Can we cull the herd from arm-chair callousness, or take a vaccine against it?

[seal]

What makes me thoughtful in the whole swine flu debate are the people who claim that it's bad to take a vaccine because it's not natural..because H1N1 and other pandemics are supposed to cull the population, take away the weakest and sickliest examples and build up immune defense in the rest. It is admittedly seldom expressed in such a brutal blunt way (it is often used with historical examples of pandemics, far far away in time and sometimes about brown people on the other side of the world from Sweden), but a fairly simple logical analysis would still lead to such conclusions from the "naturalist" argument, when taken out of a private context and into a pamphlet waving public mission.

Have they really examined this school of thought properly? To me it is a very callous view on humanity and also an oddly self centric view on vaccine.

Don't get me wrong, it is perfectly okay to not take any vaccine, particularly if you feel confident in your own health and if you're reasonably sure you're not going to be close to a high risk person.

..but the "culling" opinion (which I've genuinely heard expressed more than once is almost nazi-like in its clinical brutality. Today, so many people get to live that would have been part of infant or child mortality rates 100 years ago, perhaps even you or I would be among these! People who seem healthy today, would perhaps not have been up to par with conditions in historical times. My own husband, with his asthma, would probably not have survived childhood 150 years ago, and many many other wonderful people, people who have contributed to making the world a better place, both on modest as well as larger scales. Is it not right to try fighting a disease for the sake of these risk groups, instead of letting "nature run its course"?
And isn't it hypocritical to talk about "nature's course" in today's modern age, where we frequently, every day, every moment use cheats, enhancements and aids to make life easier, funner and more humane? Because the people claiming such opinions are always from a privileged part of the world. You won't hear someone who really is subject to all the whims of nature in their daily struggle, to display such amazing lack of wider empathy. My thoughts go to the aids problem in Africa..isn't it easier to "let nature run its cause"? What about the handicapped or mentally ill? is it right to invest resources so that they can function as fully as possible in society, with tools, meds and therapy? Is that too against nature? It's certainly cheaper to let them be, isn't it?

Or is it simply that some people think that it is only the things they have selected as such, that are "unnatural", while they happily keep using other man-made inventions to heighten the value of their daily lives.

In the end, I think it is everyone's personal choice which is most important, and these thoughts aren't meant to dispute any such personal view on if or if not to take any vaccine, it is meant to perhaps put a little pressure on those public or semi public opinions which are rooting for selective "naturalism" like a sleazy Washington lobbyist in a cheap suit.
(the analogy is meant to inspire notions of badly researched populism and a type of empathy which you can treat as any party clothes hanging in your wardrobe, just take it off whenever it suits you!)

There is absolutely nothing wrong with not taking the vaccine, I have heard very respectable personal arguments against it, it's of course not wrong to take the vaccine either, the best opinion for why to do that was expressed by a friend of mine just recently: do it out of solidarity. If you care about high risk people in your life, if you expose yourself to large crowds where such people are, then it's certainly a showing of solidarity to minimize the risk of spreading the bug around them. The point is merely that I'm willing to bet that for many people in a country such as Sweden it is often not a sign of fear, nor a sign of egoism if they take the vaccine, it is a sign of thoughtfulness.

(This text is inspired mostly from the situation in Sweden, where the government has bought vaccine for all 8 million people, which these people can choose or not choose to take, and which is virtually free of charge if you take it. In the US, vaccine is still very scarce, and it is unclear which groups will be able to get it and at what cost. Also, as a side note: what's written isn't primarily inspired by a popular or notorious Swedish female doctor, I'd rather not discuss her or her opinions here, I merely want to impress that if someone has a certain stance in public, there is a responsibility which comes with that stance, both ethical and professional. A doctor who proclaims that they won't take a vaccine when there is a pandemic going on, would not get terminated because of his/her opinion, they simply aren't fit to work with the sick and the weak among the general public because they could with such great ease be carriers, and thus affect and even kill those in the herd who would have been "culled" had we lived in the dark ages.)

