pledging them but actually giving them. The Novavax factory in Middlesbrough should come online soon and that might be a good time to start offering them around.

Obviously the British Government has a responsibility to UK citizens, but even from a purely self-interested point of view, quite soon there will come a point at which a vaccine dose will do more good for the UK if it’s in the arm of an Indian citizen than a British one. We live in an interconnected world: variants can get here easily from anywhere, and a crippled world economy is bad for us, too. We are still doing amazingly well with our vaccination programme, and it may be that we can soon start to afford to be generous.

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The dangerous naivety of Green anti-vaxxers

By Ian Birrell

But also, this is a huge reason to really push on with the vaccination campaign, and to especially focus on ethnic-minority groups. One senior scientist I spoke to said that some of the things we can do are pretty obvious, like finding healthcare providers who can speak the predominant minority language in affected areas. They’re not necessarily easy — Urdu-speaking health professionals don’t grow on trees — but we ought to try.

Most importantly: while I understand Hancock’s eagerness to say that most of the people who are in hospital have chosen not to get the vaccine in the end, vaccine scepticism is everyone’s problem, not just the sceptics themselves. Britain is ending lockdown — that’s great — but even a relatively small number of vaccine sceptics, if they’re clustered enough, could make the opening-up go very badly wrong.

There’s more. The Moderna vaccine was ready to go last January, within a couple of days of the SARS-Cov2 viral genome being sequenced. But it was not approved in the US until December, after months of testing and regulatory caution. If it had been approved instantly, many hundreds of thousands of lives would have been saved. It could all have been over a long time ago.

But, on the other hand, the history of vaccines is not entirely unblemished. In 1955, a batch of polio vaccine caused thousands of cases of polio, hundreds of cases of paralysis, and 10 children’s deaths. If people had been more cautious then, those lives would have been saved – and perhaps people would be less nervous about vaccines generally. Certainly the incident raised vaccine fears.

Which of these is the lesson we need to draw? Are we too cautious, too risk averse; or is it wise to be risk averse when it comes to vaccines, to avoid driving public panic with rare but real disasters?

A year ago today, on 23 March 2020, we went into lockdown. In the past 12 months, we’ve come to understand a lot of technical concepts – infection fatality rates, vaccine efficacy rates, exponential curves. But the most significant thing is that we have all had to become utilitarians. We all now think in terms of QALYs, utils, the greatest good for the greatest number.

As soon as lockdown began, there were fights over whether it did more harm than good. Both advocates and sceptics of lockdown argued in the same terms. The economic damage would undoubtedly ruin livelihoods; but would it do more harm, as measured in quality-adjusted life years (QALYs), than letting the virus run unchecked?

The argument over lockdown was a version of the famous trolley problem: if an out-of-control train is hurtling down a track towards five rail workers, should you divert it onto another track, where only one person is working? To hugely oversimplify, the utilitarian answer is yes: you save five lives for the price of one.

But not all ethicists are utilitarians. To again oversimplify, deontologists – Immanuel Kant is the best-known example – say you should follow certain rules: some things are always wrong, whatever the consequences. It is generally (though not universally) accepted that Kant would not pull the lever. He would say it is wrong to act to kill the one person, even though it would end up saving four lives on net.

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How safe is the AstraZeneca jab?

By Tom Chivers

The great revelation of Covid-19 is that we are all consequentialists, or all claim to be. With lockdown, the argument wasn’t usually over whether it was simply wrong to kill people with lockdown but permissible to let them die from Covid. It was whether lockdown saved more QALYs than it cost. We’re not arguing whether it’s wrong to kill one to save five – we’re arguing about the number of people on each track.

Last week, several countries suspended use of the Oxford-AstraZeneca vaccine because of fears over blood clots. I think it was a terrible decision.

For that matter, so does the European Medicines Agency. It says that whether or not the vaccine causes some small number of clots (which it may do, in a subset of people), the correct decision is to carry on vaccinating people with it as quickly as possible. “[T]he vaccine’s proven efficacy in preventing hospitalisation and death from COVID-19 outweighs the extremely small likelihood of developing DIC or CVST,” it said in its statement. (It’s worth noting that the US trial has now announced its results, which were very positive, and had zero cases of CVST in its 21,000 participants.)

Again: this is stark utilitarian language. If we pause the delivery of the Oxford/AZ vaccine, we will prevent X deaths from blood clots. But it will also lead to Y deaths from Covid because fewer people are vaccinated. If X is smaller than Y, then vaccinating is a good idea. We’re not arguing over whether it is wrong to kill a small number by giving them a vaccine, even if it saves lives; we’re arguing over how many we would save. Again, we’re not arguing about whether we should pull the lever, we’re arguing about how many people are on the track.

(Of course, X could well be zero, and I think it’s very possible that it is. Certainly, X is much, much smaller than Y. But the principle is unchanged.)

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Why don't women feel safe?

By Tom Chivers

Utilitarianism is absolutely how we should be thinking. For one thing, it’s not clear to me that the distinction between killing someone through action and allowing them to die through inaction is even coherent. If I am driving, and a child runs out in front of me, and I don’t press the brake – is that act, or omission? Or, for that matter, is stopping the vaccine rollout the act, or is continuing the vaccine rollout?

The philosopher Jonathan Bennett argues that things should count as an “action” if, of all the bodily movements I could have taken, only a small fraction would lead to this outcome. So pushing a car down a hill to a cliff would count, because I could have done millions of things – tap-danced, written a sonnet, played volleyball – and almost none of them would have made it roll down a cliff. But not stopping a car when it is already rolling towards a cliff would not, because if I’d tap-danced near it, the car would have rolled over anyway; only a small subset of actions, like putting a big rock in front of it, would have stopped it. Maybe that works as a distinction, but I don’t know if it answers my “not pressing the brake” question.

What’s interesting, though, is that true utilitarianism is extremely complex. In the pandemic, mercifully, it’s often been pretty straightforward to work out which of two actions is better. Lockdown almost certainly saved more lives than it cost, because 1) loads and loads of people were dying and 2) if we hadn’t locked down, the economy would have taken a huge hit anyway (as Sweden’s did, almost as much as its neighbour Denmark, despite the lack of a lockdown) because of all the people too scared to go to the shops or the office while a deadly pandemic was raging. Certainly it’s not the case that countries which controlled the virus better had worse economic outputs.

Similarly, rolling out the Ox/AZ vaccine despite some small risk of a small number of clotting deaths is almost certainly a good idea because 1) the vaccine will save so many lives and 2) it turns out that stopping the rollout scared people anyway. It’s not a finely balanced situation. The utilitarian calculus is fairly straightforward.

But this is by no means always the case. Eliezer Yudkowsky is an AI theorist and arch-utilitarian, who argues that a sufficiently enormous number of people getting dust specks in their eye is worse than one person being tortured for 50 years. When I asked him a rather stupid question about utilitarianism, he said that “most people” (he did not say “especially you, Tom Chivers” but it was, I felt, heavily implied) were not “smart enough” to operate on a utilitarian basis, because the real consequences of any given action are so complex and unknowable.

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Will we pass the Boris roadmap tests?

By Tom Chivers

Here’s what I mean by that. If I leave the house and cross the road to go to the shop, I will slightly change the flow of the traffic. Some cars that would have gone through a green light will now have to stop at the red. That small change will slowly affect the entire road network, like the butterfly flapping its wings and causing a thunderstorm. Eventually it will mean that cars which would have been in fatal crashes will now not, while cars that wouldn’t have been now will. Some people will live who would otherwise have died, and vice versa. I can’t possibly predict the outcomes of even a tiny, inconsequential act like going to the shop.

So instead of trying to predict the outcomes of each action in real time, we ought to behave as quasi-Kantians – to establish rules to follow, and then follow those rules: if we try to compute the best outcomes on the fly, it’ll work out worse, because we’re not very good at it. (For one thing, you might end up sitting in your house, alone, unable to go to the shop in case you kill thousands of strangers.)

For instance, go back to X and Y above. If X is smaller than Y – if fewer people will die from blood clots than would be saved by the vaccine – then we might say that the vaccine is a good idea.

