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What do Covid-19 vaccination and the stabbing death of a woman outside of her New York City apartment have in common? The bystander effect.

The bystander effect concept emerged after Catherine “Kitty” Genovese was stabbed to death in 1964. According to press coverage at the time, none of her neighbors came to her help despite being aware of what was happening. Although the coverage was later debunked, it gave rise to the bystander effect theory, which says that an individual witnessing someone being attacked is less likely to help the victim when there are other people around. Essentially, the thought is that someone else will take care of the victim; it’s not the individual’s problem. Of course, when everyone thinks this, the victim suffers without aid.

I believe we are experiencing a bystander effect on a societal and national level with vaccinations for Covid-19.

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There is no shortage of reasons for why some people are “holding off” on being vaccinated. They include concerns over a new vaccine technology (despite decades of research leading up to this), a rushed process (slashing redundant bureaucratic red tape in order to save lives), and ramped-up anxieties over unknown side effects that might occur as a result of the vaccine (exceedingly rare throughout the history of vaccinology).

Among health care workers who are declining vaccination, two chief reasons are deciding they are at low risk for complications from Covid-19 and preferring to take a wait-and-see approach in the hopes of allowing more time to elucidate potential side effects. In other words, the “individual” — people who are hesitant to become vaccinated — is willing to wait, hoping that others will step in. Meanwhile, the “victim” — our country — is suffering through the worst public health emergency of the last century.

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Marcus Aurelius, one of history’s greatest thinkers, stated, “And you can also commit injustice by doing nothing.”

The problem with the mindset of holding off or refusing to be a “guinea pig” is that for anyone, but especially for health care workers, it has unintended consequences, including heightening anxieties about the vaccine.

Health care workers must realize, especially now, that they have a sphere of influence that affects their loved ones, co-workers, and communities at large. For each health care worker who is hesitant to receive a vaccine, some people in their networks become more skeptical than they already were. This ignites a social domino effect of worsening hesitancy based on unfounded fears.

The people most affected by this are the next in line, waiting with great anticipation to see how the health care workforce will accept the vaccine.

I believe that this effect takes place even when health care workers delay their dose for admirable reasons, such as distribution dilemmas. The ultimate consequence of this is unnecessarily prolonging the pandemic with preventable loss of life.

I am not advocating for blind trust here. In fact, I empathize with people who are hesitant or scared about receiving one of the new vaccines. I have a remote history of anaphylaxis, so believe me when I say I was feeling nervous on the way to getting my first dose of a Covid-19 vaccine, mere days after hearing warnings for those with a history of allergies.

Yet on the day of my appointment, I thought of the people who have dedicated their lives to preparing for moments such as this. I thought of Jonas Salk, the inventor of the polio vaccine, who shifted the entire paradigm of medicine and infectious disease as it was then known without the decades of data we so comfortably lean into now. I thought of Anthony Fauci, Paul Offit, Peter Hotez, Michael Osterholm, and countless others who have poured their hearts and souls into giving us a way out of the mess we have found ourselves in. I trusted them more than I did myself, even though I’ve had nearly a decade of education in biochemistry and medicine. So I proceeded onward, in the face of my fear and against my natural intuition, and am now a proud recipient of both doses of a Covid-19 vaccine.

The late Vice Admiral James Stockdale, a philosophical fighter pilot and Vietnam prisoner of war for eight years, quotes the Stoic thinker Epictetus and tells us, “Tranquility, fearlessness, and freedom. You can have these only if you are honest and take responsibility for your own actions. You’ve got to get it straight: you are in charge of you!”

With that in mind, I call on those who work in health care to trust in the thousands of scientists who helped make this vaccine possible. To know you are setting an example for your families, colleagues, and communities. To understand there is no other solution to ending the pandemic than widespread vaccination. And to believe that, in the utmost of our current capacity, the vaccines have been solidly vetted and we understand them to be effective and safe.

The buck stops with you. Be brave. Get the vaccine.

