Last Tuesday, Reuben College welcomed Dr. Donald Palmer, a Visiting Reuben Fellow, to give our third Tuesday Talk of the year. Dr Palmer is an immunologist from Royal Vet College, who is also dedicated to enhancing public engagement and representation in science. His talk was wide-ranging, and for those of us new to the area, we had the chance to take a little educational journey to “T-cell university” in the thymus. The second half of the talk centred on strategies for public and community engagement.
As a bioethicist, both parts were really interesting to me. Dr Palmer’s expertise in science communication came out not only in his discussion of schools outreach activities, but in his explanation of a complicated phenomenon—immunosenescence—which was made that much more understandable to someone trained in philosophy through his analogies: it turns out, “the thymus is like T-cell university, where T-cells become educated, fully competent individuals” sent out into the body after they “graduate”. But with crumbling university infrastructure as we age (i.e., with our thymuses shrinking over time), fewer T-cells can graduate, and we end up with reduced immune response to infections and vaccines, but more vulnerability to inflammatory chronic diseases.
All of this is also acted as a bit of a primer for talking briefly about vaccines, and then about the rise in vaccine hesitancy. Communities facing social inequities, particularly in housing, health, education, and employment, showed lower vaccination rates during COVID-19. When Dr Palmer investigated reasons for hesitancy in his local area in London through focus groups, people highlighted experiences of medical abuses or mistrust in healthcare systems, fears of being part of an experimental group, and exposure to misinformation propagated through social media. To move beyond vaccine hesitancy, we need to address the roots of the problem, reducing societal inequalities, engaging with trusted members of local communities, building sustainable relationships for outreach, and providing timely and targeted messages for groups who are most marginalised.
Over a delicious moussaka, roast veg and Greek salad main course (with, BONUS, fresh bread and whipped butter alongside), my table talked about what resonated with them the most from the talk. For me, parts of the conversation were not unfamiliar. In the bioethics community we have talked a lot recently about how disparities in housing, employment, education, income and access to social support affected people’s experiences of lockdowns and other public health actions. I myself have argued for more context-specific ethical justifications for public health actions that take into account differing needs. But talking about the problem is not enough: Dr Palmer’s talk really brought home to me that we can have an impact. Whether we are immunologists, anthropologists, clinicians or statisticians, whether we are students or academics, it is both perfectly possible and part of our job to think about creating local impact.
So, over baklava for dessert, we puzzled over, how can we increase vaccine uptake? How can we ensure that diverse pathways to postgraduate education aren’t closed off? How can we counteract generations of medical mistrust borne from past and ongoing abuses experienced by marginalised groups? A few of our collective conclusions: it starts with conversations—it starts with making that podcast, or visiting that high school, or connecting with that faith leader, or even just listening to that person’s worry. This Tuesday talk provided a model for just how we can achieve that.
