Articles, Blog

Epidemics: Of Anti-vax and Politics

December 30, 2019


I want to talk about antivax and vaccine hesitancy.
I want to talk about how the way we are fighting it isn’t working, about how we should maybe
change our perspective on the issue. And were we to live in a lesser hellworld, I could
just pick any random video of an internet skeptic that rants over someone who cries
about mercury in the shots and I could cut him off at strategic moments in order to calmly
explain how persuasion works, how we should focus not on individual choice, but on systemic
causes and maybe even look at the politics underlining the phenomena. But I can’t do
that because the skeptics are having mental breakdowns denying the science of human sexuality.
So I have to actually write an essay. With a thesis, that I’ll have to defend. Using
facts. And logic. The European Center for Disease Control reported
in 2018 over 1000 new cases of measles in Romania, 2500 in Italy, 2500 in Greece and
almost 3000 in France. In Ukraine there were 12.000 cases reported. In Brazil over 2000
cases, in Venezuela over 5000. In Thailand it’s hard to say, but the thousands of cases
resulted in over 20 deaths. In the Philippines over 18000 cases. And I don’t think there’s
a lot of talk about it. We care about measles not because it’s a
particularly deadly disease. It’s not, although every death from a preventable condition is
a tragedy. We also are looking at measles because it’s extremely contagious and it
spreads very fast. The gaps in measles immunization coverage reveal gaps in coverage for other
vaccine preventable disease like polio or diphtheria. This is why we can think of it
like a canary in the coalmine. Yet it still doesn’t really interest people.
At most we get some article telling us that the last month was even worse than the one
prior, without much contextualization and maybe some hand wringing about anti-vaxxers.
The rational internet cartoon avatars [the irony is not lost] that made their bread and
butter out of trying to inform the public and mocking pseudo-science peddlers are now
screaming about SJWs or something. The liberal TV edutainment and comedy people seem to think
that all evil in the world begins and ends with Donald Trump. And the right-wing…well,
funny thing, the right-wing is profiting from it. We’ll see how a bit later. Now. The fact that the punditry is silent
even in the face of a politically maneuvered anti-vax movement that coincides with a global
measles epidemic, also means, I think, that the debate has been settled. The lines have
been drawn and the territory marked. There is no controversy to fuel the engines of our
attention economy. The mainstream opinion is that vaccines are good, while the vaccines
skeptics know what spaces to frequent to build up networks and power, until they can topple
the mainstream in one fell swoop. But if the pro-vaccines movement quote-unquote
won, it did so during those obnoxious debates. Which I find troubling. Because just bombarding
people with facts, mocking them, presenting them with study after study, won’t do us
any good. It didn’t up to this point, hence the epidemic. It might even have backfired
as some studies about confirmation bias seem to point out. This is why it’s more important
than ever to understand vaccine skepticism and its relation to the measles outbreaks. The narrative we’ve used up to this point
is simple: a parent reads on a blog or forum or Facebook group that vaccines contain mercury,
cause autism, are made from human fetuses, don’t actually work and that the diseases
aren’t actually that bad, in fact they’re natural and healthy. So the parent doesn’t
vaccinate the child. The child might or might not get infected, but the parent certainly
is: with the antivax virus. And they themselves start to frequent said blogs, forums or Facebook
groups, even starting ones of their own. This is a simple story, with a simple solution:
debunk the bad science and convince the parents to immunize their kids. It’s of little wonder that this story was
favoured by science journalists and popularizers, some more self-styled than others. Maybe they
liked the story, because they had the solution. They could write their own blogs, set up their
own forums and Facebook groups, they could author books, make videos, petition the politicians
to sign pacts for science and the governments to fund programs or studies to exhaustively
debunk what was pretty obviously bunk science. Because, you know, when you’re a hammer…
But more than anything, they liked the story since it fit into an even broader narrative
they believed: that people are individual agents who make rational decisions based on
the information they have access to. And if they don’t take the “right” decisions,
it just means people don’t have the right information. But it’s clear for anyone even casually
pursuing those aforementioned spaces that the bunk science is just a pretense and underneath
it steams a stew of distrust for authority, grief, guilt, love for their children, the
need to be a good parent and the fear of failing that, fear of doctors, of their aseptic, uncaring
ways and their relation to Big Pharma, suspicion about the state and its power. Some of which
are incredibly valid feelings and justifiable concerns, although not nearly as conspiratorially
linked. These concerns feel even more valid when you’re already in a very private and
individualistic mindset. When you concern just with yourself and maybe a few close friends.
When what you do with your kids is nobody else’s business. And what happens to anti-vaxxers’ kids?
In some rare and tragic cases they get very sick, maybe even with lifelong repercussions.
Sometimes even ending with their death or life-long damage. But for the most part, if
they somehow catch it, they’ll probably stay at home with a rough fever and itching,
playing videogames and drinking lots of liquids because they have parents that do and can
care for their children, despite their bizzare ideas about immunology. As we can see in this
accurate documentary film [clip din Home Alone 3]. Sometimes parents will organize measles
parties so they can control when the child gets the virus. These aren’t the populations
that epidemics are made out of. And aren’t really the populations that can be persuaded
by facts and logic. Studies, testimonials, intuition and especially
