I was never a Manhattan guy, but I was down in town before. You know, like a few times you couldn't make anything out like it was just everything was just snipe destroyed. I just stood like gigantic whole rubble everywhere. On September eleven, Jonathan Dematto was working as an emergency medical technician in the Bronx. By the time he was able to get from his station to the Financial District, it was dark. He helped search for people among the rubble.
Lots of smoke, lots of uh yeah, I guess from the fires that were all They're lots of smoke. It was definitely something on the embassy. Again. He was a kid, only twenty two years old and on the job for maybe a year. John is now a lieutenant paramedic with the New York City Fire Department. He's grown a bit numbed to the daily stresses of his line of work. A lot of these things don't get to me. Not not that I don't I don't the late because I do relate. But if I let everything get to me,
I would never be able to do this job. In two decades on the job, there had never been a day quite as insane as September eleventh, it stood out for him as maybe the most extreme moment in his career. That was until March. On this Monday night, ramping up the response to the COVID nineteen outbreak, we're seeing the epicenter of the coronavirus outbreak shift here to the United States.
Bad News New York City coronavirus cases sore now accounting for one third of all cases in the US, and to stop the spread of the virus, government were taking it. John says the intensity of nine eleven doesn't even come close to what he has endured over the past year. Now, in addition to saving lives, it frequently feels like he is also risking his own. Clearly, when masked up, we
have goggles on. You know that you're protected, but you're exposing yourself to this every single day versus that was a one time event. Since March, the looming threat of contracting COVID nineteen has been unyielding for John. This is every day. Hopefully you don't get it today, you know, hopefully you protect yourself properly and whatever the case is. Just after Thanksgiving, John shared an article from CNBC on Facebook. It suggested that doctors needed to warn people that vaccines
might come with side effects. The article clearly annoyed him. He thought concerns about vaccines were overblown and people should just get there as soon as it was available. Here's John reading has posed. Of course you should know the side effects. Does it matter? Though the virus has shut the entire world down for almost a year. People have lost their way of life. Our kids are definitely going to be the stupidest generation for all the school they
have missed. Families are ruined. But make sure you don't get vaccinated because of the side effects. I get it. Someone agree, but oh well. Then his ant texted him. She was like, you know, listen in the end, do what you want. But um, I'm gonna send you a few things. So my aunts and nurse. She's in disease control. So I said, all right, I said, let me look because I'm I say anti factor, I was never I'm still not an anti factor. Like I get my flu shot,
I don't technically believe in it. It's only accurate. One video John's aunts to him was especially persuasive. Most of the information in the video was not true, but John didn't know that. Historically coronaviruses of vaccines for coronaviruses have had a terrible safety record. The video shows an older, bespectacled man in a boxing suit at a podium. We've decided to not name the person in this video in
hopes of avoiding spreading this kind of misinformation. The concerns he raises would be pretty terrifying if they were true. He suggests that drugmakers were ignoring major safety issues in the interest of rushing a vaccine to market as quickly as possible. Once I saw that video and the literature she was sending me, I was like, man, how I didn't even consider not getting it? And I if I didn't know it was an R and A type sequence,
what else do I know about it? You know? What John's referring to here is the fact that both the Maderna and Fiser covid vaccines use a technology called m RNA. A lot of vaccines people are familiar with, like the ones for polio and the measles, work by using a tiny amount of weakened or inactive virus to trigger an immune response. Initially, John had just assumed that's what the covid vaccines were, but m RNA vaccines instead teach the body how to produce proteins that spur an immune response.
It's kind of like an instruction manual for how to fight COVID. There's a lot of excitement over m RNA vaccines because it's way faster and easier to develop them. They don't require growing large amounts of a virus and then taking the time to weaken or inactivate it, and m r n A vaccines have been studied before for the flu, zekea and rabies. Cancer research has also used mRNA to trigger the immune system to attack cancer selves.
