Dr Remy Daroowala provides some good advice on engaging with anti-vaxxers and the vaccine hesitant in Daily Maverick, 14 September 2021.

He recommends a process of “active listening” to learn about their concerns and unmet needs and to find out if the person is ready for a conversation about vaccination. He notes that if the person is “a full-blown conspiracy theorist”, you are unlikely to “convince this person no matter how hard you try” and that walking away with “grace and equanimity” may be “doing more for your cause and your mental health than you realise”.

It is indeed frustrating arguing with a “full-blown conspiracy theorist” but there are ways of reaching into their world. There are two chinks in what appears to be an invulnerable intellectual armour that depicts all counter arguments and evidence as necessarily corrupted by shadowy political-economic forces.

The first is to show that the profit motive is alive and well in their own world of seemingly natural healthcare. The second is to show that the anecdotes about cures and protection they trust in the place of scientific evidence can be countered by anecdotes about unnecessary deaths.

Dr Daroowala correctly notes that the broad anti-vaccine movement is “seen by its followers as aspirational, with voices speaking against the establishment, to independence and naturalism” and as making a “positive health choice by stepping away from the medical-industrial complex”. An important point to make in this context is thus to show that the anti-vax movement is fuelled and supported by a medical-industrial complex of its own: the purveyors of alternative medicine who use anti-vax rhetoric and misinformation about Covid-19 as a marketing strategy.

Most Covid-19 vaccine misinformation online in the United States is driven by 12 individuals, almost all of whom work in the “alternative medicine” space as booksellers, chiropractors, vitamin peddlers, osteopaths and their kin in the pseudoscience world. In the early 2000s, at the height of South Africa’s Aids epidemic, purveyors of alternative medicine benefitted from president Mbeki’s distrust of antiretroviral treatment and South Africa’s tragically delayed roll-out of antiretroviral treatment. Alternative therapists, both local and international, offered untested cures in their place, and many of them were supported by Mbeki’s Health Minister Manto Tshabalala-Msimang.

Notably, the “Rath Health Foundation”, a Netherlands-based international company specialising in vitamins, was allowed to run a pseudoscientific “trial” in Khayelitsha which reportedly spread misinformation about antiretroviral treatment and resulted in several deaths.

The symbiotic connection between anti-science conspiracy thinking and the acceptance of “alternative” healing modalities was and remains important today. Joseph Mercola, the leading member of the “dirty dozen” of Covid-19 misinformation in the United States, is worth over $100-million and profits directly through the sale of his alternative products.

Today, the Rath Foundation bizarrely claims that micronutrients can reshape human DNA to prevent Covid-19 infection and that this is a more effective approach than “synthetic” vaccines. Pointing out that there are major corporate interests at work in their own “holistic” or “naturalist” alternative medical universe — and that these products are untested and can kill people — may well give conspiracy theorists pause for thought.

Those who reject evidence from scientific trials and epidemiological studies showing that vaccines are effective and safe are not simply making a “positive health choice by stepping away from the medical-industrial complex”. They are choosing to accept untested therapies over tested treatments and to believe the claims made by those seeking to profit by sowing distrust in science. They choose to believe anecdotes and narratives — and for this reason, a further chink in the seemingly impenetrable armour of conspiracy thinking comprises anecdotes of failure and tragedy befalling their fellow travellers.

During the Aids epidemic, some prominent Aids denialists served as “living icons” by claiming that they were “living proof” that it was possible to live healthily by ignoring HIV-prevention protocols and rejecting antiretroviral treatment. One of them was Christine Maggiore, who campaigned against taking antiretrovirals for HIV prevention or treatment. She was lauded on concert platforms by the Foo Fighters, appeared on the cover of Mothering magazine with a “no to AZT” slogan on her naked, pregnant belly, and visited Mbeki. Tragically, her baby daughter and then Maggiore, herself, died of Aids.

Maggiore’s death was a major blow for Aids denialism. During the Aids epidemic, I participated in a collaborative international website called “aidstruth.org.” It is no longer actively updated but retains an online presence. We used it to debunk Aids denialist claims, but our most popular and probably most influential page was called denialists who have died. When Maggiore died of a common Aids-related illness, many, seemingly “full-blown conspiracy theorists” took heed, changed their minds and started taking antiretrovirals.

In South Africa, the deaths of Peter Mokaba, the anti-apartheid youth leader turned Aids denialist, and of Fana Khaba, a popular Johannesburg DJ, were tragic, but important local narratives about the dangers of trusting alternative treatments over scientific medicine. Both listened to Mbeki and his health minister, both took alternative cures, both died. That they were popular voices, with a large following, was especially important.

A recent report documenting the large number of conservative anti-vaccination radio talk show hosts who have died of Covid-19 in the US is likely to be similarly important. For some people, this is “death shaming”, an uncivilised mocking of the dead. Yet the Aids epidemic has taught us that tragic narratives about unnecessary death are not merely unseemly morality tales: they are the only evidence that people who distrust science are likely to accept. Concern about appearing empathetic or compassionate should not detract from publicising, or talking about, such stories. The stakes — saving lives — are too high. DM