Southern Cross University’s Professor Jon Wardle has been in the news recently for challenging some common assumptions about the Northern Rivers, COVID-19 vaccination and natural healing.
Professor Wardle is Foundation Director of the National Centre for Naturopathic Medicine (NCNM) and Maurice Blackmore Chair of Naturopathic Medicine at SCU. In addition to clinical qualifications in nursing and naturopathic medicine, he has postgraduate qualifications in public health, law and health economics and holds visiting positions at Boston University, University of Washington and University of Oxford.
Byron Healing sent Professor Wardle seven questions. These are his responses.
1. Is it true that the Northern Rivers is vaccine hesitant in your opinion? Could you elaborate?
The data does show some parts of the NR are more vaccine hesitant than the Australian average, but most of this is about childhood vaccination, not adult. While there is definite overlap, there is a large subset of the vaccine hesitant community who have concerns about childhood vaccination that don’t translate to adult vaccination, because a lot of the concerns are about the development stage of children during the intervention (though it should be noted that driving to the appointment is still the most dangerous part of any vaccine recognised in Australia).
Whether that hesitancy will turn up in respect to COVID vaccination remains to be seen – now availability is secured, vaccine rates across the NR are increasing above the state average, and the vaccine hesitancy tracker done by researchers at the University of Melbourne shows South Australia to be the major current area of concern, rather than the Northern Rivers.
NR is also a big area – Byron and Tweed have lower levels of vaccination than other areas but Ballina, Casino and Lismore are all pretty comparable with state averages. It’s a diverse population. Even then the most vaccine hesitant areas have majority support and uptake – three quarters of the population. It’s not as much as you’d like to see, but it certainly doesn’t support the notion that the entire region is anti-vaccination.
2. Is natural medicine incompatible with vaccines from Big Pharma? Why/not?
I think we need to divorce the fact of where things have come from and focus on what they are. The distinction is not there like it used to be. It’s just not that black and white.
The truth is that much of natural medicine comes from companies on the scale of big pharma – the idea of natural medicine being a cottage industry are long gone, but the products of that scaled-up industry are often still quite good – in some cases even better than before because of better quality control.
A lot of influencers speaking on behalf of natural medicine and discrediting the ability to use both approaches are actually monetising that message considerably. And while it’s true that big pharma has many, many problems – it’s pathologized many things that shouldn’t have been pathologized, particularly in mental health and women’s health, in order to make a buck – but it does create some good products, often because of the wonderful researchers and clinicians who are removed from those business decisions and are there to solve the world’s health problems.
I’m a fervent believer in integrative healthcare – taking the best from natural medicine and what they call ‘conventional’ medicine – the ‘best of both worlds’ approach. You’ve got to do what is best for your body. On that basis there are a lot of conventional interventions that work well with natural medicine. I believe vaccines are definitely one of those.
A lot of natural medicine is focused on trusting your body and building its capacity to fight disease. That’s precisely what vaccines do. They’re minimal dose, they’re safe, they’re preventive in nature and they actually work by teaching your body’s own immune system to fight disease should you be exposed.
We’re even starting some work with colleagues in Arizona on how natural products can even improve the immune response, making it both safer and more effective. Dogmatically following labels doesn’t really make for good medical or naturopathic practice, and I think everything should be judged on its merits.
3. Have you faced attacks for your views? If so, how have you responded?
Vaccination is an incredibly contentious space, and I think pretty much everyone working in this field has had some form of attack. Some of them are pretty wild. When I received my first NHMRC grant looking at vaccine hesitancy, an anti-vaccination activist published a picture of the front door of my house on an anti-vaccine Facebook group.
But a skeptic group also started a campaign to my Dean and Vice-Chancellor trying to get me fired from my university because they thought it was improper for a naturopath to be commenting on the issue, or even be employed by a university. These are pretty fringe groups though, and support has been far more common.
Unfortunately though, these fringe groups do stop others from commenting publicly. Generally these fringe groups aren’t for turning, and are often more interested in fighting with their opposite fringe counterparts, so I try not to focus attention here. My key focus is on those who genuinely have questions and concerns. Many of these concerns are valid, and many are actually resolved quite easily after even a cursory discussion.
