Saturday, September 26, 2009

Health Care Workers Wig Out

Some, not all.

I'm reading Kevin Phillip's American Theocracy. Phillips (here's his Wikipedia entry) is a graybeard among right-wingers with a lot of campaign experience and time spent in Republican presidential administrations. He's also notorious among older lefties (he made my own personal enemies list a long time ago), but he's also an impressive thinker and generally behaves with real modesty and gentility.

Anyway, reading his books is an easy way to learn stuff and gain new perspective. I'm not very far into American Theocracy. but Phillip's framing of the Republican party of the last 20 years as the first religious party in US history is quite persuasive. And his grasp of the detailed way in which Christian fundamentalism has reshaped American political culture is very helpful.

So when I read this morning on the front page of The Washington Post that "Mandatory Flu Shots Hit Resistance" among health care workers, I'm thinking Phillips is right and, of course, the lunacy continues to spread.

One health care worker is quoted saying that she (he?) doesn't want to "be forced to take something [she doesn't] want to take." Apparently, she doesn't want to be a "guinea pig" for the swine flu vaccine. Another critic says we're on a slippery slope here; first it's vaccinations for health care workers, pretty soon it's going to be estrogen shots for everybody and we're all going to be hooked up to milking machines, I guess. And then there's always the my-body-is-my-temple line, which would be the beginning of a decent argument if it weren't for the fact that most temples are only averagely clean and probably harboring a surprising number of infectious things.

Even an SEIU spokesperson is sounding the alarm. "These mandatory vaccination programs are really sucking the air out of the room to deal with infection control in a more comprehensive manner," said Bill Borwegen, occupational health and safety director of the Service Employees International Union. "This is the worst time to be demoralizing health-care workers: when we need them to be on the front line of this epidemic."

But there is neither scientific evidence nor political theory of any sort that supports any of those arguments against mandatory vaccinations for health care workers. In the mini-series John Adams, Abigail Adams and a handful of little Adamses get vaccinated against smallpox. Pater John is in France seeking additional French assistance for the American Revolution and Abigail reasons that with only herself available to work the farm and care for her children a case of smallpox in the family could devastate their lives. So she decides to get everybody vaccinated, even after her doctor tells her that there is a decent chance that though the vaccinations would likely protect them, there is a small chance the vaccinations could also cause the illness.

The decision made, the doctor shows up at the farm hauling a nearly dead guy with open smallpox sores who seems too out of it to have actually agreed to be involved. In a fairly nauseating sequence, the doctor cuts open one of the man's fresher sores and scoops up the puss, then one by one, makes an incision in various Adams family arms and spoons in a little bit of the goo. One child gets a mild case, but recovers, and the family holds things together on the homefront. That was more than 225 years ago.

Given that turn of events, I'm tempted to argue (with equal illogic) with those who think that giving in to mandatory vaccinations is a step on the slippery slope that leads us to eroding freedoms and milk machines that John Adams was a key figure in the success of the American Revolution, that the health of the Adams family (the John Adams family) was a necessary component of Adams' effectiveness, that vaccinations helped preserve the Adams family, and that vaccinations are therefore a foundational part of our freedoms. But I would have to be even dumber than I sometimes look to make that argument with a straight face.

Still, given how long vaccination has been a proven medical approach to treating some diseases, it shows a severe deficit in what should be common medical knowledge for a contemporary health care worker to imagine themselves as a guinea pig in a vaccination experiment. And given that exposed, unvaccinated people get flus far more often than vaccinated people, it follows that health care workers are far more likely than the rest of us to contract the swine flu. Further, the primary collective responsibility of the 12 million health care workers in the US is providing health care to the other 310 million of us, so it makes sense that you wouldn't want them to get sick at a faster rate than the rest of us do. After all, "we need them to be on the front line of this epidemic." Therefore, we protect them first and best--we vaccinate them all. Duh.

Let me add here that I'd have less problem with a person saying, "I'm not getting vaccinated because I believe this whole swine flu-thing is a media hallucination," but nobody's saying that. In any case, every national health service in the developed world is calling for vaccination. That's pretty much equal to the absolute scientific certainty that we all evolved from apes and took a million years to learn to wipe our butts.

