Understanding Swine Flu More than Science

As the vaccine for H1N1 flu, more popularly known as swine flu, makes its way into the everyday lives of more people, the discussion about tensions between “science” and “society” have escalated, especially in the state of New York, where its Department of Health mandated that all health employees receive this vaccination along with the seasonal flu vaccination. Not surprisingly, there has been opposition by many of these employees. In the United States, where we all learn from the earliest age to declare our individual rights and to value our autonomy above all else, many workers have stated that this mandate clearly violates their First Amendment rights. At the same time, other stakeholders in this debate have also tried to shape the debate in various ways . . . and these ways matter.

One place to hear different points-of-view and arguments about both—“why to take or not take the vaccine” as well about “the mandate” (and these shouldn’t be collapsed into the same issue, although they have overlaps)—is in a great segment on NYC public radio’s Brian Lehrer show.

Some were opposed to the mandate itself and believed vaccinations should be voluntary. One counter-argument was that mandating health-care workers to undergo vaccinations to protect patients was not a new thing. Some of those who opposed the mandate simply opposed taking the vaccine, fearful that it hasn’t been properly tested, given how quickly it was developed as well as manufactured. Outside of the mandate issue, health-care and non-health-care workers across the country make similar arguments and thus are opposed to taking the vaccine themselves or having it administered to their children.

Outside of this segment, many, especially scientific experts, attempt to frame this debate as being between scientific fact versus misinformation and misconceptions (i.e., an ignorant public), claiming vaccination technology and science are completely safe.

Surely, there are misconceptions, and these obviously need to be clarified. Science could tell us with near certainty the safety of a vaccine, but there are qualifications. There are risks, for some more than others, especially those with immunity problems. But even if we assume that science could tell us the H1N1 vaccine is completely safe for all people, this fact does not address other concerns, such as the continued tension between individual rights and public health (and this concern goes even for non-health-care workers), which isn’t a new problem. Furthermore, the debates emerging over H1N1 vaccine and New York State’s mandate are manifestations of many other tensions, including distrust of big pharma, of experts and their expertise “card,” of discrimination, of medicine, etc., etc. For some, their distrust may be simply visceral, but I suspect most individuals are constructing well-reasoned, if qualitative, arguments for their decisions that are central to their lives.

Those who use what I’ll call the scientific-fact argument are only addressing what they assume can be the only factor that individuals, families, and communities take into account to make decisions about using technologies in their lives, and this just is not so.

As an update, the Brian Lehrer show had an obstetrician come on in a following segment to talk about vaccinations and pregnancy. In another excellent segment, the call-ins demonstrated they wanted the best scientific and technical information, but then they took such information and enrolled it into their complex lives in a process requiring a number of other assessments not answerable only through such information. In other words, they were calculating—even if only qualitatively—highly complex risk scenarios.

Posted In: Policy

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