The Swine Flu Vaccine Screw-Up: Optimism as a Public Health Problem

Cross-posted with TomDispatch.com.

If you can't find any swine flu vaccine for your kids, it won't be for a lack of positive thinking. In fact, the whole flu snafu is being blamed on "undue optimism" on the part of both the Obama administration and Big Pharma.

Optimism is supposed to be good for our health. According to the academic "positive psychologists," as well as legions of unlicensed life coaches and inspirational speakers, optimism wards off common illnesses, contributes to recovery from cancer, and extends longevity. To its promoters, optimism is practically a miracle vaccine, so essential that we need to start inoculating Americans with it in the public schools -- in the form of "optimism training."

But optimism turns out to be less than salubrious when it comes to public health. In July, the federal government promised to have 160 million doses of H1N1 vaccine ready for distribution by the end of October. Instead, only 28 million doses are now ready to go, and optimism is the obvious culprit. "Road to Flu Vaccine Shortfall, Paved With Undue Optimism," was the headline of a front page article in the October 26th New York Times. In the conventional spin, the vaccine shortage is now "threatening to undermine public confidence in government." If the federal government couldn't get this right, the pundits are already asking, how can we trust it with health reform?

But let's stop a minute and also ask: Who really screwed up here -- the government or private pharmaceutical companies, including GlaxoSmithKline, Novartis, and three others that had agreed to manufacture and deliver the vaccine by late fall? Last spring and summer, those companies gleefully gobbled up $2 billion worth of government contracts for vaccine production, promising to have every American, or at least every American child and pregnant woman, supplied with vaccine before trick-or-treating season began.

According to Health and Human Services Secretary Kathleen Sebelius, the government was misled by these companies, which failed to report manufacturing delays as they arose. Her department, she says, was "relying on the manufacturers to give us their numbers, and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy."

If, in fact, there's a political parable here, it's about Big Government's sweetly trusting reliance on Big Business to safeguard the public health: Let the private insurance companies manage health financing; let profit-making hospital chains deliver health care; let Big Pharma provide safe and affordable medications. As it happens, though, all these entities have a priority that regularly overrides the public's health, and that is, of course, profit -- which has led insurance companies to function as "death panels," excluding those who might ever need care, and for-profit hospitals to turn away the indigent, the pregnant, and the uninsured.

As for Big Pharma, the truth is that they're just not all that into vaccines, traditionally preferring to manufacture drugs for such plagues as erectile dysfunction, social anxiety, and restless leg syndrome. Vaccines can be tricky and less than maximally profitable to manufacture. They go out of style with every microbial mutation, and usually it's the government, rather than cunning direct-to-consumer commercials, that determines who gets them. So it should have been no surprise that Big Pharma approached the H1N1 problem ploddingly, using a 50-year old technology involving the production of the virus in chicken eggs, a method long since abandoned by China and the European Union.

Chicken eggs are fine for omelets, but they have quickly proved to be a poor growth medium for the viral "seed" strain used to make H1N1 vaccine. There are alternative "cell culture" methods that could produce the vaccine much faster, but in complete defiance of the conventional wisdom that private enterprise is always more innovative and resourceful than government, Big Pharma did not demand that they be made available for this year's swine flu epidemic. Just for the record, those alternative methods have been developed with government funding, which is also the source of almost all our basic knowledge of viruses.

So, thanks to the drug companies, optimism has been about as effective in warding off H1N1 as amulets or fairy dust. Both the government and Big Pharma were indeed overly optimistic about the latter's ability to supply the vaccine, leaving those of us who are involved in the care of small children with little to rely on but hope -- hope that the epidemic will fade out on its own, hope that our loved ones have the luck to survive it.

And contrary to the claims of the positive psychologists, optimism itself is neither an elixir, nor a life-saving vaccine. Recent studies show that optimism -- or positive feelings -- do not affect recovery from a variety of cancers, including those of the breast, lungs, neck, and throat. Furthermore, the evidence that optimism prolongs life has turned out to be shaky at best: one study of nuns frequently cited as proof positive of optimism's healthful effects turned out, in fact, only to show that nuns who wrote more eloquently about their vows in their early twenties tended to outlive those whose written statements were clunkier.