In fact, one of the primary reasons people often become hesitant and choose not to vaccinate is the politics – they try to ask questions, people assume they’re trying to be difficult and they don’t even get to have a conversation. So they start looking around for someone who will lend an empathetic ear and more often than not, unfortunately, it’s usually those who advise against vaccination, rather than those who advocate for it.
We shouldn’t let the success of many anti-vaccination communication strategies obscure a lot of the failures of public health to be better at communicating with people. Vaccination attitudes are often a proxy for larger concerns about medicine, government intervention and personal autonomy, and de-escalating, de-politicising the discussion is the key to building trust (I wrote about this in The Guardian here).
One of the problems we often see is that many policy responses over-reach in terms of trying to force the hand of the vaccine hesitant, and that actually erodes trust. Provoking this kind of policy response is actually a strategy of some anti-vaccination activists, who know that arguments based on the effectiveness or safety of vaccines alone are not at all attractive to most people, but arguments against authority are. I try not to fall into these traps.
Most attacks come from a very small, fringe group of people – the proportion of people in Australia who are truly anti-vaccine is truly tiny – and the key is to build trust with that broader group who might be hesitant, but are genuinely open to hearing all sides but are often blocked off from having those conversations.
4. What would you say is the majority view among Northern Rivers natural health practitioners re the COVID vaccines? Is there any significant division?
Without surveying or talking to every single one you can never be sure, and I’m known for my views which may bias what I’m being told, but certainly the majority opinion I’m hearing is supportive, and I’ve seen far more supportive messages in media and social media from this group than opposition.
The naturopathic schools in states where mandates for student clinical placements exist aren’t getting any more pushback from naturopathic students than we’re seeing in nursing or allied health. I think it’s naïve to say everyone’s on board though. There are some who are hesitant, and one or two who are dead against, but this is something I’m seeing across the NR in a number of professions – just look at the social media feeds of nurses saying they refuse to work with mandates.
I think it probably reflects what we’ve found in our previous national and international studies – there is a level of hesitancy in the natural health professions, probably more than some other professions, but this is a minority opinion and probably reflects the fact that many people come to this profession due to dissatisfaction with conventional medical approaches more than any inherent philosophical opposition.
It also reflects the fact that it is an unregulated profession – you can come and do a four year degree to be a naturopath at a university like ours, but you could also hang a shingle up tomorrow if you wanted to. A lot of practitioners who get de-registered in other professions often resurface as naturopaths or natural medicine practitioners because there is no regulation.
This is clearly a recipe for attracting a fringe group of unqualified practitioners co-opting the term naturopathy for their own gain, sometimes offering dangerous advice, yet despite multiple government reports recommending naturopaths be regulated for the past 40 years, and overwhelming professional and public support for this. there has been no action.
One thing I have noticed, however, is even those who are supportive of vaccination are often scared to voice this support. Until just a few months ago, even GPs were advised by their associations not to talk to their patients about the different vaccines due to potential medico-legal and regulatory concerns. That’s GPs, you can imagine the concern a profession like naturopathy that doesn’t have those institutional, legal or regulatory protections would have.
Because of this, most practitioners won’t even discuss the issue of vaccination unless specifically asked. I personally think this is a missed opportunity. Naturopaths are trusted more by many parts of the vaccine hesitant community than medical doctors or nurses; we should be supporting them to support those patients. It’s an approach primary health networks in the US and other parts of NSW have been using quite effectively.
5. What advice do you have for people inclined to natural medicine who have chosen not to be vaccinated so far?
My first piece of advice would be to reflect on why. Is it because it doesn’t seem natural? Many supplements are made in vats with even more adjuvants than vaccines yet are still safe and effective.
Is it because you trust your body? In that case vaccines are perfectly compatible because they aren’t a pharmaceutical/pharmacological intervention as much as a tool to teach your immune system to work better.
