I've noticed a growing conversation on social media about vaccines and who is and who isn't planning to take the vaccine for COVID-19 when it's available. I weighed in on one post to say I absolutely plan to take it as soon as my turn comes up. I was asked why, and that's when things got tricky for me. I noticed other people in the thread saying they had analyzed the results of the clinical trials while others had analyzed the criteria for inclusion in trials, and others had read detailed analyses and all had elaborate reasons for why what they found gave them confidence, or more often, gave them pause. I don't think most of the people on the post are virologists or immunologists, although I could be wrong. They seemed earnestly concerned and knowledgeable compared to a lot of the conversation happening in social media. To responsibly push back on this skepticism (which I felt I needed to do), did I need to provide scientific evidence for my confidence in the vaccine? Did I need to counter with details from my own reading of the scientific evidence? Is it possible my own confidence in the vaccine is ideological, not rational, now that so much has become politicized?
Then, suddenly I realized, I definitely do not need to read the clinical trials and the idea that I would need to, as a non-scientist, is yet another residue from the spread of market ideologies into everyday life. As a social scientist, the creep of market thinking into all aspects of life is something I've thought about a lot but I hadn't connected it to the vaccine debates. This realization came as my son and I played with our dog with the tv on in the background. Yet another commercial came on for yet another pharmaceutical with a crazy sounding name. We have a family tradition of mocking all of the drugs with silly names and horrid side effects. Why do we even have commercials for pharmaceuticals? Most countries prohibit such advertising. The idea that we need to go to our doctor and ask about a specific drug is an effect of capitalism: there is no reason but corporate profits for why I, a patient, should ask my doctor about a specific brand-named drug when it is literally my doctor's job to be up on the latest therapeutics. The idea that I need to choose a doctor to receive good care is capitalism. The idea that I need to choose the right insurance policy to receive good care is capitalism. The idea that I need to analyze the safety and efficacy of a potential COVID-19 vaccine before taking it is, unfortunately, capitalism.
Corporations have spent 40+ years working to infuse our thinking on every conceivable subject with certain market-based thought patterns. See this and this. Instead of demanding universal healthcare as a human right, we in the United States have been duped into thinking that healthcare is a good that we should purchase and that "market competition" (itself a myth) will deliver the best results. This is a long con. According to this kind of thinking, whether or not we receive good care is a consequence of how savvy we are as consumers, how much we research we do to game out our options and our resources to purchase the best product. Once inside the system, the thought pattern tells us that adequate care requires us to be knowledgeable, empowered and assertive advocates, standing up for ourselves both in terms of calling out poor treatment, but also in talking to our doctor about drugs we saw advertised on tv.
This thought pattern makes us think that our health in general is a result of how effectively we consume. Our body is a commodity we care for by consuming market based goods: the right ones in the right quantities. If we are overweight, underweight, ill, suffer from chronic conditions, etc., it is because we have not found the right balance of consumption, wellness, selfcare, advocacy, etc. and may have to shift our consumption to other kinds of goods: supplements, vitamins, detoxifying cleanses, exercise classes, or maybe glucose monitors, compression stockings, etc. The structural conditions for health are ignored and invisible in this kind of thinking.
This has radically altered our conceptualization of "public health." We may no longer have a conceptualization of public health in the US at all. That's the strongest explanation I can see for why we've done so appallingly badly at handling this virus. The best thing is probably for a mass vaccination effort to begin within days: everybody gets a time slot and everybody gets a jab. But because we've replaced our conceptualization of the public good with individual wellness, suddenly even vaccines for the biggest pandemic in a century are a debate: what should I, as a knowledgeable consumer, choose to do?
I teach about health disparities and the unforgivable history of medical negligence, abuse and violence under the pretext of medical care is long and horrible. People have a right to question everything about every aspect of healthcare and the inherent biases and omissions in science. Even in a perfect system, we have to advocate for ourselves and our loved ones. We social scientists play an important role in keeping other scientists on their toes. But these legitimate concerns and critiques should not further destabilize the idea of public health as a public good in which public agencies are charged with taking care of us all, the public. The most abbreviated version of this is what Biden and Harris have said: When Dr. Fauci says the vaccine is safe, I'll take it. Not because Biden and Harris say so, but because Fauci is the visible face of a massive (albeit woefully disrespected and underfunded during the Trump era) public health infrastructure that is meant to take care of us so that we do not need to individually read the science.