All of this is to say that this may be a newer technology, but it is definitely not an unknown one. Everything we know at this point suggests the m RNA vaccines are not only safe, but extremely effective. Still, it's true that there has never been an m RNA vaccine on the market, and the video pointed out to John that this was just yet another aspect of the pandemic that felt uncertain. I really don't know much about it, and to be honest, I'm I'm a little skeptical about
the whole the way the RNA does its thing, you know. Um, I'm a little skeptical about it. The video was convincing. Here was this guy whipping out all of these big scientific terms, speaking passionately, seemingly pleading to anyone who would hear, that we are putting everyone at risk with this vaccine. And then when my aunt sent me this video, when I was watching it, this one in particular, doctor I started talking about how he identified an issue with the protein.
When John saw that video, it planted the tiniest seed of doubt in his mind about getting the vaccine. Suddenly, the potential side effects didn't seem that irrelevant anymore. What if I take it and something happens to me down the road, I'm torn between both, you know, I really am a torn between both. So then I started doing my research on the on the actual doctor who did the video, and everything came back like positive on the doctor. John felt like he needed to learn more about what
the skeptics were saying about this vaccine. He spent hours researching them. And if you go looking for this stuff on the internet, it is not hard to find information that confirms your worst fears. It's very, very scary stuff. I've been a doctor for a long time. Before me, my father is a doctor. I'm not anti vaccine, definitely. You should not be calling this the COVID nineteen vaccines. The reason is, whatever you call it, it's experimental. I don't really want to be the first person to take
grand new things when it comes to medicine. How many of those happily queuing up to be vaccinated, no that The list of possible adverse event outcomes what most people call side effects, includes the following on various syndrome transverse myelitis myelitis and capalo myelitis meningitis. And the game is to prevent the therapies till everyone is infected and push
the vaccine. Convulsions, stroke, nocalypsy, cataplexy, and they'll kill millions, as they already have with their vaccines, kill millions, venus authoritis death. You really don't do the law sque The more he read and watched, the more John's tiny theed of doubt grew. One text from his aunt had taken
John from vaccine advocate to full blown skeptic. I was so blind, I didn't even look to see what the other side, what the people who are not getting the vaccination, and why I didn't even consider it, like It wasn't even a thought in my head, like why would I not get the vaccination. I didn't know it was an RNA type vaccination. I still I thought it was a weekend fly virus. So after I started doing research, I was like, Okay, I understand why some people aren't getting it.
John is not alone. A February pupil found that about thirty of Americans did not plan to get vaccinated. That number was actually an improvement over earlier polls. Those numbers are troubling. Some experts suggest that they are probably not high enough for the vaccine to work. How do we get to this point, to a point where even healthcare workers are suspicious of the vaccines. If anybody understands the toll of this virus, it's people on the front lines
like John Sure. Their online conspiracy theories and the way some coronavirus vaccines have been made is kind of new. But the thing is, this crisis in public confidence didn't start in March, or with the development of a COVID nineteen vaccine, or even with the misinformation heavy presidency of Donald Trump. It has been brewing for a long long time. I'm Christophe Brown, a healthcare reporter for Bloomberg News. This
is Doubt, a podcast from Prognosis. We're going to tell you a story about how vaccines have gone from something viewed as harmless, routine, and life saving to something polarizing, protested, and feared. Over the past year has felt like the once fringe concerns about vaccines have suddenly gone viral. This is not a podcast about science. This is a podcast about how people come to hold their beliefs. We know vac scenes are safe and effective, but we'll show how mistrust, misinformation,
and the Internet all undermine that fact. In the past year, we've seen that growing vaccine hesitancy has serious consequences. It has made it that much harder to control the pandemic. John the paramedic, still remembers the very first COVID nineteen case he treated. It was a gentleman who sick, not terribly sick, but sick, really weak, hell short of breath. This was April of last year. As a lieutenant, John's
job involves a lot of paperwork. The virus had already been spreading for weeks before he went into the field and saw someone sick with what seemed to be COVID. When he got to the scene, he didn't know what to make of it. But not like you see some people that I just can't read. He was just short of you know. In the paramedics put the pulse socks on them and it was like sixty. Pulse socks is