Are we ready to abandon faith-based medicine of both the individual and public health variety? Faith in private enterprise and the market has now left us open to a swine flu epidemic; faith alone -- in the form of optimism or hope -- does not kill viruses or cancer cells. On the public health front, we need to socialize vaccine manufacture as well as its distribution. Then, if the supply falls short, we can always impeach the president. On the individual front, there's always soap and water.

Barbara Ehrenreich is the author of 16 books, including the bestsellers Nickel and Dimed and Bait and Switch. A frequent contributor to Harper's and the Nation, she has also been a columnist at the New York Times and Time magazine. Her seventeenth book, Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America (Metropolitan Books), has just been published. An examination of recent studies of the medical ineffectiveness of positive thinking, mentioned in this essay, can be found in the book. To listen to the TomDispatch audio interview with Ehrenreich that accompanies this piece, click here.

Copyright 2009 Barbara Ehrenreich

 

Comments

[LightningJoe]

Barbara, it would be nice if your article's leader text referred to PHARMA's role in the unrealistically optimistic outlook this past summer, and their further role in the continuation of their preferred all-is-well meme later on. As it is, the leader seems primarily to implicate our government. True, the government by now should know better than to take a profitist's word for pretty much ANYTHING, but the basic misinformation was not their fault. If the leader text is not yours to call, then that's another problem that needs a solution.

I'm a long term fan of yours, but I like concission in the arguments I peruse -- it saves SO much time and effort on my part. To wit, the problems with pharma in this case were not primarily that of over-optimism, but of their misrepresentation of the facts; trying to induce an unfounded optimism -- and a resultant complacency -- in the public press. They clearly were not ready, but rather than making themselves ready, or at least warning us ahead, so that our expectations would be more in line with reality, they tried to keep us sleeping, unaware of the real situation. Perhaps they thought that if they were lucky, everything would work out for the best, and their gamble would pay off.

Pharma AND the government should be learning by now, that later disappointment is NOT better than telling the truth up front.

[Matt Osborne - Huffpost Blogger]

I WANT MORE BARBARA!!! She doesn't write for HuffPo often enough!!!

[wealthandriches]

I think concerning isjois comment that we can see there is very favorable outcomes many times when there is a health concern that when we look to diet first to see if our issues can be resolved just as he did with his children.

Our immune systems if working properly will take care of the majority of infections. It's our job to educate ourselves in what our bodies need to have a healthy immune system and then to follow through and make sure we get it. I'd much rather do this FIRST before taking any drug or shot that has been proven to have adverse affects in a lot of children and adults.

[fionasnp]

Barbara, you are the best! I wish you had a regular, weekly column here.

[DonRoberto]

Forget arguments over the role of the market versus the role of government --- the public health is a national security issue, and should be treated as such. There is no reason for America's national security to be completely and utterly dependent on the boardrooms of some of the world's largest multinationals.

[Corners]

I dont hear a lot of people if anyone bring up the fact that a while back when the industry promised all those doses it as thought that adults would need 2 injections. Later on it was found out to be only one shot needed. I wouldn't look at the white house but the drug makers who saw half their profit go up in smoke after their promised doses for the population.

[theycallthewindmariah]

Barbara Ehrenreich is one of my favorite authors. She's always astute.

It's a foul-up of private business, but the Obama administration will take the blame.

I remember, as a child, that vacinations were always at school or in the libraries and that the lines were never long. Health Departments were like branches of the military and most every school had a nurse. Our well-being was considered a matter of national security.

We need an FDR.

[DonRoberto]

We have an FDR. What we don't have is FDR's Congress.

[ramal]

As always, Barbara is right on the money. Ehrenreich for Secretary of Health and Human Services by overwhelming proclamation of thinking Americans everywhere.

[isjois]

I wish you would write a book about the "personal responsibility" scam.

We've been so brainwashed to accept that every bad thing that happens - is somehow our fault. We live with tremendous guilt and fear. It seems this is where the push for "positive thinking" comes from. We may not "actually" be responsible for someone crashing into our car, BUT - "we can choose our response". Instead of being mad about all of the inconveniences associated with a car accident...we SHOULD be grateful we weren't killed! No time for disappointment in our society - suck it up, pull up your bootstraps, get with the program! Besides...it probably WAS your fault - you shouldn't have been in front of that other car!