But those aren’t the only numbers involved. What happens if a few people die from blood clots, and that bad publicity scares others into not taking the vaccine? Does that mean we should stop the rollout? Or, as it in fact turns out, would stopping the rollout for minor fears scare more people? Those stark X and Y figures are only the surface froth: computing the real “consequences” of any action is phenomenally difficult.

In non-pandemic times, we seem to have a simple rule for this: when a vaccine is linked to some negative impact, we suspend its use and investigate it. Concerns (baseless ones, as it turned out) about mercury in the hepatitis B vaccine led US regulators to stop using it in 1999. Australian concerns over febrile convulsions in children led them to suspend the use of the influenza vaccine in under-fives in 2010.

Is this the right rule? Not all vaccine fears are baseless: remember the polio vaccine deaths above? But that was an old form of vaccine, made by deactivating a live virus; obviously the virus had not been sufficiently deactivated. Modern mRNA, protein subunit or viral vector vaccines are not biologically capable of causing the infection they are meant to protect against, and the process for deactivating viruses when we use them in vaccines nowadays has been vastly improved. And, also, for the vaccine to have reached the public, it must have been through Phase III testing in tens of thousands of people; hundreds or thousands of person-years of testing.

And following that rule has led to some pretty negative outcomes. Suspending the Ox/AZ vaccine, as we saw above, does not seem to have boosted public confidence – rather the opposite. Similarly, the suspensions of the US hepatitis vaccine and the Australian flu vaccine seem to have been associated in both cases with a dramatic reduction in vaccine uptake. The public doesn’t hear “We’re just checking this vaccine is safe, to reassure you;” they hear “This vaccine is dangerous, and we’re taking it offline.”

In the wider world of medicine, regulatory institutions such as the MHRA, EMA or FDA have a rule in place that says something like “You need to do years of incredibly rigorous trials on new drugs, to prove safety and efficacy to some P<0.001 level, before we will roll it out to the public.” That’s because even if speeding up the process would likely do more good than harm, it only takes a few thalidomide-type disasters to damage public confidence.

That makes sense – even in the pandemic, there were lots of very confident people telling us that some drug or another worked; sometimes they were right, and it was tocilizumab, but sometimes they were wrong, and it was hydroxychloroquine. But this need for perfect data has been far too widely applied, and led us to avoid much lower-cost and easily reversible interventions, such as masks, border closures or a ban on mass gatherings like Cheltenham Festival, for far too long.

We’re all utilitarians now, as I say. The pandemic has forced us to be. But the tricky bit will be learning when to be the short-term utilitarian, working out the pros and cons of the individual case, and when to be the quasi-Kantian rule-follower.

Obviously pandemic time differs from peacetime, but I think we should learn to be a bit less rigid in some of our rules. The panicked need to suspend vaccines at the first sign of danger, for instance, can be relaxed somewhat. Modern vaccines are amazingly safe. In any case, when we shut down vaccine programmes out of an overabundance of caution, in the hope of reassuring the public, it seems to have the exact opposite effect.

I’m not saying we should have immediately rolled out the Moderna vaccine the moment it was available, or that we should have carried on giving a lethal polio vaccine to children in order to prevent vaccine hesitancy. But it is ridiculous that Americans still can’t take the Oxford/AstraZeneca vaccine, that it is sitting unused in warehouses even as it is already saving thousands of lives elsewhere; that whole nations have suspended its use in a doomed attempt to reassure the public of something they didn’t need reassuring about. Perhaps, after a year of this pandemic, we finally ought to realise that when it comes to vaccines, the real danger is in being too cautious.

A couple of days earlier, Macron saw his most likely rival in next year’s election, the far-right leader Marine le Pen, creep to within 4 points of him (52 to 48%) in voting intentions in the two-candidate second-round in May next year.

Those polling figures need to be taken with a pinch of salt. Other opinion surveys are far more favourable to the French president. Long-distance election forecasts are as hazardous as long-range weather forecasts. Le Pen has her own problems.

All the same, the poll gave Macron a jolting reminder of the chain of unfortunate events which could confront him in the final full year of his mandate: a lingering or worsening pandemic; a stuttering French vaccination programme; and a darkly negative, even angry swing in popular opinion. Small wonder if the President’s mood has been a little unpredictable.

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Can Emmanuel Macron reinvent himself?

By John Lichfield

Speaking to a group of foreign correspondents at the Elysée Palace last Friday, Macron barged, Trump-like, into a blazing quarrel over reduced Covid vaccine supplies to the EU from the British-Swedish pharmaceutical company AstraZeneca. He suggested that there was “growing evidence” that AZ’s cheap-and-easy-to-use product was “quasi-ineffective” for people over the age of 65 and possibly for people over 60.

No such evidence exists. There is a shortage of formal evidence that the AZ-Oxford vaccine works on the over-65’s. There is no evidence that it does not work at all.

This was an unusual Macron mistake (if it was a mistake). He is verbose but he is usually careful with the facts. France is already the most vaccine-sceptic country in the world. Why would a French president cast doubt on a vaccine which will be one of three available to France in the next, critical months?

A few hours later, Macron chaired what may turn out to be the single most important meeting of his presidency. The outcome was decided by a presidential hunch which flew in the face of scientific advice.

A meeting of the Health Defence Council last Friday afternoon was expected to place France into a third Covid lockdown. The chief medical adviser and health minister had warned Macron privately (and other experts had warned him publicly) that the faster-moving “British variant” of Covid was starting to spread rapidly in France.

France was already suffering 20,000 new cases and 400 deaths a day — bad enough but less than most of its neighbours. The experts warned that, without a lockdown, the new variant would tip France into the kind of 1,000 deaths-a-day “epidemic-within-the-epidemic” suffered by Britain since Christmas.

Macron decided against the lockdown. He had, according to Elysée sources, prepared for the meeting by studying reams of data himself. He looked at not just the slowly rising cases but the “incidence rate” (which was stable) and reports on virus traces in waste water in the Paris sewers (falling).

In any case, the French — and especially the young French — were not in the mood for a third lockdown, Macron judged. Unless threatening figures became deadly facts, the French would resist another confinement. There would be widespread disobedience. Restaurants all over the country were already defying the partial lockdown rules — some secretly, others openly.

If there were another lockdown, the mental health problems of isolated students — something Macron had promised to address only a few days earlier — would become desperate. Large union demonstrations against Covid-related job losses are already threatened in March.

It was time, Macron decided, to gamble and defy the European trend towards third lockdowns. France could become “the country which didn’t have to lock down” when others did. “If we succeed, we will have saved ‘French exceptionalism’,” one senior Elysée official told the newspaper Le Figaro.

Instead of a new confinement, Macron decided to reinforce — or rather enforce properly for the first time — an existing 6pm to 6am curfew. All non-imperative travel from outside the EU would cease. Large non-food department stores and shopping centres would close. If the pandemic worsened, France could still lock down in the next couple of weeks.

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There is something a little worrying about this account of such a vital meeting. The decision to avoid a lockdown was taken partly for good reasons (to spare the country’s shredded nerves) but also for dubious ones (to create a positive narrative that France could still succeed where others failed). The gravitational field of the presidential elections next April and May is, it appears, beginning to skew Macron’s personal and political compass.

Until now the President has prided himself on taking early and firm decisions on lockdowns (a first from mid-March to May and a second from late-October to mid-December). He boasted that these prompt decisions saved lives, compared to the delayed lockdown in Britain in March and the weak and poorly-enforced partial lockdown in Germany last autumn.

This time he decided to delay, partly for political reasons. The choice is all the stranger because Macron and his government have given so little attention to another potentially positive “national narrative” — France’s vaccine roll-out. After a glacial start (400 jabs in 4 days), the French programme took off reasonably well in January. France managed 1,486,493 vaccinations by the end of the month including 45,468 second injections. This was almost 50% ahead of the modest government target of 1,000,000 jabs.

Having caught up a little, France looks likely to fall off the pace again this month and drop behind Germany and Italy — never mind the extraordinary figures achieved by Britain. The government’s promise of a rapid acceleration in February (4,000,000 injections) has been mysteriously scaled back. The official plan is for 1,400,000 second jabs and 1,000,000 first time injections.

Yes, you say, but isn’t that the fault of the EU’s slow vaccine supply programme, which has been disrupted by production problems at the Pfizer and AstraZeneca factories (and also problems with the third supplier, Moderna)?