short for pul sock cimeter. It's a small device that slides onto a person's finger and can measure how well their heart is pumping oxygen through their body. Any reading below ninety is low. Someone with a reading of sixty like this man would usually be having a lot of trouble breathing if they were conscious at all. This guy was weak and pale, but only a little short of breath. I've never in my life seen somebody with a sixty
like that looks fairly okay. But over and over throughout the last year, John witnessed patients his blood oxygen levels were dangerously low, yet looked relatively fine. It was weird every job the cruise, whether the patient was just sick or whether the patient was really short of breath or unconscious. Every job, the pulse oxes was seventies and eighties, and
that's not something that you commonly see. When you're like the first line work of seeing someone who's that sick, and then the hospital doesn't even have to treat it, but yet you have to a lot of the cruise got nervous and panic. All of this uncertainty around COVID was a scary thing for John. He wasn't just worried about himself when he saw COVID spreading like wildfire. He was worried about bringing it home to his five kids,
and especially to his four year old son, Nico. It was right after Nico was born they found some pretty severe are issues with his heart. We were leaving, we would leave in the hospital, were discharged, and that at hospital a few like two or three years probably had to implemented. A post office check comes down to the post office. Did a post office check and his was so if it's less than fifty, it gives an arrow
like less than and he popped up less than. Oh no, I can't mean this keeps in the in the room with us today like he's not the quote cyanotic, he's not blue, he's not breathing heavy. How was this kid's post office less? So they did it with another one, the other machine, same thing that was it gone to come upstairs, you know, brush from upstairs. I su su did a whole bunch of tests. Within two hours. They were like, we have to transform out. We'll go on
an ambulance. It turned out that Nico had multiple problems with his heart. He was born without a pulmonary valve and without the wall that divides the left and right chambers of the heart. Nico has had so many surgeries in his short life that John can't remember exactly how many. He's gone through eight on nine surgeries, you know, um, and still needs some down the road. People with heart issues are especially at risk of developing severe cases of
COVID nineteen. The disease can also damage the respiratory system and make it harder for the heart to work. If I if I brought him in the room, you would lookt him. You never even know he had all these surgeries. He's like, amazing, But I don't want to get him sick, you know. Back in the spring of John's job felt especially dangerous. There was so little information about exactly who was most at risk for the virus, and Nico was
waiting on a critical surgery to repair his heart. The Fire Department offered hotels to first responders who are worried about bringing the virus home to their families. I debated taking this these hotels because they had them in every borrow that they had, But but then I'm like, you know, am I gonna see my kids for weeks? On him? That? And John couldn't very well leave his wife at home with five kids to take care of by herself. John
has close cropped, dark hair and a thin mustache. He looks young and projects the sort of zen attitude of chillness about the state of everything. But when I talked to him over Zoom, I can tell that he is tired, reclining against the headboard in his bedroom. Other times, when we talk kids, often in our the conversation that Nico is that Nico Lorenzo. Why John now has more overnight workshifts. They can go for sixteen hours, and he's constantly dealing
with his kids when he's home. It's not a stretch to say that John is anxious for the pandemic lifestyle to be over. He might be wary of the vaccines, but he understands better than most people how serious the virus is, and he's tried hard to protect his family from it. And of course the clearest path out of this for John and for everyone is mass vaccination. If people get vaccinated, a virus like COVID just doesn't have enough hosts to keep on surviving and thriving. Eventually, you
can't find anywhere to live, so it dies out. That's how polio was eliminated from the US and many other countries. That's why we don't really worry about tetanus or whooping cough, or at least until recently, the measles. And yet one deceptively convincing video started John down a path that led him to decide against getting a vaccine. So let's talk a little bit more about that video, the one John's aunt sent him. The man talking in this video is
a staunch vaccine skeptic. He's not a medical doctor, but the head of an arcane research institute that supports research into topics, including the risks of several vaccines. But his first hit on Google suggested he was affiliated with a well known university as well as the founder of a medical journal. It's not a single vaccine manufacturer took heed of my warning to remove those unsafe epitopes from thevaccines.