Comments

[somerled.livejournal.com]

Somewhere in here you've turned italics on but not off.

I didn't know people were putting forward the "just let people die" argument against vaccination. It isn't a very smart argument, and I agree with you that those people are staggeringly hypocritical. I think a lot of people do misunderstand the relationship between natural selection and vaccination. Getting the vaccine leaves a person in the same condition as if they had had the disease and fought it off. Flu strains come and go a lot faster (season by season) than we can evolve through natural selection (millions of years) and there is absolutely no evolutionary advantage to carrying an antibody code for a particular season's flu into the entire future of the species just because that flu strain appeared one given Fall.

We got rid of smallpox and polio through vaccination, not through natural selection. We had those diseases in the population a lot longer than swine flu will ever be around. We never developed a genetic resistance to them, in the pre-vaccination times some people survived, some didn't, and it had nothing whatsoever to do with genes—if your parents survived smallpox, you could still die from it.

People are mostly ignorant about these things and you mustn't pay any attention to them ;-)

[sealwhiskers.livejournal.com]

I fixed the italics fest!

The "let people die" argument is rarely or never served in such words, although I have heard the word "culling" used, in a very general way, often put in a historical context about "other people", so it will pass as more kosher. In general it is wrapped up in arguments about mass-vaccinate for a people, making them more vulnerable and their bodies not being able to develop "natural" antibodies. Yes, it's ignorant...but the scary part is that these opinions have been written in media by doctors and researchers. (sure, they're not vaccine doctors or researchers, but still peope with titles that the broader masses pay respect to)

It was actually my reading on smallpox which educated me and made me more aware about vaccine in general and how it works. Not that I couldn't learn more, mind you...

[somerled.livejournal.com]

I wonder if scientists, on the whole, have done too little to demonstrate things to the wide public. It seems like ignorant and what-should-be-fringe viewpoints get a lot of attention, and are not aggressively enough debunked. Maybe we need to crack down on religious schools and be unapologetic about the way science is presented in public schools and discourse.

[sealwhiskers.livejournal.com]

I think you're right..but the ignorance in Sweden is not of the "usual" kind, it is often the ignorance of the half-educated, of the secular, otherwise reasonably smart people who take fairly complex matters and bend them to their liking, whether it is factually correct or not. Like economic theories, there are complex theories in science, it seems, which make for such detailed and extensive study to understand correctly, it is easier, even for an educated person to "pick" a stance which for whatever reason suits them, without checking it out thoroughly and independently first.

I can't imagine the level of frustration many vaccine researchers and experts must overcome, even while listening to some people who aren't classically ignorant, but have finished some higher education or even medical school!

[jinxle.livejournal.com]

Or is it simply that some people think that it is only the things they have selected as such, that are "unnatural", while they happily keep using other man-made inventions to heighten the value of their daily lives.

Bingo! I bet these same people would be full of disapproving frowns for people who refuse blod transfusions or surgery on religious grounds.

As far as I understand here, the vaccine is being given to health workers, and high risk groups. I think your average healthy adult could get it if you really wanted it... but that being said, I know literally tens of people who have had swine flu (suspected and unconfirmed, as they no longer test), and on the whole their experiences have been on a par with, or less severe than, normal seasonal influenza.

I'm also not quite sure why H1N1 is such a panic button, when the figures seem to show it would kill many many fewer people than a regular year of bog standard 'flu. But maybe I've missed something there.

[sealwhiskers.livejournal.com]

I think it's only unique as a flu in the way it spreads more easily (due to it being a new virus). For most it's far from deadly, but for those that are vulnerable, it is dangerous because of its novelty, and because it makes breathing particularly hard. The groups for which it could be dangerous are also at large different from those commonly vulnerable to flu deaths (the elderly and those already carrying another serious condition).

