In the fractious public dialogue about Covid-19, one point of unity stands out: An effective vaccine is what’s needed to stop, or at least control, the pandemic.

The anti-vaccine movement could derail that solution.

To stop Covid-19, many people — most people, really — would need to have either survived infection with SARS-CoV-2, the virus that causes the disease, or been vaccinated against it. By sowing the seeds of doubt and denial, anti-vaxxers could influence many people not to get a vaccine, allowing the virus to persist and be persistently infective.

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Viruses don’t discriminate among political parties. But the response by the U.S. government to the pandemic has become highly partisan, and there is little reason to think that deploying a vaccine won’t be tarred by the same partisanship, despite the typically nonpartisan nature of vaccine opposition.

Many in government, including President Trump, have turned to science denial. This isn’t usually wholesale denial of the utility and epistemological underpinnings of science, but rather denial of a scientific consensus on a particular topic. Climate change deniers, for example, typically see themselves as being on the side of science. A 2015 Pew survey found that 79% of adults are positive about the impact of science “on the equality of health care, food and the environment,” yet only 50% believed that climate change is mostly due to human activity.

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Likewise, there’s often a large difference between the consensus among scientists who study a topic and the public perception of that topic. In the same Pew study, 88% of scientists affiliated with the American Association for the Advancement of Science believed that it is safe to eat genetically modified foods, but only 37% of U.S. adults agreed.

The continued spread of SARS-CoV-2 is a practical demonstration of what happens when science denial supplants evidence-based decision-making at multiple levels of government, from mask mandates to reopening schools mid-pandemic. Denial has led to needless deaths and suffering.

How can denial be identified? In 2009, Pascal Diethelm and Martin McKee defined science denial as employing some or all of five characteristic elements. All five of these have been deployed in the last few months, sometimes by the government. Public health advocates should be ready when they are deployed again.

The first characteristic is the use of conspiracy theories to frame a scientific consensus as the product of a conspiracy of bad actors. A bevy of conspiracy theories concerning SARS-CoV-2 have already been spread on social media. The president has used coronavirus briefings as a platform to share conspiracy theories, such as physicians lying about Covid-19 to hurt his reelection chances. A widely circulated conspiracy video bizarrely claims that SARS-CoV-2 is human-made, and that Bill Gates was involved in distributing it to profit from a future vaccine. Online, anti-vaxxers have begun framing a future coronavirus vaccine as a part of a conspiracy to enforce compulsory vaccination.

Karl Popper, a philosopher of science, described these kinds of conspiracy theories as being like Homer’s conception of the gods’ behavior on Olympus as determining events in day-to-day human life. Conspiracists believe that the actions of secret puppeteers control the impersonal and otherwise unpredictable events in our lives.

Conspiracy theorists are rarely effective in identifying real conspiracies or enacting counter-conspiracies for a simple reason: Things rarely go to plan. Conspiracy theories often hinge on unlikely events and large groups of people successfully keeping secrets for long periods. When real conspiracies are uncovered, it is often because secrets are hard to keep, especially when they require the coordinated actions of hundreds or thousands of people.

The second characteristic of denial is the use of fake experts. These are often credentialed individuals who hold views outside the broader scientific consensus. For example, the president has shared videos of Dr. Stella Immanuel (and several other lab-coat-attired individuals) to promote false claims that hydroxychloroquine is an effective treatment for Covid-19, and that masks do not slow transmission of SARS-CoV-2. Similarly, science denial marginalizes legitimate experts, such as Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, who has become a trusted voice about the pandemic for many Americans.

Fake experts exploit the dual nature of expertise. An expert is someone who is highly skilled and knowledgeable, and is identified as an expert by the perception of skill and knowledge. That perception, created by language, dress, and other accoutrements, is not always accompanied by actual skill. Given the number of people carrying credentials like M.D., R.N., or Ph.D.,” it will always be possible to find “experts” who speak outside of their domains of knowledge, or who create the perception of knowledge without truly possessing it.

A third characteristic of science denial is selectivity. As more and larger studies are published, it has become clearer that hydroxychloroquine is not an effective treatment for Covid-19. But it will always be possible to select weaker elements of research to attempt to discredit a larger body of research, such as those who cherry-pick papers to discredit the use of masks.

Anti-vaxxers have now spent more than two decades selectively reading the scientific literature to cast doubt on vaccines, centering their arguments around ever-smaller minutiae. A prominent 2016 anti-vaccine documentary implied a “cover-up” over a minor disagreement about the interpretation of a statistical study of measles vaccination, premised on a now-retracted reinterpretation of the statistics, which had made a number of errors.

We should expect to see no less than a fully dishonest misinterpretation and mischaracterization of whatever clinical trials are conducted in the lead-up to the approval of a vaccine to prevent Covid-19.

The fourth characteristic of science denial is the creation of mobile goalposts, or unreasonable expectations for what research can accomplish. Whatever the results of clinical trials for whichever vaccines come to market, anti-vaxxers will find new standards for what research they believe should be completed.

For a time, anti-vaxxers tended to focus on mercury in a vaccine preservative as what they believed to cause injury. When out of an abundance of caution that preservative was removed from almost all U.S. vaccines, many moved on to aluminum as the enemy toxin.

Anti-vaxxers will frequently demand double-blind, placebo-controlled studies to prove safety and efficacy (believing, I suppose, that such studies do not exist) and when shown those studies, they retreat even farther — to demanding a saline solution placebo, or some other control. These demands are not being made honestly, and meeting them would only be met with a new goal post.

The fifth sign of science denial is the use of logical fallacies, such as mischaracterizing other’s arguments to make them easier to refute, or making arguments that are orthogonal to the point being made. (It is also true that pointing out another person’s logical fallacies is the fastest way to make people hate you.)

Although logic is a tool that can be used to determine if a conclusion follow from its premises, the rhetorical use of fallacies is a time-honored political tradition. Anti-vaccine arguments frequently attack people instead of ideas, confuse one vaccine for the entire category of vaccines (which often use very different technologies), or draw unwarranted conclusions.

To address denial, advocates of vaccination need to do more than treat denial as stemming from an information deficit, a strategy that is often ineffective. They will need to untangle the partisan threads that have characterized pandemic policymaking to date. When vaccination is made partisan, the truth of the “facts” will matter less to many people than whether those “facts” support their partisan leanings.

Overcoming science denial requires addressing its emotional underpinnings, not its justifications. This means listening to people’s concerns, both legitimate and illegitimate, and addressing them with patience and kindness. Russia has already approved a vaccine tested on just 76 people, stoking concerns from Western scientists not only that the approval is premature, but that it could further undermine trust in the approval process.

Public trust of scientists is hard earned, and constantly faces erosion. Those who believe in science must stand vigilant against science denial, recognize it, and address the concerns that underlie it.

Jonathan Berman is an assistant professor in the Department of Basic Sciences at the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, national cochair of the 2017 March for Science, and author of “Anti-Vaxxers: How to Challenge a Misinformed Movement” (MIT Press, September 2020).

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