It's easy to see how a video like this might make vaccines seem confusing and scary to anyone, especially in a time plagued by the uncertainty of the past year. Videos like this are designed to seem plausible. The man spits off a litany of figures and complicated sounding biological terms, insides research that he says is peer reviewed, but he doesn't leave a whole lot of time for you to
think too hard about what you're watching. Before you can sift through each scary claim, he's moved on to another. The only single data point, the datum that we have on what percentage of patients exposed human patients exposed to a coronavirus vaccine have had serious adverse events. He's from lit Darna trial and that number. It's big statements like this that people got seriously ill to make the video
so persuasive, but it's also just not true. In data submitted to the FDA for authorization, Moderna reported that out of more than fifteen thousand patients that received the vaccine, about one experienced any serious adverse events, a number that was about the same as people who received a placebo shop. The number of serious potential side effects has been even
lower since distribution of it began. But the video was recorded in October, before any of this data was out, and the man in the video seems to be cherry picking numbers from a very early trial of the vaccine involved just fourteen people. But for John, there was now doubt percolating in his mind where there had not been any before. To be honest, the big game changed to me was that that video I saw, and the fact that I checked that doctor's credentials and it all checked out.
That was a big game change to me. I want to be clear about a few things here. There is still a lot we don't know about both COVID nineteen and the vaccines intended to prevent it. It is easy to see how people fall down the rabbit hole like John did and wind up scared or skeptical, But there is also a lot that we do know. These vaccines have been tested thoroughly and appear safe. That information can just sometimes be hard to find. John says the newness
of it all made him a bit skittish. The doctor had said that he identified an issue with it, but and he works in this field. But they chose they were They were so far into the process with the with making the vaccine. He said that they just continued to go along with it. When John did his homework, he told me he found both good and bad things about this misinformation spreading researcher. I felt even if half of his concerns were correct, it was enough to worry about.
John told me he recognized the limits of what he could learn by simply googling, so he tried to get the fire department to host some kind of information session about the vaccines. He also consulted with the fire department doctor. She too, told him she was skeptical about the vaccine. She says she was opting out because she doesn't trust an RNA type vaccine vaccination because it's there's a lot
of unknowns to an RNA type vaccination. They've been working on if he is, but there's a lot of unknowns. At the end of the day, though, it seems like the biggest issue is that John just couldn't bring himself to trust the people meant to calm his doubts the vaccine. The president, he means, Donald Trump here swear it was going to be in by a certain time. Every One said it will never be ready by that never ready, and this is going on and on and on. It's
gonna be ready by this time. It's gonna be ready by this time. It will never be ready. Boom, it was ready by the time. These are medical professionals that you're supposed to trust, but they can't even get on the same page. So why should I believe them about an RNA virus? The tricky thing about vaccines is that they require public trust in order to work in an environment in which the facts keep changing. What version of
them do you even believe? At the start of the pandemic, public health officials in the US went on record thing masks were not necessary. While face masks are currently required in some parts of China to prevent the spread of the deadly coronavirus here in the US, the Centers for Disease Control is not yet recommending them for the public. Then, more study of the virus revealed masks were in fact critical instruments and slowing its spread. Doubt about masks naturally followed,
so did protests in the US. None of this was helped by a president who promoted claims not backed by science. Former President Trump suggested the possibility of ingesting bleach to combat the virus. He also promoted the wonders of a drug called hydroxy chloroquine to treat COVID without any credible evidence to back it up. Worse yet was the lack of agreement between the White House and public health figureheads such as Anthony Fauci, the most senior expert on infectious
diseases in the country. Like John said, who do you trust when the people you are supposed to trust can't agree with each other. Heidi Larson studies mistrust of vaccines. She's the founder of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. It's a nonprofit that looks at how rumors about vaccines spread and why
a time like COVID is really full of rumoring. For a good reason actually, because even the scientists are learning every day, and if you look at the formal definition of a rumor, it's a piece of yet unverified information, so it has the potential to actually be true or come true, but it also it I sometimes say rumors have a bad reputation because we always assume they're bad, but but actually people are trying to figure out based
