America’s Challenge Isn’t Vaccine Hesitancy. It’s COVID-19 Denialism.

Several years ago, two sociologists researched whether Americans were willing to take a novel vaccine during a pandemic. Taking poll data from the midst of the 2009 H1N1 swine-flu outbreak, they broke out hesitancy by race, age, and partisanship, among other factors. Although the H1N1 pandemic was very different from today’s COVID-19 pandemic—not nearly as many people in the United States fell ill, far fewer died, and vaccines were not as widely available as they are now—the results were striking.

The researchers found widespread hesitation. Nearly two-thirds of Americans were unwilling to receive a shot. But those qualms were relatively evenly distributed in the population. Older people were more willing to get the vaccine than younger ones, and white and Latino people (about 37 percent each) were more willing than Black people (25 percent). Democrats (39.6 percent) were more willing than Republicans (32.2 percent), but the spread was small.

Twelve years later, there’s another pandemic, another vaccine, and more vaccine hesitancy—but that hesitancy has spread differently within the population. Although public-health experts initially worried that Black Americans would be highly vaccine-hesitant, there’s now racial parity among people who want shots. Instead, young conservatives are the great outlier. According to Kaiser Family Foundation polling, 13 percent of Americans say they definitely won’t get a COVID-19 vaccine, but that includes 18 percent of people ages 30 to 49, and a whopping 29 percent of Republicans. Hesitancy is particularly high among people who live in rural areas and white evangelicals—for whom increased church attendance correlates with increased hesitancy, according to a survey from the Public Religion Research Institute.

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COVID-19 vaccine hesitancy doesn’t line up with the H1N1 polling, nor with standard patterns of hesitancy—for example, crunchy left-wing opposition to childhood vaccinations. But the patterns do line up with resistance to mask wearing and stay-at-home orders.

In other words, the pattern of resistance to the coronavirus vaccines looks less like COVID-19 vaccine hesitancy and more like COVID-19 denialism. While a significant chunk of Americans profess to be uneasy about getting shots to prevent COVID-19, most come from the swath of the population that has tended to downplay the disease’s severity and to resist other measures to fight it, rather than the swaths that have resisted vaccines for other diseases.

The U.S. has reached a turning point in its fight against COVID-19; all FDA-approved vaccines are now open to all adults. Soon anyone who wants one will be able to get one, and scarcity will no longer be a controlling factor. The Biden administration this week rolled out plans to reach out to vaccine-hesitant groups, including rural Americans and Republicans, in an effort to move closer to herd immunity. But some Americans seem to believe that scientific concern is being weaponized for partisan ends, and see their own resistance as a defense of freedom. And if the problem is not vaccine hesitancy but COVID-19 denialism, then overcoming it may prove much harder.

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The same demographic splits presenting now on vaccines have existed all along. In both May and December 2020, Kaiser found more-than-30-point splits between Republicans and Democrats on mask wearing, and NBC News found similarly large gaps. Other pollsters found differences of a similar size between Democrats and Republicans on whether respondents were regularly practicing social distancing and supporting stay-at-home orders. All these factors move roughly in line; the partisan split also corresponds to the divergent approaches that Presidents Donald Trump and Joe Biden took toward the pandemic on the campaign trail.

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If vaccine hesitancy was driven primarily by worries about the vaccines, then the government’s decision to pause distribution of the Johnson & Johnson vaccine over blood-clotting concerns would likely drive increased hesitancy. Public-health experts wrung their hands over the pause for exactly this reason. But so far, polling has shown no discernible shift in how willing people are to get a vaccine, even as surveys detect deep concerns about the J&J shot. Meanwhile, roughly three-quarters of Republican men ages 18 to 49 are “not concerned at all” about a coronavirus outbreak in their area, according to Civiqs polling.