No, it isn’t. By the end of January France had received 2,600,000 (mostly Pfizer) jabs. It had used only 1,490,000 of them. It has 1,110,000 doses unused, in stock or unaccounted for.

The difficulties with supplies from Pfizer and AstraZeneca have now eased. France should receive a little less than 5,000,000 doses in February, adding to the 1,000,000 in stock. But France is planning only 2,400,000 injections this month.

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Europe shows its true colours

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Officially, the health ministry blames the shortfall on supplies from Big Pharma. Unofficially, France teems with stories of poor logistics, unambitious management and shortages of staff and needles. Professionals at the sharp end (literally) blame a cumbersome health service administration. Enthusiasm is sometimes lacking at all levels because staff (including 76% of care home workers, according to one survey) are infected by the widespread national allergy to vaccines.

Part of the French problem is legitimate. Britain’s 12-week delay between first and second injections has hugely boosted the UK headline figure for first jabs. France, like other EU governments, has dismissed that long gap as too risky. France gives the second jab after 28 days — and therefore needs to keep some doses back to fulfil that pledge.

In his meeting with foreign correspondents, Macron attacked Britain’s long delay between vaccine shots as “not very serious” and even dishonest. “We are lying to people when we tell them they’ve been vaccinated by getting one injection of a vaccine that consists of two injections,” Macron said.

He has a point. But the short French delay doesn’t fully explain the slow French roll-out. There were enough doses in France last month — and there will be more than enough this month — for a far more ambitious programme of both first and second jabs.

When the programme got off to a glacial start in late December, Macron made his anger known publicly. The rules were simplified. Urgency became briefly evident. Since then, urgency has abated but the President said little until last night.

He told TF1 TV news that France would “offer” a vaccine to all adults who wanted one before the end of the summer. He denied that that French vaccine programme was falling behind schedule. But his words were chosen carefully. “Offering a vaccine” is not the same as completing the required two injections.

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France is infected with anti-vaxxers

By John Lichfield

Until now — despite many complaints and some failures — France’s record on coping with the Covid pandemic has been reasonably good. With the same size of populations, France has had 76,000 deaths, compared to 110,000 in the UK. Generous and early French furlough and economic support schemes — which provide the models for the British ones — helped keep the loss of GDP last year to 8.3% compared to 11.3% in Britain.

On vaccines, the UK is oceans ahead. Hence, I suspect Macron’s grumpy and inaccurate comments on the failings of the AZ vaccine last Friday. The president has been irked by Britain’s success with vaccines when he feels (correctly) that France has done better with almost everything else.

The French “failure” also extends to vaccine research. The Pasteur Institute abandoned its attempts to create a Covid vaccine last month. The French pharmaceutical giant Sanofi delayed its roll-out target until the end of this year after mistakes in testing. In both cases, this may have mostly been bad luck, rather than bad science. The rush to create Covid vaccines in months instead of years has created a global lottery of inspired versus less inspired guesses.

All the same, the French failures have been embarrassing for a President who argues that France and the EU must reconquer “strategic and economic sovereignty” from the United States and China. By comparison, the British government and British media have been able to vaunt the success of “our” vaccine. (“Ours” meaning that it was invented by an international team of scientists in Oxford and multiplied industrially by a British-Swedish company with a French boss).

So, at the meeting with foreign journalists, Macron was already in narrative-building mode. He wanted to play down and denigrate the British narrative (“fast vaccines trump all”). He wanted to prepare the ground for a “French narrative”, including the lockdown decision or “non-decision” that he took a few hours later.

The President evidently hopes to be able to sell in the election campaign in spring next year a three-part French success story. The three elements would be: resisting a third lockdown; making a plodding success of a “careful” and “honest” vax programme; and opening up French lives and the French economy by the autumn (when the elections will be six months away).

He could yet succeed.

Take Macron’s promise to  vaccinate  all adults, (52,000,000 people) by the end of August. Many adults will refuse. The willingness of the French to roll up their shirt sleeves is increasing but has reached only 56% (the equivalent of 29,000,000 adults).

Two jabs for all willing adults might require 58,000,000 injections or 276,000 a day. The planned jab rate in February is less than 100,000 a day.

Hope remains, however. France’s vast network of local pharmacies will be allowed to vaccinate people from later this month once — irony alert — the easy-to-store AstraZeneca vaccine becomes available. As AZ supplies increase in April and May, the French pharmacies say they will be able to vaccinate up to 500,000 a day. But that would require a massive effort by the French government to get the vaccines out to them.

Another grimmer narrative is also possible.

What if  Macron’s gamble last Friday fails? France is forced into lock down later this month. The vaccine programme remains laborious. Cases and deaths explode just as they begin to fall elsewhere.

Worse, the UK, for all its earlier Covid failures and crippling self-imposed Brexit trade barriers, succeeds while France fails. Macron’s presidential rivals (including Ms Le Pen) are presented with a counter narrative. Britain surfs on its rapid vaccine campaign to an early retreat of the pandemic; British lives and businesses open up; deaths in Britain fall. France’s do not. Macron’s election chances evaporate (not necessarily to Ms Le Pen’s ultimate gain).

It is small wonder that the President is in a tetchy mood.

He wasn’t alone. The Archdeacon of Croydon, the Ven Rosemary Mallett, then issued a similar statement: “I also hear that there are a number of people from black and minority ethnic communities who are finding themselves really worried about the vaccine… Please, please, get yourselves vaccinated.” The Diocese of Southwark went one step further, bringing in an urban epidemiologist, Professor Tolullah Oni, to lead an online forum to try and disabuse churchgoers of their fears.

As a priest with a black majority church in the same diocese, I am also making every effort to reassure people that the vaccine is safe.

It seems, however, that the same cannot be said of the very people whose jobs it is to promote the “public understanding of science”. Take Professor Alice Roberts, the Professor of the Public Engagement in Science at the University of Birmingham, who is also the President of Humanists UK. At the same time as Bishop Karowei and others were pleading with their communities not to see science as a threat, she was doing her level best to ridicule people of faith.

Without any consideration for whether now is an appropriate time to go on the offensive, Professor Roberts, displaying that jocular, superior tone so beloved by professional religion haters, took to social media to sneer about the resurrection, the virgin birth and so on. It “all seems a bit … makey-uppy,” she proclaimed.

Here, of course, Roberts is following in a tradition well-established by another former Professor of the Public Understand of Science, Richard Dawkins. He famously denounced God as “a vindictive bloodthirsty ethnic cleanser, a misogynistic, homophobic, genocidal, phillicidal, pestilential, meglomaniacal, sadomasochistic, capriciously malevolent bully”. This too from the person paid to promote the public understanding of science: “Science is interesting and if you don’t agree you can fuck off.”

Such a callous attitude is symptomatic of the growing “facts don’t care about your feelings” school of thought. But those tasked with the public understanding of science surely need to do a lot better than “fuck off” if they are to win over the sorts of communities who see in science some sort of threat.

That was, after all, one of the chief concerns of the “public understanding of science” movement that took form following the Bodmer Report, commissioned by the Royal Society and published in 1985. On its opening page, it explained that “many personal decisions, for example about diet, vaccination, personal hygiene or safety at work or at home, would be helped by some understanding of the underlying science”. Concerns about vaccination scepticism were there on the very first page. That’s partly why it recommended that “scientists must learn to communicate with the public, be willing to do so, and indeed consider it their duty to do so”.

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This is undoubtedly a noble aim. But in recent years, what began as considerate public engagement has become tainted by a new group of public intellectuals who, comfortable in their own echo chambers, understand their role as preaching to the choir.

Roberts and Dawkins are not the only ones who have taken it upon themselves alienate religious believers. Brian Cox, Professor for Public Engagement in Science at the University of Manchester, argued on the Joe Rogan podcast only last week that physics “ruled out” the existence of the soul. Likewise Jim Al-Khalili, Professor of Public Engagement in Science at the University of Surrey and former President of the British Humanist Association, has said that “someone of a religious faith will just stick their fingers in the ears and say: ‘I’m not listening, there’s nothing you can say that will make me change my mind.’” So too Professor Richard Fortey, Collier Professor for the Public Understanding of Science and Technology at the University of Bristol, has suggested that proponents of Intelligent Design should be known as “IDiots”.