[pachamama.livejournal.com]

Actually it doesn't seem to be hitting the elderly particularly. Most deaths are people of childbearing age, especially pregnant women and people as you say with pre-existing conditions. And its high communicability is not primarily because it's new; it's a genetic character of this particular flu, that a high proportion of folks exposed to it go on to contract it. Which is why the possibility of it mutating into a more deadly form but keeping that high communicability is so scary.

[sealwhiskers.livejournal.com]

I didn't express myself very clearly; I meant that the elderly are usually among those who are vulnerable to flues, but this time the risk-group dynamics are different.

[pachamama.livejournal.com]

It's not really about masses of people dying, it's about 2 other worries: the fact that it is so very contagious means that the risk is that vital services will grind to a halt because everyone is home sick in bed. And 2) that if the virus does mutate into a more deadly strain but with the same high communicability, then we're really fucked; and the more people it incubates in, the higher the chance for fatal mutation.

[tommdroid.livejournal.com]

I can not see anyone who is willing to put up their own family, relatives, for culling. It's easy to claim natural selection when your children are healthy and strong and your parents are not that old yet...and perhaps more importantly when the claimer is healthy and strong. Each to their own, so to say.

[sealwhiskers.livejournal.com]

oh..but you know the Swedish syndrome..it can never happen to ME or MINE, we live in the best of all countries after all!

honestly: the notion that you could vaccinate in order to protect those in risk groups is so rare in this "debate", it makes me stagger. It's all about me, me and ME. "Doctor Dahlkvist" even went out in media and said that she wasn't likely to get H1N1 because of her superior way of eating, not a thought in her blog or any of her public expressions about the fact that she could carry the bug without having symptoms of illness, that she could carry it and spread it to vulnerable sickly people with other conditions, while she was working as a doctor...

[tommdroid.livejournal.com]

Exactly.

Me, me, me....or my closest family is not in the risk group.

Both my parents are in the risk group, and they are getting the vaccination already. I have not received the letter yet. Also at work I have people in the risk group, I think I have not asked them, just assumed knowing their medical history, so for me this is not an option I think about twice.

Back when I was 19 I worked for elder care for a year. During the winter we all got the flu, and regardless we were called in to go work before we were really well, because everyone was down with the flu. Of course we brought it home to our caretakers. And two died. We had all of us more or less been to these caretakers so it was impossible to say who brought it to them. It could had been me and I felt very VERY bad about it. I'm not ever going to put myself in that position ever again.

[sealwhiskers.livejournal.com]

yeah, and according to the logic of some shit I've read (more than on one occasion), the risk of killing people in risk groups is still totally worth it for the sake of selective naturalism.

[browniegirl322.livejournal.com]

i think too that (at least here) people are tired of being sold to by pharmaceutical companies. We don't know what to take seriously, who to trust, because we feel like we're nothing but dollar signs. Every disease and disorder is pushed like an epidemic. We get drugs pushed on us at the doctors office, on tv, on the radio, in our magazines...It's overwhelming and tiring.

I know that's turned a lot of people off. It's not that they want people to die naturally, they're just using that a thing to say that they think makes them sound some combination of philosophical or scientific (HA!). They're not thinking about it properly because they aren't at risk, so they CAN say that. It's a silly thing for them to say, and I don't think anyone really wants the weak to die. if they would stop and think about why they feel the need to reject that they do, perhaps we'd have some real reform going on, but...

[sealwhiskers.livejournal.com]

I don't think anyone wants the weak to die either, particularly not on a personal level..they just may think it's okay for them to not get protection from dying, just because they themselves don't need such protection. If I was a superhuman, belonging to a race of superhumans who had bullet proof skin that absorbed the bullets and then repelled them out of said skin, acting as a machine gun on those around me, maybe I would become ignorant too, claiming that giving out bullet proof vests to thin skinned humans was bad for humanity, because fewer mutations would happen and it would stump the evolution of superhumans. (weak analogy, I know..) ;)

You are right Ang, it is a very different situation in the US from how it is in Sweden, partially because of the power big pharma has in the US, and partially due to other circumstances related to health care and government. This post was mostly inspired by what's going on in the Swedish debate about these things...I still love to be citizen of a country that bought in vaccine for its whole people, enables you to get it for around $20 and where you actually have a proper choice if or if not to get it.