What's going on is - at best - disingenuous. Many people are facing oppressive struggles because of other peoples' fears or selfishness. That's how I view this swine flu "screw up". But, instead of being mad there isn't more vaccine - I'm disappointed that we aren't taught to properly care for our bodies to avoid these illnesses...I'm frustrated that we don't have better employment practices, so that people can collect "sick pay" and stay home when sick...I'm mad that we've been brainwashed into thinking that we need another drug/vaccine to help us maintain our insane pace of life. For those of us dealing with disabling vaccine side effects, it's disturbing to watch others beg and line up for a "cure" that could be worse than the "disease".

[NYCartist]

It's based in not spending money to care for people who are ill and disabled. If it's your individual responsibility, not society's, then you have to take care of it and society, health insurance plans, etc. don't have to pay out. Works for all kinds of things: poor, housing problems, lack of good schools, no jobs, etc.

[katmeyster]

No amount of "personal responsibility" can overcome structural inequities and social injustice. When the game is rigged, when the playing field isn't level, when everything is set up to maintain the power structure -- it is cruel to blame everything on the victim.

[LightningJoe]

That is pretty much the premise of "Bright-Sided"

"...brainwashed into thinking that we need another drug/vaccine to help us maintain our insane pace of life."

...or to "cure" the disfunctional sex that our overstressed corporate turn-over lifestyle brings about!

[FTracy3]

Swine Flu, Cash For Clunkers, etc. Should we be even slightly worried that the Congress is also being "unduly optimistic' about government run health care? I don't like the current system but the government has yet to do much of anything that leads me to believe they can handle what they're proposing.

[isjois]

As long as we keep electing politicians who admit they dislike "big government"...and who actively work to dismantle programs that are helping our citizens...it will be a struggle to implement effective programs that benefit those of us who need reform.

Instead of creating a new health care system, they should expand Medicare (or Medicaid) to cover all (who want it). I haven't met anyone who has Medicare (or Medicaid) who wants to give it up - that should make us feel better about "government run health care".

[Marnie1]

Where were you five to 10 years ago when this trend, of less vaccine being available later and later into the fall and winter, began?
When I first got asthma in 1990 there was vaccine available in my physician's office, sometimes as early as August. Since I have a respiratory ailment I am among the second tier judged to be eligible for the shots. Elderly, infants, and the seriously compromised are in the first tier. As each year passed the dates of arrival became later and later the availability became iffy and eventually this prescription only medical treatment became available only to those who could stand in lines for hours, outdoors regardless of weather, with no prescription and no screening for "need," until we have reached the point where the flu season, which now begins in late summer actually arrives before, the vaccine (which takes a year to identify, purify and reproduce) and there is no controlled access to the vaccine. Which is often given without prescription and administered by non certified civilians. With payment being made to an unknown company, which may or may not adhere to HIPPA regulations.

So Ms Ehrenreich, my question is, where have you and the other complainers been for the last 15 years?

[isjois]

"The latest study, conducted by the UCLA School of Public Health, interviewed the parents of 13,944 infants, children and adolescents. The results of the study show that a child who has had DTP and tetanus vaccination is 50% more likely to experience severe allergic reactions, over 80% more susceptible to sinusitis, and twice as likely to suffer from asthma." (http://www.suite101.com/article.cfm/chiropractic_health_care/60068)

Perhaps your asthma was caused in part - or whole - by vaccines.

[DonRoberto]

They know now that many of the allergy problems people encounter come from homes that are too "clean" to properly adapt the young children who live there to the many common allergens they will encounter thoughout their lives. Kids whose parents keep clean homes are also more likely to have their kids vaccinated.

Bottom line, way too many Americans are science-illiterate, and cannot differentiate between a correlation and a cause.

[ramal]

So isjois, have you just sat on your hands and done nothing, yourself, for the last ten to fifteen years?

[isjois]

Both of my children suffered adverse vaccine reactions. We were advised to put our son on Ritalin and research institutions for our daughter.

