Abandoning a career because you don't believe in science is not a flex
October 16, 2021 12:11 PM   Subscribe

Politics have always been in health care.It's just when it's finally affecting you, you give a damn. TikTok's Nurse Nya goes down the rabbit hole of antivax nurses so you don't have to... and gets results. (Post title from here.)
posted by The corpse in the library (60 comments total) 34 users marked this as a favorite
 
It's popular to say on the internet that nursing is being a cop for grownup mean girls. It's not quite as popular to point out that that's sexist and classist, since nursing and healthcare assistance are pink-collar professions.

That said: the women that are like that have taken the opportunity this year to show their whole asses. Nya's tiktoks are great, and I am glad to see they are getting the response they need. I especially like this one (although it is unrelated to COVID) because I have absolutely heard professionals joke about this.
posted by Countess Elena at 12:43 PM on October 16 [20 favorites]


It's good to see people in the profession call it out from within. Those who have no regard for the safety of those in their care, let alone themselves, should find another line of work. Preferably somewhere they can celebrate their stupidity without hurting or killing others.
posted by They sucked his brains out! at 12:55 PM on October 16 [16 favorites]


If every single person who got vaccinated were to post to social media some kind of triumphant video, the protest videos that get so amplified because the Vast Majority isn't all chiming in all the time would disappear in the flood.

Social media is poison because Those Who Will Shout Their Views outperform the most of everyone who just lives life.
posted by hippybear at 1:18 PM on October 16 [33 favorites]


Sounds the current wave of quitting because of vaccine mandates means we may lose health care professionals who don't believe in health care, teachers who don't believe in science, and cops who don't believe in public safety.

Not totally clear on what the downside of all this is.
posted by ricochet biscuit at 1:45 PM on October 16 [156 favorites]


cops who don't believe in public safety.

Cops: "Every cop must make it hope after the end of their shift. We can't do that if we're held accountable and can't kill whoever we want with impunity."

Also cops: "COVID-19 is the #1 killer of cops? Meh. Fuck those vaccine mandates."
posted by Your Childhood Pet Rock at 1:49 PM on October 16 [45 favorites]


If every single person who got vaccinated were to post to social media some kind of triumphant video, the protest videos that get so amplified because the Vast Majority isn't all chiming in all the time would disappear in the flood.

They don't get amplified because somebody else isn't chiming in. They get amplified because the social media companies choose to amplify them.
posted by GCU Sweet and Full of Grace at 1:50 PM on October 16 [37 favorites]


nursing is being a cop for grownup mean girls

AIUI the evidence that more nurses correlate with better patient outcomes is really strong.
posted by clew at 1:58 PM on October 16 [12 favorites]


Man, the whole TikTok thing is annoying.
posted by signal at 2:02 PM on October 16 [41 favorites]


If every single person who got vaccinated were to post to social media some kind of triumphant video...

Heh, I thought up a good bit of shtick to tell my college students, but decided against it because it would be like browbeating them (and they are required to get vaxxed anyway.) I was was going to say "Look at me, I got vaccinated and I've...never been happier" (with an ironic delivery that suggests that I am not particularly happy.)

The problem is that getting vaccinated was unambigiously good for only a few months, and then the Delta variant came around and it became clear that we can still catch and transmit it. So, I'm still not doing the things I love. Not going to the movies or dining indoors. Went to my first indoor concert this week (with a mask on) and hated it. I have to do my job with a mask on. So there's not that much to cheer about, unless you are a stupid asshole anti-vaxxer who is disconnected from reality.
posted by anhedonic at 2:27 PM on October 16 [8 favorites]


anhedonic - part of the reason WHY the Delta variant exists is because of the anti-vaxxers being slow to get vaccinated, which gives time for variants to develop. So to my mind, it's still worth it to push the "yay vaccine" narrative.
posted by EmpressCallipygos at 2:41 PM on October 16 [32 favorites]


If every single person who got vaccinated were to post to social media some kind of triumphant video, the protest videos that get so amplified because the Vast Majority isn't all chiming in all the time would disappear in the flood.

A large proportion of my facebook friends who got vaccinated in the first group did post their selfies. But after the 500th one (or whatever), they probably stopped getting that much engagement, so the algorithm didn't prioritize them. "Nurse gets vaccine" is a "dog bites man" sort of post and people stopped being excited about it after a while. Someone dressed in scrubs ranting about vaccines will provoke engagement (both pro- and con-) in a way that posting anodyne "just got vaccinated!" photos just won't.

getting vaccinated was unambigiously good for only a few months, and then the Delta variant came around and it became clear that we can still catch and transmit it.