[browniegirl322.livejournal.com]

it wasn't a weak analogy. i do understand what you mean. :)

[carrieb.livejournal.com]

That is one of the most horrible things I've heard in a long time. The person who came up with that line is not fit to be around people. I must say I'm shocked to hear it was uttered by a doctor.

I have heard that same line of thought with regards to infertility treatment and think it is cruel, but can sort of see the point if I really stretch my mind. Regarding a disease? Nope. Can't see it. I hope the doc isn't vaccinated against polio, the measles or anything else. See how strong she really is.

The people I know who don't want to get it are just scared that it might have even worse effects than the swine flu itself. THey are generally anti-vaccination anyway. Of course, here in the US the point is mainly moot since there is a severe shortage.

[sealwhiskers.livejournal.com]

Disclaimer: the opinions cited in this post come from several public sources, all of them educated and some of them doctors, it's not from one and the same person. I agree with your statement otherwise.
I actually think that fear for side effects from the vaccine or other similar fears is a very legitimate reason for not taking it, and I respect such a persnoal choice to not take it...

[carrieb.livejournal.com]

Ack! That makes it all the worse!

I do agree that people who are taking it out of fear of side effects have a legitimate concern. It is really hard to trust something that is so new. Heck, it is really hard to trust the big Pharm companies in general.

[lizardek.livejournal.com]

I suspect anyone who uses the culling argument against vaccination would be abruptly reversing their opinion if it was suddenly themselves or their own loved ones on the line.

[sealwhiskers.livejournal.com]

I am convinced that the people talking about the population becoming weakened by the vaccine, would think otherwise if their spouse or child died "for the greater good" of a "sturdier" population.

[pachamama.livejournal.com]

I think this is an ignorant twisting of a legitimately interesting scientific question, which is about the role of the immune system in controlling disease and the relationship between immune system development and various types of immune challenges. There has been an ongoing argument that says we in the west have weakened our immune systems by our insistence on sterility in baby environments, not permitting adequate gentle challenges through eating dirt and worms and so forth to assist in immune system development. There is also an argument that says that administration of too many direct challenges (ie vaccines) to an immature immune system can damage it in ways we don't fully understand, with consequences we cannot predict. These are different arguments, and ones I could understand being invoked in the swine flu debate. But the "culling the weak" notion is pure ignorance and stupidity.

[sealwhiskers.livejournal.com]

Well, the "culling of the weak" is seldom phrased in such a way (although I have heard the word used more than once, in a historical pandemic parallel example to this one, about brown people, far far away). The argument of immune system development is the one used, and that we should let nature run it's course, the vaccine being unnatural or dangerous and inhibiting our bodies etc etc.

But make no mistake, it is often enough a secular way of talking about the survival of the fittest.

[pachamama.livejournal.com]

it is often enough a secular way of talking about the survival of the fittest

I think it's a really interesting social phenomenon: that of what happens when individual interest is perceived as actually directly against the group interest.

For example, there are a lot of data that suggest that academically able kids do better in ability-streamed classes but that their less-able counterparts do significantly worse in ability-streamed classes. Your kid is academically able -- what do you do?

H1N1 immunisation is unabmiguously a positive measure to reduce the risk of scary mutation, or of secondary deaths caused by failure of key services due to sick personnel, but might cause you an an individual discomfort/expense/side effects/inconvenience/etc -- what do you do?

The answer for some people is to try to make out that your individual interest really is the group interest somehow -- that you are serving a larger cause of improving the species.