the present moment show that just offering information doesn’t really change minds.
What does tend to work is leveraging interpersonal relationships, building a relation of trust
with the pediatrician, seeing first-hand the effects the disease can have when it reacts
especially strongly or when there is no care provided to the patient. And by building a
sense of responsibility and solidarity with the whole community. But that’s haaaaaard! It’s worse than
hard! There’s nothing to be gained from it. Other than the wellbeing of our society.
In which we live [Joker trashboi]. There’s no online brand-building, there’s no book
deal, there’s not even an idea for a snarky sketch. So, is trying to change anti-vaxers minds
worth it? Yes! Absolutely! The more unimmunised nodes in the population graph there are, the
wider it can spread, the harder it is to be contained, the more it puts at risk the general
population. Especially young children who didn’t get to take their shots or people
who cannot be immunized because of other health issues. These two vulnerable groups are also
those most likely to die from the disease. A non-trivial number of those infected in
this current wave of outbreaks are those who skipped immunisation during the 1998 Wakefield
study scare, when the MMR vaccine was wrongly linked with autism. So vaccine hesitancy is
linked to the current epidemic, but more obliquely than we would like to think. If we go beyond the numbers and broad, country-wide
statistics and look at those who actually get sick and how, we’ll arrive at a different
story. In 2017 Octavian Coman investigated the measles
epidemic for the Romanian magazine DoR. He finds that it started in the Reteag village
mostly affecting the local roma community. The people there are living during most of
the year in Italy, near Naples, migrating back home during the winter. We’ll come
back to Naples in just a bit. They travel with their children who miss getting their
shots in Romania and cannot get them in Italy because they’re not cared for by the Italian
public health system. While abroad the children are catching the virus and on their returning
are spreading it throughout the community and beyond, especially through hospitals where
they can come in contact with other unvaccinated patients, whose immune system is already strained.
This dynamic is hardly unique. It repeats, for example, in the Belgian city of Charleroi. This explains how the virus travels between
countries and why it’s so much more spread out in Europe than in the US. It still doesn’t
explain why the number of registered cases in any one European country is one order of
magnitude greater than in the whole of US. For that we should look at why the infected
people people weren’t immunised in the first place. Contrary to some perceptions, there is poverty
and disenfranchisement in Europe. Especially in the South and in the East, in rural regions
and in minority ethnic communities. These poor and marginalized people sometimes aren’t
even registered to any GP, or figure into public statistics. But that’s the least
of their concern because they live in improvised housing, without plumbing or electricity and
are suffering from hunger. This is how you get to situations like that from Zizin village,
Romania, where half the children aren’t vaccinated. Some among them think the sickness
comes from the grime and the dirt. You might think that’s an ignorant anti-vax position,
but that would miss the point. Their skepticism doesn’t come from reading a mommy-blog.
They think like that because they have been pushed to the margins of society, they’ve
been ignored and mistreated by the authorities, even by the doctors, and are living in abject
poverty in makeshift houses. Even so, when they struggle to get the shots, as was the
case for some of the people interviewed by Coman, they find that there’s a shortage
and there aren’t any more doses. All the education and mobilisation campaigns in the
world would do squat if there is no vaccine to administer. The stock is so limited that in some cases
doctors received 20 times less doses than they required. Octavian Coman concludes that’s
because the Ministry doesn’t care for the people in general, not just about poor people
or roma people in particular, and because of historical political instability. This
doesn’t explain why in the past coverage could have been maintained at over 95%. And
why the situation repeats itself in other European countries. Since 2010 the immunization rate started to
fall in Bulgaria, Croatia, The Czech Republic, Estonia, Finland, Greece, Lituania, Holland,
Poland, Romania, Slovakia and Slovenia. Yeah, those are two different countries. Some experts
opine that the vaccines are the victims of their own success, and people don’t seek
out immunisation now that the disease is a distant memory. They also think that the anti-vaccination
movement is at fault. This sounds more like speculation. Speculation coming from a place
of expertise and speculation that might very well point to a real phenomena. But speculation
that doesn’t explain why it happens in all these countries, in the same historical moment.
After all, the Wakefield study was published in 1998. But there is something that might
explain this convergence. The Great Recession and the austerity measures that followed. All over Europe the public health systems
were hit with budget cuts, especially in the preventative care departments. This means
a dwindling stock of vaccine doses, limited and strained personnel that cannot offer sufficient
access to their patients, much less extend that access to people from poor and marginalized
communities, compounding the lack of interest or even antagonism the authorities already
showed to these population. As a way to manage this, the states started to put more pressure
on individuals to provide care for themselves, turning healthcare from a community concern
to a personal matter. For example, when I was a little trashboi I got my shots at the
daycare and at school. There were enough doses for all the children, it was fast, efficient
and the schools could keep accurate records of who got what shots. Now the vaccination
is done at the GP, so the parents have to make time, set up an appointment, take the
child to the doctor to have their shots, if there are any. I have the feeling that this