It's still unambiguously good. The Pfizer vaccine is still 50% effective against infection with delta.
posted by BungaDunga at 2:44 PM on October 16 [17 favorites]


(you should absolutely wear masks but I hear so many people who say that since they still have to wear a mask, the vaccines don't stop you catching COVID. This is not, as far as I can tell, correct. The vaccines are still partially protecting you against COVID, they're just not as effective as they seemed to be in the spring. It's not a binary on/off.)
posted by BungaDunga at 2:50 PM on October 16 [9 favorites]


anhedonic - part of the reason WHY the Delta variant exists is because of the anti-vaxxers being slow to get vaccinated, which gives time for variants to develop. So to my mind, it's still worth it to push the "yay vaccine" narrative.

I don't think we can conclude this. The Delta variant was first detected before the vaccines were widely available, and had spread to the West almost simultaneously with the very beginning of the vaccine rollout. If Israel had had no vaccine refusers they might have avoided their Delta surge, barely? But it's not obvious that the US or Europe had any real opportunity to halt Delta.
posted by BungaDunga at 2:56 PM on October 16 [10 favorites]


The problem is that getting vaccinated was unambigiously good for only a few months, and then the Delta variant came around and it became clear that we can still catch and transmit it.

My understanding is that while this is the mainstream view, it is misleading. Delta is not really any different from any other variant, or even any other possibly existing variant at this stage of the pandemic. Vaccination antibodies made by the immune system are supposed to have a half-life (your body maintaining high levels of anti-virus proteins is thought to be unsustainable, biologically expensive, etc.), whereas cell-mediated immunity (T cells and B cells) takes 8 months or more to develop and mature in the body, and also time to kick in when infected. What this means is that any vaccine (with few exceptions, e.g. measles) is better understood to work in your body as a fire extinguisher: your house can catch fire, but there's a suppression system that kicks in after any infection. This explanation is what I got from watching many episodes of TWiV, a virology podcast led by academic American virologists.

My own takeway is that the real culprit is lack of vaccine-induced herd immunity. Vaccines were never meant as personal forcefields, and somehow the experts forgot to teach the public the important ideas behind vaccinology. And without vaccine-induced herd immunity, we are failing to leverage the greatest strength of vaccines which is the synergy that arises when everybody gets vaccinated, significantly enhancing protection through a network effect if you will.
posted by polymodus at 3:20 PM on October 16 [58 favorites]


the real culprit is lack of vaccine-induced herd immunity.

Part of the problem is that Delta is so infectious that the threshold for herd immunity is really high. Like, 85-90+% high. And we have only just recently started approving vaccines for children. So actually hitting herd immunity for Delta would be hard- something like 7% of the US population is under 5 years old. Which means you'd have to get nearly everyone else.

Portugal is probably the closest but still isn't quite there: "The virus is still causing cancellations, lost work days and sickness — in rare cases severe. It spreads less quickly and less far than it would in places with lower vaccination rates — which benefits everyone, including the 12-and-under children not yet eligible for shots. But herd immunity remains elusive. Daily calculations about risk remain, even without large ranks of unvaccinated people to blame."
posted by BungaDunga at 3:42 PM on October 16 [21 favorites]


The problem is that getting vaccinated was unambigiously good for only a few months, and then the Delta variant came around and it became clear that we can still catch and transmit it.

Even with the Delta variant (currently dominant in Canada), vaccinated people are of order 10 times less likely to catch, and 20-40 times less likely to be hospitalized/intubated/dead with, COVID than unvaccinated people are. The "fourth wave" currently going on in Alberta, Saskatchewan, and British Columbia (and to a less-catastrophic extent elsewhere in Canada) really and actually is a "pandemic of the unvaccinated".
posted by heatherlogan at 4:29 PM on October 16 [21 favorites]


nursing is being a cop for grownup mean girls
There are definitely shitty nurses out there, but mostly nurses are the backbone of medical care, their skill and effort can make or break people’s recovery, and they do not get the respect and support they deserve for doing an impossible job.
posted by evidenceofabsence at 4:41 PM on October 16 [59 favorites]


Somehow basically every nurse I've ever met inside a hospital or other care facility has been somewhere between perfectly fine and utterly lovely. The (very few) I've met outside of a hospital have either been terrible people, purveyors of obviously fraudulent woo, or both.

