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Sandro, I would like to hear your thoughts on the vaccine angle of all of this. The social, political and historical influences on vaccine trust and mistrust before COVID, how COVID has impacted all of it, and is there anything specific we should be considering so we can get enough of the population vaccinated.

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This is a great question. I do think that some of what we are seeing in vaccine hesitancy is a reflection of mistrust in the system, coming from decades of poorly handled public health messaging. We are at a moment when we need people to follow public health advice--in this case get vaccinated around COVID--but we have not built the foundation of trust that leads to people listening to the advice of public health. All to further suggest the importance of us being careful not to over-moralize and alienate populations.

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Thanks for these really thoughtful arguments.

Few quirks I’d ask:

1) How much do you think the finger-wagging on social media actually shapes the messaging people hear? Meaning how much of the moralism is simply within the echo-chamber of public health?

2) Do you feel like your arguments about moralism applies to policymakers, as well? It may be true that shame is a dreadful tool to inform individual public health decision making, but what about public servants? Shame is a better tool to drive policy choices—and policy informs the structural circumstances in which individual decisions get made.

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1. I do think that social media has played a big role in this. Social media of course just reflects general population chatter, nothing new there. But what is new is that chatter is now elevated to visibility that is unprecedented, and that of course influences the public conversation. I will write a bit about social media and its influence on decision making in a future post.

2. Good point. I do not know and have to think about that. My first blush thought is that it applies, but perhaps less, given that policy-makers ultimately are reflecting public opinion--including opprobrium. There is of course something unappealing about encouraging policy-making through overt moralizing if it does not also include reasoned argument, but I do not discount that it may have a role.

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Once in a while, we get to read a thought provoking piece. Thank you.

-@nastikxy

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Your best newsletter yet. Thank you and please keep ‘em coming.

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Thought this was really great. Thank you!

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