On Fears of Nuance and Needles
I've heard that Pfizer has released a new vaccine against the novel coronavirus this week. On hearing this news, I unconsciously began to brace myself for an ugly public debate about vaccination. The dialogue proposes to be a continuation of the raging battle to decide which is more important: individual rights, or public welfare.
The traditional arguments about vaccines are predictable—even scripted. Are perceived personal risks in taking vaccines outweighed by the public health benefits of controlling disease? Anti-vaxxers cite fears ranging from autism to inoculation with nano-technology and stand on the individual's right to refuse vaccines, while pro-vaxxers claim that public health is only served when all citizens cooperate to achieve herd immunity. The latter lend weight to their arguments by observing that some fragile members of society can't be safely vaccinated, so we must cooperate in an effort to protect them. This is merely one arena where we explore this essential tension between individual rights and social responsibility. Also, since many of the anti-vaxxers' concerns about personal safety might be dubiously supported, it's also an arena where we may observe the fight about truth, conspiracy, and science. Quite fascinating really—if only it weren't so ugly and scripted.
Let me turn that all on its head for you now.
For public health reasons, I doubt that I will take this vaccine. Of course I believe in individual rights—some might call me a social libertarian—so if other people take the vaccine for personal health reasons, I support their right to do so. Do you see how this flips the script? I understand that many pro-vaxxers promote vaccines for public health reasons, and I'm sure those arguments hold up as far as they go; I just don't think they go very far. I think they go about a hundred years, which isn't much in my opinion.
I don't really buy the conspiracy theories about vaccines being unsafe for the individuals who take them, but I do have concerns about propping up our collective immunity with technology instead of relying on strong genetic, cultural, and ecological health. I believe that human immune systems should be exercised; that we are evolved to respond to disease through natural, cultural, and biological processes; and that technological interference with those processes weakens public health.
Now, before some hot-tempered leftist accuses me of something similar to eugenics, let me be clear that I am not saying vaccines are bad, or that weak people should die. I am saying that vaccines are a tool, and some of us should use that tool, and perhaps overuse of that tool could be dangerous for public health. It doesn't have to be all-or-nothing. If you are concerned about your personal health, get a vaccine. If you are concerned that insufficient participation in vaccine programs might immediately endanger fragile members of society, promote the vaccine program. I share those concerns, and also have other competing concerns. This is called nuance.
I am concerned that long-term use of vaccines could leave us without the biological and cultural resilience to withstand viral stress. Personally, I do not feel that my family is strongly at risk to this or other diseases. I believe it serves public health for some number of low-risk people to remain unvaccinated, because this fosters biological and cultural resilience to disease without the crutch of technology. I see this as a personal risk—albeit a small one—that certain members of society should take. I don't expect applause. I don't care if you agree, but it would be nice if you could break out of the pre-fabricated narratives that the media continually amplifies and attempt to understand that this debate could have nuance.
It doesn't have to be scripted.
I'm a farmer. I refuse to use anti-fungals and pesticides on my crops, because I believe that this practice props up weaker plants, kills important life in the soil, and downgrades the health of the system overall. When I save seeds from my plants each year, I choose the strongest specimens with the assurance that this seed is not deriving its strength from my artificial interference. It isn't eugenics to observe that this same process occurs in human populations unless that observation is used to promote systemic abandonment of fragile individuals. I am not promoting this abandonment, I would never promote this, and I am glad people are making vaccines. I also envision a world in which vaccines are not needed or needed much less.
The emphasis on vaccination completely ignores the fact that our public health is made fragile by poisoned food, poisoned water, hyper-individualism, economic colonization, hierarchical social structures, undervaluation of caregiving, and an unfamiliarity with epidemics that is caused by the vaccines themselves. That's a long list of things (incomplete though it is); maybe you should read it again. Every one of these factors makes us prone to contagion, contributes to poor disease outcomes, and strains our public health and infrastructure. This whole array of biological and cultural factors needs immediate attention if we are to protect fragile members of society.