If the vaccine mandates cause the latter to self-select out of the profession, it will be better for everyone involved, especially in the long run.
posted by wierdo at 4:48 PM on October 16 [19 favorites]


getting vaccinated was unambigiously good for only a few months

Even with the delta variant (which as others have pointed out, variants are inevitable), the vaccines are still shockingly effective at preventing hospitalization and death. Which is precisely what the trials were tracking. If there was an error in messaging, it was that people started extrapolating that -- initially within reason, but without nuance -- vaccination kept you from getting/transmitting at all. I can see how, if you went into all this thinking the shot would be like an anti-covid forcefield, I can see how it would be disappointing to realize that human bodies are messy and human psychology messier still.

Eric Topol is a good person to follow if you care about this stuff. For instance, per CDC data, the delta variant caused a slight bump in case rates among vaccinated, and a massive death toll among the unvaccinated. Our own local surge has started to recede somewhat, although there are still far too many people on ECMO, a type of machine that is sort of like dialysis for lungs and requires 24/7 1:1 nursing care. So while it's on the whole a good thing that nurses who are unvaccinated/prolonging the pandemic are no longer employed here, it also puts an even greater burden on those who remain, some of whom are nursing their own former colleagues.
posted by basalganglia at 4:50 PM on October 16 [22 favorites]


I think I've mentioned elsewhere, my partner is a nurse who has been deeply embedded in vaccine advocacy work on Facebook for the past six years or so (prior to going into health care, actually). I've gotten to hear a lot about antivax nurses in particular in the past year or two, because understandably they're something of a pet topic of frustration. So when I saw this FPP, I went "oh!," shot it over to T, and asked if they were familiar with Nurse Nya.

They told me that they weren't, but that they're delighted to see her, and that they know that vaccine advocacy groups have a problem insofar as voices from Black nurses in particular and nurses of color generally are much less likely to get shares than voices from white nurses... and that while there's a chance that they hadn't run into Nurse Nya's work before because of the Facebook/TikTok divide, they think it's more likely that she simply hasn't been amplified in their circles before now.

The thing is, voices like Nya's are incredibly important in vaccine advocacy for the simple reason that communities of color with a long list of reasons not to trust white establishments are a lot more likely to trust and listen to people who come from their own communities. The specific furious comparison Nya makes, to discrimination in the workplace she has experienced as a black woman, and the way that real discrimination works? That's a powerful example!

T's comment on the "is nursing the profession of pink collar cops?" discussion is that the controlling assholes seeking power within their profession are a definite presence, but also a definite minority inside the profession. That said, my partner also adds that they know an awful lot of caring, incredibly hard-working CNAs and LPNs of color who don't advance up through the ranks or get the higher paying position because the white "cop nurses" on that power trip seeking to control other people make sure to keep them there, and that the way that power tripping often manifests in nursing usually runs along racial and sometimes class lines. Nursing hierarchies often run along clear racial lines, and it's important to be aware of that when you think about nursing as a profession.

Anyway, from both of us, thank you for sharing Nurse Nya's work around. She's doing a great job. I can hear all the videos T's watching delightedly echoing down the hall, and I'm going to go dig into some more of them when I'm done with this comment.
posted by sciatrix at 5:19 PM on October 16 [59 favorites]


Even with the delta variant (which as others have pointed out, variants are inevitable), the vaccines are still shockingly effective at preventing hospitalization and death.

Some local stats on vaccine efficacy just ’cause that’s what I know: 99% of COVID cases that have been sequenced in NYC in recent weeks (really all but a few) have been the Delta variant. Even though vaccines are somewhat less effective against Delta, right now unvaccinated folks are 7.5 times more likely to get sick, 11.2 times more likely to be hospitalized, and 28 times more likely to die.

I feel like that gets really lost in articles with headlines about the declining vaccine efficacy rates, because vaccinated folks being 28 times less likely to die even with reduced efficacy is a pretty huge difference.
posted by evidenceofabsence at 5:46 PM on October 16 [16 favorites]


Man I just keep hearing video after video of Nya's takes echoing across my living room. She's got such a really lovely blend of firmness and compassion; she is so careful about where she directs her ire and how she does it, so that it targets only the specific foolishness she's talking about. She's never personal when she's being critical. It's very very good outreach type work.

