Rethinking Health Equity: Critical Perspectives on COVID-19 Vaccination and Public Policy
Nate Doromal and James Lyons-Weiler Ponder a Critical Viewpoint on Health Equity
Nate Doromal and James Lyons-Weiler
This article examines the application of critical theory and equity concepts on the matter of health. In no way is it an endorsement of critical race theory, wokeism, or applications of concepts of equity that involve taking from those who have to those who have not merely for the sake of wealth reallocation.
Health equity is the idea that everyone, regardless of race, demographic, or income level, can attain their highest levels of health through equal access to healthcare. It serves as a guiding principle for public health institutions in pursuing social justice, which aims for a fair division of resources, opportunities, and privileges in society.
Since the COVID-19 pandemic, the role of public health has expanded dramatically in society. It becomes all the more necessary for those who work in public health and those for whom it serves to critically assess how these institutions are fulfilling the role of social justice.
It is here where Critical Theory could, arguably, help. Critical Theory aims to reveal, critique, and challenge the existing power structures, enabling us to ask the essential question – Are our societal institutional structures providing social justice?
When fully applied to the COVID-19 public health response, it becomes clear that more complex ethical and moral issues need to be discussed beyond what government public health officials are telling us.
From a social justice standpoint, making sure everyone has a "life-saving vaccine" is a tempting one. "Inequities in access to healthcare" have been used by the vaccine industry to use government funds to promote vaccination in minority populations and the populace.
However, the reality of vaccine injury changes this dynamic significantly. As of October 27, 2023, there have been 35,501 deaths, over 211,257 hospitalizations, and 68,416 permanent disabilities reported to the US Vaccine Adverse Events Reporting System (VAERS).
While public health officials argue that association-based reports to VAERS cannot be used to provide proof of cause, the system's purpose is to identify safety signals, and these numbers are abnormally high relative to the other vaccines. Additionally, equivalent vaccine injury numbers have been seen in Europe and other areas, lending credence to safety concerns.
Moreover, the facts that data from VAERS is consistent with the literature regarding COVID-19 vaccine adverse effects, that temporal correlation is observed (in which many reported deaths within days of vaccine receipt), and a dose-response is seen (with higher percentages of adverse effects in occurring in those that receive a greater number of vaccines) suggest, when applying the Bradford-Hill criteria, that the COVID-19 vaccines are causal to the post-vaccine adverse effects. (Related: See Dr. Jessica Rose’s treatment of the BH Criteria to the problem of causal inferences using VAERS data):
But even more important are the personal stories of people hurt by vaccine injury and death. Many of these people had their lives ruined by doctors and public health authorities who told them that the jab would keep them safe. By ignoring them, the vaccine-injured have had to organize to have their voices heard.
One woman surveyed by the COVID-19 vaccine injury advocacy group React19 reported, I did it [take the vaccine] as my part to help end the pandemic. All it ended was my good health. Another man who received the jab as part of military service said, I did it to continue a lifetime of protecting my country. Now, who's protecting me now?
To dismiss these cases as coincidental or causally lacking is cruel beyond measure.
We asked Wayne Rohde, a scholar focused on the US National Vaccine Injury Compensation Program for 14 years, of his overall impression of the fairness and “equity” of the COVID-19 special “compensation” program. He replied:
“Within the PREP Act, a compensation program was established and later replaced by the CounterMeasures Injury Compensation Program (CICP) in 2010 to help process vaccine injuries from the H1N1 virus vaccine.
The CICP is financed by general taxes held in the Covered Countermeasure(s) Process Fund (CCPF) through Congressional appropriations, is located in the Department of Health and Human Ser vices (DHHS) and is operated by the Health Resources and Services Administration (HRSA).
The CICP is an administrative process without access to the Judicial system for appeals and rulings. There is no transparency of decisions to the public unlike the decisions of the NVICP.
The actual compensation for COVID related petitions is limited to unreimbursed medical expenses. The inability to access the judicial system for redress of injuries. The injured are now being denied due process and their constitutional rights.”
Currently, the etiology and mechanisms for vaccine injury are better understood than ever before. However, medical professionals do not yet have an adequate framework for determining who is at risk for vaccine injury. That is not to say that those at risk of harm are potentially identifiable - it just means the science done to discover the risk factors and biomarkers of risk of vaccine injury has not been conducted. That’s a travesty of medical and social justice beyond compare.
