Who's to blame for vaccine hesitancy?
Corporations, conspiracies, and “counter-science”
The FDA’s decision to pause and then re-start the use of the single-shot Johnson & Johnson COVID vaccine has prompted an interesting debate. Did the agency undermine confidence in vaccines by highlighting an extremely rare but severe side effect? Or did the pause prove that the system is working as it should, giving Americans tangible evidence that the Covid vaccines are being scrutinized by regulators?
What’s odd about this debate, I think, is the extent to which the most obvious culprit behind vaccine hesitancy is mostly absent!
To put it bluntly: if we want to understand why so many people are willing to believe conspiracy theories about how Big Pharma has covered-up reports of adverse health consequences to protect profits, we should probably consider cases where Big Pharma actually did cover-up reports of adverse health consequences to protect profits.
Corporations as culprits
Let’s take Johnson & Johnson as an example. Pre-pandemic, Johnson & Johnson was best known to many American consumers as “the baby company”. Perhaps less well-known is the fact that J&J has engaged in a decades-long corporate conspiracy to cover-up evidence that its signature baby powder is linked to ovarian cancer.
I feel a profound awkwardness in making this point. And perhaps I should clarify here that I am not an anti-vaxxer. I would’ve happily taken the J&J vaccine if it had been available to me! (Instead, I recently got my first Moderna shot.)
But J&J’s dishonest and reckless behavior is now an established fact. If you haven’t followed the reporting on the baby powder scandal, I encourage you to listen to the Verified: Dust Up podcast.
The J&J baby powder scandal
Thanks to a wave of lawsuits from women suffering from ovarian cancer linked to talc-usage, we now have documents showing that asbestos was found in J&J talc in 1971,1972, 1975, 1984, 1985, 1986, 1998, 2002, 2018, and 2019.
We even have this remarkable piece of evidence: an edit to the J&J website made in 2013, changing the phrases “our talc-based consumer products have always been asbestos free” to “our talc-based consumer products are asbestos free”.
But this wasn’t just about PR strategy. For decades, J&J has pursued a sophisticated program of counter-science — by which I mean the kind of denialism that apes the language, techniques, practices of scientific inquiry.
For J&J, counter-science consisted of four main elements:
1. Cherry pick the evidence
Cherry-picking was institutionalized as one of J&J’s practices in a 1973 memo, which described the company’s strategy of initiating safety studies “only as dictated by confrontation”, so as to “minimize the risk of possible self-generation of scientific data which may be politically or scientifically embarrassing”.
2. Control the testing standards
J&J aggressively fought to make sure that its preferred testing methods – which were less sensitive to the presence of asbestos – became the industry standard. This led to the truly absurd situation in the 1970s, where the FDA found no asbestos in J&J’s talc samples in one case using a test that was “incapable of detecting chrysotile fibers”, the most common type of asbestos! In 1974, J&J lobbied the FDA to adopt x-ray scanning techniques that could only detect quantities of asbestos above 1%. In recent litigation, one of the expert witnesses for the plaintiffs compared the company’s testing methods to “trying to weigh a needle on a bathroom scale”.
Even as recently as 2018, the FDA continues to show extraordinary deference to J&J on testing standards, even asking the company to recommend a list of talc testing experts to take part in a public hearing. J&J provided three names: all three had worked with J&J in the past, and two had testified as an expert witness for the defense during talc litigation.
3. Argue that any asbestos found is “within tolerable limits”
Remarkably, J&J was arguing that any concentration of asbestos under 1% was safe - for babies! - at the same time that the FDA had proposed a rule that drugs could contain no more than 0.1% asbestos.
4. Attack the credibility of scientists who find different results
Internal documents from the 1970s show that J&J maintained a list of “antagonistic personalities”, naming several independent scientists who had found the presence of asbestos in J&J talc products.
One scientist - Fred Pooley - had called Johnson & Johnson to warn them of his findings, which he planned to present at an occupational health conference in Britain in 1975. After the company pressured him, he withdrew.
One of his colleagues, Arthur Langer, continued their research at Mount Sinai Medical Center and published the findings in 1976. Executives from Johnson & Johnson met with Langer and his colleagues and warned them of “frightening mothers unnecessarily”. The company even forced the president of Mount Sinai to issue a news release disputing the findings and endorsing the use of baby powder.
Johnson & Johnson used its financial heft to control the work of independent scientists: for example, the company funded a doctoral student to work in a lab testing samples from their suppliers’ talc mines. When J&J discovered that the lab had detected asbestos in at least half the samples they analyzed, the company canceled the student’s scholarship.