On and on it goes. Indeed, it was in this spirit that, back in 2019, the National Secular Society successfully lobbied Public Health England to remove a suggestion from their literature that some people, worried about vaccinations, might like to seek advice from “faith leaders”. Following his victory, Stephen Evans, the NSS’ Chief Executive, crowed: “Advising people to approach religious leaders on healthcare decisions is incompatible with the best interests of individual patients and the wider public.”

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Certainly it is true that not all faith leaders are taking the sort of lead exemplified by the Bishop of Woolwich. But the scornful rhetoric used by the NSS is equally unhelpful. “Some of these fanatics are obstinate, some are deluded or exploitative,” was how one author on the their website described religious attitudes towards Covid-19.

It doesn’t matter how many mosques and cathedrals open themselves up as vaccination centres; there will always be those who want to turn the complex relationship between religion and vaccination into some sort of culture war — using the present situation to leverage more condemnation of religious belief. And that is profoundly unhelpful, not least because it ultimately undermines the efforts of religious bodies to explain to their communities that science is their friend.

Some people just can’t move on from those tired, old, 19th-century debates surrounding science and religion. In fact, we’ve almost come to expect it from anti-religious campaigning organisations like the NSS. But what we should not expect, let alone accept, is the fact that so many of those now tasked with increasing the public understanding of science regard it as part of their brief to attack religion — it can seriously undermine the communication of all the good that science can do to people who may not share the same world view.

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The current pestilence has powerfully reminded us that we are all in this together, and that, unless vaccination is going to be imposed by law, people have to be persuaded about its importance. This is, after all, precisely what the entire public understanding of science movement was intended to achieve, as opposed to being used as a Trojan horse for the advancement of attacks upon religion.

Perhaps it’s high time we had someone in one of these roles who believes in God. This is not an argument about religious privilege — nor one about greater inclusivity. It is simply an argument about public health.

According to one estimate, more than 65% of Nobel Prize-winning physicists in the 20th century were Christians or had a Christian background – a figure which rises to more than 72% for chemists. Yes, a Christian background isn’t necessarily a sign of faith. After all, Professor Roberts went to a church school herself — and sends her children to one. But surely it is not beyond the wit of the scientific community to find someone who can communicate with religious people without resorting to condescension. And if it is, perhaps they should call upon Bishop Karawei.

In a clip that’s been viewed more that 10 million times, O’Brien interviews Ross, whose Advance New Zealand Party failed to secure enough votes to win a single parliamentary seat in the recent general election — although “interview” isn’t quite the right word for what happens. Maybe what I mean is “humiliate”.

She starts by calling him a “loser”. He smiles gamely. Then O’Brien asks if he has any regrets; he rattles off a boilerplate answer praising the people he worked with, and she bowls straight back in. “Do you want to have another crack at answering that?” she says, “Because I just asked you if you have any regrets. You’ve just been part of a political movement which has been peddling misinformation during the election campaign. Do you have any regrets?”

Advance New Zealand are often referred to as an alt-right party, which doesn’t quite convey its full bizarreness as a political entity. For the 2020 election, Advance formed an alliance with the Public Party, which is a kind of grab-bag of the conspiracist and crankish. Imagine someone scraping all the maddest bits from the carcass of Facebook — a reclaimed slurry of 5G alarmism, anti-vax propaganda and scaremongering about electromagnets — and turning it into a manifesto. That, very roughly, is the Public Party.

One of the group’s candidates was a self-proclaimed psychic who withdrew from the race 24 hours after announcing her candidacy, presumably due to unforeseen circumstances. And that’s the most benign end of the lunacy that Ross bound himself to by allying the two parties, since the Public Party is also an avid promoter of covid conspiracies, something Advance New Zealand were happy to go along with. During the campaign, the New Zealand Advertising Standards authority upheld a complaint against Advance for spreading misinformation about coronavirus; Facebook shut down the party’s page for the same reason.

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By Sarah Ditum

That’s why O’Brien went in hard on Ross with her questioning. When he tries to defend himself, she slaps him down, saying: “You know exactly what you were doing; you were whipping up fear and hysteria among vulnerable communities.” When he ventures something dubious-sounding about death rates, she talks clean over him: “No, no, no, I do not want to hear any of that rubbish.” At the end, after he’s manifestly failed to salvage any dignity from the encounter, she terminates the interview with a tart, “You’re dreaming, mate.”

New Zealand apparently already has a word for this: Ross had been Tova’d. But for most of the rest of the world this was new, delightful, glorious. Glenn Greenwald of The Intercept called it “an absolute masterclass”. NYU journalism professor Jay Rosen said it was “the way it should be done”. Such fun! Well here I am, the killjoy who says you don’t need a third Negroni and that the hot bartender encouraging you to order it probably doesn’t really fancy you anyway.

It is fun — but so what? O’Brien says herself that Ross’s career is over, and it’s highly unlikely that most of the people fawning over her interview style had ever heard of her victim before this moment. He was a nonentity when he walked onto her set: now he’s just a nonentity that everyone has heard of. Which I guess makes him… an entity, of sorts?

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And if the interview didn’t, after all, take down a worthy foe, what did it achieve? O’Brien slammed Ross for misleading “vulnerable communities”, but it’s highly unlikely that anyone who believed his nonsense was going to be dissuaded from it by watching this encounter. Yes, there’s a simple principle of right and wrong, truth and falsehood here — but simplicity is exactly the problem with the way a lot of issues are handled by the media.

Carve any subject down to its barest conflicts, and you won’t help people find enlightenment and resolution. Instead, you’ll make them feel attacked, embattled, inflexible. In a recent piece Amanda Ripley warned of the dangers of journalism that goes in pursuit of simplicity; and which has, unfortunately, the effect of making everyone more committed to the certainties they’ve already chosen. Instead, she says, they should look for complexity, arguing that “Complexity counters this craving, restoring the cracks and inconsistencies that had been air-brushed out of the picture. It’s less comforting, yes. But it’s also more interesting — and true.”

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Perhaps it doesn’t matter very much in the case of Ross. Advance got less than 1% of the vote, so you can hardly think of him as the representative of New Zealand’s Covid-denying left-behinds. More worrying is the idea that O’Brien is some kind of role model for journalists — “the way it should be done”. What she offers is the stupefaction of a cheap pleasure, which is fine once in a while, but nothing you can live on. Turn this approach on an actually popular populist, rather than a sadsack failure content to soak up the last moments of his dead career, and you’d quickly have a polarised nightmare.

Rather than attack people as liars or presume their bad faith, Ripley suggests journalists should look for ways to open conversations: instead of telling people what they think, ask them about why they believe the things they do. Often, the things that people seem to be at odds over are just proxies for underlying issues; and sometimes, those underlying issues are more tractable than you ever expected.

It’s even possible that the questioner could be the one to change their mind about something. A world where you might be the dumbass after all isn’t very reassuring, but it’s a lot more plausible than one where you’re only ever right.

Addressing a vaccine-sceptic fellow Republican, Governor Scott said, “We’re in the middle of a pandemic. One of the front-runners on the Democratic side has questioned the science of vaccines. Do you accept, like I do, that vaccines are essential to public health and getting us out of this economic crisis that we’re in?”

Governor Scott is on the side of vaccines. His claim was that Lt Governor David Zuckerman, a pony-tail wearing Democrat who is now the challenger for the Governor’s job in the November election, is an anti-vax candidate.

Now, Vermont politics is rather incestuous and sometimes downright weird. One of the questions asked of the Governor by a fellow candidate during the debate was: “How do you justify not speaking up against the Department of Corrections forcing people to masturbate and measure their penis size or having undocumented strip searches called the naked monkey dance?” But putting that eccentricity to one side, there can be no doubt that David Zuckerman, a Democrat who may well become the Governor of the state of Vermont, or in the future a replacement in the Senate for its most famous political son, Bernie Sanders, has sided with people who do not approve of vaccines.