[sealwhiskers.livejournal.com]

I wish you could write some articles for some newspapers over here, particularly in answer to some shit I've read...

[idemandjustice.livejournal.com]

My mom has COPD, so I sorta take it personally. People who believe in the "culling" idea think it's okay for my mom to just die, right?

I'm not sure what I'm doing about the vaccine at this point. I was going to get it for Simon, but then he went at got the flu, which, well, since there have been no cases of seasonal flu, that means it's pretty certainly swine flu. But they can't test for it on him, so they advised we still get the vaccine. But they've started the vaccine clinics now for it, and he's still recovering. You're not supposed to get the flu shot when you're sick, right? I'm thinking they may run out before he's well enough to get the vaccine. And does he really need it, when it's pretty damn certain he just had swine flu?

I just don't know.

[sealwhiskers.livejournal.com]

People who by logical results from their public arguments passively promote culling aren't even aware that while they may not get sick, someone else could DIE from their bugs.

I really hope your mom can get the vaccine as soon as possible, and the rest of you too, if you can and want it.

[tooticky.livejournal.com]

I don't think there's an inoculation against callousness, especially when it comes to brilliant ideas in the abstract. :) It's human nature, I'm afraid.

[sealwhiskers.livejournal.com]

yeah...I know, but I try anyway... :/
It's hard to listen to or read, this new wave of ignorant self-centrism nouveau.

[katsu]

Honestly, I think whether or not it's okay for people to not take a vaccine is a lot more complicated than that. Particularly with flu vaccines, since they don't necessarily produce the same amount of immunity you'd get out other vaccines. So the idea for public health is generally to vaccinate as many people as possible, since that way hopefully enough people will have a good reaction to the vaccine that they won't be able to get infected and pass the virus on to someone that either couldn't get the vaccine or didn't have much of an immune response to it.

Just makes me think of this article: A Pox on You

So it's this very uncomfortable thing... do you compel people to be vaccinated when that seems kind of wrong? Or do you let people choose to basically kill immuno-compromised people? Which is kind of how it hooks in with your own argument. If someone wants to kill themselves off by refusing modern medicine because it's not "natural" then I guess that's their right. But the utter selfishness of someone basically contributing to the death of a child with cancer because they claim natural selection? Ooooooh does that make me mad.

[sealwhiskers.livejournal.com]

That article is exactly my argument, I wish Swedish media could print more stuff like that, to shut up those bone heads who say "relax..the flue is naaatural, but the vaccine is not, you're gonna be just fiiine (and screw those who may not be just fine from YOUR bugs)"

Here in Sweden, where the state actually has bought flue vaccine to cover the whole country and clinics are carrying out mass inoculations, there have been some imbeciles trying to piss people off by indicating that the government is trying to force or compel you to take the vaccine, merely by trying to encourage as many as possible to go.

Truth is: some people in this country have a better system of State than they deserve. I wish some good Americans could come live here instead of them, and we could ship them to some red state where they have true "freedom" with a government that doesn't care two tosses either way.

[katsu]

I could go for that. I'd put my parents on the first plane so that my dad could finally retire without getting screwed in the behind by a health insurance company.

[sealwhiskers.livejournal.com]

Your parents are fantastic people and deserve the Swedish system better than many Swedes.

[berchshill.livejournal.com]

I'm so glad you addressed this issue, because the general callousness of people has really been getting me down lately. Add to that the fact that I can't get hold of a damn flu shot because somebody messed up... ARGHH!

Whatever happened to solidarity in this country? Most of my in-laws are skipping the vaccine for pseudo-scientific/egoistic reasons. One even has a baby at home. I don't get it!

[sealwhiskers.livejournal.com]

Some Swedes are too spoiled to know the front or ass end of the word solidarity. Sadly. Rural southern Sweden..well, hm, maybe I'm a little extra prejudice about solidarity and that particular part of the country. I could be entirely wrong though, I've heard town situated adults further north talk like brats too...