I really like her work. And she's funny, too!
posted by sciatrix at 5:50 PM on October 16 [12 favorites]


The sad thing is that once this situation stabilizes, those same anti-vax nurses that quit will just hire on somewhere else, probably for more money. At least until the next round of needed vaccination occurs.
posted by JustSayNoDawg at 7:07 PM on October 16 [1 favorite]


A few years ago I saw something on twitter about nurses being grown up mean girls and I was confused because honestly I have never, ever met a nurse who was not a genuinely lovely (but seriously overworked) person.
posted by maggiemaggie at 7:17 PM on October 16 [11 favorites]


I’ve never heard that “mean girls” thing before this thread. It is not at all my experience.
posted by The corpse in the library at 7:23 PM on October 16 [8 favorites]


vaccinated people are of order 10 times less likely to catch, and 20-40 times less likely to be hospitalized/intubated/dead with, COVID than unvaccinated people are

Studies that attempt to measure this directly seem to be coming up with something more along the lines of 40-some percent less likely to catch, and 80-90 percent less likely to have a severe outcome or die. It may depend on how recently you were vaccinated, though. And that "severe outcome"/"death" bit is pretty important!
posted by atoxyl at 7:27 PM on October 16 [6 favorites]


Mean girls or no, hospitals without nurses are basically prisons
posted by eustatic at 7:32 PM on October 16 [1 favorite]


Here's an article from 2015 that uses that phrase: Mean Girls of the ER. Search for "nurse hazing" and you'll find a bunch of articles and research on the phenomenon of bullying and hazing in the profession.
posted by mogget at 7:59 PM on October 16 [1 favorite]


I'd like to point out that growing up pre-Covid, we we told growing up that getting the polio/chicken pox/whatever vaccines we got as kids meant we weren't EVER going to get that stuff. Literally the only shot you can get that might not work all the way that we're told about before this was the flu shot, and that's always been the "we can't guarantee the flu because it changes too much every year." Nobody ever told me "oh, you can still catch it." Ever.

Seriously, being told now "just because you're vaccinated doesn't mean you're safe from catching the disease, it only means you won't have it AS BAD if/when you catch it" is a TOTAL HEADFUCK. Especially when the original news from Pfizer/Modern was 95/94% effective, which I reasonably understood to mean "my odds of catching it are now so low I don't really have to worry about it any more." So can we acknowledge that those of us who haven't spent 20 years studying diseases didn't have that as casual common knowledge?
posted by jenfullmoon at 9:00 PM on October 16 [41 favorites]


Well the mean nurse thing is kinda true. Whenever I orient a new nurse I’m always super nice and helpful to them all day, then at the end of the day I lean in real close and say “can I give you my most important advice about being a nurse?”
When they lean in, I look them in the eyes, and say, “don’t fuck it up”.
posted by triage_lazarus at 9:24 PM on October 16 [5 favorites]


I'd like to point out that growing up pre-Covid, we we told growing up that getting the polio/chicken pox/whatever vaccines we got as kids meant we weren't EVER going to get that stuff.

Lies (or at least oversimplifications) our teachers told us.

No vaccine has ever been 100% effective. We don't have to worry about getting sick because enough people are vaccinated that they fizzle out rather than becoming an epidemic when a case is introduced from someplace where they are endemic thanks to the collective impact of the less than 100% individual protection they afford us.

Enough people are vaccinated to permit us this lack of worry precisely because vaccination is required for enough things that it's nearly universal.
posted by wierdo at 9:35 PM on October 16 [24 favorites]


Part of the problem is that Delta is so infectious that the threshold for herd immunity is really high. Like, 85-90+% high.

So TWiV's Prof. Racaniello seems to have a different view on this; in contrast to reporting he says the threshold is still 70-80% (irregardless of Delta, and notably he and his colleagues are very skeptical of media claims about transmissibility), that he believes the spread by vaccinated people is a very low percentage, and therefore current outbreaks is being driven by unvaccinated pockets of populations (i.e. a geographically uniform assumption). He suggests that while some countries are now nearing the predicted herd immunity thresholds, if it is observed and confirmed that herd immunity is not taking effect, then something may be wrong with the original calculations for the thresholds. But from what I can tell what he's saying, we do not know the reason at this time, and could include the possibility/factor that Delta is more infectious, but not necessarily so without empirical evidence.
posted by polymodus at 10:04 PM on October 16 [2 favorites]


If you are white and have never experienced meanness from nurses, perhaps temper your sureness about their character when they’re dealing with people who are not white. Similarly, if you are middle or upper class. Again, if you are able bodied or “acceptably” disabled, understand that you are getting a different experience from people who aren’t. If you are on an equal or better power footing with nurses _you are in no position to defend them based on your experiences._
posted by Bottlecap at 11:25 PM on October 16 [57 favorites]


just because you're vaccinated doesn't mean you're safe from catching the disease, it only means you won't have it AS BAD if/when you catch it