Anytime that asbestos was found, J&J would take the same sample and test it again, always producing a negative result. The difference, they argued, must be the fault of the independent scientists: their equipment was faulty, their labs were contaminated, their procedures were out-of-date.
As J&J CEO Alex Gorsky put it in a deposition in 2019: findings of asbestos in J&J’s talc products over the years were “later shown to be inaccurate, incomplete and just not correct”.
What is counter-science?
I borrowed the term “counter-science” from Ulrich Beck, the German sociologist whose work grapples with the importance of risk in post-industrial societies.
Here’s the relevant passage:
Everywhere the spotlight in search of a cause falls, fire breaks out, so to speak, and the hastily assembled and poorly equipped ‘argumentation fire company’ must try to put it out with a powerful stream of counterarguments, and save whatever can still be saved. Those who find themselves in the public pillory as risk producers refute the charges as well as they can, with the aid of a ‘counter-science’ gradually becoming institutionalized in industry, and attempt to bring in other causes and thus other originators. (Beck 1992, 32)
As far as I’m aware, people don’t often attribute the term “counter-science” to Beck, perhaps because he only mentions it once in Risk Society. But the image of the “argumentation fire company” is so brilliant that this passage always stuck in my mind.
And here’s a little piece of serendipity: in one of the episodes of Verified: Dust Up, they interview Fred Pooley. Remember him? He was the scientist who wanted to present his findings about the presence of asbestos in talc products at a conference, but eventually withdrew after being pressured by J&J.
Anyway, here’s what he had to say about his subsequent work for the company (episode 4, around 18:40 minutes):
Fred Pooley: “I used to - how can I put it - I acted like a little bit of a firefighter for Johnson & Johnson. If there was a sample that had been vilified by somebody… then they would normally say would you look at this, just to check this out?”
The job of the corporate firefighters is not to put out the flames per se, but to hose down each piece of evidence with a steady stream of objections, quibbles, question-marks, and denials.
For the guiding principle of counter-science is that until they are proven, risks simply do not exist. When Johnson & Johnson demanded that its talc products should only be tested with crude methods incapable of detecting small quantities of asbestos, the company sought to hide any contamination not just from the regulators, but from itself.
As Beck quipped, the entire apparatus of recommended testing procedures and “acceptable limits” is based on a simple mantra: “in case of doubt please protect toxins from the dangerous interference of human beings”. (p.66)
From corporations to conspiracy theorists
Corporate counter-science becomes fodder for conspiracy theorists in two ways.
In the first sense — and again, this is a little uncomfortable to say — large corporations doing actual conspiracies does lend a sheen of credibility to the genre at large.
But there’s a second, almost genealogical, link that I’m trying to draw between the two. Corporate counter-science has established a set of techniques and strategies that have become the dominant language of the contemporary anti-vax movement, and its precocious younger sibling, the anti-mask movement.
This may seem surprising. The anti-vax movement, of course, contains many subcultures that are totally unrelated to science, or indeed counter-science (e.g., dogmatic refusal of “unnatural” remedies; religious objections to vaccines derived from stem cells; Bill Gates boogeyman-ism).
But there’s a large and vocal part of the anti-vax movement that primarily employs language, types of evidence, and rhetorical strategies that are associated with modern science.
This contingent is perhaps even larger in the anti-mask movement. Scholars at the MIT Visualization Group have just put out a study comparing the use of data visualization on Twitter by Coronavirus skeptics and mainstream figures (Lee et al. 2021).
Here’s a video preview:
And here’s one of the key findings:
The Twitter analysis establishes that anti-maskers are prolific producers and consumers of data visualizations, and that the graphs that they employ are similar to those found in orthodox narratives about the pandemic. Put differently, anti-maskers use “data-driven” narratives to justify their heterodox beliefs. (Lee et al. 2021)
And the authors didn’t stop there. They complement this large-scale analysis of tweets with an in-depth ethnographic study of anti-mask groups on Facebook.
Many of the users within these groups are skeptical about the potential benefits of a coronavirus vaccine, and as a point of comparison, they often reference how the tobacco industry has historically manipulated science to mislead consumers. These groups believe that pharmaceutical companies have similarly villainous profit motives, which leads the industry to inflate data about the pandemic in order to stoke demand for a vaccine. (Lee et al. 2021)
This skepticism pushes anti-mask activists to seek out unmediated access. Indeed, the paper describes how these groups provide online “tutorials” on how to access and analyze open-source data, often providing sophisticated interpretations of the pros and cons of different data sources.
