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Vaccine hesitancy and George Washington

There seems to be quite a lot of vaccine hesitancy in the United States, with perhaps as many as 35% of adults projected to refuse the COVID-19 vaccination. One argument is – of course – freedom: Why should the government tell us what to do?

The problem with this argument is that the freedom not to be vaccinated is actually quite a new argument in American history, as Servitje, Lincoln and Yamey tell us in their USA Today piece.

They say:

While some anti-vaccination groups use the term “medical freedom” to reject preventive measures against COVID-19, our nation’s first leaders were strongly committed to public health, including vaccinations. George Washington ordered mass inoculation of his troops against smallpox to secure a victory against the British in the Revolutionary War.


However, Servitje et al make a small error in their – otherwise excellent – article, but actually, the truth is even more staggering. In the otherwise excellent article, Servitje et al do not mention that George Washington did not order his troops vaccinated.

George Washington ordered variolation, a procedure that incurred a much higher risk than Jenner’s vaccine which was not introduced until 1796, whereas Washington’s order came in 1775.


As Gareth Williams writes in his excellent Angel of Death book:

“Smallpox kept George Washington’s unprotected army out of British-occupied Boston and later wiped out the American forces besieging Quebec (…) Washington (another scarred victim of smallpox) subsequently decided to order large-scale variolation of the American forces, which abolished their fear of the disease and was probably decisive in enabling them to chase the British out”

Angel of Death, page 145

Such was a fear of smallpox that even a pretty scary procedure like variolation was preferred to getting ill. Which in no way diminishes Servitje et al argument, as the risks of complications from COVID-19 vaccines are small compared to the risk of variolation which in turn were minuscule compared to smallpox where the fatality rate could be 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox.

Erratum: Washington indeed wrote “inoculation” and Servitje et al never say that he referred to vaccination. This has now been taken into account in the text.

Pandemia2021.pl: a blog in Polish

As I have found myself writing an increasing number of articles on coronavirus in Polish, I have created a new blog which is specifically to address misconceptions about the pandemic over in Poland.

All Polish-language posts published on this blog will stay here, but they are also copied to the new blog.

By the way, the picture above (licensed from Shutterstock) depicts a historic old Main Square in Warsaw, with the famous Syrenka (Mermaid) monument in the background, and of course anti-COVID masks in the foreground.

Juggling vaccination numbers

At today’s press conference, the Vaccine Minister, Nadhim Zahawi, has been presenting some numbers:

He says 82% of adults have had a first dose, and 60% have had a second dose.

He says if 85% of all adults are double vaccinated, and the vaccines are 85% effective, then the protection level is 72%. That means 28% of the population would still remain unprotected.

UK Covid live: 16,135 new cases reported – highest total for more than 4 months | Politics | The Guardian

While all these numbers are correct, they need a bit of unpacking and unpicking. While they sound very positive – and, no doubt, the UK vaccination drive is amazing – they are hiding some slightly worrying facts.

Firstly, in the UK there are about 16 million people in the age band 0-19 years and 51 million people 20 years old and above. Assuming 82% applies to those aged 19 and above (and extrapolating England %s to the UK), this means 63% of the whole population. For the double dose, 60% of adults correspond to only 46% of the total population.

It is quite startling that the government is excluding young people and children from the calculations. I think we do have a pretty strong evidence that they also become infected and are capable of infecting. While the symptomatic proportion, hospitalisation and death rates are lower for younger people, it is naive – or dangerous – to exclude them.

Assuming further that the mix of the vaccines is 50% Pfizer/Moderna to 50% AstraZeneca, and the efficacies of 33% both types single dose, and 66% and 98% for two doses, we get 43% effectively protected and 57% effectively unprotected. This also assumes 100% Delta strain (which is not too far).

63%-46%=17% is only jabbed once and with 33% efficacy, it is only 5% population protected.

46% have double dose: 23% with Pfizer (22.5% effectively protected) and 23% with AstraZeneca (15.8% effectively protected).

Together, 5%, 22.5% and 15.8% yields 43.3%.

Adding to it perhaps 25% post-infection immunity and assuming random distribution of those among vaccinated, we get about 60% immunity in the whole population.

This is absolutely fantastic and is certainly already making a lot of impact on the spread of the Delta variant. In other words, Delta would have spread much quicker and possibly reached much further than we expect it to go.

But it also means that we are not yet safe and indeed that there is still quite a lot to do.