Something very strange has been happening in Missouri: A hospital in the state, Ozarks Healthcare, had to create a “private setting” for patients afraid of being seen getting vaccinated against COVID-19. In a video produced by the hospital, the physician Priscilla Frase says, “Several people come in to get vaccinated who have tried to sort of disguise their appearance and even went so far as to say, ‘Please, please, please don’t let anybody know that I got this vaccine.’” Although they want to protect themselves from the coronavirus and its variants, these patients are desperate to ensure that their vaccine-skeptical friends and family never find out what they have done.
Missouri is suffering one of the worst COVID-19 surges in the country. Some hospitals are rapidly running out of ICU beds. To Americans who rushed to get vaccinated at the earliest opportunity, some Missourians’ desire for secrecy is difficult to understand. It’s also difficult to square with the common narrative that vaccine refusal, at least in conservative areas of the country, is driven by a lack of respect or empathy from liberals along the coasts. “Proponents of the vaccine are unwilling or unable to understand the thinking of vaccine skeptics—or even admit that skeptics may be thinking at all,” lamented a recent article in the conservative National Review. Writers across the political spectrum have urged deference and sympathy toward holdouts’ concerns about vaccine side effects and the botched CDC messaging about masking and airborne transmission early in the pandemic. But these takes can’t explain why holdouts who receive respect, empathy, and information directly from reliable sources remain unmoved—or why some people are afraid to tell their loved ones about being vaccinated.
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To outsiders, the social dynamics of the con appear peculiar and irrational. Those caught up in it can seem self-destructive and, frankly, clueless. But to sociologists, including me, who study fraud, such behaviors obey a predictable logic.
The seminal text in the field—Erving Goffman’s 1952 essay “On Cooling the Mark Out”—observes that all targets of con artists eventually come to understand that they have been defrauded, yet they almost never complain or report the crime to authorities. Why? Because, Goffman argues, admitting that one has been conned is so deeply shameful that marks experience it as a kind of social death. The victim, he writes,
"has defined himself as a shrewd man and must face the fact that he is only another easy mark. He has defined himself as possessing a certain set of qualities and then proven to himself that he is miserably lacking in them. This is a process of self-destruction of the self."
Goffman notes that other life events, such as being fired or dumped, can evoke similar feelings of humiliation. But people targeted by con jobs can save their pride by denying the con as long as possible—or claiming they were in on it the whole time. This saves face and cheats social death, but allows the con to continue unchecked, entrapping others. In doing so, marks prioritize their self-image over the common good.