My son couldn't sit still...focus...his ears were full of fluid. At a local study, we learned he had three food allergies. Within days of removing soy from his diet, his ears cleared up. We cancelled plans for ear tubes and his ears have been fine ever since. We decided to test for other food allergies and as various foods were removed...his ADHD symptoms started to disappear. At age four, he could barely talk...now, he's above grade level in some subjects and a total bookworm.

My daughter was non-verbal and diagnosed as severely autistic. Today, she's in a typical classroom. She reads, writes, does math and interacts with her peers. She's able to tell us her needs and answer our questions. She's not "cured" - but, I'll say she's made tremendous progress.

I wouldn't say I've "sat on my hands and done nothing" - my kids need things "healthy" children don't usually require - therapy, specialist visits, etc. As a parent, I've researched possible treatments our doctors don't have time to look into. I wish I could "do more" out there in the community - I really do! I attend conference­s/forums/P­TA meetings, join local groups, volunteer and post comments about things that concern me (FWIW). Someday, I hope to "do more". Do you have suggestions for me?

[maribelles]

No matter how much is written/broadcast about it, I think this flu is a trumped up scam emanating
from big pharma for the purpose of keeping people fearful and disempowered. Nothing more. Flu and other common sickness will come and go as long as we are on the earth, and we have bodies with immune systems made to overcome that. I would NEVER get a flu shot or vaccine. NEVER.

Where is the talk of our immune systems? They are easy to support and maintain, even a 5 year old can learn. Yet this fearmongering focuses on schools, and the guilt of families with children instead of the common sense of hygiene and bolstering the immune system. All the talk is of fear, fear, fear, losing work to the flu (as if that is anything new) .

And who has not seen through, come on people - this "impending" "epidemic", as if there is a train about to roll into the station at just the right moment with little swine flu buggies ....we have been hearing about this for months, is there some "big brother' timing this so called epidemic? Like, maybe when more vaccines are made? Winter will come and go and then the new story will be that it is a Spring-activated virus, or some-such, to keep the ball rolling.

Health care comes from "caring for health", and I challenge everyone to learn more about doing that right there in your homes.

[isjois]

Great comment!

[DonRoberto]

Anyone who knows anything about epidemiology knows better than to buy into your "swine flu as conspiracy" theory. While the pharmaceutical industry may be capable of such a cynical ploy, the many thousands of scientists and doctors who have done the actual research are not.

[isjois]

Many of my relatives are in medicine and they are truly good people. They are not plotting to hurt anyone. There are no "conspiracies" in their lives.

But...quietly they ask - what if our vaccination program is harming some people?

Human beings survived thousands of years without vaccines. Why are some so convinced we would see massive deaths if we scaled back on our current vaccination program?

And - some scientists and doctors DO benefit financially from their "research". Look at Paul Offit. When you create something that makes you a millionaire - how quickly are you going to admit it may cause harm to some?

[lmj417]

This is pharmaceutical company run health care. Ask anyone on Medicare if they will give up their government run health care.

[isjois]

Faved!

[blue53]

Finally, some common sense! It's the drug companies stupid. Has anyone seen a representative one of these companies on TV? Has any reporter ask any question other than "Has the President failed". The MSM is failing us hourly in this country. Too bad we can't vote them out.

[schatsie]

READ the Book VACCINE A before taking another vaccine...... and think about the Autism epidemic....The paragraph about Big Government and Big Corporations is spot on about Health Care just the same way it is spot on about Defense, think Halliburton, etc....

If we had privatized Social Security the way that the Bush Mafia wanted, then we would really be in the deep doodoo..... and Clinton debating with Bush is just endorsing the Bush family and he should read FAMILY of SECRETS before doing this......

[isjois]

Thanks for mentioning autism.

The CDC just raised the figure to 1 in 100 American kids having the disorder...
while some autism organizations place the number at 1 in 91.
It's likely higher than both.

With 1 in 6 American kids learning disabled, all of us should be collectively asking why.

If not vaccines (causing all of these childhood disorders) - really, what?!

[palindrom]

What? Maybe increasing maternal age, which has a proven link to autism? Unlike vaccines, for which no good study has ever found a convincing link.