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During a debate in the Vermont Senate in 2015, about efforts to force more parents to vaccinate their children, Mr Zuckerman said the pharmaceutical companies were in it for the money, rather than the health benefits. He maintained this gave parents the right to keep their children un-vaccinated:

“For me, as long as there’s the extreme financial conflicts of interest out there that are driving much of this debate and discussion, I have to maintain the individual right for someone to do their own research as well and make that decision,”

It was the classic vaccine-sceptic position. Yes, vaccines can help, but let’s go slow. Let’s open the door to talk of money, of freedom of choice, of ‘research’ that might lead to the conclusion that politics drive the vaccine movement. Let us, in other words, muddy the waters.

Fast-forward to now. What is the position, the official position, of the Democratic party, when it comes to vaccines against the Coronavirus, SARS-CoV-2? Muddier than it could be, some are saying.

In a series of interventions, senior Democrats have cast doubt on the reliability of any vaccine available soon. Let’s start at the very top with Joe Biden, the presidential candidate. “Let me be clear: I trust vaccines,” Mr. Biden said. “I trust scientists. But I don’t trust Donald Trump, and at this moment, the American people can’t either.”

Mr Biden said later that he would take a vaccine before election day, if the doctors told him it was safe. But the implication was clear: an early vaccine could be suspect.

Kamala Harris, his choice for vice-president, went further. When CNN’s Dana Bash asked whether Harris would trust a vaccine released by the end of the year, or sooner, the candidate responded, “I think that we have learned since this pandemic started, but really before that, that there’s very little that we can trust that comes out of Donald Trump’s mouth.”

Which was not exactly no, but not exactly yes. She received backing from another hugely well-known and respected Democratic politician, the Governor of New York Andrew Cuomo, who announced that his state would carry out independent tests on any vaccine: “Frankly, I’m not going to trust the federal government’s opinion and I wouldn’t recommend to New Yorkers based on the federal government’s opinion.”

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And just in case Donald Trump were to find a way of importing a vaccine from Britain, that base was covered off too by Nancy Pelosi, the speaker of the House of Representatives, just last week, with a suggestion that British medical regulation was suspect: “My concern is that the UK’s system for that kind of judgment is not on a par with ours in the United States. So if Boris Johnson decides he is going to approve a drug and this president embraces that, that is a concern that I have.”

It is worth saying clearly that the Democratic party, around the United States and for many years, does have a record of backing vaccines. The Republican record is more mixed, and Donald Trump himself has flirted with the anti-vax movement. But what worries some enthusiastic backers of vaccine science is that the Democrats risk undoing the work they have done in the past – and of damaging Americans’ already shaky trust in science and medicine.

The view that Donald Trump might be untrustworthy on medical matters is hardly controversial.   It might make political sense for the Democrats to point this out so that the White House cannot make some baloney claim that a vaccine is ready and if you vote Trump you will get a jab in a few weeks time and your job back and everything will go back to normal. You can see why Joe Biden and his team might want to inoculate themselves against that.

But this is (relatively) subtle politics. What if most people just don’t concentrate that hard on the detail? The risk is that the message they get is less “Donald Trump is dodgy when he promises a vaccine” but more: “the vaccine is dodgy.”

It’s the dodginess, stupid.

One of Americas most prominent anti-vax campaigners isn’t complaining. For Robert F Kennedy, JFK’s nephew, the Democrats’ attitude has been helpful to his cause: “There is undeniably a lot more scepticism about vaccines,” Kennedy said. “It’s gone from maybe 5 to 10 percent to up to 50 percent range.”

He seems to have got that about right. In a national poll conducted for CNBC/Change Research at the end of last month only 42% said they would definitely or probably receive the inoculation when it first became available. That figure has fallen from 58% in July.

And who, politically, has had the biggest change of heart?

An extraordinary collapse in support from registered Democrats contributed to the overall change: only 30% said they would definitely get a vaccine, down from 57% in July.

Mr Zuckerman in Vermont is still an unusual Democrat but scepticism about vaccines – or at least about this potential vaccine – is widespread among the party’s supporters. It has been encouraged by the leadership. If Joe Biden becomes president and a vaccine becomes available he will be accused by the anti-vax movement of raising a legitimate set of doubts, and then ignoring them. It could be a powerful message.

It is pretty certain that no vaccine will actually be available before the election, or in its immediate aftermath. But the political fight may have done more long-term damage, and that is damage that the United States could do without. As Andy Slavitt, a former Obama administration health official, put it recently: “Done right, vaccines end pandemics. Done wrong, pandemics end vaccines.”

The politics of vaccination is a high-risk area, with a danger of unintended consequences. The Democratic party has done what it felt it had to do, but American doctors have been given yet another reason to furrow their brows.

The guessing game began. Their clothes didn’t scream Socialist Worker Party. So what were they protesting? Who were these children, and what did they need saving from? The Bedroom Tax? Black Lives Not Mattering? Turkey Twizzlers?

As we crowded into Trafalgar Square the answer became obvious: satanic paedophile cults.

There, a crowd of true believers were gathering for the grand jamboree of dissent that was the Unite For Freedom Rally. I had accidentally stumbled into the conspiracy theory motherlode. There were many more QAnon posters — the particular creed that these two were devoted to. But there were also posters that advertised Bill Gates’s largely unrelated attempts to depopulate the West. Then the vaguely related but far more established anti-vaxxers. Then the ultra-modern 5G types. A man in a cut-out face visor held a garish folk art poster with more orthodox anti-Semitic Rothschild tropes, even as more milquetoast libertarians used their posters to assert only that “masks are muzzles” and “new normal = new fascism”. Finally, there was a single placard, perhaps designed to unite these disparate sub-tribes under a single belief system. It said only: “SCAM”.

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The Unite For Freedom Rally had been advertised online as aiming for ‘an end to Government lies and the restoration of all freedoms’, but its remit went far wider than that, because its organiser was Kate Shemirani.

In recent weeks, Shemirani has emerged as the leader of Britain’s anti-Covid conspiracists. The quickest way into her belief system is to note that she refused chemotherapy for breast cancer on the advice of a husband who thought 9/11 was an inside job, then embarked on: “a fat-free, salt-free, sugar-free vegan regime including high doses of vitamins as well as 13 juices a day, five coffee enemas and mistletoe injected into her stomach”. Anti-vax is her strong suit, but you name it and Shemirani will believe it.

So why was she teaming up with Dolores Cahill? Cahill is a doctor and a professor from University College Dublin. She’s a world expert in biomarker discovery and diagnostics; you can’t say that about people who squirt mistletoe into their tummies.

Cahill was one of the early speakers. She believes we’ve over-egged the lethality of coronavirus (perfectly reasonable), and also that vaccines carry safety risks (debatable, but she has the scientific chops to make a case). Just upstream of her, the day’s first speaker quoted nothing more noxious than Karol Sikora and Carl Heneghan, putting a mainstream case that anyone locked down with Toby Young would know only too well.

Yet just 20 minutes later David Icke was onstage, joining all imaginable dots as he hammered his emetic catchphrase: “People of England get off your knees, the lion sleeps no more.”

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Many conspiracy theories are already negations of other conspiracy theories. Is it a necessary or merely a sufficient condition to believe that Bill Gates is trying to depopulate the Western world, in order to believe that a New Jersey pizza parlour is a global hub for the dial-out molestation of children?

If Dolores Cahill believes that vaccines containing aluminium risk long-term toxicity if injected intra-muscularly, how does this square with Shemirani’s view: that they are full of microchips bearing ‘Darpa thought-monitoring agents’? Curiously, no one seemed interested in debating anyone else’s view. The crowd cheered everything.

‘Sharing a platform’ is a peculiar modern fallacy — a kind of lo-res conspiracy theory in itself about how ‘wings’ in politics work. But there’s also something quite strange about the bland pax that prevails here. In the world of deep belief, it seems all are welcome, more belief is always better, and nothing is ever contradictory so long as it pushes against power. It’s like one of those pan-faith conferences beloved of CofE bishops and Prince Charles. I do Buddha. You do Allah. They do Yoga. But — hey man — we all worship the same spiritual dimension.

Are conspiracy theories on the Left or on the Right of politics? Only their targets give it away. Inside the horseshoe, a hatred of the shadowy ‘Elites’ invokes both a libertarian desire to live freely and a leftist desire to topple power hierarchies. The sleight of hand that resolves the paradox is that no one is ever required to define what comes after the Elites are toppled.