Clayton Korson is a final-year medical student at the Creighton University School of Medicine applying for a residency in emergency medicine.

  • I applaud those who have volunteered to receive the Moderna or Pfizer/BioNTech COVID mRNA vaccines, and I hope they have no side effects or adverse reactions, and stay healthy and disease free.

    • That said – there have been several incidental deaths of those who received these mRNA vaccines since December. The Norwegian Ministry of Health determined that dozens of individuals over the age of 80 who received these vaccines in Norway soon died, apparently from side effects which overwhelmed them physically as they were not in peak condition at their age(80 and above). And the side effects appear to manifest themselves in older individuals, contrary to the belief that only young healthy individuals have side/adverse effects from these vaccines “because of a healthy immune system”. I won’t recommend these vaccines to my relatives in that age group, I do recommend they wait for the Johnson & Johnson or Novavax vaccines. Some may say it is statistically insignificant and rare, so was my relative’s terminal illness.

      Another thing are the sporadic media reports of “sudden” deaths with people(aged 41-60) who received the mRNA vaccines. There were reports of at least 3 people(to my knowledge) who were relatively healthy at the time. A doctor in California is known to have had hypertension(constant high blood pressure), which I have, and then died after receiving his 2nd dose of one of the mRNA vaccines(which was not specified). Yes this is infrequent, but there are unknown risks and long term adverse effects that were not evaluated over several years for these vaccines. The mRNA vaccine technology initially had a high failure rate, there are still unknowns involved in this technology which has really only been actively tested for 10 years.

      I do not believe anyone should be required to take only the 2 mRNA vaccines. I believe there should be a choice(in the US) between the COVID vaccines of: Moderna, Pfizer/BioNTech, Johnson & Johnson, and Novavax. I believe the side effects that have been observed for each vaccine should be known by all those who receive them. And yes I believe the majority of people should receive some type of COVID vaccine. But there should not be coercion involved – none of this “get whatever shot is given, and don’t complain”. I am also against the pre-ordering of 200 million doses of only Moderna or Pfizer vaccines with their complicated storage requirements. Vaccines with the simplest process of production, distribution, storage, and delivery should receive priority. Of course that is only an opinion.

  • I already had it. I have allergies that can be concerning with this shot. They don’t know long term effects. They dont even know how much immunity will have with it. You want me to take it? No I won’t. I am not risking my life to give some one else false comfort. I have as much immunity as anyone taken the shot. If people who didn’t have it want it I get that but it is still a choice. When they determine how much immunity one has with it then I will consider it. Why take the chance and not know if Your going to get it anyway? Your idiots just to go along blindly and not consider all information.

  • “Nothing is without risk. You still get in your car and drive every day, don’t you? Take ownership. Go get vaccinated.”

    Yes, we still drive everyday, but no one has made changes to our car’s drivetrain, tires, brakes, etc. overnight so we know it will operate like it did the day before when we parked it.

    We are all unique because we all have unique DNA. There is no guarantee that while one person may have no negative impact from changed DNA, other people’s DNA change could result in a myriad of short or long term debilitating conditions.

    Yes, another issue is the freedom aspect. Airlines for example could start having a quick blood test before boarding and only allow people with the modified DNA to travel, regardless of anyone’s symptoms. Dividing people into separate groups would lead to a very bleak future. Also, have the changes to DNA been analyzed regarding unique 1:1 matches for law enforcement purposes?

    There are several reasons for the wait and see mentality to modify one’s DNA which may only be 90-95% effective for a disease that has a recovery rate of 99.997 for most.

  • It is simply too early to be labeling people who have not yet gotten the vaccine as free riders or bystanders. Some of us are giving up because there are so few vaccines available. My husband is over 70 and has one co-morbidity is on three waiting lists and yet no one has called. UC Health who prided itself on rolling out a large scale vaccination event last weekend apparently ignored people who were already on the waiting list and vaccinated other individuals. We are not going to worry about getting the vaccine. If they call us great but I will not wait at my laptop daily for a reply.

