Tel Aviv University’s School of Public Health issued their most recent results of a survey on what sociodemographic characteristics and behaviors were associated with higher uptake of the coronavirus vaccine. 

Now, I am a big fan of statistics and epidemiologists.  Obviously, I have a Masters Degree in those fields.  But I was a bit surprised by a few things in this report. 

1.       They used a telephone survey of 447 respondents.  First off, I am not a big fan of telephone surveys on getting accurate reflections on what the public thinks.  I know that I always respond to those telephone surveys ‘cause I want to help out those researchers. However, I also know the abysmal response rates of those things.    Also, there’s no mention of what type of phone number it was, landline or cellular.  We know that fewer people are purchasing land lines, especially the younger generation, so calling someone on their landline, having them answer, AND responding to your survey already puts a bias on your sample.

 

2.       They say that they wanted a representative sample of the Israeli population.  Always an important aim in population surveys.  However, the eventual distribution of the sample was 50.1% self-defined as Jewish and 48% as Arab.  Now, being that the current distribution of Jews and Arab citizens in Israel is 80% Jewish, 20% Arab, I was a bit surprised about their distribution. 

 

 

3.       One of the factors they wanted to explore was whether the level of self-defined observance, secular, religious, haredi (ultraorthodox) had an effect on vaccine uptake. Yet this question was asked to both Arabs and Jews.  I would argue that those Arabi Israelis who define themselves as religious are different than Jews who define themselves as religious?  How does that work?  And what religion were the Arab participants? Christian? Muslim? They also lumped religious and haredi together,  even though there is a huge difference in health behaviors among those populations, depending on geographic area and socioeconomic status.

Overall, 84.6% of the sample had received at least one dose of the vaccine, and 65.6% had received three doses.  They found that those participants who had higher education were more inclined to have received the vaccine than those who did not. Additionally, those who defined themselves as religious/haredi (Jews and Arabs?) were less likely  to have received the vaccine.

 

Now, don’t get me wrong.  I firmly believe in data driven decision making. In having your academic institutions use their expertise to give us a better understanding of what is happening in public health in our corner of the world.  But these researchers’ assumptions seem big to me.  And misleading.  With the foregone conclusion that the less educated and more religious aren’t complying with solid public health measures.   While that could be accurate in some situations, I don’t think these types of surveys are demonstrating that.  I believe we need to focus funding and thought into real reasons why individuals chose, and continue to choose, not to vaccinate.

·         General mistrust in the medical system

·         Increasing role that misinformation plays in medical decision making

·         Lack of support in medical decision making on the part of the medical system

·         General ignorance about disease/health in the world

·         Lack of transparency on the part of pharmaceutical companies to acknowledge, publish, follow up on side effects of many medications

 

 

I know these influence the average citizen’s decision-making process when faced with a choice about what action to take.  Let’s address those questions in public health first.