The bystander effect, Covid-19 vaccine edition

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.

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.

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.