This suggests that the real reason for hesitancy is that a significant chunk of Americans are simply skeptical about COVID-19. There is room for difference of opinion about the efficacy of certain measures taken to combat it—we’ve seen experts do an about-face on masks, and stay-at-home orders now seem less important than masking. People in this age bracket are also less likely to die or get very sick from COVID-19 than others. But the gap in skepticism surpasses mere degree and extends into type. No wonder vaccine hesitators are particularly repelled by Anthony Fauci, who has become the public face of efforts to fight the pandemic.

For some vaccine refusers, the motivation is simply trolling. An essay in American Greatness, which is what passes for the intellectual outpost of Trumpism, published yesterday explains, “My primary reason for refusing the vaccine is much simpler [than worries about personal liberty or medical complications]: I dislike the people who want me to take it, and it makes them mad when they hear about my refusal.”

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How widespread this attitude is, or what degree it is a primary motivation, is impossible to know. But it’s probably just one part of a spectrum of COVID-19 denialism. You don’t have to look very hard to find examples. You probably know people who doubt that the disease exists, or who believe that it’s being overhyped. If not, examples abound in reporting on COVID-19. Or you can look at Congress, where Ron Johnson of Wisconsin, the de facto leader of the Senate Republican disinformation caucus, dabbled in dark theories in a radio interview this week.

“Why is this big push to make sure everybody gets a vaccine?” he wondered. “And it’s to the point where you’re going to shame people, you’re going to force them to carry a card to prove that they’ve been vaccinated so they can still stay in society. I’m getting highly suspicious of what’s happening here.”

Johnson did not explain what, or who, it was that made him suspicious. This is typical. Adherents of this kind of thinking are convinced that COVID-19 is a hoax perpetrated by someone, for some reason, but are rarely clear about who might have done so, or for what purpose. The vague, imputed explanation is that restrictions, whether stay-at-home orders or mask mandates or vaccine passports, are part of a plot to restrict Americans’ freedom. But who is behind it or to what end they wish to restrict these freedoms is never made entirely plain.

While Trump was in office, some of his defenders argued that COVID-19 was a hoax cooked up to destroy his presidency. No doubt, Democrats did seek to weaponize Trump’s inept handling of the pandemic against him; although Trump made some real errors—he was himself a leading COVID denier for weeks—countries with more responsible leaders also suffered serious casualties, and it’s unclear how much better the U.S. would have fared under a “normal” president. In any case, Trump is now gone, yet the deniers persist.

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This is a golden age for conspiracy theories, but conspiracism is not a new phenomenon. In his classic study of conspiratorial beliefs on the American right, Richard Hofstadter traced an evolution from “vaguely delineated villains” such as Freemasons and Catholics, in the 19th century, toward specific ones, such as attacks by Joe McCarthy and the John Birch Society on presidents and other officials. Today, the right retains some specific villains. The QAnon theory, for example, is preposterous, but it is coherent: It offers clear villains (a range of American elites), a clear goal (to enable a worldwide child-trafficking ring), and clear mechanisms (wresting control of the federal government).

But COVID-19 denialism of Ron Johnson’s variety has no clear villains, and no such coherence. Why is someone making up the pandemic or exaggerating its dangers? What is their goal? And why do so many people keep dying and getting sick from a hoax? In this way, COVID-19 denialism more closely resembles the right-wing denial of climate change. Unsurprisingly, both Trump and Johnson have also been primary exponents of climate nonsense. Conservative skeptics insist that the planet’s warming is not real, and is simply a plot to destroy freedom. One can tease out some objections to specific policies—some progressives want a carbon tax, which many climate-change deniers oppose—but how one goes from there to an immense conspiracy to deprive everyone of basic liberties is anyone’s guess. Whose idea is this? What’s their goal? And why do global temperatures keep rising if it’s a hoax?

Standard vaccine hesitancy is a public-health problem. So is COVID-19 vaccine hesitancy. But its apparent roots in COVID-19 denialism suggest that combatting it will require more than just persuading Americans to trust medical science—it may take convincing them to trust each other, too.