I inserted myself into a conversation at a bar about Covid and vaccines. Here’s what happened

This essay was adapted from Jess Steier’s newsletter, “Unbiased Science.” For the last few weeks of summer, my mom visited from Florida. It was amazing, as it always is, to have her here spending time with the family doing lots of things and nothing at all. Going to the lake with the kids, playing board games, having hours of conversation, and taking endless trips down memory lane. The night before her flight, we stopped at one of our local spots, a dive bar/restaurant where we can be super casual and enjoy greasy bar food over drinks. At the table next to us was a group of four men, in their late 60s or thereabouts if I had to estimate. It was clear they’d been there a while, judging from the empty beer glasses scattered across the table (no judgment). They were talking at a high volume, so I couldn’t help but hear when the topic of Covid and vaccines came up. My ears perked up like a retriever hearing the word “walk.” In particular, I heard one of the guys talking about how rushed the vaccines were and how “they” lied to us and how mRNA was an experiment and we were guinea pigs. I did my best to stay out of it. It was Mom’s last night, and I didn’t want to intrude on their conversation. As a Brooklyn Jew who talks with my hands, I physically sat on my hands as if this could keep me quiet. But, alas, the science within was bursting out of me, and I leaned over and gently said, “Actually, mRNA technology has been around and tested for decades …” And contact was made. I shared that I’m a public health scientist, and they seemed to welcome my interjection and had more questions. Turns out, the four guys represented a spectrum of scientific skepticism, and they were seated in order of increasing skepticism, going clockwise. One was clearly very “on board” with science and echoed my sentiments. The next two guys were quite receptive but expressed varied levels of skepticism, and the guy seated closest to me was the most vocally opposed to the health and science establishment. He was a tough nut to crack! The conversation lasted about 15-20 minutes and was very respectful, though my exchange with the last fella did get a bit heated at times. I thought it might be helpful to share a bit about that discussion because I’d be willing to bet that he was saying out loud what a lot of people are thinking or wondering, and it might help others in public health think through when and how to engage in conversation with strangers. We tackled six major topics. 1. mRNA technology: decades in the making They had no clue that mRNA technology was not new at all. They were also unaware of its applications outside of Covid-19. The development of mRNA vaccines spans over 40 years of research: 1978: The first successful transfection of designed mRNA packaged within a liposomal nanoparticle into a cell was published, in both mouse cells and human cells. 1990s: The first mRNA flu vaccine wastested in mice. 2013: The first human clinical trials using an mRNA vaccine against rabiesbegan. 2023: Katalin Karikó and Drew Weissman won the Nobel Prize for their discoveries of modified nucleosides that made it possible to develop effective mRNA vaccines. This is a very abridged summary, but this point is: mRNA technology is far from new. It faced significant challenges that took decades to overcome, including how to prevent mRNA from being rapidly degraded in the body and how to package it for effective delivery using lipid nanoparticles. “OK, OK — but how did we get a vaccine so quickly? We were guinea pigs,” one of the men told me. Here’s how it happened. Operation Warp Speed, launched in May 2020, invested $18 billion to accelerate vaccine development. The program didn’t skip safety steps; it ran them in parallel: Clinical trial phases overlapped rather than running sequentially Manufacturing began before trials were complete (financial risk, not safety risk) The government pre-purchased doses to incentivize rapid development Multiple vaccines were developed simultaneously to increase the chances of success The speed came from removing financial barriers and bureaucratic delays, not from cutting corners on safety testing. I explained how all the research on mRNA set the stage, and we got very lucky that the vaccines were effective against SARS-CoV-2. This was news to them. 2. “They lied to us — the vaccines never prevented Covid-19.” This complaint (that the vaccines “never prevented Covid”) was far from the first time I’d heard it. It reflects both a misunderstanding about vaccine goals and the challenge of communicating during a rapidly evolving pandemic. The vaccines’ main endpoint in clinical trials was preventing severe illness, hospitalization, and death, not preventing all infections. And they succeeded remarkably at this primary goal: The original vaccines were actually quite effective at reducing transmission initially, with studies showing 40%-60% reduction. But as the virus mutated (as viruses do), particularly with the Delta and Omicron variants, the vaccines became less effective at preventing transmission. However, they remain highly effective at keeping people alive and out of the hospital — their primary purpose. I addressed the communication issues with empathy. We were in the middle of a global pandemic with millions dying. Communications were made under extreme pressure, and I don’t envy those officials, nor can I say with confidence I would have done things differently. My brilliant colleague Aimee Bernard has a great analogy for this: Every car mechanic across the U.S. uses different messaging for why you need your engine fixed or your brakes replaced. Each one explains it differently based on their knowledge, their customer, and the specific situation. Now imagine if all those mechanics had to agree on one message and deliver it simultaneously, while the cars were actively catching fire, and half the owners insisted cars don’t actually need brakes. That was Covid messaging. Looking back, it’s easy to criticize decisions about masks, mandates, and lockdowns. Perhaps officials could have communicated more clearly about uncertainty or adjusted decisions as we learned more. But at that time, they were responding to an acute global emergency with limited information. In retrospect, clearer messaging about what vaccines could and couldn’t do, and that they were primarily about preventing severe outcomes rather than all infections, might have prevented some of this confusion and distrust. The guys seemed to appreciate my acknowledgement of this. We found some common ground. 