Is it because you’re young and healthy and aren’t worried about COVID because you can recover well with natural medicine? I like to think of myself in this camp, and reckon I’d come out of a COVID infection okay, but long COVID scares the bejesus out of me – we’re seeing young people possibly incapacitated for ten years or more due to post-infectious sequelae. I’ve worked in this area in the original SARS, Ebola and Chikungunya – often because natural medicine is one of the few options for these conditions – and if I’m perfectly honest avoiding long-COVID rather than acute-COVID was actually my prevention priority.
Is it because you think ‘natural’ immunity is better than vaccine-acquired immunity? If that is the case, it might surprise you that the mechanism for both – acquired immunity – Is exactly the same. Vaccination just does it in a targeted way, that doesn’t illicit the non-targeted immune response that can potentially create havoc in the body before the body begins to recognise the pathogen.
It is ultimately a personal choice to vaccinate or not, but it is one I think people should be given the chance to reflect on. And the alignment and similarities between vaccination and natural medicine are actually close if you reflect on them.
The case for vaccinations is incredibly compelling, and the case against them pretty underwhelming. Most people get that, and if given the chance to actually think about it and not be side-tracked by the politics of vaccination, most people will arrive there of their own volition.
6. Are there any legitimate reasons for not being vaccinated against COVID? If so, what are they?
We do have medical exemptions for not vaccinating for COVID, and I do think those are valid. This includes those who are immune-compromised, or those who have had severe reactions to vaccines.
I do think everyone should be vaccinated, but I do have concerns about mandates, I do think it should be a choice that people are able to come to. The vast majority of people will if given the chance.
The main concern I have with mandates is they work well in the short term but potentially create problems longer term. Australia already has an incredibly high-level of support for vaccines of all types, higher than many countries. We trust our vaccines, but we don’t trust our politicians. The problem is this popularity of vaccines means politicians can’t help themselves but do something to ‘look tough’ on vaccines. Politicians are trying to get some of the halo effect associated with vaccines but at the same time this results in some of the stink of politicians rubbing off on the vaccines.
Unfortunately this might end up with us facing some of the issues we see in countries like the US or France, from which Australia has been largely insulated against due to high support for vaccines. This erodes the trust in vaccination programs, because it gets caught up in arguments about government and authority rather than the validity of the vaccines themselves.
Frankly politicians need to stop playing silly buggers with the politics of vaccines as much as the anti-vaccination groups do. Policy responses and discourse are driving many people’s concerns, not the vaccines themselves.
7. Are there any non-vaccine, preventative alternatives for those concerned about getting COVID who would prefer not to get vaccinated for any reason?
It would be nice to think that there is an alternative, but there just isn’t. Not in the sense that something can do the same thing that vaccination does. Vaccination is highly targeted, it trains the immune system with a minute dose to recognise a pathogen the instant it enters the body.
There is definitely a role for natural medicine in COVID, and this is something we are looking into. Last year we worked with the World Naturopathic Federation and the World Health Organization to do an evidence summary series of several potential natural medicine products that showed they could reduce some symptoms. I’ve just finished editing a special issue of Frontiers in Pharmacology on the potential of natural products in COVID, which showed definite potential for many products.
As part of Oxford’s Rapid Review team we did a review and meta-analysis of the Chinese government’s protocols for traditional Chinese medicine COVID treatment, which did show improvement in symptoms, but probably not as much as the government’s claims.
It’s comforting to think that there is a natural alternative out there, but there just isn’t anything that can do the same thing. This is why some people promote alternatives like ‘homeopathic’ vaccination – but again even the homeopaths reject this and it is promoted by people co-opting a therapy to fill a market void, not an effective tool.
There is a lot of potential for natural medicine to be used in conjunction with vaccination, or as an adjunct treatment during acute infection, and in my opinion a very big role for natural medicine in recovery. I will be using both if I or my family ever get infected, I want all options on the table. But it just doesn’t replace vaccination.
And this is the key – many people try and avoid vaccination because they think by avoiding vaccination they avoid its potential risks. But you’re not avoiding risk, you’re simply choosing to replace one risk set with another. And in my opinion the risks of not being vaccinated outweigh the risks of being vaccinated – even at an individual level, particularly as we start ‘living with COVID’.