This isn't accurate! It doesn't provide 100% protection from infection, but neither does it provide 0%. Even from Delta.
posted by praemunire at 11:31 PM on October 16 [7 favorites]


I'd like to point out that growing up pre-Covid, we we told growing up that getting the polio/chicken pox/whatever vaccines we got as kids meant we weren't EVER going to get that stuff. Literally the only shot you can get that might not work all the way that we're told about before this was the flu shot, and that's always been the "we can't guarantee the flu because it changes too much every year." Nobody ever told me "oh, you can still catch it." Ever.

What about the tetanus vaccination? IIRC you have it about every 5 years in childhood, then boosters every 10 years.
I agree that the impression given is that the other childhood vaccinations confer lifelong immunity, but have always known that they don't work for everyone, which is one of the reasons it's so impotant to get vaccinated who can
posted by kumonoi at 12:38 AM on October 17 [5 favorites]


> If you are white and have never experienced meanness from nurses, perhaps temper your sureness about their character when they’re dealing with people who are not white. Similarly, if you are middle or upper class. Again, if you are able bodied or “acceptably” disabled, understand that you are getting a different experience from people who aren’t. If you are on an equal or better power footing with nurses _you are in no position to defend them based on your experiences._

Investigations launched after Atikamekw woman records Quebec hospital staff uttering slurs before her death
posted by sebastienbailard at 12:56 AM on October 17 [9 favorites]


Henry VIII @SussexHenryVIII

A nurse I worked with suddenly quit last week... only to find out that her next job requires the COVID vaccine too.

Watching antivaxx nurses in multiple facebook groups realize that the mandates mean there is nowhere to go... has honestly been delicious. GTFO of my profession.

11:54 AM · Oct 13, 2021·Twitter Web App
posted by sebastienbailard at 1:00 AM on October 17 [21 favorites]


"Seriously, being told now "just because you're vaccinated doesn't mean you're safe from catching the disease, it only means you won't have it AS BAD if/when you catch it" is a TOTAL HEADFUCK. Especially when the original news from Pfizer/Modern was 95/94% effective, which I reasonably understood to mean "my odds of catching it are now so low I don't really have to worry about it any more." So can we acknowledge that those of us who haven't spent 20 years studying diseases didn't have that as casual common knowledge?"

"95/94% effective" means that it fails (to whatever extent) about one time in twenty, so definitely worth doing but not absolutely effective.
posted by Nancy Lebovitz at 5:02 AM on October 17 [8 favorites]


The messaging about the vaccines was pretty unclear from the beginning. Statements were made that the public interpreted to mean one thing, and the further education about "exactly what was meant" has, indeed, felt like a headfuck.

I'm a person who has worked hard to stay on top of real information about this whole thing because of all the disinformation out there, but I'm not an immunologist, just a lay person. The messaging that the vaccines were 90+% effective was not couched with any sort of caveat of "you could still get sick, just not as bad". It was really only after the vaccines had been out for a while and people were not getting them in the hoped-for numbers, and then delta variant came around and was much more contagious, that they started talking about being sick while vaccinated.

When those first cases started being reported, they were all called "breakthrough cases", as if they were a real anomaly, not to be expected. The reporting has continued to change.

How much of this is because of the emergence of the delta variant and thus the changing nature of the pandemic, or how much of this is because they simply weren't forthcoming from the beginning, I do not know. But the messaging has been really muddled, and it has indeed felt like a headfuck.

Doesn't mean everyone shouldn't get vaccinated, though.
posted by hippybear at 5:21 AM on October 17 [7 favorites]


My own takeway is that the real culprit is lack of vaccine-induced herd immunity. Vaccines were never meant as personal forcefields, and somehow the experts forgot to teach the public the important ideas behind vaccinology. And without vaccine-induced herd immunity, we are failing to leverage the greatest strength of vaccines which is the synergy that arises when everybody gets vaccinated, significantly enhancing protection through a network effect if you will.

Part of the issue is the time-course of Covid. Peak infectiousness is somewhere before or at symptom onset when the virus is still mostly in the upper respiratory tract, preventing spread therefore requires your immune system to ramp up much faster than it can and much faster than it needs to for you to avoid serious illness. This also explains the waning immunity from infection. Antibodies wane (natural process, and a good one or your blood would be a maple syrup goop of antibodies) and so your prompt response wanes as well. Your memory T cell reaction stays strong for much longer but it takes a few days for Covid to trigger it and by the time it has, you may already have spread it.