3. “Only sick people died from Covid” and “The numbers are exaggerated” They made two separate claims here, so I addressed both. While it’s true that certain groups were at higher risk, Covid-19 killed people (and continues to kill people) across all demographics: CDC data shows that while risk increased with age, deaths occurred in all age groups. Although most Covid-19 deaths occurred in people who had underlying conditions, studies have shown that many people without documented comorbidities also died of Covid-19; for example, a study in Tennessee found that 20% of deceased Covid-19 patients had no comorbidity data recorded, and a study that looked at Mexican data found this number to be as high as 30%. I brought up long Covid and the fact that many continue to suffer long after their acute illness resolved. While acknowledging that death from Covid-19 is much more likely in people who have an underlying condition, I shared that many of these risk factors aren’t limited to people who are visibly “sick.” Common conditions like obesity, asthma, cancer, diabetes, heart disease, and even depression are included in the list of underlying conditions, along with other factors such as smoking, pregnancy, and physical inactivity. Because these conditions and behaviors are so widespread, affecting a large percentage of Americans, the majority of the U.S. population faces an increased risk of severe illness or death from Covid-19, not just those with serious illnesses. This highlights how broadly Covid-19 risk extends across the population. When it came to claims that the numbers were exaggerated, I got a bit heated. One of the guys said that “they lied about how many people died from Covid-19.” He brought up death certificates and how docs were slapping on Covid-19 when people “actually died from other causes.” It was the “dying with not from” canard. I talked about my husband, who’s an ER doctor, and the process for filling out a death certificate, which he’s had to go through countless times in his career. I told them how, in 2020, he resigned himself to dying on the frontlines from the virus and lived separately from the kids and me in an Airbnb out of fear of infecting us. How he wept when he lost his first (of many) patients to the virus — an otherwise healthy man in his early 40s. I brought up how several of my good friends are clinicians in New York City, and they’d share how it was like a war zone with makeshift morgues and people dying in hallways. This wasn’t hyperbole. It was the reality health care workers faced during the surge. The death counts, if anything, may have been undercounted in the early pandemic due to limited testing and reporting delays. It was only five years ago, but it seems people are forgetting the chokehold this virus had on the entire world. Many people who die “with” Covid-19 may not have it listed as the direct cause of death on their death certificates, but that does not mean Covid-19 was harmless and uninvolved in their deaths. Covid-19 often worsens existing health conditions, tipping the balance and hastening death in people with underlying health conditions. This means that Covid-19 may act as an indirect killer by exacerbating other diseases. So people are mistaken when they argue that public health experts are overstating (or lying about) the Covid mortality risk by including people who died “with” Covid. Covid-19 remains a significant and harmful factor in these deaths, even when not listed as the principal cause. 4. “We are censoring people who do not fall in line.” They brought up censorship and the “liberal slant” of media. They felt that science had become like a religion where anyone who questioned the narrative was labeled a quack, and that these “silenced” voices were actually brave truth-tellers. I acknowledged that this is genuinely complicated. There’s a crucial difference between: Legitimate scientific debate among experts (which is essential to science) Dangerous medical misinformation that could get people killed But who decides which is which? And what happens when we get it wrong? It’s complicated. Scientific disagreement is normal — it’s literally how science works) We have peer review, we debate at conferences, we publish competing studies. When thousands of experts reach consensus after rigorous testing, like they have on vaccine safety, that consensus reflects the weight of evidence. But we’ve created a system where going against scientific consensus is often misguidedly seen as courage. People like Robert Malone (a prominent critic of the Covid vaccine who describes himself as the “inventor of mRNA vaccines,” an overstatement of his role in the process) and Retsef Levi (an MIT professor who called for stopping all Covid vaccinations) are celebrated as heroes “speaking truth to power.” They’re invited on podcasts, featured at rallies, and now appointed to CDC’s Advisory Committee on Immunization Practices — the committee that shapes U.S. vaccine policy. Meanwhile, the thousands of pediatricians, immunologists, and epidemiologists who’ve spent decades studying vaccines are painted as either corrupt or cowardly. Having an MIT title or M.D. after your name becomes enough to override the expertise of thousands of specialists. That’s not a scientific debate anymore — it’s about who the general public perceives as brave, even if it’s for the wrong reasons. Science isn’t a religion; it’s a process of questioning, testing, and revising. But that process requires good faith engagement with evidence, not just contrarianism dressed up as skepticism. 