So what's American Theocracy got to do with this? Lots, but since I haven't actually thought this post all the way through, I'm just going to cite one of Phillip's very relevant and important observations:

"...the substantial portion of Christian America committed to theories of Armageddon and the inerrancy of the Bible has already made the GOP into America's first religious party.

"Its religiosity reaches across the board--from domestic policy to foreign affairs. Besides providing critical support for invading Iraq, widely anathematized by preachers as a second Babylon, the Republican coalition's clash with science has seeded half a dozen controversies. These include Bible-based disbelief in Darwinian theories of evolution, dismissal of global warming, disagreement with geological explanations of fossil-fuel depletion, religious rejection of global population planning, derogation of woman's rights, opposition to stem-cell research, and so on."

Phillips' deeper point, I think, would also note that not all of these examples of the Republican clash with science are manifested in religious terms. They are simply the outcome of a continuing argument against scientifically proven ideas that is older than the Catholic church's persecution of Gallileo for asserting that the sun was the center of the solar system.

Well, now you can add health care workers rejecting vaccination to the list of stupid fundamentalist arguments with real science; arguments that gain credibility because the culture has already been dumbed down. The notion that you can't vaccinate people and also remind them to wash their hands frequently might work if the people in question were infants, but we are talking adults here. Adults we are clearly going to have to contend with, even at the risk of losing IQ points.


  1. Well, Jeff, I don't think a person needs to be dumbed-down or a fundamentalist to turn down a vaccine, especially an untried one. And one hardly needs to be a conspiracy theorist to wonder about Big Pharma and whether its profit motives are always consistent with the health of the nation (to borrow a word from you: Duh). I have read only a few articles -- pro and con -- on this latest vaccine, all of them by doctors. It seems there is room for healthy debate among reasonably intelligent people.

    All the best, my friend.

  2. Hey, Margaret, nice to hear from you. Nicer still to know that someone stuck with one of my longer posts all the way to the end.

    But here's my perspective on what I wrote and the issues you raise:

    1. Vaccination is a really old technology. And though a vaccine can (and does) cause individual harm, there's no evidence that any vaccine from a US government-sponsored program did not accomplish the goal of preventing widespread infection by a targeted virus. This is, in general, a social good whose value increases in direct proportion to the severity and rate of infection.

    2. I'm sure health care workers have been "guinea pigs" in the past, but it takes a special sort of ignorance for a health care worker to cast themselves here as a victim. Given the apparent authenticity of the predictions about H1N1 and what it will do, it makes sense that health care workers get flu shots.

    3. Along with you, I hate that there is a Big Pharma. And I hate that government action so often facilitates the profit-seeking activities of the drug companies. It is a certainty that some of those companies will make a profit on swine flu, but until the people achieve greater control over the means of production, some interests will make unconscionable profit.

    4. Personally, I've already had swine flu--in it's last iteration more than more than 30 years ago--I'm very likely immune to what's coming next. Here's a link to a WIkipedia entry on that 1976 outbreak, the panic (arguable overreaction) that preceded it, the controversy over the vaccination program at the time, and the casualties that resulted from the flu itself and from the immunization program:

    5. When I was at In These Times, we published a cover story about unsafe vaccines, particularly those including Thimerasol, a mercury-based compound used as a vaccine preservative, especially in Third World countries lacking the ability to keep supplies refrigerated. Some people believe vaccines including mercury-based compounds have caused autism in children. The compound is banned in the US. But our investigation of the subject showed only anecdotal evidence that vaccines can cause autism. It was also pretty clear that if mercury-based preservatives are banned, tens of millions of vulnerable people will go unvaccinated with far worse consequences for the health of a community.

    6. Sure there's room for debate about all of this, but I believe that the debates get out of control when we pander to the basic fundamentalist quarrel with good science, and I'm saying that you can find that quarrel at the root of a lot of what passes for political debate in this country. I'm all for a good anti-capitalist critique of health care and corporate interests, I just don't want to see that legitimate critique adjusted to accommodate the mindset that would cheerfully muzzle Galileo.