Miscellany: On issues surrounding vaccination mandates

On corporate capture of regulatory and legislative bodies: 

I don’t think it is remotely controversial to propose that our regulatory and legislative agencies subsist in a state of capture by corporate interests—specifically Big Pharma, in this case. We have repeatedly observed an analogous phenomenon in the “Military Industrial Complex” that Eisenhower famously warned about in his 1961 “Farewell Address.” To wit, weapons manufacturing firms successfully lobby congressmen to advocate for military engagements for which those same firms are contracted to supply armaments and equipment. That this regularly transpires is hardly a “conspiracy theory,” in the derogatory sense of that term. The pharmaceutical corporations accomplish the same thing via the so-called “revolving door” between drug companies and regulatory agencies. Former FDA Commissioner Scott Gottlieb presently sits on the board of Pfizer. He also sits on the boards of both Illumina and Tempus Labs, as well as Aetion. The first two sell FDA-authorized COVID-19 test kits while the latter was contracted by the FDA to research and develop national COVID-19 policy. Stephen Hahn was the head of the FDA when it granted the “Emergency Use Authorization” of Moderna’s COVID shots. Now he occupies an executive level post with Flagship Pioneering, the parent company to Moderna itself. Mark McClellan was the FDA commissioner from 2002-2004. Since 2013, he has occupied a seat at the board of directors with Johnson & Johnson.* 

All things considered, I must admit that I am somewhat shocked at the credulity with which many people have approached this vaccination issue given that it is impossible, in principle, for extensive and long-term safety studies to have been conducted on a vaccine that has only existed for the better part of one year. Moreover, our regulatory agencies have deemed it acceptable to allow these companies themselves to conduct their own safety studies on these products. Of course, if history is any indication, an FDA approval is no guarantee that a drug is safe. And in this case, despite that the standard since this pandemic began has been to identify “case” with “infection,” each of these companies carefully differentiated these two things in their trials and hence did not rely on the PCR test but rather on observable symptoms to measure the effectiveness of their product. Hence it was an optimistic, though plausible hypothesis that the vaccines would prevent infection. This hypothesis was enlisted as a premise to support the conclusion that folks have a “civic duty” to get the vaccine for the sake of quelling the corona-tide. Regrettably, it has been demonstrated that the hypothesis was not true and hence it cannot really serve as a premise anymore. Yet despite that the premise for the mass vaccination campaign has been discarded, the conclusion has been forcibly, and dare I even say “violently” retained.

Again, I don’t think it is remotely controversial to suggest that the pharmaceutical companies would be pushing this agenda, nor can it be factually denied that they wield a great deal of influence over our regulatory and legislative bodies, and apparently our media institutions as well. In fact, these companies actually have a fiduciary duty to their shareholders to maximize their profit margin. If anyone can devise a more effective strategy for a pharmaceutical corporation to corner a forever market and garner untold consumers than to systematically undermine people’s basic health and well-being while simultaneously advocating your product as the only solution, I would like to hear it.

I will stop here because this could go on interminably on the present theme. I do think it is worth thinking critically about the actual effectiveness of these vaccines and whether the massive mid-pandemic vaccination campaign with a non-sterilizing vaccine might actually be driving the escape variants by placing a selective pressure on an evolution that would otherwise proceed by random mutation. We presently have more cases in Alaska with a 60+% vaccination rate than we did with a 0% one last October. It is important to index case/infection numbers to a specific month given the evident seasonality in infection rates that SARS-CoV-2 has demonstrated. Either the vaccine is not working, the virus is becoming more infectious, or people are becoming less-robust. Or perhaps a combination of these. If there is another explanation, pray-tell. 

Ordinarily, a virus will evolve to become more infectious but less fatal. But the vaccines risk creating a scenario that would allow the virus to become more deadly by protecting vaccinated individuals from the worst symptoms. If this evolutionary gradient were allowed to play itself out, we may see a situation in which the fatality rate begins to drastically increase, especially for anyone who has not received the vaccine. This would render the vaccine virtually necessary for survival. The crucial point in this scenario is that it would have been precisely the mass vaccination campaign that led to the increasing virulence and fatality of a virus that was originally relatively innocuous. I hope this hypothesis will be disproven but it follows the model of a disease that is endemic to many populations of industrial chickens called Marek’s disease which was originally comparatively benign but evolved to achieve a nearly 100% fatality rate following a vaccination policy that was analogous to the one that Western society is presently undertaking. Again, I hope that I am totally wrong about this but I wish people would really think carefully about it. 

On freedom and vaccination mandates:

Some have opposed vaccination mandates on the basis that they compromise the free-will of persons. While I think this is important, it is also an abstraction from the essential issue that is at stake. People generally do not allow calculus of individual and collective risk to determine every decision in their lives and if they did, it is not clear that those lives would still be worth living. One fundamental source of value in life is freedom in the sense of personal sovereignty of body and spirit. No one wishes to be deprived of the capacity to make free decisions in respect to his or her physical, psychological, or intellectual being. Seen in this light, it may be clear how someone could advocate for vaccination on the condition that the decision that it stem from personal decision while at the same time remaining deeply opposed to it insofar as the vaccination were compelled. This apparent discrepancy would follow precisely from the fact that such a scenario would run rough-shod over freedom as a basic source of value in human life. 

