Vaccine Fundamentalism—War Metaphors in the Covid-19 Response, Vaccine Policy, and Public Health, Part 1

By Nate Doromal, Guest Contributor

The metaphor of war has long been a part of public health. In responding to the Covid-19 pandemic, the world’s public health agencies mobilized and shut down entire parts of society under the utilitarian goal of stopping the spread of Covid-19.

In America, entire states were locked-down, public schools were dismissed, government public services halted, and businesses closed, while grim pictures of death were painted, pictures of sick and dying on ventilators were broadcast, and vivid dialogue of “overwhelmed” hospital capacity were plastered on mainstream media. Journals and media outlets played along, streaming out content about the dangers of Covid-19 and the need for continued lock-down. Dissenting views on social media were censored by social media tech companies.

Ostensibly the public health response escalated over time while new real-life data emerged that contradicted the severity of the Covid-19 forecasts. What was supposed to be a short lockdown response dragged on for months; the American economy faltered and sank in the wake of the response, and American state governors extended their short-term emergency powers to extend the lockdown period.

Public health officials themselves disseminate the war mentality with the repeated message: We are at war with an invisible enemy that must be eradicated. War mentality emphasizes the need for self-sacrifice in order to stop Covid-19 spread. And the weapons of war are glorified; public health authorities glorify its chief weapon of vaccination.

Like any war, there is collateral damage. The collateral damage here are the bedrocks of medical ethics, informed consent, human rights, civil liberties, and even science itself. How can proper science be conducted when one goal, “deliver a vaccine at warp-speed,” is emphasized over healthy scientific skepticism and public discourse? The ultimate collateral damage, of course, is among those damaged or injured by decisions resting on faulty science.

A further examination of the public health response to Covid-19 reveals a deeper problem: the metaphor of war and the assumption of vaccine fundamentalism has long been part of the public health mindset.

Vaccine Fundamentalism – Does Nothing Else Matter?

The war metaphor leads to a reductionist thinking style that leads to two exclusive outcomes. We either 1) win by eradicating the disease in question, or 2) the pandemic continues and threatens all of humanity. Peaceful coexisting is seen as a kind of surrender.

Citizens are given sham choices: either participate in the war effort or side with “the enemy.” Psychological shaming is used to coerce naysayers into participating; after all, who wants to be on the “pro-disease side?” Efforts to destroy the threat are prioritized as the most important consideration. Central to public health is the weapon of vaccines, and it has a sacred status in public health.

Vaccine fundamentalism is the belief that vaccination is the most important public health intervention, that it is above criticism, and that increasing the metric of vaccination uptake rate is the core purpose of public health agencies.

A public health official might defend the practice of vaccination through the often-repeated standard dogma of vaccine fundamentalism: vaccines have saved millions of lives, represent cost-efficient public health intervention, and an abundance of scientific research has shown time and time again that vaccines are safe and effective. Due to their importance, vaccines are above reproach and neither questioning them nor criticizing them is permitted. 

While the practice of vaccination does have a place in the public health repertoire, the repercussions of such fundamentalist thinking cannot be ignored, and must be completely understood.

The chief consequence of vaccine fundamentalism is that public health policy over-emphasizes a single reductionistic metric: increased vaccination uptake. And consequently, single-minded pursuit of any goal can lead to other detrimental outcomes which have been almost entirely  ignored.

Charles Eisenstein, in his book Climate: A New Story explained, “This pattern of thinking is called fundamentalism, and it closely parallels the dynamics of two defining institutions of our civilization: money and war. Fundamentalism reduces the complex to the simple and demands sacrifice of the immediate, the human, or the personal in service to an overarching ulterior goal that trumps all.”

Warmaking in the Efforts to Drive Vaccine Uptake

When vaccine fundamentalism is combined with the war metaphor, public health takes on the mantra of increasing vaccine uptake to fight disease at any cost. However, the behavior of public health institutions to achieve that goal can lead to perverse consequences that are seemingly the opposite of policy goals.

Public health institutions have lamented the rise of anti-vaccine sentiment. In response, they have developed elaborate strategies to deal with vaccine hesitancy. But they are missing the crucial point that mistrust of public health institutions arises from their ulterior goals of increasing vaccine uptake at whatever the cost.