The continued promotion of COVID-19 vaccine injury by public health is hypocritical and antithetical to health equity . Public health cannot maintain ethical integrity and promote a medical intervention known to cause worsened health in a minority of the populace and claim to stand for health equity. It is discriminating against an unknown - but nevertheless potentially identifiable - set of people in the populace.
Furthermore, the use of government-driven mandates to push the vaccines is troublesome. After the Biden administration took power in 2021, it seemed natural for officials to explore the use of vaccine mandates aimed at the adult populace to drive uptake of the COVID-19 vaccine to achieve the state goal of stopping the pandemic.
But, due to vaccine injury, a travesty of social justice has occurred due to a critical fact – government force has been used to drive COVID-19 vaccine uptake, AND these vaccines are hurting people.
Government public health officials must understand that social justice goes beyond economic concerns. For proper social justice to exist, people must be free to self-determine their lives without oppressive influence and have their human freedoms protected.
The use of vaccine mandates by the government is a setback for social justice. It is a wake-up call to government and public health officials that national vaccine policy has become oppressive.
At this point, it is essential to ask how public health has become blind to its hypocrisies, the plight of the vaccine-injured, and the oppression done in the name of public health. This is where the application of Critical Theory can help. It functions as a lens by which we can analyze the embedded power that can utilize societal institutions to benefit specific categories of people while harming others.
Dr. Alvin Moss, M.D., an expert in bioethics, refers to the public health preference of mandates without exemptions as “a last vestige of paternalism” in a society that is rejecting paternalism everywhere else.
From a critical theory perspective, the problem is one of culture – Public health has a colonialist mindset.
Just like how the European colonialists imposed their might upon the indigenous populations of the third world using military violence while claiming to bring the truth, the men and women of medicine and public health can see themselves as the "representatives of science" getting the truth to the ignorant lay folk by their merits and education.
Thus, the colonialist mentality of medicine and public health in which these professionals convey “divine knowledge” to the stupid lay people who are expected to obey without question, is not dissimilar to how the “superior white Europeans” imposed their cultural views on “stupid brown people” in their colonies (See citations for this language use, below).
With this mindset, it becomes easy to promote vaccination as the one-saving solution, to deny evidence that the prescribed solution has problems, to medically gaslight those claiming to have experienced vaccine injury, to attack other whistleblower doctors by removing their ability to practice, and to advocate for the censorship of those in the public who disagree.
These actions have a commonality in that they preserve the power of the medical and public health institutions and the prestige of the doctors, public health professionals, and scientists working for them.
There is an information asymmetry in that these professionals are the ones studying the pandemic and whom society relies upon to interpret scientific data accurately. However, due to the colonialist mentality, these professionals can fall prey to moral hazards and overlook how they are being biased in their recommendations in ways that preserve their power.
During the pandemic response, we saw the following problems:
Interpreting the data in ways that affirm their previous pronouncements (i.e., increasing the number of vaccine doses despite evidence of diminishing efficacy over time and new strains).
Dismissing alternatives that do not conform to their vision of how the pandemic should be dealt with (i.e., ignoring natural herd immunity and using Ivermectin).
Interpreting the scientific data to justify the use of oppression by the government (i.e., repeated messaging to mask publicly and to take the COVID-19 vaccine despite evidence that it would not stop the pandemic).
Aside from the colonialist mentality, medicine and public health have a conflict of interest problem.
Critical Theory allows us to see a fundamental problem with national vaccination policy - the pharmaceutical corporations have too much say in the national vaccine programs and benefit financially from government mandates.
Rampant conflicts of interest exist between the government's public health institutions and pharmaceutical companies. The latter will always push for more vaccines to be added to the vaccine schedule and lobby politicians to mandate them.
Pharmaceutical corporations have an outsized influence on academia and government scientific institutions. There is a revolving door between government regulators and industry; after their tenure finishes at the government, a former regulator often takes a lucrative position with the pharmaceutical industry (i.e., former CDC director Julie Gerberding took a job with Merck and was given over a million dollars of Merck stock).
Often, public health funding is used to benefit dominant medical interests. For example, the Allegheny County Board of Health in Pennsylvania recently received over $1M from the US Centers for Disease Control and Prevention to try to increase "access to healthcare" to minority populations in Allegheny County. Of course, by that, they mean allopathic medicine, not naturopathic, chiropractic, integrative, or holistic medicine.
Change is needed. Public health has long outstanding problems that have damaged their reputation - potentially beyond repair.
If they were to be addressed, several actions would need to be taken.