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One reason for the present boom times for the likes of Shemirani is an age-old one: in times of trial we turn to faith. Another is more specific: the spectrum between conspiracy and truth is as blurred as it’s ever been.

The present moment seems designed to test the premise that Michel Foucault and R.D. Laing tried to write into our culture: that madness itself is a social construct, and a rational response to an insane society. Glaring contradictions in plain view are a force multiplier to the paranoid. In normal times, those contradictions are hidden by the sheer imposing gloss of an advanced society.

Yet anyone who has participated in the past few weeks of British life will be able to stick at least one finger in the gap between appearance and reality. Is it terribly surprising that some will also give it a wiggle?

Every day we are being asked to participate in what amounts to hygiene theatre. Never mind the rule of six, witness the contradiction between wearing masks in the queue for your coffee, and not when sat down right next to the queue. Witness the perspex shield between you and the barista. Then watch agog as the same server calmly places a receipt into your hand. It only takes a few seconds of googling to learn that a covid particle is 0.125 microns across, while a high-end N95 mask protects only against particles 3 microns or bigger. The size difference between a football and a goal.

Those who study conspiracy theories point out that they are seldom based on nothing. Normally, a kernel of jarring truth is exagerrated, kneaded, worked on. In the world of QAnon, that process of growing the dough even has a name: ‘baking’.

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It’s not much of a conspiracy to say that day-to-day, we are often asked to practise folk epidemiology to avoid frightening the horses. My mask doesn’t so much protect you as it protects some semi-imagined other who would be too scared to go onto a packed tube carriage without an implement that only months ago the WHO said didn’t work.

So where exactly is line between frightened horses and the ‘scared sheeple’ prominent on so many Unite For Freedom posters? The paranoid already see life as one big psyops game. In the Covid age, government sees it as one big Nudge Unit. Is that much of a difference?

Some of the sheer arbitrariness involved in Covid rules is unavoidable. Other bits are merely the voice of a government that has learned to speak in an infantilising tone. But both implicitly force the mainstream to cede ground to the nutters, to reveal that they may have some small, limited point. Around that tiny reef of truth, the barnacles of Q and Anti-Vax and Gates and 5G are attaching themselves.

After the Iraq War, the fallout from Alastair Campbell’s 45 minute dossier disintegrated our belief in what ‘they’ were telling us as foreign policy. Covid is rapidly turning into a home front version. The bourgeois conspiracy Iraq unleashed: “It’s all about oil”, is not too far from the Covid libertarian one: “It’s all about control.” Both feed more feral versions: “It’s all about Israel,” and “It’s all about mind control.”

This week, the Australian state of Victoria witnessed yet another extraordinary act of police overreach: footage of cops stomping on a mentally ill man’s head, after running him down in their car, for what seems to be little more than the crime of breaking curfew.

Rather than shrink in shame, the state’s premier, Dan Andrews, used his news conference to justify their actions with a shrug. “Much of this, sorry, all of it can be avoided,” he told the press, “if people don’t protest.” What paranoia is unjustified in the face of Andrews’ statement? What part of V For Vendetta is still science fiction? Who’s the real nutter here?

Between Il Duce Dan in the real world, and the vile fantasies of QAnon online: that’s the narrow ledge of sanity on which we must all perch.

Vaccines really do work, and have saved millions of lives — indeed, it’s perhaps the biggest irony in medicine that one of the most effective and beneficial interventions known to humanity is the one that’s regarded with the most mistrust and suspicion. With the Prime Minister, we might ask: why can’t these recalcitrant anti-vaccine fools just trust the experts?

But it might be unwise to take such a black-and-white view of the anti-vaccination movement. For although the evidence on the effectiveness and safety of vaccines is clear, scientists and doctors have been anything but immune to missteps and errors in how they’ve dealt with them over the years. Pitting the wacky, hidebound anti-vaxxers against the sober, all-knowing experts risks glossing over the mistakes those experts have made in the past — and failing to learn from the cautionary tales.

Last week was a big week for vaccines. As well as the government’s flu vaccine push, initial results from two new COVID-19 vaccine trials appeared in the journal The Lancet — one from the UK and one from China. They join a US trial from the week before in showing that their candidate vaccines have tolerable side-effects and definitely do cause an immune response. These Phase I and Phase II trials are just the first — albeit crucial — steps on the way to finding a working vaccine. Next, we move to larger, Phase III trials that involve many thousands of people, testing whether those who get the vaccine are actually less likely to catch Covid-19 than those who are injected with a placebo.

It does feel somewhat ironic that The Lancet in particular is taking the lead in publicising the research on Covid-19 vaccines: besides being a super-prestigious medical journal, the main public claim to fame of that particular journal is in publishing one of the worst and most damaging vaccine studies of all time. That was, of course, Andrew Wakefield’s notorious Lancet article linking the MMR vaccine to autism. Its appearance in 1998 fanned the flames of the anti-vaccine movement, with crushing media suspicion falling on the MMR — and a resulting deadly surge in measles cases in the UK and worldwide.

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Many large, high-quality studies have since found that Wakefield’s MMR-autism correlation — as well as his cockamamie theory about how the attenuated virus from the vaccine causes gut- and brain-related symptoms — is untrue. Worse, though, is the fact that Wakefield wasn’t just wrong — he was a fraud. He fabricated the medical records of every single one of the children in his study to make it appear as if their autism symptoms had come just after the MMR, whereas many had shown symptoms before, or a long time after, receiving the vaccine.

The publication of the Wakefield paper will forever be a stain on The Lancet, and on the peer-review process of science more generally. Even without the fraud, a study with such earth-shattering implications that only included twelve patients should never have been published somewhere so prominent. Compounding the damage was the sheer amount of time it took for the paper to be officially retracted – an astonishing twelve years. All the while, anti-vaxxers could point to a peer-reviewed study — in The Lancet, no less! — to support their view.

Wakefield was pushing at a door that, while perhaps not fully open, was certainly ajar. The anti-vaccination movement has been with us for a long time — indeed, as long as vaccines. Some renowned historical scientists have been a part of it: for example, Alfred Russel Wallace, who came up with the idea of natural selection independently of Charles Darwin, was an implacable opponent of the smallpox vaccine during the late 19th Century.

Whereas Wallace was certainly a bit “nuts” — he spent a great deal of time trying to convince his peers that spiritualist mediums really could talk to the dead and take photographs of ghosts — his approach to analysing the effects of vaccines (he argued they were actively dangerous) was statistically quite sophisticated for the time. And given that statistics were in such an early phase of their development, the pro-vaccine side hardly had much more convincing data to oppose him.

Wallace also expressed his opposition in terms of anti-paternalism (he wrote that compulsory vaccine laws were “a gross interference with personal liberty and the sanctity of the home”) and even socialism, claiming that vaccines were seen as a quick fix that failed to “get rid of the foul conditions” that caused disease to spread among the poor of Victorian Britain. These arguments were, of course, completely wrong-headed, but they weren’t the ravings of a madman, and they hint at the complexity of the anti-vaccine position: defenders of vaccines need to work on multiple fronts to combat objections that are anything but easily-debunked.

Psychologists are fond of invoking a whole series of cognitive biases to explain why people are irrational about vaccines: the availability heuristic (where people focus too much on a few scary stories at the expense of a more rational appraisal of the situation), omission bias (where having committed an act, like getting your child vaccinated, feels worse if something goes wrong than having not done anything), and so on.

But more recent evidence seems to suggest a simpler reason is at play: if people think there’s a high chance they’ll regret vaccination, they’re less likely to do it. Evidence that we can change people’s beliefs about vaccines for the better is scarce; but changing them for the worse by providing more credible-sounding reasons for regret — like Wakefield’s MMR-autism connection — is much easier.

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Alas, the publication of Wakefield’s study is far from the only significant fumble by vaccine scientists and regulators over the years. Relatively soon after his phony paper was published, the US and the EU capitulated to anti-vaccine campaigners on the issue of thiomersal (sometimes spelled thimerosal), a mercury-containing chemical that had long been used as a preservative in vaccines, and had been — you guessed it — linked to autism by the anti-vaxxers.