  • Interestingly, nobody seems to question the underlying assumption in the myriad of news articles aimed at convincing the public to accept the jab – that doing so would somehow end the pandemic. If the trials conducted by all the vaccine manufacturers have been expressly stated to look for data on the vaccine’s effectiveness to prevent “mild cases of COVID-19” (this is the FDAs current qualification of an effective shot), while not being designed to collect any data in transmission, then why is there this egregious assumption that it will prevent the virus from spreading? Why do we assume what the science has said nothing about, save the messy post-vaccine epidemiological data (which itself still points to continued transmission).

    Indeed, the CDC, WHO, and he manufacturers themselves warn of this, and recommend the very same precautions for those vaccinated as for those without any shot. How then will we ever hope to achieve herd immunity if our government will allow pharmaceutical companies to develop vaccines (and approve them with few questions) that don’t even accomplish the basic function of an immunization? Perhaps this is why many intelligent people are “hesitant” to revive the vaccine, because the public messaging is so clearly ignorant and the primary means are psychological coercion.

  • The phenomenon scribed in the article has a very long, very well-documented history and has an entire discipline built up around it. It is called the free-rider problem (not the “bystander effect”) and economists the world over have spilled countless gallons of ink attempting to devise a solution to the the problem. “Public Health” is by its very definition a public good so I would encourage policy-makers to figure out a way to “privatize” it. Perhaps the feds could make “relief” payments contingent upon successful vaccination.

    Regardless, the author has clearly tailored his education so narrowly that he is completely unfamiliar with this very common and very basic phenomenon and that is a huge reason why “public health” responses have been ham-fisted and mostly ineffective.

  • I subscribe to Statnews for the outstanding accurate and detailed biotech coverage, so it’s very disappointing to see this article which perpetuates the “bystander effect” myth of Kitty Genovese’s brutal rape and murder in NYC in 1964. To the author/editor/fact checkers, please check this 2016 New York Times article which cites the errors in their original story which launched this falsehood and consider a retraction:
    https://www.nytimes.com/2016/04/05/nyregion/winston-moseley-81-killer-of-kitty-genovese-dies-in-prison.html

    • It looks like you may have overlooked this line in the second paragraph, PK, with a link to the debunking: “Although the coverage was later debunked,”

      Pat Skerrett
      STAT

  • These people are simply selfish. They want the benefit from the vaccine but want other to take all the risks. The joke may be on them if they catch it while waiting. Too bad.

    • What do you care. Worry about yourself and take the shot. Why care if someone is waiting just gets you to the front faster for shot unless your questioning it to.

  • Looking at it with a (continental) European perspective I can’t see how vaccine acceptance levels are even a factor to worry about in the US, or anywhere for that matter. I think all democratic countries have seen their share of weak response from their respective governments but as it stands the US is only behind Israel and the UK in their vaccination effort. So not much to complain.

    You guys will reach that critical level of 20-30% of fully vaccinated population mostly among elderly that will take 80-90% of the hospitalization risk off the table, effectively ending the pressure for restrictions with a matter of weeks. In Europe this will be months away, sadly.

  • No matter how you sugar coat it this is still the first time this type of vaccine has ever been administered to people, correct? If so then our knowledge of any possible long term side effects is limited to the relatively small number of people in prior tests and the lead up process to EUA approval. Sorry, but given the number of drugs pulled from the market years after they passed all of the tests associated with the normal approval process….I will wait for a more standard version of a vaccine…..Many of us who feel that way are low enough on the totem pole that we would be waiting anyway, and speaking for myself I would rather not roll the dice on such a novel product.

    • Hello,

      Thank you for reading this and for your thoughts.

      I want to point out that you can make a similar argument regarding long term effects from COVID. We don’t know what sequela will happen in 1, 5, or even 10 years from now. Except the odds of severe sickness from COVID is much higher than from the vaccine.

      Nothing is without risk. You still get in your car and drive every day, don’t you? Take ownership. Go get vaccinated.

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