change does little except to obfuscate the lack of resources and personnel available. The state being both unable and unwilling
to offer care to its citizens finds in the anti-vaxxers the perfect scapegoats. Who,
in turn, find in the state’s disinterest and incapacity a perfect justification for
their belief. Every time some government official reports the wrong number of people who got
infected, the anti-vaxxers can gleefully shout that the state is lying about or fabricating
the whole epidemic. Not that the anti-vaxxers are completely blameless, especially as they
get closer to the reins of power. In Italy, during their last election both
the far-right nationalist Northern League party and the populist Five Star Movement
courted anti-vaxxers. One of the first acts of their coalition government was allowing
parents to self-certify to the schools that their children had the required vaccines.
That, of course, ends up allowing unvaccinated kids into the classrooms. It’s worth mentioning
that, for all that’s worth, after years of fanning the flames of anti-vaccination,
Beppe Grillo, one of their most prominent figures, signed a so called ”pact for science”.
This was aimed at curbing the distortion of medical and scientific facts for political
gain. After the party got into power. Earlier I said to keep in mind the city of
Naples, as the place where seasonal migrant Romanians contracted measles and brought it
back in their own country. It also was one of the earliest cities that embraced the Five
Star Movement. Not surprising since it is the hometown of its leader Luigi Di Maio.
Hmmmm. Even if the party wasn’t close to people
with a strained relation to the scientific fact its agenda which focused on a broad anti-corruption
message and promising techno-utopian solutions such as an Universal Basic Income does little
to address the problem of an underfunded medical system and of marginalized populations with
little to no access to it. And let’s not forget their dangerous coalition
partners, Liga Nord, a right-wing populist party that favours a flat income tax and were
the ones responsible for allowing parents to send unvaccinated children into schools.
Liga Nord is as well an anti-immigration party, so you might imagine what their solution to
an epidemic might be. They’d certainly not extend the public healthcare system to include
every resident, not just Italian citizens. Instead they’d offer but paranoid control
of the borders In France which has a rate of measles immunisation
below the 95% threshold needed for herd immunity, Marine Le Pen stokes anti-vaccine sentiment
when the country already has a shockingly high rate of skepticism towards vaccines.
A 2016 survey revealed that out of 67 countries, France ranked the highest in anti vaccine
sentiment. Surse: Most recently Republicans in six American
states blocked laws that would tighten regulation, making it harder for parents to avoid immunising
their children, while in a few others they made efforts to loosen existing regulation. You could say there’s an epidemic of right-wing
hostility to vaccination. This has been labeled as an anti-science stance. But that stance
isn’t a means onto itself. They’re not anti-science because they’re uneducated.
They simply cannot educate themselves, because the facts would run against the very core
of their ideology. Which demands starving the state, at least pertaining to public services,
and posits an antagonistic relation between the state and the citizens and an atomization
of community into individuals who make rational decisions for their own self-interest. This is why all over the world right-wing
politicians are leaning into skepticism towards vaccination if not downright stoking the fires. It’s not that they don’t believe the science
or that they have a deep, genuine, albeit misguided, concern about vaccines. They may
or may not. But for them it’s just another way of cutting costs, of ruining the public
sector and of pushing their nationalistic agendas. And they don’t use arguments, logic,
stats. They appeal to the people’s distrust of the government. They make accessing public
services much harder, but they make the people feel empowered. This doesn’t really look like the anti-vax
movement of old. It’s not the collection of white suburban ladies that Samantha Bee
made fun of on Comedy Central, celebrities that peddled their own naturist cures and
american-style libertarians. They are all still there and are probably still doing the
brunt of the work in building hesitancy towards immunisation. But now they are instrumented
by populist politicians who present themselves as having the same worries as the common folk
regarding the intrusive, opaque and forceful imposition of the state into the lives and
bodies of the people. Which is why the measles epidemic won’t
be fought by applying a really sick burn to Jenny McCarthy on Twitter or by making yet
another video about why the Wakefield study is bunk. It will be fought by building a shared
sense of community. It will be fought by creating a state that’s safe, democratic and trust-worthy.
It will be fought by having a comprehensive, well-funded public health system that leaves
no one behind no matter their background, class, race or ethnicity.

3 Comments

  • Reply Uncle Thomas June 26, 2019 at 9:51 am

    I think we need to question what pharmaceutical companies put into vaccines. We also need to remember that China over-prescribes anti-biotics which creates the potential for super-bugs which can affect the whole world.

    People on the left need to look deeper at companies like Pfizer, GlaxoSmithKline, ect and how they make money by watering down vaccines. Not to mention families like the Sackler's who helped to create the opiod crisis today. The Left has given up so much ground and has allowed the right to take on the cause.

    I'm sure you being Romanian as I think you are should remember Ceaucescu and his policies on abortion and AIDS. If you spoke on your experiences in Romania you could beable to show the appropriate version of socialism.

  • Reply Paul Policarp June 26, 2019 at 2:58 pm

    "Facts and….

    …ˡᵒᵍᶦᶜ"

  • Reply The Swoletariat July 22, 2019 at 7:18 pm

    was that an impression of Margy?! that was amazing!

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