Many diseases are not like this. Measles takes much longer to "ramp" up so your body has a lot of time to "outramp" the virus with its protective immune response.

I will say though, I think other commenters who say that previously they had always expected viruses to protect from infection and not just disease do have a good point around expectations. I'd never thought about it that way but I think the the layman, than is probably right and is how most people thought about vaccines before this.
posted by atrazine at 5:53 AM on October 17 [10 favorites]


I actually thought the messaging was usefully nuanced when vaccines were first coming out. Before authorization we were told we would likely have to live with masks for some time, even with vaccines. Right after they started being distributed we were told we needed to keep NPIs in place until we understood whether these vaccines protect against infection or just some level of disease and/or death. Around mid-spring, if memory serves, the data were suggesting that the vaccines available in the US protected against infection as well, and in mid-May the CDC took this to mean they could advise vaccinated people to relax all NPIs. Over the next two months, restrictions lifted here, Delta rose to prominence, and the effectiveness of the vaccines waned some. So then the messaging had to change again.

It feels to me at this point in the pandemic like we really should not expect a silver bullet. In May perhaps it seemed to lots of people like we had one, and I think that CDC messaging did encourage this. From this perspective I worry a little bit about how loud the conversation is around boosters. I'm a huge fan of vaccines, I am counting down the days until my child is eligible, and I will get a booster when I'm told to, but I'm not sure at this point that we can keep the epidemic from expanding without continuing NPIs. My fairly well-vaccinated county (>70%) has a mask mandate and an Re right around 1. If we took the mask mandate away, I imagine we'd see that start to climb. But statistics do suggest we're better off than the rest of our less well vaccinated state, and so of course I want everyone who is not vaccinated to get vaccinated. I don't know.

Is anyone working on a nasal-route COVID vaccine? Would that change the calculus for immunity against infection/transmission?
posted by eirias at 5:59 AM on October 17 [4 favorites]


Oh, and yes agreed on "breakthrough" case being really unhelpful phrasing from the beginning. I think hippybear is totally right that this makes it sound like something that you occasionally expect to happen rather than a pretty frequent occurrence.
posted by atrazine at 6:00 AM on October 17 [5 favorites]


I will say though, I think other commenters who say that previously they had always expected viruses to protect from infection and not just disease do have a good point around expectations. I'd never thought about it that way but I think the the layman, than is probably right and is how most people thought about vaccines before this.

I think the culprit in this is that this is an absolutely new type of virus, which we're still in the process of learning about. The non-COVID-19 vaccines we have work so well and dependably because we have a deep history of study and experience from which to draw when it comes to developing vaccines.

We have none of that with COVID-19. Thus, it can definitely be upsetting when one gets messaging about the level of effectiveness of the first crop of vaccines. It hasn't helped, of course, that the bugger is evolving rather rapidly, making the first batch of vaccines, developed to fight the OG COVID, a bit less effective against the variant(s).

It wil get better.
posted by Thorzdad at 6:10 AM on October 17 [3 favorites]


I have long been fascinated with anti vaxxers and they absolutely do not understand vaccine science. (A common refrain about childhood vaccines among them is, "your child is vaccinated so why should you be afraid of my unvaccinated child?" As if there's a bubble around a vaccinated kid) What was surprising was to find out most people (here in the U.S.) seem to misunderstand it, even if they trust vaccines and medical science. The data is there, I have seen endless explanations in the media, and yet people still believe vaccines are a shield instead of, as someone said above, a fire extinguisher.
posted by tiny frying pan at 6:18 AM on October 17 [10 favorites]


Vaccines really WERE protective against infection (not just serious disease) with earlier variants of the virus, and within six months of being administered. Scientists couldn't know how they'd fare after that when the trials were only about that long. And scientists couldn't know how they'd fare against variants of the virus which weren't spreading yet. So "vaccines are 90% protective against any infection" wasn't bad messaging -- it was the truth, as scientists knew it at the time. That was the data found in the Phase III trials.

But scientists aren't sooth sayers. They don't know about things that haven't happened yet -- like waning immunity and new variants.
posted by OnceUponATime at 7:02 AM on October 17 [4 favorites]


Ah, that’s interesting that there might be a racial aspect to if we’ve had negative experiences with nurses. I’m white and have an unremarkable accent so that definitely could be true for me.