All of the strategies used by the public health institutions to increase vaccination uptake rely upon a key assumption: the core of vaccine refusal lies with the refuser’s ignorance of scientific knowledge and acceptance of misinformation delivered by vaccine deniers.

The warmaking is evident here. There is a separation of the people into two separate groups: those who comply and those who do not. The latter are given a label of vaccine hesitant or vaccine denier. Public health implicitly sees these groups as a form of deviance that must be corrected through the good efforts of public health. 

Public health authorities also embed an important assumption here: those who question vaccines do not have valid concerns. The war metaphors of public health permit a callous dismissal of any vaccination concerns and grievances that occur within the medical setting. This diminishment of concerns and grievances naturally leads to more distrust amongst the populace of public health institutions.

There are numerous problems with the war mentality that public health officials ignore. Charles Eisenstein summarized: “The war mentality represents an unfortunate confluence of ignorance, fear, prejudice, and profit… The ignorance exists in its own right and is further perpetuated by government propaganda. The fear is that of ordinary people scared by misinformation but also that of leaders who may know better but are intimidated by the political costs of speaking out on such a heavily moralized and charged issue.”

Vaccine Fundamentalism Erodes Public Health Trust

The war mentality dehumanizes the enemy as unworthy of engagement on an equal level. Similarly, public health officials have taken the policy of refusing to initiate two-way dialogue regarding vaccine concerns for fear of legitimizing vaccine concerns. However, these strategies backfire in that those same concerns grow in the public.

What public health officials also fail to realize about the refusal to engage in productive two-way dialogue with those who have concerns is that this action is a form of epistemic violence. Philosopher Kristie Dotson defined epistemic violence as a “refusal, intentional or unintentional, of an audience to communicatively reciprocate a linguistic exchange owing to pernicious ignorance. Pernicious ignorance should be understood to refer to any reliable ignorance that, in a given context, harms another person (or set of persons).”

The pernicious ignorance on part of public health authorities lies in the refusal to fully investigate any criticisms brought forth against the vaccine program. Instead, these criticisms are immediately labeled as vaccine misinformation to reduce their legitimacy in the public eye. Public health authorities respond by extolling the virtues of vaccines.

Dissenting voices are drowned out by a strawman argument; the virtues of vaccines are used as a response to legitimate concerns without actually addressing the concern at hand. Thereby an insidious form of confirmation bias occurs; the presumptive rationale for vaccines comes from a one-side assessment from the past that is never revisited.

This strategy backfires because those people bringing the grievances feel unheard. In response to the deafness of public health institutions, these people must do the equivalent of yelling louder.  They band together, form coalitions, begin grassroot campaigns, and advocate for change with legislators. As a result, well-organized organizations (Children’s Health Defense and ICAN) have arisen whose primary purpose is to advocate for those whose concerns are not heard and to push government for public health reform.

The war metaphor then encourages public health officials to double-down on forceful activities to stifle inroads made by vaccine critics. Public health agencies in partnership with social media tech companies began censorship campaigns of vaccine misinformation, public relations agencies pushed out increased negative press on “anti-vaxxers,” and previously unrelated institutions started calling for increasingly draconian policies regarding vaccines.

Paternalism in public health has long been criticized, but war metaphors elevate this charge. Public health agencies have taken a hard paternalism stance. They have positioned themselves as a necessary police figure that defends society from the threat of pandemics, one that is willing to override citizen concerns, censor free speech, and engage in violence in pursuit of its goals.

Public health broadcasts a message that is essentially elitist in nature, asking the people to have faith in the public health experts without question. Public health sees itself as society’s primary epistemic authority on public health related matters, and any questioning of its authority is met with umbrage.

The public is aware of these problems, and distrust of public health has been increasing over the past few decades. Vaccine fundamentalism is dangerous because the very strategies used by public health officials to increase vaccination uptake also ironically lay the groundwork for undermining the public good on which the entirety of the public health system is based.

Vaccine Fundamentalism as a Threat to Medical Ethics

According to the American Medical Association Code of Ethics, a core precept of medical ethics is, “A physician shall, while caring for a patient, regard responsibility to the patient as paramount.” How does the responsibility to the patient as paramount work when at odds with state public health goals? Ideally there is the assumption that what is good for the state is in line with what is good for the patient but this is not always the case.

