Finding Empathy While Fighting Misinformation

A few days after New Year’s Day in 2021, I became one of the first pregnant women to receive the COVID-19 mRNA vaccine.

After weighing the risks of vaccination versus the risks of not getting vaccinated, my decision was crystal clear. I decided for myself, my unborn third son in utero, my family, my patients, and my community. After getting the vaccine, I worked with the outreach groups at Massachusetts General Hospital to share my personal story, as well as the scientific data on vaccination and pregnancy, with the hope that our community would be empowered to make the decision to vaccinate on their own terms. The moment that the media content went viral in my home country of Japan, where there was significant hesitancy toward vaccinations, was the serendipitous event that changed my life.

While it was clear that the overall impact of my communication to the public was very positive, I also received gestures of hate from people who were part of the antivaccine movement. I was accused of being a bad mother, because it was “child abuse” to vaccinate as a pregnant mom. Mass General and Harvard received anonymous emails about my “unethical conduct” for recommending vaccination to pregnant people. There were X-Acto-knife blades that arrived in the physical mail addressed to me. A fake death certificate was made for my unborn baby that declared, “Reason of death: mother’s vaccination.” The response gradually expanded beyond the topic of vaccination and evolved into comments about my appearance, how I spoke, and about my being a woman. I was reminded of the deep-seated gender inequalities in the Japanese culture. The thousands of online comments and direct messages kept pouring in.

This unexpected experience made me realize a few things: (1) the power of misinformation in impacting one’s health, (2) the lack of support for parents who need to make hard decisions for their families, and (3) the psychological harm of unconscious biases that connect to inequality.

As parents — particularly mothers — we are often put in positions where we need to make responsible decisions for our children, yet it’s so hard to access scientific and accurate knowledge that will allow us to make those decisions. In addition, we are rarely given support to walk through that process, and we are somehow always criticized for the decisions we make for our children, no matter what decision that might be.

This was very familiar to me both as a mother and a child psychiatrist. Unfortunately, child psychiatry has been a field of abundant misinformation and prejudice. While theories that mothers who act “cold” could “create” children with autism or psychosis were scientifically debunked many decades ago, the terms “refrigerator mothers” and “schizophrenogenic mothers” still continue to be used in some circles. Parents of children who struggle psychiatrically are often shamed and made to feel guilty. Even the existence of pediatric mood disorders that have neurobiological underpinnings, such as depression or bipolar disorder, continues to be a topic of dispute, and parents continue to be blamed for their children’s mood dysregulations. There are various treatments that could help children and families with social and emotional difficulties, but misinformation and prejudice create a high barrier for the people who need help to seek it out.

Misinformation and prejudice can significantly alter or even end lives. To tackle misinformation and prejudice, we need to advance science and disseminate knowledge. I made a pledge a long time ago that this would be part of my life’s work. Being a child psychiatrist, never in my life had I imagined that it would happen in this way, as I became a scientific advocate during an infectious disease pandemic. When the world was suffering, however, I knew that I had to carry out my pledge.

When I received the overwhelming amount of hate from those who were hesitant about vaccinating, I took a deep breath, hugged my family, gathered my support system, and decided to talk to the “haters.” I went onto Japanese national TV every single day for more than half a year and spoke from my heart.

As a clinician-researcher, I thoughtfully explained the scientific evidence of the mRNA vaccine and clinical data on COVID-19. I did so with empathy and understanding of the struggles of the pandemic, as well as the fear that people felt toward the vaccine. I discussed the risks and benefits of vaccination, and I spoke about my own hardships of being a mother of three as the world shut down. I was eventually asked to join a nonprofit project founded by like-minded doctors to tackle medical misinformation surrounding the COVID-19 vaccine. Together, we worked with the media and the Japanese government in delivering accurate scientific information to the public.

Thankfully, people listened. In January 2021, media reports in Japan noted that only 7 percent of the Japanese population responded that they planned to receive the COVID-19 vaccine, but by September 2021, over 80 percent of the population had been vaccinated. In 2022, our nonprofit received the Minister of Health, Labour and Welfare Award, which is given to medical advocates that made the most health impact in Japan.

I also had a hidden agenda of feminism throughout this mission. As I mentioned, many of the comments that I personally received during the vaccine advocacy targeted the fact that I was a woman. As of 2023, the World Economic Forum ranked Japan 125th out of 146 countries in gender equality. In my Japanese medical school class that graduated in 2007, there were only 15 women out of 100 students. My male classmates frequently stated with confidence that they did not think that women should become doctors. In 2018, an investigation found that multiple medical schools in Japan systematically deducted female applicants’ scores on entrance exams to reduce the number of female doctors. Their inexcusable justification was that “women have children and can’t work as much as men.” This statement was widely accepted by the public. My decision to leave Japan was directly related to systematic sexism.

When I started appearing on Japanese national TV for vaccine advocacy, it was a shock to the viewers. Not only had I been vaccinated as a pregnant person, but also I was a female physician in a leadership position at Harvard, while having a family. This incited microaggressions, such as, “I initially doubted you because I thought you are a woman who has ‘won’ it all,” to comments that sexualized or attacked me directly.

I, of course, did not enjoy these statements, but it made it clear that there is a need for representation of women with expertise. I felt even more that I needed to be present in the media and have these academic conversations, and so I continued to talk publicly about my experiences as a Japanese female physician and why systematic sexism is a problem for both men and women.

Throughout this experience, I had many conversations with people who were on the other side. Initially, I assumed that there was a separation of “us” and “them.” What opened my eyes was that many of the people who showed hesitancy about the vaccine shared the same goal as people who advocated for vaccination: to protect the health of ourselves and our loved ones.

I will carry this lesson with me as I live through a time in American history when the divisions of society are undeniable. In the past, I used to think about divisions of ideologies as two colors never mixing together, separated by a clear line. I used to envision “crossing the divide” as changing the entire color of the other side. Finding empathy for people who appeared to be on the opposite side allowed me to think differently. Now I realize that the colors and divisions are much more nuanced. There is a gradation of each color from dark to light, and there are parts where two colors mix. “Bridging the divide” might mean that we are able to cherish the nuances of the colors, even to change the tones of those colors on divisive issues.

Mai Uchida is HMS associate professor of psychiatry at Massachusetts General Hospital.