I think of nurses (and I’m lumping in CNAs, MAs, etc in here — basically, the people who help you and who aren’t the main doctor) as being women of color. And the nurses posting these videos of themselves crying at their phones as being white.
posted by The corpse in the library at 7:05 AM on October 17 [2 favorites]


Speaking as another non-medical-professional, I think a lot of it is that right now is the first time everyone alive right now has had to learn about vaccine efficacy in the wild together, at the same time. Before COVID, I didn't really think about it. Get your shots because that's what you're supposed to do to protect yourself and others, right? Herd immunity has been so thoroughly established in the US for most diseases for which vaccines exist that the ones we don't have vaccines for (the STDs are what I remember, although I'm sure there are more) seem like the big bads. I know antivaxxers have been a thing for a decade or two, and eg: Measles outbreaks happen in low-vax communities, but I've been lucky enough not to be near one, and I'm sure many others have too, so I didn't spend too much energy thinking about how those worked. From my privileged perspective, if you took some reasonable precautions against the diseases without vaccines, you COULD essentially use vaccine-induced herd immunity as a shield.

Right now we're in a situation with COVID where there's not herd immunity, so the vaccine+herd immunity thing doesn't work nearly as well as people expect from previous experience. Maybe older people who lived through Polio and etc have a better sense. But few people are equipped to understand efficacy numbers in a gut-sense kind of way.
posted by Alterscape at 7:10 AM on October 17 [7 favorites]


told growing up that getting the polio/chicken pox/whatever vaccines we got as kids meant we weren't EVER going to get that stuff.

Growing up right before the chicken pox vaccine was a thing, I don't remember there being a lot of explicit vaccine messaging until I was in highschool or undergrad. I'm not sure if that's because I was a kid and didn't notice anything beyond a quick "we get shots so we don't get sick" or if it was because people just went and got their shots. So the intricacies of why everyone getting vaccinated was an important part of the process didn't get discussed a lot.

I do remember herd immunity as a term getting tossed around a bit when there were outbreaks of measles or whooping cough. I think unless you were in an area with an outbreak it'd have been real easy to miss. Or have a nurse for a mom who'd scold the newspaper while reading about said outbreaks

I don't think I'd heard of nursing as a mean girl thing before. But I do remember my mom liked working the nightshift because she didn't have to deal with coworkers as much.
posted by ghost phoneme at 7:19 AM on October 17 [2 favorites]


No one should understand ANY science in a gut sense kind of way. Science isn't what sounds right to one's ear - that's my biggest irritant with people "doing their own research" - they only believe what makes sense to THEM, which as we know, is wrong and disasterous.
posted by tiny frying pan at 7:19 AM on October 17 [12 favorites]


Okay, whoa, I didn't mean "gut sense" like that, though I can see why it sound like I did. Let me try an analogy: I'm a software developer, and I've been developing software long enough that I have enough of a library of experience that I can say "this approach has worked well in the past," or "that algorithm looks O(n^2) so basically let's not okay?" or "Let's run the profiler to make sure, but I feel like this thing is probably the problem." I can and do run benchmarks or do formal validation if I need to, but I have a good intuition for what the relevant numbers I observe mean. Vaccine efficacy hasn't been relevant to my life like that before, so it requires more thought to make sense of something like "What does 90% effective against severe disease and 70% vaccination rate mean for my lived experience?" After this experience, you can bet I have a better idea about what those numbers mean, practically!
posted by Alterscape at 7:29 AM on October 17 [7 favorites]


There are far too many people who use "intuition" as their MAIN guiding force, instead of actual facts, we can agree on that, surely?
posted by tiny frying pan at 7:35 AM on October 17 [3 favorites]


And who don’t or can’t distinguish between educated intuition based on expertise and uneducated gut feeling.

But also I think a larger part of the picture is overall low levels of numeracy among most people. Especially when it comes to reasoning about more complicated causality and probabilistic effects, that simply isn’t intuitive to humans, and most people haven’t had a solid enough mathematical education to accurately interpret some of types of data or results about efficacy that come up with vaccines (or in public health contexts in general).
posted by eviemath at 7:58 AM on October 17 [8 favorites]


There are far too many people who use "intuition" as their MAIN guiding force, instead of actual facts, we can agree on that, surely?

Intuition, rationalization, category error, false equivalence, etc. Every comment section on a news site these days is a bouquet of fallacies.

The Toronto Star reported today that GM Canada will require its employees to be vaccinated. One of the first comments was that this was outrageous; you don’t have to show you are free of polio to work somewhere.