On the vaccination mandate viewed from the Utilitarian and the Deontological perspectives:

One difficulty that occurs to me in respect to the Utilitarian calculus is that it is predicated on making an accurate prediction which in turn, depends on having correct premises or priors. Beginning with incorrect priors will likely lead to an inaccurate prediction that could actually lead to the opposite of the intended outcome. This represents an unavoidable difficulty with all Utilitarian thinking in application since the consequence by which any action is evaluated does not yet exist at the time in which that action must be performed. 

In respect to the premise that a general mandate will benefit “the greater good” in this case: I think it is far from certain that mass vaccination will mitigate the spread of SARS-CoV-2 and some studies even indicate that it could exacerbate it (cf. 1) or drive the evolution of escape variants (cf. 1). The vaccination trials did not test for infection or transmission but only for symptoms and hence the “efficacy” of the vaccines was not, in principle, related to stopping the transmission of the SARS-CoV-2 from the very beginning. The common misconception that it was can only be ascribed to the complexity of the issue or perhaps to an effective marketing campaign on behalf of the pharmaceutical corporations. 

Apropos the Kantian analysis of this question: the application risks being extremely complex. Still, one feature of it that seems obvious to me is that any compulsion of someone to act against his conscience is an affront to autonomy. This might seem trivial until it is seen that autonomy is the source of “the good will” as such and hence the condition for all morality as Kant sees it. It strikes me as unlikely that anyone refrains from taking the vaccine on the maxim that he or she intends to jeopardize the safety of others but if I am wrong about this, then the same person is acting immorally. By the same token, a person could refuse the vaccine out of his or her sense of Pflicht (i.e. often translated as “duty,” in English despite the markedly different connotations of these terms—it were better rather to attempt to grasp the German word eo ipso and this can be helped by associated with the familiar cognates “plight” and “plot”) in which case the same action would be an expression of morality and not its opposite. 

On university vaccine mandates:

One response to the spread of SARS-CoV-2 is to promulgate a universal vaccination mandate and that appears to be what many institutions have settled on. The logic of such a response is predicated on the premise that the vaccine prevents infection and transmissibility of the virus, which it does not (cf. 1, 2). Hence, it would be by accident and not by design were the policy to be successful in its stated aim. In any case, the inverse of a vaccination mandate would, of course, be a universal prohibition on vaccination. Obviously, that is not what our institution has settled on, and moreover, that is not on the mind of even the most extreme opponent to vaccination. Instead, the two feasible options seem to be (a) the universal mandate on the one hand and (b) a general recommendation on the other, since anyone would be free to get the vaccine and no one would be compelled not to. 

I have trouble following the logic of the argument that mass vaccination will have any bearing on whether universities are able to continue in-person classes or anything else related to COVID responses. This is because the vaccines are not designed to prevent infections but only to mitigate the severity of symptoms. At the same time, “cases” has been defined not in terms of symptoms, but rather in terms of infection, which in turn has been defined as anyone who receives a positive result from a PCR test—which, incidentally, lacks any standard of calibration that is uniform across testing sites and is hence, scientifically meaningless in determining the severity of a pandemic. There was certainly a prospect that the vaccines might have prevented infection, but that was not part of the efficacy trials so the question remained unsettled at the outset of the vaccine rollout. But now, the better part of a year later, the evidence is clear that they are “non-sterilizing,” which means they do not prevent infection. If the vaccines had been shown to prevent infections, then the logic would be sound and the vaccination mandate would make sense. But I don’t see how the conclusion to establish a mandatory vaccination policy can still follow from a premise that has been shown to be false. It makes sense that everyone should be permitted to receive the vaccine, and even perhaps encouraged to receive it, but I remain skeptical over whether the mandate is the right decision in this case. 

It has been observed that students and faculty are still free to abstain from receiving the vaccine as long as they consent to weekly testing and hence the mandate is not really so severe as many of its critics make it out to be. But at the same time, submitting to weekly testing is obviously not an attractive or convenient prospect and it is designed to pressure people who have reservations about the vaccine—for any reason—to get it for the sole sake of expediency, which in my view should not be the primary basis of medical decisions. The university is not providing on-site testing and hence the logistical cost of submitting to weekly testing risks being substantially more than some full-time college students or employees will be able feasibly to manage. The difficulty will only increase with the onset of winter since it is hardly feasible for anyone without a car to be waiting for hours at a drive-in testing site, which is the only sort of testing site within walking distance of campus.

Photo by Kenneth Carpina on Pexels.com

*Thanks to Jordan Schachtel for his research into this: https://dossier.substack.com/p/the-revolving-door-all-3-fda-authorized.

3 Comments Add yours

  1. Wayne Fair says:

    This post would serve well as a vaccine of sorts to counter viral disinformation.
    Thank you, Max, for your courage and boldness!

    Liked by 2 people

  2. c l barton says:

    A very comprehensive analysis of the situation. Thank you for this post, it is so important to try to engage as you are right now

    Liked by 3 people

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