Vaccine fundamentalism has the perverse consequence in which doctors may be inculcated to deliberately ignore or undermine patient concerns in service to the primary public health metric of increasing vaccination rates. 

While public health agencies do actively collect and classify the types of concerns that parents have, these activities are done under the goal of addressing vaccine hesitancy; due to vaccine fundamentalism, there is an assumption that the proper decision for the individual is to take the vaccine, regardless of personal circumstances.

Rather than use data to facilitate open dialogue, they use this knowledge to create strategies against vaccine hesitancy. For example, the CDC has created training materials that teach healthcare providers how to achieve greater conversion of individuals from vaccine hesitant to vaccine compliant.

Medical ethics acknowledges the importance of informed consent in preserving both patient dignity and trust in the medical system. The healthcare providers’ use of behavior modification techniques to achieve increased vaccine uptake is questionable and deceptive.

Even doctors are not immune to the pressures of vaccine fundamentalism as the war burden ultimately falls upon them to ensure their patients are compliant  with public health vaccine recommendations. According to research undertaken by Dr. Paul Offit, providing vaccine information in order to obtain compliance is time consuming. It was found that 53% of physicians spend 10 to 19 minutes discussing vaccines with concerned parents, and 8% of physicians spend 20 minutes or more with these parents. They also reported that pediatricians experienced decreased job satisfaction because of time spent with parents who have significant vaccine concerns.

There can be no true informed consent if the patient cannot freely refuse the treatment nor is there true informed consent if the consequences of refusal include the potential repercussion of terminating the doctor-patient relationship. Certainly medical ethical guidelines can do better.

According to bioethicist Nir Eyal, “Coercion, deception, manipulation and other violations of standard informed consent requirements seriously jeopardise that trust.” The value of informed consent does not show up in any epidemiological model but it has a powerful intangible value to all those involved. Is vaccine fundamentalism so important that it warrants destroying trust in the medical system?

Dismissing the Vaccine-Injured: Collateral Damage and Vaccine Fundamentalism

No grievance regarding vaccines is more serious than vaccine-injury. A mere possibility of vaccine-injury is insidious: what is meant to be a prophylactic life-saving procedure performed on a healthy recipient may end in his or her serious injury or death.

It’s easy for medicine and public health to remain silent about or minimize the perception of vaccine injury. As pediatrician Dr. Robert Sears discussed in a public talk, the very idea of vaccine-injury is a hard one for doctors and public health specialists to accept, therefore, out of a need to protect their collective ego identity, the default position of the medical profession is denial of vaccine-injury.

However, the public health authorities’ approach to vaccine-injury is a two-faced one. While it acknowledges that vaccine-injury can happen, but, in the same breath, it proclaims “vaccine injury is very rare” and “vaccines are safe and effective.” The same doctors tasked with giving vaccines parrot the same talking points.

First and foremost, vaccine-injury is indeed real. The United States Vaccine Injury Compensation Program, a program run by the federal government which compensates those injured by vaccines has so far has paid out over $4.4 billion.

Moreover, there is evidence to suggest that vaccine injuries are systematically undercounted. A CDC-funded study “Electronic Support for Public Health–Vaccine Adverse Event Reporting System” done in 2007 by Harvard Pilgrim Health Care estimated that fewer than 1% of vaccine injuries are reported to VAERS.

A subsequent analysis done by JB Handley paints a damning picture: “In 2016, VAERS received 59,117 reports of vaccine adverse events including 432 deaths and 10,384 emergency visits. If those 59,117 reports were 1% of the actual total, that would imply there had actually been 5.9 million reportable adverse events from vaccines in a single year.”

War metaphors in public health lead to the implicit acceptance of vaccine injury as acceptable collateral damage in the war against infectious disease. A hush-hush approach is the norm where it is not professionally acceptable for a public health official or doctor to acknowledge or discuss the reality of vaccine injury (and those who do are quickly disowned by their peers and professional organizations).