on bits and pieces of information, what's the story? So I think they've particularly thrived in the context of COVID more than any other scientists or public health expert I interviewed for this podcast Heigh he preaches empathy an understanding of people who are skeptical of vaccines. She doesn't like the phrase anti vaxer. She says it's too polarizing, too ignorant of the broad spectrum of opinions people have on
this subject. I think one of the problems with the framing of the pro and the antie is that it kind of pushes out this middle group that are undecided but there are still open and I think if there if they're not getting a reasonable answer, or even feeling like they're judged or as some say, demonized for just asking questions, it hardens them and they're more vulnerable to some of the more extreme views. We've taken a cue from Heidi here. You'll notice that we don't use the
term anti vax are very often in this series. Sometimes the rumor is not really about the rumor. It's about a lot of distrust, and people are because of their distrust the system, they make assumptions. Their default is distrust. If people trust the system. They're not out there looking for rumors. But if you don't trust the system, you are much more gullible to conspiracies and others. The rumors that have cropped up over the past year are not
unique to the pandemic. Conspiracy theories have circulated that five G wireless technology is the real culprit of the virus. Similarly, three G was suspected to cause stars in two thousand three, and four G was linked as wine flew in two thousand nine. The rumors have less to do with any particular disease than a general distrust of the system. The tensions that underlie those ideas pre d the rise of Donald Trump or the emergence of a deadly and highly
contagious virus in Wuhan, China. The pandemic, though, has allowed those rumors to spread more than ever. What has been interesting to me, and more than I expected, was the way that that COVID rumor UH and broader anti vaccine
narratives have gone way beyond the usual circles. These groups are looking for others who feel like them because it strengthens their numbers, and they really maybe care less about the vaccines and more about the principle of my choice, my freedoms um, which is very deep in the in the anti vaccine groups these days, it's as much about that for many of them as it is any particular vaccine. All of the uncertainty of COVID nineteen has heightened the
tensions that were already fueling concern earns about vaccines. Many people cite the newness of the vaccines as the root of their hesitancy. They doubt because they feel there isn't a convincing argument to prove the vaccines are safe. In fact, there is a horde of data provided to the FDA and vetted by independent experts that all suggests that authorized COVID nineteen shots are not only extremely safe, but extraordinarily effective. Still, all that data can be hard to parse. It isn't
easily understandable to most people. But a misleading headline about elderly Norwegians who died shortly after getting their job, well anyone can infer what that means. The fictions at times are just more accessible than the facts. But for vaccines to work, most people have to take them. As soon as enough people lose confidence that system falls apart. Heigh he says is that COVID nineteen is an opportunity for the public health community to correct the record on vaccines.
I see COVID as an absolutely huge opportunity because if we get this right, we can shift the landscape around confidence. If we get it wrong, it's also going to shift it into not a very good place. She says that to win the trust of people like John first, the public health community needs to listen if we want to
get enough people vaccinated to stop COVID. As a public health community, we need to be listening and getting back to the people who do have emerging concerns that are specific to COVID that even if we don't have a perfect answer, we engage with them, because if we don't, there's a lot of other eager groups trying to engage them. The number of frontline health workers who have declined the vaccine is maybe one of the most surprising stories of
the past few months. Heidi made me think about John and all of his fellow first responders who opted out of the vaccine. In February, f D and Y said that more than half of its paramedics and e m t s declined vaccination. A March pole by The Washington Post and Kaiser Family Foundation found that three in ten frontline health workers so they were either unsure about getting vaccinated or didn't plan to at all. When we talk, John continually brings up that he feels he wasn't supported
by the fire department during the pandemic. He feels he wasn't given enough training and that testing wasn't a priority at his station. He also brought up nine eleven. He says he and other responders were not prepared with equipment like respirators to protect them from all the debris in their He have health issues like sleep apnea now disorder in which breathing stops and starts while you're sleeping, and