What would Ulrich Beck have to say about this? Well, on the one hand, Beck clearly predicted a kind of democratization of scientific fluency, as individuals are forced to seek out explanations for the mysterious illnesses and ailments they experience. As he put it: “people themselves become small, private alternative experts in risks of modernization”.
But from our vantage point, Beck’s view of these “citizen-experts” seems a little… naïve? He seems to assume that unlike industry, citizens have no ulterior motives in investigating cause and effect. Nor is he particularly concerned that citizens lack the proper training or contextual knowledge to interpret scientific data.
For example, here’s Beck describing how parents in Germany linked high levels of sulfur dioxide to respiratory infections among children:
The parents begin to collect data and arguments. The ‘blank spots’ of modernization risks, which remain ‘unseen’ and ‘unproven’ for the experts, very quickly take form under their cognitive approach. They discover, for instance, that the established acceptable values for pollutants in Germany are much too high. Although investigations have shown that children suffer pseudo-croup surprisingly often even at a short-term level of 200 micrograms of sulfur dioxide per cubic meter of air, twice that amount is permissible according to the prevailing prescribed values in Germany. This is four times as much as the World Health Organization considers acceptable as a short-term value. Parents prove that measurement results only fall within the ‘acceptable’ scope because the peak values from heavily impacted neighborhoods are averaged in with values from wooded residential neighborhoods and so ‘calculated away’. ‘But our children’, they say, ‘are not getting sick from the average value.’ (Beck 1992, 61)
Now, of course, Risk Society was first published in 1986, so this is pre-internet (or pre-internet-as-we-know-it). It is clear that Beck imagines these “citizen-scientists” as being primarily concerned with uncovering the causes of dangers in their own community and their own lives. Whether the focus is dying forests or children with hacking coughs, these citizens are anchored by the tangible side effects of modernization.
In some sense, these individuals are the precise opposite of the anti-mask activists, some of whom insist that the pandemic cannot be real because they cannot see tangible evidence of it in their daily lives.
The internet lowers the cost of participation in such activities and creates new incentives, attracting those who enjoy shock value as well as entrepreneurs who see an audience ripe for grifting.
Perhaps part of Beck’s naïveté comes too from a sense of nostalgia for the radical participatory movements of the 1960s and 70s, which were already fading from view as he wrote Risk Society.
Still, Beck is clearly sensitive to the idea that invisible risks may tempt conspiratorial thinking:
… the risk society contains an inherent tendency to become a scapegoat society: suddenly it is not the hazards, but those who point them out that provoke the general uneasiness. Does not visible wealth always confront invisible risks? Is not the whole thing an intellectual fantasy, a canard from the desks of intellectual nervous nellies and risk promoters? Is it not spies, communists, Jews, Turks, or asylum seekers from the Third World who are ultimately behind it? The very intangibility of the threat and people’s helplessness as it grows promote radical and fanatical reactions and political tendencies that make social stereotypes and the groups afflicted by them into ‘lightning rods’ for the invisible threats which are inaccessible to direct action. (Beck 1992, 75)
Beck also worried about the fact that as complexity increases, judgments about risk are increasingly divorced from personal experience:
The ‘experiential logic’ of everyday thought is reversed, as it were. One no longer ascends merely from personal experience to general judgments, but rather general knowledge devoid of personal experience becomes the central determinant of personal experience. Chemical formulas and reactions, invisible pollutant levels, biological cycles and chain reactions have to rule seeing and thinking if one wishes to go to the barricades against risks. In this sense, we are dealing not with ‘second-hand experience’, in risk consciousness, but with ‘second-hand non-experience’. (Beck 1992, 72)
To Beck’s list of invisible risks, we could add: Covid case counts, seroprevalence, the reproduction number, and vaccine efficacy. Little wonder, then, that so many have tried to convert these “second-hand non experiences” into something more tangible, by seeking unmediated access to data sources (Lee et al. 2021).
A policy recommendation
Corporations like Johnson & Johnson haven’t just given the anti-vaxxers plenty of ammunition. They’ve also given them the misinformation instruction manual.
If we are serious about countering misinformation, we need to find ways to make corporations pay for these externalities. Johnson & Johnson has reportedly set aside $4 billion to cover litigation costs relating to talc-based products. That is nowhere near enough. The company’s stock price barely reacted to the news of the cover-up. The CEO who lied in a deposition is still CEO. And the corporate firefighters are still in business, dousing each new piece of incriminating evidence with a steady stream of counter-science.
Beck, Ulrich. 1992. Risk society: Towards a new modernity. SAGE Publications. https://books.google.com/books?id=QUDMaGlCuEQC.