The premise of vaccine fundamentalism is thus: If vaccines are the way to win the war on infectious diseases, then vaccines themselves are too important to be deterred by the collateral damage of infrequent vaccine injury. An emphasis to win the war would naturally lead to a competitive strategy where the means are developed to hide the extent of vaccine injury and to limit the liability resulting from those injuries.

The  National Childhood Vaccine Injury Act of 1986 created the means for reporting and compensating vaccine injury, but it did not create the impetus for public health officials nor vaccine manufacturers to investigate claims of vaccine injury. Even when repeated injuries are observed time and time again, there is no research impetus to investigate the etiology behind why these injuries are occurring. After all, how is criticism possible when you have deprived your naysayers of good complete data, with which they could prove their case?

The war metaphor and vaccine fundamentalism lead to plausible deniability and lackluster safety investigation as the default strategies for defending the public health agencies’ vaccine program. The vaccine safety organization ICAN filed a lawsuit against the Department of Health and Human Services, to find out whether or not HHS  has performed the biennial  vaccine program safety oversight that they were required to do by the 1986 Act, which HHS has apparently failed to do even once for more than 30 years.

War metaphors in public health and vaccine fundamentalism have led to a situation where vaccine-injured individuals and families are themselves seen as enemies by the very public health systems that are meant to serve them. There are four injustices at play here: 1) the vaccine injury itself, 2) the denial by the public health systems of vaccine injury, 3) the adversarial nature of the government compensation system, and 4) the larger denial by society at large. Public health as a whole can do better from an ethical standpoint.

The Ends Justifies the Means: Ignoring Conflicts of Interests

In the drive to win the war on infectious disease, resources need to be mobilized but an important overlooked question is: Who benefits from the policies being promulgated?

One need not look far to realize that the vaccine market is a very financially lucrative model. A financial estimate reported by Bloomberg reports that the vaccine market is worth $58.4 billion. The Moderna CEO claimed that the Covid-19 vaccine alone could bring in $2 billion to $5 billion in peak annual sales for the company.

In the United States, the CDC’s Advisory Committee on Immunization Practices (ACIP) has the task of deciding what vaccines should be added and removed from the schedule. Their decisions carry considerable weight for both citizens who take the vaccines and the vaccine manufacturers who benefit from the captive market created by government mandates.

There is evidence that ACIP might be compromised by conflicts of interests with industry. A 2000 report by the US House of Representatives Committee on Government Reform reported: “Members of the advisory committees are required to disclose any financial conflicts of interest and recuse themselves from participating in decisions in which they have an interest. The Committee’s investigation has determined that conflict of interest rules employed by the FDA and the CDC have been weak, enforcement has been lax, and committee members with substantial ties to pharmaceutical companies have been given waivers to participate in committee proceedings.”

Another report in 2009 by the Department of Health and Human Services reported serious ethical violations at the CDC. According to the New York Times: “The report found that 64 percent of the advisers had potential conflicts of interest that were never identified or were left unresolved by the centers. Thirteen percent failed to have an appropriate conflicts form on file at the agency at all, which should have barred their participation in the meetings entirely, Mr. Levinson found. And 3 percent voted on matters that ethics officers had already barred them from considering.”

Vaccine fundamentalism has led to a situation where public health agencies do not adequately police themselves regarding conflicts of interest. If the goal is to “win a war” then the need to remove decision-making bias and to prevent regulatory capture takes a backseat thereby allowing entities who have huge money at stake on the outcome to improperly influence the outcome.

Do More Vaccines Equal Better Health? Is Public Health Succeeding?

Is public health succeeding? This is a fundamental question because so much investment and effort has gone into vaccination at the expense of other lines of possible public health endeavors.

Public health agencies proudly proclaim vaccines as one of the greatest public health achievements of all time, boasting of the eradication of smallpox, elimination of polio and measles in the Americas, and controlling incidence of a wide list of other infectious diseases. In the 19th century, infectious disease was rampant and deaths from such diseases were common.

Public health rightfully deserves the accolades for the fact that infectious disease death is relatively rare. An examination of infectious diseases mortality done in JAMA reported the following: “Infectious disease mortality declined during the first 8 decades of the 20th century from 797 deaths per 100,000 in 1900 to 36 deaths per 100,000 in 1980 … From 1938 to 1952, the decline was particularly rapid, with mortality decreasing 8.2% per year.”