a chronic sinus problem. At the end of the world, this is what I gotta wear a seat machina if I want to see in the bed because my wife doesn't want to hear me. It wasn't just public health officials John didn't trust. He was also wary of the authorities at the job giving him access to the vaccine. John isn't the only first responder who feels like the advice coming from the top can't totally be trusted. My name is Anthony almagera, I am the vice president of the f D and y E M S Offices Union
Local thirty. I'm a lieutenant paramedically f D and y E M S Coument and explaining why so many of his colleagues have trepidation about the vaccine. Anthony also brought up nine eleven. We're a little leary about the c D c S advit. They told us the air was good at nine eleven, and so people didn't wear masks or respirators, and look at how many people got sick from that based on their advice. Anthony says that many of his union members have expressed concerns about the speed
of vaccine development. Some of his female coworkers say they're worried about how it might impact their ability to have children. People would you know had trepidations about taking it, and rightfully so right We've never produced a vaccine this quickly in human history. I had my own trepidations. Rather than falling down a YouTube rabbit hole, Anthony read pharmaceutical industry
publications to learn how RNA based medicines work. He also read both the studies from the Maderna and FSER Clinical trials. Like John, he spent a lot of time trying to figure out how he felt about the vaccines. You wound up convinced that any risk that might be connected to them was worth it. He decided get the shot. In this day and age, with so many ways to verify something, people just aren't doing it, and they go on feeling
instead of fact. So I feel that vaccine is not going to be good for me, and then when I respond why, they don't have a scientific answer. They don't have an answer that's deduced from some type of reasoning. It's based in feeling. When Anthony did get vaccinated, he made sure to share the news widely. I don't know how to break through other than by example. So when I went and got my shot, I posted it everywhere. I encouraged others to go get it. I updated people
in real time on our message boards. Hey, I'm twenty four hours after this, after the shot. I have a little soreness in the arm, but otherwise I feel fine. So John and Anthony both started out in the same place. Both are doubts about this revolutionary vaccine. They wanted to learn more, but the sources they found led them to different conclusions Anthony when I hadn't got it, and John he chose to skip it. There were too many questions
that I have out there. I'm not I'm not going to get it until maybe down the road, if I even do. John is still worried about Nico, but over the summer his son had a surgery the doctors told the family made him far less vulnerable to the disease. If Nico hadn't gotten that surgery, John says, he may have gotten the vaccine. I don't have a risk factor, you know, I don't have a risk factor, so all
other than being a little heavy, I don't. I don't have high blood pressure, diabetes, and he kind of cardiac me personally, So for me to survive the disease, it's like n versus taking something that they really haven't given out before. John is clear that he is not an anti vaxer. People like John are exactly who heigh he is talking about. He is not against vaccination. He just has some concerns. In fact, he says he sometimes argues with his wife's best friend, who he says is extremely
against vaccines. He's not opposed to ever taking a COVID nineteen vaccine in a few months. If it's all going well, he might reconsider his stance. When I see like, are there any adverse reactions? Um, stuff like that, and I seem more I may reconsider. I don't know, but whenever a friend or family member or colleague asked John about his decision to not get vaccinated, he sends them that same YouTube video that has answent him, the one that
first made him doubt. I always tell them I don't want to jade your decision, like I want your decision to be your decision, you know, especially me, who was going to get it at first and then I changed my mind. John says that so far he sent that
video to seven or eight other people. If you're the guy in the video, do you hope the seven or eight people John sent it to pass it on to another seven people, and then they sent it to another seven people after that, and soon enough her message is everywhere, person by person, the skepticism spreads. It's contagious. It's designed to be that way. People like that guy know what they are doing. They know how to ryle folks up. Next time on doubt, we'll go back in time, tell
all of this started. We'll show how a select few have exploited anxiety and uncertainty to make people believe misinformation, and to make that misinformation and go viral. That story is the story of a man named Andrew Wakefield. Doubt is written and reported by Me Christ and v Brown. So for Foreheads is our senior producer. Molly Nugent is our associate producer. Our theme was composed and performed by Hannis Brown. Special thanks to Bloomberg editors Rick Shine and
Tim Anette and my colleague Angela colo Veto. Francesco Levi is the head of Bloomberg Podcast. Be sure to subscribe to Prognosis if you haven't already, And if you like our show, please leave us a review. It helps others find out about the show. Thanks for listening, See you next time.