Last month, Ashley Richards, a woman whose 46-year-old husband died after contracting the Delta variant of COVID, wrote an open letter to unvaccinated Americans urging them to get the vaccine. Neither Richards nor her husband had been vaccinated. “We thought we were invincible,” she wrote. “Our thoughts were that we were young and healthy and that if the virus reached us we would be sick for a bit and we’d move on with our lives.”
It’s impossible to know how many people have avoided the vaccine for the same reasons as Richards and her husband—but this rationale comes up again and again in pleas from people who didn’t get vaccinated and are now begging others to take COVID seriously.
People who were eager to get vaccinated as soon as possible last spring may be baffled by this kind of logic. There are three COVID vaccine options available, one of which has now officially been approved by the FDA; all are completely free regardless of insurance status, and side effects beyond the expected flu-like symptoms are extremely rare. Meanwhile, Delta is absolutely pummeling large swaths of the U.S., and some hospitals have been forced to start rationing treatment. To better understand why unvaccinated people might be interpreting their not yet having COVID as proof they aren’t at serious risk, VICE spoke with three experts to figure out what may be behind this specific type of vaccine hesitancy.
Jessi Gold, a psychiatrist and director of wellness, engagement, and outreach in the Department of Psychiatry at Washington University in Saint Louis School of Medicine, told VICE that forgoing the vaccine because you’re confident you’ll survive if you get COVID can be a coping mechanism during a time of fear and uncertainty.
“It’s a way to defend against worry and anxiety,” Gold said “To say, ‘I need a vaccine because COVID is a risk to me’ makes it real.”
Carl Fichtenbaum, professor of clinical medicine in the Division of Infectious Diseases at the University of Cincinnati College of Medicine, agreed that for some people it’s a coping mechanism. “When you ask yourself, ‘How do I get through a pandemic and survive without driving myself crazy?’ some people choose to say ‘I’m generally healthy so even if I get it, I’ll be OK,’” he told VICE.
But experts emphasize that if you’ve made it this far without contracting the virus, it’s because you’ve been lucky—not because you’re invincible or have some kind of natural, inborn immunity. Fichtenbaum said this kind of thinking fits into the common mindset that “bad things” will happen to other people but not to us.
“You hear of people getting hit by a car but you never think it’s going to be you,” Fichtenbaum said. He said people who say things like, “I’ve always been pretty healthy so I’ll be fine; [COVID] will happen to someone else” are engaging in a similar thought pattern.
But adopting the mindset that you’ll be OK and some kind of natural, inborn immunity will protect you, you’re not doing your part to protect yourself or others. “You’re getting the benefits from other people who do get the vaccine and walking through life on the coattails of others,” Fichtenbaum said. But your luck may run out eventually, especially given how transmissible the Delta variant is and the fact that mask mandates in several states have been walked back.
Robert Amler, the dean of the School of Health Sciences and Practice at New York Medical College and a former chief medical officer at the CDC, noted that fear also plays a role in this type of vaccine hesitancy.
“Hesitancy, complacency, and a certain amount of fear of the unknown are extremely human,” Amler told VICE, explaining that people may feel this way because they have concerns about taking a new vaccine, they desperately want to believe COVID will go away on its own, or both. “The problem with that approach is simply that the virus really is still here and is still a threat, even though we would all feel more comfortable if we could just think about other things,” he said.
As Amler said, vaccine hesitancy is human and natural—but if folks are unable to put those feelings aside, even more people will get sick and die. This was the case for Michael Freedy, a 39-year-old father of five who died from COVID in July. Neither Freedy nor his fiancé, Jessica DuPreez, had gotten the vaccine because, as DuPreez later explained, the couple planned to wait a year so they could learn of any potential side effects and reactions.
“If you’re hesitating, it’s not worth hesitating for. I’m not going to be able to change anybody's mind who is directly against it, but those of you who are hesitating and think it can’t happen to me because I’m young, it can,” DuPreez said after her fiancé’s death. “Then you'll be sitting there wondering why you did it, and you’re not going to be able to hug your family again.”
While it’s true that many young, healthy people have avoided infection thus far or only had a mild case of COVID, Fichtenbaum emphasized that “it’s not because their body has some sort of amazing immunity that’s better than everyone else’s, and it’s not because they just won’t come in contact with the virus. They’ve just been lucky.”
Some people may feel confident that they’re fine to go through life without the vaccine because, for example, their roommates contracted COVID and they didn’t. But Amler confirmed that prior exposure without infection is not some sort of proof that you’re naturally immune, or that you had an asymptomatic case and now have antibodies.
“Unfortunately it just doesn’t work that way,” he said. “It’s like saying ‘I saw a big crash or a multi-car collision on the highway but I just missed it and I wasn’t affected.’” You’re still just as likely to crash as you were before—and you probably wouldn’t stop wearing your seatbelt because you weren’t affected this time.
Amler also pointed out that, when it comes to car crashes, at least half the time it will be another driver who made the mistake that led to the crash, not you. “We get behind the wheel thinking we’ll be fine because we’re conscientious and sober, but we can’t be sure that the other drivers on the road are on the same page,” he said. It’s the same with COVID. “You’re fine and healthy and you take care of yourself, but what you don’t see is that the virus can be lurking and you can get exposed. Even if you don’t succumb, you could infect a loved one without meaning to.”
People who aren’t vaccinated are especially at risk of getting infected and spreading COVID to their loved ones now that the Delta variant has overtaken the U.S. Amler emphasized that this variant reproduces much more quickly than the original COVID virus and therefore is even more contagious. According to the CDC, the Delta variant is more than twice as contagious as previous variants. Furthermore, some data indicate that it causes a more severe illness. Per the CDC, studies conducted in Canada and Scotland found that patients who contracted the Delta variant were more likely to be hospitalized than those infected with the original virus or the Alpha variant.
All this to say: Each person infected with Delta is carrying a lot of particles, which are just waiting to be coughed or breathed out into the environment of other people. Just because you didn’t get sick from your roommates who had the original variant last year doesn’t mean you’ll be so lucky when it comes to Delta.
Assuming that you won’t ever get COVID or that, if you do, it’ll be a mild case, is making a calculation based on information you simply don’t have. Fichtenbaum pointed out that no one actually knows how “good” their immune system is because it’s unlikely they’ve had the necessary testing done (and even the tests that do exist aren’t perfect and can’t tell individuals whether they will be protected from infection or severe disease due to COVID). And even so, many people are perfectly healthy until the moment they’re not. Everything from a cancer diagnosis to a heart attack can affect otherwise healthy people, and the belief that only “sick” people will get a severe or fatal illness is simply false.
“You’re taking a calculated risk that, ‘I’ve never been that sick before, so I probably won’t get sick again,’” said Fichtenbaum. He said those are the exact words he heard from a 47-year-old man he treated who arrived at the hospital with COVID and never went home.
Amler said that, although hesitancy is understandable, it’s not something any individual or the general public can afford.
“We would all feel more comfortable if we didn’t have to worry about [COVID] and believe everything will be fine,” he said, “but that’s not the reality. The virus is searching for susceptible, vulnerable bodies to get into.”
“The fact is, we’ve got the best tool that’s ever been produced against this virus,” Amler continued. “To not take advantage of this tool we have at our disposal is a crying shame. It’s just a terrible shame to needlessly keep yourself susceptible [to COVID] when you don’t have to be.”
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Update: this article was amended to address confusion around the use of the phrase “natural immunity.”