First, the notion of health equity needs to be made more comprehensive to consider vaccine injury and other iatrogenic harms from public health recommendations. Health inequity is far more than lack of access to healthcare; it is also proper redress of iatrogenic illness, that is, illness caused by medicine.
Second, as power accumulates in public health institutions, the amount of oversight, accountability and transparency also needs to increase. Citizens need an increased say in how these institutions work and mechanisms for their voices to be heard.
Third, vaccine coercion and injury must be publicly recognized as social justice problems - and must stop. It is not acceptable that medicine push vaccine mandates or gaslight the vaccine injured. It is inappropriate for corporations to profit to tune of billions of dollars by externalities the cost of injuries and death to the public.
Fourth, the colonialist mentality needs to be replaced with the service mentality. Public health officials need to recognize, take to heart, and begin to act like that they are servants of the people. All public health practices need to be reoriented around informed consent and respect for the dignity of the public as a key first principle.
We look forward to a world where medicine and public health can work with and for the people instead of being another “colonialist overlord.” The oppression must stop now.
References
American Public Health Association. (n.d.). Health Equity. Retrieved from https://www.apha.org/topics-and-issues/health-equity.
Centers for Disease Control and Prevention. (n.d.). CDC’s CORE Commitment to Health Equity. Retrieved from https://www.cdc.gov/healthequity/core/index.html.
Centers for Disease Control and Prevention. (2023, September 12). Selected Adverse Events Reported after COVID-19 Vaccination. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html.
Fedak KM, Bernal A, Capshaw ZA, Gross S. Applying the Bradford Hill criteria in the 21st century: how data integration has changed causal inference in molecular epidemiology. Emerg Themes Epidemiol. 2015 Sep 30;12:14. doi: 10.1186/s12982-015-0037-4. PMID: 26425136; PMCID: PMC4589117.
Great Barrington Declaration. (2020). Retrieved from gbdeclaration.org
Karan, A. (2019, December 30). Opinion: It’s Time to End the Colonial Mindset in Global Health. NPR. https://www.npr.org/sections/goatsandsoda/2019/12/30/784392315/opinion-its-time-to-end-the-colonial-mindset-in-global-health
Leicester Declaration. (2003). Retrieved from https://www.ipetitions.com/petition/the-great-leicester-declaration
Merck. (2014, December 10). Merck Announces Appointment of Dr. Julie Gerberding as Executive Vice President for Strategic Communications, Global Public Policy and Population Health. Retrieved from https://www.merck.com/news/merck-announces-appointment-of-dr-julie-gerberding-as-executive-vice-president-for-strategic-communications-global-public-policy-and-population-health/
Niemiec, E. (2020). COVID ‐19 and misinformation. EMBO Reports, 21(11). https://doi.org/10.15252/embr.202051420
Strozewski, Z. (2022, January 12). Doctor’s medical license suspended over accusations of spreading COVID misinformation. Newsweek. https://www.newsweek.com/doctors-medical-license-suspended-over-accusations-spreading-covid-misinformation-1668679
Washington, Robert E. “Brown Racism and the Formation of a World System of Racial Stratification.” International Journal of Politics, Culture, and Society, vol. 4, no. 2, 1990, pp. 209–27. JSTOR, http://www.jstor.org/stable/20006991. Accessed 16 Nov. 2023.
"stupid lay folk"
Baer, D. (2022, March 26). Professionalism is a bias-making machine that needs to end. Here’s how to dismantle it. Business Insider. https://www.businessinsider.com/professionalism-is-a-bias-making-machine-how-to-dismantle-it-2022-3?op=1
"divine knowledge"
Wikipedia contributors. (2023, October 17). The White Man’s burden. Wikipedia. https://en.wikipedia.org/wiki/The_White_Man%27s_Burden
"superior white Europeans"
Reporter, G. S. (2021b, October 1). The colonial mindset is deeply embedded and persists today. The Guardian. https://www.theguardian.com/world/2021/oct/01/the-colonial-mindset-is-deeply-embedded-and-persists-today
We must begin to realize and share that the mantra of health equity is just another tool to increase revolving door customers for life feeding the cash cows whilst using minorities and oppressed exactly like many politicians who ensure oppression and division continues. The only way to true health equity is to avoid pathologizing the gifted human body from day one and practice healthy ways keeping the (most common kind of) doctors and medical systems away.
This is imperative.
"Public health officials need to recognize, take to heart, and begin to act like that they are servants of the people. All public health practices need to be reoriented around informed consent and respect for the dignity of the public as a key first principle."