I would protect fragile individuals from the poisoning of their food and water by the very pharmaceutical companies that manufacture this vaccine. (Millions of tons of pharmaceutical waste are released into the environment every year!) I would protect fragile individuals by addressing cultural barriers to controlling the spread of disease; I would hold multinational corporations responsible for extractive activities that release zoonotic viruses. All of this would protect the weak among us, but holding space for that multiplicity of causes requires nuance. It requires that we reject the polarized scripts that divide us amongst ourselves. Nuanced exploration of a vaccine's threat to long-term public health need not be read as abandonment of the weak. It's just that short-term public health and long-term public health might have competing needs. It's OK for vaccines to have upsides and downsides. We don't have to be afraid of nuance.
Consider that many of the factors that exacerbate this pandemic have been cultural, and so they are obviously untreatable through vaccination. This is immediately clear when we see that hyper-individualism in the United States has left us far worse off than other, more socially-conscious countries. Yet the pandemic itself has certainly increased our social consciousness. If we have to do this again soon—and it's likely that we will—the barriers to mask-wearing would be much less. The insistence on business-as-usual would be much less. Perhaps—and only if we insist upon this and demonstrate the will to strike otherwise—our medical infrastructure will be ready, caregivers will be valued, and at-risk populations will receive the care they need.
Our newfound experience with pandemic inoculates us against new diseases in a way that vaccines could never do. In fact, that cultural inoculation is prevented by vaccines; it's precisely because of vaccines that we haven't had a similar pandemic in 100 years. (Keep in mind that it's probably better to have smaller, more frequent outbreaks than larger ones further apart, because medical systems aren't so overwhelmed and are stimulated to adapt and prepare.)
I agree that vaccines improve collective resistance to disease in the short term (about 100 years). I mostly agree that vaccines are safe for the individuals that take them, even if I don't trust the pharmaceutical companies. However, I am concerned that vaccine-reliant populations are actually more fragile to pandemic on long time scales, and that vaccine reliance enables us to cover up other public health crises such as the chronic illness created by terrible diet and poisoned ecology. I believe that herd immunity should be a function of socially conscious culture as much as biology, and I think vaccines might weaken social consciousness.
A nuanced analysis is honest about pros and cons. In contrast, I've routinely heard pro-vaxxers referring to the COVID crisis say that, "This is a world without vaccines." That is fiction. We don't live in a "world without vaccines," and we can't pretend that vaccines only exist when they re working or that they haven't helped shape our failed response to this crisis. It's dangerous to compare our crisis to a "world without vaccines." It is stupid and fictional. Honestly, it's a page out of Trump's book. Vaccines exist, and they don't always work. When they don't work, it's not a "world without vaccines." It's a world where our reliance upon vaccines has failed. These are very different worlds.
My goal in writing all this isn't to sway your decision to get a vaccine or not. I really don't care, and I don't think it's nearly as important as it's made out to be. Some people will get vaccinated. Some people won't. Some of the people who don't will have entirely different reasons than mine. How much does that really matter? My goal in writing this is to model the nuanced thinking that I wish could become part of public debate in general. My goal is to undermine the scripted narratives and team sport politics that have come to dominate American thought. I am less concerned about our reliance on vaccines than I am about our sloppy thinking. I would remind us that these issues aren't as simple as they're made out to be. There are legitimate public health arguments both for and against vaccination. There are legitimate personal freedom arguments on both sides as well. My goal is to find nuance in what others would paint in monotones of red and blue.
I am not afraid of needles. I'm not afraid of viruses. I'm terribly afraid of a society that has lost the ability and willingness to engage in critical thought.
"Millions of tons of pharmaceuticals..."
Buhner, Stephen Harrod. The Lost Language of Plants. The Ecological Importance of Plant Medicines to Life on Earth. White River Jnctn, VT: Chelsea Green. 2002.
Wu, M; Atchley, D; Greer, L; Janssen, S; Rosenberg, D; Sass, J. Dosed Without Prescription: Preventing Pharmaceutical Contamination of our Nation's Drinking Water. NRDC White Paper. December 2009.