The idea of injecting mercury into your child’s arm can be made to sound very frightening, but the type of mercury in thiomersal (ethylmercury) isn’t the same as the type we normally discuss with reference to mercury poisoning (methylmercury, which stays in the bloodstream for far longer and can have seriously damaging effects even at small doses). There was never any evidence to support campaigners’ assertions that vaccines containing thiomersal were linked to autism, but something certainly appeared to be going on once the health experts suddenly decided that thiomersal had to go, banning it from almost all vaccines given to children from around the turn of the century.

Those authorities began speaking out of both sides of their mouths, at once saying thiomersal was completely safe and also recommending it should be removed from vaccines “as expeditiously as possible”. What were parents supposed to think? Again, anti-vaccine campaigners used the confusion to boost their message, with a flare-up of the mercury-autism controversy — as well as a plethora of personal injury claims in courts — occurring after the preservative had needlessly been removed from the vaccines.

Not only did the experts put other countries that still used thiomersal in their vaccines — particularly those in the developing world — in an invidious position, they also torpedoed their own future authority. Any use of “completely safe” or “no evidence for adverse effects…” would now be met with references to their seeming lack of straightforwardness on thiomersal.

This history of vaccination gives numerous further examples. The rushed, politicised rollout of the flu vaccine in the US in 1976 — and the potential increase it caused in the rare neurological condition Guillain-Barré Syndrome — has been blamed for spawning anti-vaccine suspicion; as have the catastrophic lab errors that caused live polio viruses to be injected into 200,000 children in 1955, permanently paralysing hundreds and killing ten.

Although safety procedures have since improved dramatically, disasters do still occur, such as the 2016 case of the faulty dengue fever vaccine in the Philippines which ended up making the illness worse. Other failures are not the fault of doctors or scientists, but still produce terrible PR for vaccines: who could forget, for example, the fake vaccination programme used by the CIA to spy on Osama bin Laden’s secret compound and get his family’s DNA?

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So do you have to be “nuts” to hesitate about vaccines? Certainly, you have to be somewhat detached from reality to believe, as some do, that Bill Gates is only helping fund the development of a Covid-19 vaccine so he can inject us all with microchips. And to be an anti-vaxxer, you have to be grossly ignorant of the evidence for the near-miraculous effects of vaccination on human wellbeing. But in seeking to persuade those who aren’t hardcore members of the movement, scientists, doctors, and politicians need to learn the lessons from the list of historical precedents where things haven’t gone to plan.

Those lessons are obvious, but underappreciated. We mustn’t underplay any side-effects of the Covid-19 vaccine. We mustn’t provide confident-sounding yet contradictory advice — as we already have during this pandemic in the case of facemasks, first advising that they were useless and maybe even dangerous (which may or may not have been a “noble lie” to preserve mask stocks for healthcare workers), then mandating their use in shops and on public transport. We mustn’t give any credibility to conspiracy theories. And we must above all be honest and transparent about how the vaccine works, who is prioritised to get it and when, and what our targets are for its eventual rollout across the population.

When the Covid-19 vaccine comes — and let’s not hold our breaths, but the early signs are promising — it’ll join the ranks of the most important medical discoveries of all time. Let’s use the failures of the past to inoculate ourselves against errors in the future — and ensure that the vaccine becomes the pandemic-stopper we need it to be.

Stuart Ritchie is the author of, Science Fictions: Exposing Fraud, Bias, Negligence and Hype in Science

Unfortunately — for marketers, at least — the idea of influencers, as so many things, is (to paraphrase Adam Kucharski’s excellent book The Rules of Contagion) either true and not interesting, or interesting and not true.

Obviously there will be differences in how effective some people are at spreading ideas. People who have lots of friends might be more capable of spreading them than people who have very few, for instance. In that sense, “influencers” — people who spread ideas more than the average — clearly exist. It’s true, but not interesting. 

But the idea that some are hugely more effective — that they will spread ideas to thousands or hundreds of thousands more people than the average — is not borne out by the facts. It’d be interesting, but it’s not true. Some people may be a bit better at spreading ideas, but not much, and it’s very hard to work out in advance who they are.

As Kucharski explains, the idea of influencers comes from the maths of contagion. You can use the same numbers to explain how memes spread as you do to explain how viruses do. The equivalent of an influencer in viral contagion is a “super-spreader”.

There’s a bit of a panic going on about one such in Britain. There’s a “hunt” for a “feared coronavirus ‘super-spreader’”, who is believed to be the source of at least four infections.

The trouble is that this idea of a “feared super-spreader” implies that they’re somehow different. Kucharski refers to Malcolm Gladwell’s book The Tipping Point, in which Gladwell solemnly explains that 168 supposed super-spreaders in a 1981 gonorrhea outbreak were not “like you and me”; they were “out every night”, “had vastly more sexual partners” and so on.

But again it doesn’t really stand up. In the gonorrhea case the main difference was length of time without treatment — people from deprived backgrounds who had worse access to medical care, so had more time to spread the disease despite being less sexually active, ended up passing it on. 

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And in general, the key thing about super-spreaders is not that they’re special but that they’re undetected. Kucharski mentions the Ebola outbreak in central Africa in 2013, where there was great study of the super-spreader phenomenon. One feature stood out, he says, but “it wasn’t a particularly helpful one … Put simply, the people driving the epidemic were generally the ones the health authorities didn’t know about.” If you’re undiagnosed and unknown to the health service, but infectious, then you have a longer window to infect people.

So far so obvious, I guess. But as Kucharski points out, the idea of “super-spreaders” sounds like someone is to blame. And if you start blaming people, they’ll start hiding. It’s a useful (if badly named) technical term for epidemiologists, but it’s not helpful if the media start using it.

The trouble is, we in the media have a need for simple narratives and simple solutions. It’s understandable but problematic. For instance, in the Times, Clare Foges argues that “the ‘me’ generation” is too selfish to take steps to reduce the spread of coronavirus: in the Second World War, “public information campaigns resounded with Old Testament authority: Dig for Victory! Make Do and Mend!” and they were obeyed: “The man in Whitehall really did know best and when he spoke people listened.”

Now, though, we’re all too individualistic — disinclined “to suffer any sacrifice for the sake of the herd”, as she put it. “The proliferation of rights and conveniences has made many of us rather self-indulgent creatures,” Foges says, and isn’t the only person to think this: Gaby Hinsliff, writing in the Guardian a few days ago, made a similar case. They both point to the rise of the anti-vaccination movement as an example of selfishness: “we all know what has happened to vaccination levels across the west,” says Hinsliff; “I’m-all-right-Jack anti-vaxxers embody the selfish conclusion of individualism,” says Foges.

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I want to gently push back against this idea. For one thing, I don’t think it’s helpful to imagine anti-vaxxers as motivated by selfishness; the decline in vaccination rates followed a gigantic scare that the MMR vaccine caused autism. The scare was false and driven by fraud (and media credulousness), but I think it’s probably more accurate — and more charitable — to assume that most non-vaccinating parents are motivated by fear, rather than selfishness. 

More generally, there just isn’t much evidence that this generation is a “me” generation anyway. The concept has largely come from the work of Jean Twenge, also famous for her work purporting to show that social media and smartphones are damaging the youth: but like that work, it is highly disputed. Most claims of major personality differences between generations are shaky. Ironically, it seems to be a stable fact that the older generation tends to think the younger ones are feckless or selfish. I would be greatly surprised if the spread of coronavirus were noticeably affected by intergenerational differences in narcissism. 

And it’s not as if there aren’t examples of past generations refusing to self-isolate, anecdotes to match those offered by Foges of Tenerife holidaymakers flouting the lockdown: as Anne Applebaum notes in the Atlantic, half of the residents of the pestilence-stricken town in Albert Camus’s The Plague “continued with business, with making arrangements for travel and holding opinions”.

The most famous “super-spreader” of all, Typhoid Mary, was repeatedly told she was spreading typhus, and twice quarantined, but refused to stop working as a cook and appears to have been responsible for about 50 cases and three deaths. She died in 1938, after a total of 30 years of enforced isolation, decades before the term “millennial” was even coined. 

I don’t know whether that sort of behaviour is more or less common now than it was in Mary Mallon’s day, or whether people were more likely to nobly sacrifice themselves in 1660 than they are now; my guess is any differences will be small and hard to detect, because people are people. But to some degree it doesn’t matter whether we are more or less selfish than we were; the question is whether we are too selfish now to self-isolate as required, however selfish our ancestors were.

