Political Science

The alleged swine flu threat has revealed the politics of science. I don’t mean the kind of ham-fisted politics at work in the climate change debate. I’m talking about the routine, otherwise invisible way in which power within the scientific community is exercised and how that translates to the more overt exercise of power in medicine and public health, the kind of politics we examine in our book Too Much Medicine, Not Enough Health.

All of us have been conditioned to believe that science is neutral and that the servants of science act on the facts and nothing but the facts, ma’am. Information about the swine flu is dominated by the promotion of vaccinations and antiviral drugs and who has access and when.

But what if there’s no good science to support those actions? What if vaccines and antiviral drugs don’t work?

An article in this month’s Atlantic sheds light on science that challenges this vaccine and antiviral drug orthodoxy and the politics that suppresses it. I’ll give you an example. Lisa Jackson, an MD working at the Center for Health Studies in Seattle, conducted several studies on the efficacy of flu vaccination that were published in 2006. These studies have been described as “beautiful” and “classic studies in epidemiology.” One study compared death rates of vaccinated people to unvaccinated people during flu season and the rest of the year.

That sounds like a roundabout way to find out whether flu vaccines work. There are two reasons why she had to ask the question this way. First, no one can get permission to conduct a clinical trial of vaccines because the CDC and NIH regard such a thing as unethical: you would have to give people a “fake” inoculation that these officials say will put them at greater risk—which, of course begs the question because they’ve assumed that vaccination works.

The second reason comes from the way that flu deaths are counted, which is very indirect. For example, someone diagnosed with the flu who subsequently dies from pneumonia is counted as a flu death. For another, the only way to determine whether someone actually has the flu is to take a swab of their nose or throat and test it in the lab for the virus. This is almost never done. Essentially, “flu-like symptoms” are counted as influenza.

So instead of counting deaths verified as the result of influenza virus infection, all causes of death reasonably attributed to the flu are counted. What Lisa Jackson and her colleagues did was to measure all deaths during flu season and compare them to non-flu season. If vaccination is effective, vaccinated people will do better during flu season but not during non-flu season. But they didn’t. They were pretty much the same. And what’s more, a vaccinated person was less likely to die in either season. The difference, from a statistical standpoint, was explained by a person’s socioeconomic and health status: those who are better off and so have better overall health are more likely to get vaccinated. But their survival is entirely explained by their better health overall.

How did the scientific community greet these and the other results that Dr. Jackson reported?

Her research was rejected for publication in major journals. As quoted in the Atlantic article, a reviewer for the Journal of the American Medical Association said, “To accept these results would be to say that the earth is flat!” This is significant because major journals are the source of health practitioners’ working knowledge.

Another vaccination skeptic, Tom Jefferson, an MD working in Rome for the Cochrane Collaboration, is simply ostracized at professional meetings despite his being a leading world expert on infectious disease and vaccination. Dr. Jefferson recently published a study of all vaccination studies in which he concluded that “Publication in prestigious journals is associated with partial or total industry funding, and this association is not explained by study quality or size.” With regard to pro-vaccination research he says, “Rubbish is not a scientific term, but I think it’s the term that applies.”

There’s a myopic commitment by US public health agencies to vaccination and antiviral drugs to the exclusion of all other measures. What are those other methods? Broadly speaking, hygiene (for example, hand washing) and social distancing—which does not mean sending people to concentration camps. It means having adults and children stay home if they’re sick and providing support services to people who have to stay in. It means keeping people out of hospitals, which is the worst place for both people who have the flu and for people who want to avoid it. Instead, we’re getting messages of panic about the coming pandemic combined with a false sense of safety from messages that vaccination protects you. If the skeptics are right (and I think they are) and vaccination and antiviral drugs not only don’t work but actual increase risk, what then? The official experts—whose careers, after all, are at stake here—don’t have a plan B—other than, perhaps, forced vaccination and marshal law.