5. Covid origins and lab leak Three of the four guys were 100% certain that Covid-19 was confirmed to be the result of a lab leak. The fourth was unsure but thought it was a lab leak. They brought up gain-of-function. They vilified Anthony Fauci. I explained that there are two main theories about where Covid came from: Natural spillover: The virus jumped from bats to humans, possibly through an animal sold at a wet market (like how SARS came from civets and MERS from camels). Lab accident: A virus being studied accidentally escaped from the Wuhan lab. The truth? We don’t know for certain. While they may have seen the White House statement or the House of Representatives report claiming a lab leak (one guy kept referencing this), the scientific community remains divided. Some agencies lean toward lab leak, others toward natural origin, all with varying confidence levels. While controversial, most scientists lean toward natural spillover based on viral genetics and epidemiology. Either way, we’re here now and need to work together. They kept mentioning “gain-of-function” like it was a smoking gun. I had to explain what this actually means. A good way to think of this is like studying a car engine. To understand how it works, you might modify parts to see what happens. Sometimes a modification makes it run faster (that’s technically “gain of function”). We do this to understand how viruses work so we can develop treatments and vaccines. The controversial type is when you deliberately make a dangerous virus more dangerous to see what could happen in nature. Whether the Wuhan lab was doing this depends on whose definition you use — even scientists disagree. Here’s what matters: This research helps us prepare for pandemics. Without it, we wouldn’t have vaccines or treatments. As another brilliant colleague, Leigh Baxt, explained to me, “How else would we understand what makes viruses tick? How would we know which parts to target with drugs?” The guys seemed surprised that “gain of function” wasn’t automatically evil, that much of it is just basic science needed to protect us. The term has become so politicized that people don’t realize it includes research that’s saved millions of lives. 6. The CDC and current changes They were very critical of the CDC. When I asked if they were referring to the current or former CDC, they looked at me with blank stares. “What is the difference?” they said. They were completely unaware of what is going on with health secretary Robert F. Kennedy Jr. and the unprecedented takeover of our public health infrastructure. That was shocking to me. To those of us in public health, it feels like the world is on fire. We’re watching the systematic dismantling of institutions that have protected Americans from disease for decades. But to most people? They have no idea any of this is happening. The damage isn’t just rhetorical. In six months under Kennedy: The CDC has lost nearly half its budget and thousands of employees. He fired all vaccine advisory experts, replacing them with vaccine skeptics. Multiple CDC leaders have resigned in protest. The agency is described as broken by former directors. Important programs targeting cancer, heart disease, strokes, lead poisoning, injury prevention, and violence have been severely weakened or defunded. The largest measles outbreak in a generation occurred during this period, while Kennedy downplayed the importance of vaccines and promoted unproven treatments. Funding for global vaccination efforts protecting millions of children worldwide has been halted. Jim O’Neill, a non-medically trained investment adviser, was appointed as acting CDC director, raising concerns about leadership expertise. A gunman attacked CDC staff, motivated by Covid vaccine opposition. The agency’s focus was narrowed to infectious diseases only, abandoning key chronic disease and injury prevention roles. Writing out these bullet points feels futile because it is difficult to convey the magnitude of destruction. This is demolition, not reform. And it’s happening while the public thinks Kennedy is fighting for them. The tragedy is that expertise isn’t about blind faith. Science invites scrutiny, demands evidence, and self-corrects. But when we reject expertise entirely, we don’t get freedom — we get chaos. We trust engineers to build bridges, pilots to fly planes. Why? Because expertise matters. Because knowledge accumulated over decades matters. Because the alternative is watching those bridges collapse. I was proud that I was able to navigate the discussion. At the end, three of the guys came up to me and shook my hand. They also shook my mom’s hand and congratulated her for raising a “bright young woman.” (She was kvelling.) All in all, it was a very good talk. I shared nuggets of info that they were not aware of. The fourth fellow was very hard to reach (and I am not sure I reached him at all). Some people can’t be convinced. But maybe, just maybe, I made him think about things he never considered. What struck me most was how much of their skepticism came from incomplete information rather than anti-science ideology. They didn’t know about the decades of mRNA research. They didn’t understand the nuances of vaccine effectiveness. They weren’t aware of the ongoing scientific debates and policy changes. This conversation reinforced for me that patient, respectful engagement with good-faith questions (yes, even skeptical ones) is essential. We won’t reach everyone, but we might reach someone. And in public health, reaching someone can make all the difference. After they left, I held my composure just long enough to down my beer. I’m much more comfortable communicating via “content creation” than live debates with slightly tipsy strangers. About 30 minutes later, the adrenaline was still surging and it felt like I was being chased by a bear. Yes, it was uncomfortable, but that’s exactly why it mattered. I wasn’t preaching to the choir or talking to an audience that was patting me on the back. I was challenging them and they were challenging me. We were actually engaging. Change doesn’t always happen in some fancy formal way, through policy papers or academic conferences or viral social media posts. Sometimes it happens around the Thanksgiving table, at high school reunions, and, yes, with random dudes at bars. Cheers!