Foges at least thinks we are, and that for that reason “the government must quickly open the box of measures which some will call draconian”, such as closing schools, shutting public transport systems, and putting whole towns in quarantine.

I’m not saying that she’s wrong, necessarily. I am just worried that the rise of coronavirus means that all of us in the opinion-slinging business are suddenly required to have thoughts on the best way to curb an epidemic, and I’m not sure that we’re the best placed to do so. We’re not epidemiologists or infectious disease specialists.

Earlier I tried to use Kucharski’s work rather than my own thoughts on the importance of super-spreaders; I hope I’ve represented his work fairly. Now I’m going to use the thinking of a senior infectious disease specialist who I spoke to a couple of weeks ago. The disease has spread rapidly since then and the situation has changed, but a few things he said stuck with me and are, I think, still relevant.

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One thing was that closing the schools sounds like a brilliant idea, and it may be necessary, but it comes at significant costs. Not only economic costs (as if “only” economic costs don’t themselves have serious consequences for people’s lives) but in terms of our response to the pandemic itself, because many healthcare workers will have children in schools.

The NHS is already overstretched, before the coronavirus has even arrived in force. If some double-digit percentage of nurses and doctors can’t make it to work because their kids’ schools are closed that will make things harder. It may reduce infection and so ease the overall burden on the healthcare system, but it’s not entirely obvious.

Similarly, he pointed out, shutting down the public transport system means healthcare workers not getting to work. Quarantining towns or shutting borders means drugs and other medical supplies not getting where they’re needed. Maybe all this is a price worth paying, but I wouldn’t want to be the one making the call, without some serious in-depth knowledge about logistical pathways, infection patterns and staffing levels. 

This isn’t a call for radical scepticism, or for blindly trusting the government. I’m sure we can make good decisions — the infectious disease specialist I spoke to was forceful in saying that public health bodies are not powerless, that we have the ability to push the probabilities towards more mild outcomes. “We have to be really calm and logical and not panic,” he said. 

But in the media we are influencers, not in the true-but-not-interesting-or-interesting-but-not-true Gladwellish sense but in the Instagram shills sense: we have platforms, and can broadcast stuff out. I think our responsibility at this point is to stay calm, not look for simplistic stories like “super-spreaders” and selfish millennials, and be careful about calling for draconian measures. Ideas spread like diseases, remember, and that goes for bad ideas just as much as good ones.

It was around the same time, in 2018, that measles cases across Europe hit a 20-year high. The sharp rise, blamed by the World Health Organization (WHO) on vaccine hesitancy, was heralded by the rapid resurgence of the ‘anti-vaxxer’ movement. Today, the threat anti-vaxxers pose to public health is even more pressing: just this month, measles outbreaks have been reported in areas of Greece, Italy, France, Canada, Ireland, the USA and Japan; the WHO ranks vaccine hesitancy among the top ten threats to public health in 2019.

It is no coincidence that the smiling presence of Andrew Wakefield – a struck-off British doctor, notable for widely discredited research linking the MMR vaccine to autism – had re-entered public consciousness in 2017 after being spotted at one of President Donald Trump’s inauguration balls. In the subsequent months, the British press had covered with interest – and often rising alarm – his exploits in America.

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But none of this was on my mind when, attending the surgery for my blood test, I was offered a free flu vaccination. Nor when I was immediately offered another free vaccine, against pneumonia. Indeed, it rather gave me pause when the friendly medical assistant ran through a remarkable litany of awful things that could happen to mild asthmatics – like me – who contracted pneumonia, including the possibility of ending up in a coma. So I consented. Like the majority of British people, I am a firm believer in the public health benefits of vaccination.

I then headed into work, where I felt completely fine for a couple of hours. Then I lost most of the movement in my left arm. I started to feel alternately boiling hot and freezing. My view of the office started to spin like a slot machine. I held on to the edge of my desk with my good arm, to avoid falling out of my seat.

The next day, I was in agony. I went to A&E, expecting to be given a prescription for codeine and summarily dismissed. Instead, as my arm had swelled to almost the size of my thigh, I was admitted as an inpatient.

Doctors tried various combinations of antibiotics to bring down my speeding heart rate, spiking temperature and grotesquely swollen arm. I’d been under the weather, but no evidence of an underlying condition was found in any of the tests the hospital ran. We were left with one conclusion: getting vaccinated had made me dangerously sick.

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For a while, I was angry that I had been given the second vaccine at all: several doctors at the hospital had remarked that they would never have bothered vaccinating a mildly asthmatic 22-year-old against pneumonia. They told me it had probably been done because the GP surgery received additional funding per vaccinated patient. Suddenly, the medical assistant’s pneumonia horror stories made a lot more sense.

But then, when a diagnosis was finally reached, I realised the stupidity of my annoyance. I had contracted a severe case of cellulitis, a common and usually non-serious condition that can occur after any break in the skin. It can, though rarely, be caused by an injection needle and it can, again rarely, become serious. In short, I had just been really unlucky.

But that isn’t a comforting explanation. When, filled with righteous zeal, I began searching the internet for a reassuring answer to why I had become so ill, the only places offering one were social media communities for anti-vaxxers. For the first time, I understood the draw of these groups – and there are a lot of them out there.

Type ‘vaccination’ into the Facebook search bar and you receive suggestions like VACCINE TRUTH MOVEMENT, Vaccination Re-education and Stop Mandatory Vaccination. The latter group is followed by more than 130,000 accounts and was recently censored by the UK Advertising Standards Agency over a paid-for Facebook post. “Parents,” it read, “not only can any vaccine given at any age kill your child, but if this unthinkable tragedy does occur, doctors will dismiss it as ‘Sudden Infant Death Syndrome’.”

The post also included an image of a baby, eyes closed, with the caption: “Owen Matthew Stokes (Aug 18, 2017 – Oct 25, 2017)… 2 month old dies 48 hours after 8 Vaccines”.

Personal stories like this one feature heavily across online anti-vaxxer communities. Most of them are about babies with congenital health conditions, diagnosed after the child had been vaccinated. But that isn’t how the graphics, videos, and below-the-cut posts tell it.

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There is a persistent belief among anti-vaxxers that ‘too many’ vaccinations at once can overwhelm the immune system, causing illnesses from encephalitis to multiple sclerosis – or, classically, neurodivergence like autism. Debunking this with scientific evidence has proved ineffective; the almost inevitable responses are another sick baby scare-story or a pseudoscientific counter-argument, backed up by the apparent authority of a naturopath.

This month, Pinterest decided that the only tenable solution was a blanket ban on all content relating to vaccines, recognising that their platform had become a hive of misinformation and scare-stories propagated by anti-vaxxers.

What’s striking about these groups, is the range of political viewpoints they can accommodate. Left-populist distrust of profit-motivated healthcare comes up a lot – its an understandable instinct, and one I felt too when I was given reason to wonder if the man who vaccinated me did so out of financial incentive. A lot of people in these communities also have strong libertarian leanings. They are inherently suspicious of government incentives to vaccinate, considering it an affront to bodily autonomy.

Research published just this week by Queen Mary, University of London, indicates that vaccine hesitancy grows in line with support for populist parties across the political spectrum. But while the populism is important, the politics is usually secondary to the appeal of online anti-vaxxer spaces. The biggest draw is having something concrete to blame for sickness and suffering. People can become horrifically ill horrifyingly quickly, and sometimes doctors don’t understand why. We all know this, but it doesn’t help much when it actually happens to us.

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For parents of severely ill or deceased children, a demographic vastly over-represented in these communities, blaming vaccines allows them to believe that they can do something active to protect other children from the suffering their child experienced. It is far more difficult to accept the helplessness of never knowing exactly how or why your child became sick, than it is to accept that their suffering is the fault of something you are able to fight against. Vaccines provide a target.

Where does that leave us? A measles epidemic in Madagascar just killed more than 900 people. To achieve and maintain immunity, we need to reframe the issue for people feeling the lure of the anti-vaxxers. The power of the case against vaccines is largely in its appeal to emotion and agency. It’s this that the pro-vaccine majority needs to address when we make our counter-case.

What happened to me was rare, non-contagious and eminently treatable. None of those things is true for the diseases from which vaccination protects us.