The problem with vaccine fundamentalism lies in attributing the victory against infectious disease mortality solely to vaccination. The 8.2% per year decline in infectious disease deaths is telling because the effect is so large that it cannot be attributed to vaccination. In fact, this period of 1938 to 1952 is prior to the modern vaccination program. Other effects in the populace including better standards of living, clean air, and clean water bear significant attribution for the above effect.

Vaccine fundamentalism leads to a revisionary history that over-emphasizes the role of vaccination thus leading to an overstatement of benefits. It is important to note that the mortality rates from infectious diseases dropped by over 90% prior to the beginning of the modern vaccination program with the development of the measles vaccine in 1963.

There is the larger question as to whether more vaccines leads to better health. The United States has one of the most aggressive vaccination schedules in the world. From birth to the age of 18, children receive over 68 doses from the full CDC recommended schedule. During the 1990s there was a tripling of the childhood vaccine schedule. Did the American populace accordingly achieve a tripling in health outcomes in the following decades?

A 2013 National Academy of Sciences report found that Americans live shorter lives and have overall worse health than their counterparts in an analysis of 17 other countries. In a PBS interview, Dr. Steven H. Woolf, chair of the committee that wrote the report stated: “The U.S. is doing worse than these other countries both in terms of life expectancy and health throughout their entire lives…  The U.S. has been falling behind other high-income countries since 1980, with the trend showing continuing deterioration regardless of administration or social reform policies.”

A reversal is needed in the course of public health direction. Vaccine fundamentalism has led to the paradigm of more is better in public health, a policy which appears to have diminishing returns. Public health officials seem to embody the mindset, “If it worked as a strategy in the past, then certainly we just need to do more of it.” This mindset is inadequate as we go further into the 21st century.

Moving Beyond Vaccine Fundamentalism: A New Ecology for Health

In the urgency to deal with the Covid-19 pandemic, public health seems to be running more and more quickly towards a cliff and exacerbating the problems above. The public health agencies pin their hopes on a Covid-19 vaccine, and drive heavy strategies to minimize incidence, including banning travel, barring children from schools, barring adults from work, etc. unless an individual has received the Covid-19 vaccine when one becomes available.

Public health has failed to account for the harms caused by its Covid-19 responses, and this speaks to the great failures of reductionism and vaccine fundamentalism. Reductionism cannot capture the numerous facets of health that exist in a dynamic interplay between the individual, their genes, and their environment.

On a biological level, new research indicates that the immune system works as a dynamic interplay among multiple systems: the innate system, the adaptive system, the interferon system, the microbiome, and the nervous system. We ourselves are a complex ecosystem of human cells, bacteria in our microbiome, and endemic viruses in our virome. This leads to the necessary conclusion: vaccine fundamentalism is an antiquated strategy for actual health.

But we cannot replace one fundamentalism with another one. Public health needs to move beyond the fundamentalism paradigm in which public health is reduced to singular metrics, and embrace a paradigm that is inclusive of a larger vision of what constitutes health.

Public health needs a new way of thinking that puts human dignity at the forefront instead of viewing the people who we are supposed to protect as mere vectors of disease. Individual choice, informed consent, and free will are shunted as delusions that must be dealt with in order to win the war. To regain the trust of the public, public health must give up on the war mentality. The sustainable path is one in which public health is on equal footing with the individual as opposed to holding tyrannical dominance over the masses.

It’s time to give up vaccine fundamentalism. We need public health to wake up from the spell of vaccine fundamentalism and the war metaphors it pursues in its implementation. It is an insufficient paradigm from a previous era, and it needs to be replaced with something that can actually improve public health.

Health for both individuals and society is multi-faceted and exists in a greater ecosystem. We are affected by microbes and our genes, but also by our environment, our choices, our cultural mores, our psychological states, and our subjective assessments of our own well-being. Public health metrics should encompass these facts.

Let public health measure and drive actual health instead of mere vaccine uptake rate.

The post Vaccine Fundamentalism—War Metaphors in the Covid-19 Response, Vaccine Policy, and Public Health, Part 1 appeared first on Children's Health Defense.

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