If only I could think of an example of a disease ended by a widespread program of vaccination.
posted by ricochet biscuit at 9:34 AM on October 17 [6 favorites]


Ah, that’s interesting that there might be a racial aspect to if we’ve had negative experiences with nurses. I’m white and have an unremarkable accent so that definitely could be true for me.

It's worth noting, and I did not know this until I spent a couple of years following my partner through their RN in the most well-regarded program in Central Texas, that nursing education can be cartoonishly awful about race. This segment from a nursing textbook on cultural and racial differences in patient beliefs about pain went viral in 2017, while my partner was in school. You can see that the segment explicitly informs students that that Black people complain more about pain than other groups, implying that this should factor into your decisions about pain medication, among other things.

One way that nursing is similar to police forces is that nursing students are almost entirely educated not by specialized teachers (as in medical school) but by retired nurses who came up themselves in the profession. This can be a good thing, as it allows experienced nurses to teach students from their own wealth of experience in patient care, but it also means that students are directly inculcated with attitudes and ideas from practicing nurses before they ever step into a floor. If those teachers don't themselves buy into and understand intercultural approaches to medical practice, it's very easy for them to effectively communicate existing attitudes and beliefs to students and very difficult to change prevailing attitudes towards marginalized patients in the profession.

For example, Countess Elena upthread links a video from Nya on mental health nurses in which Nya sharply criticizes other health care workers joking about using chemical restraints (e.g. Haldol) on unruly patients, pointing out that treating this sort of thing as a joke instead of acknowledging the humanity of patients under your care is actually kind of gross. I can tell you that T's mental health care module instructor was explicitly awful about patients on psychiatric wards under her care, frequently complained about terminology changes like requests that she stop using "retarded," and would often wistfully yearn for the days of the asylum, where patient management was "easier". It's hard to change attitudes when you have older generations in positions of authority directly transmitting them to students.
posted by sciatrix at 10:22 AM on October 17 [23 favorites]


It's popular to say on the internet that nursing is being a cop for grownup mean girls.

(I realize the poster of this was actually criticizing this statement)

If this is a true statement, it's gross and people need to have their cell phones slapped out of their snotty little hands. Nurses are the people that bust their asses doing most of the work you picture doctors doing, but that doctors don't actually do. What the hell is wrong with people?
posted by freecellwizard at 10:51 AM on October 17 [4 favorites]


If only I could think of an example of a disease ended by a widespread program of vaccination.

Um...Smallpox?
posted by Thorzdad at 12:49 PM on October 17


Um...Smallpox?

I believe the question was rhetorical.
posted by Your Childhood Pet Rock at 2:36 PM on October 17 [7 favorites]


> If you are white and have never experienced meanness from nurses, perhaps temper your sureness about their character when they’re dealing with people who are not white. Similarly, if you are middle or upper class. Again, if you are able bodied or “acceptably” disabled, understand that you are getting a different experience from people who aren’t. If you are on an equal or better power footing with nurses _you are in no position to defend them based on your experiences._

Investigations launched after Atikamekw woman records Quebec hospital staff uttering slurs before her death
This.

And lest anyone think that news story above is an isolated incident. A year later, on the other side of the country, I was just hearing stories in recent weeks from someone who works in an ER. There's a running pool among the nurses to guess the blood alcohol of any Indigenous person who comes in, with prizes and all. They were unaware the person recounting the story is Métis and so felt comfortable casually flaunting their cruel racism in front of them.
posted by bcd at 5:04 PM on October 17 [12 favorites]


Given the context I think it was an ironic reference to polio. The Americas, Western Pacific, Europe, and Southeast Asia are considered polio-free per Wikipedia.
posted by bunderful at 5:08 PM on October 17


I was always told "you can't vaccinate one person."

And "giving a vaccine is a tool, vaccination is the goal."

As if to say, it's a collective action problem. But the whole of American culture that is not dedicated to white supremacy militates against the existence of collective action problems, in order to maintain our global status of "consumer of last resort". So.

I don't think the public health agencies did a bad communications job; I feel that I understood what they were saying about masks and such, but it s just that the largest volume of mass communication that people in the US hear is constantly telling them they can buy an individual solution to any problem.

And there is the racism. So many white people I know stopped caring when it was announced that the virus disparately affected people of color. It was so dishearteningly stupid. Like, they didn't even seem to understand that 'disparately' means white people can still get it. Just, as long as the suffering was happening less to them, the whole thing didn't matter. A near perfect misunderstanding.
posted by eustatic at 11:32 AM on October 18 [9 favorites]


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