By HENRIQUE AMADOR PUEL MARTINS & CAUÊ BAASCH DE SOUZA*
A different approach to common sense
It was already known that contemporary Western society has been producing for some years a curious fauna of people with anti-scientific worldviews, giving credit to nonsense like astrology, homeopathy, anti-vaccine movement, flat earthism, denial of climate change, etc. With the pandemic, this issue was greatly amplified with the phenomenon of so-called denialists, who began to consider the Covid-19 pandemic as something manufactured and that it would be nothing more than a “little flu”, therefore being against health security measures. .
From 2021, with the arrival of vaccines, they entered the list of elements (along with masks, confinement, distancing) whose effectiveness many began to question. Faced with these questions, which are often unfounded and sometimes ill-intentioned, the answer was always something along the lines of what science has already said is this and this way. Faced with such a scientific consensus, there would be no room for questioning by lay people. While the left and honest democrats in general made a legitimate effort to combat people of bad faith spreading disinformation, the way they proceeded (and still proceed) ironically contributes to legitimizing a position that the left has historically opposed: the neutrality of science.
About this, a brief theoretical parenthesis is in order. Dealing with the nature of scientific knowledge, in the Marxist-Leninist tradition (or at least in the light of the powerful contribution of Lukács) to which the authors are affiliated, we can identify two important concepts, apparently opposite but which are in fact complementary: objectivity of science and its non-neutral programmatic orientation. The first concept refers to the fact that science is the form of human praxis that seeks to develop a deanthropomorphizing reflection of reality, striving for the level of universality, among the three degrees of generality of being (uniqueness, particularity, universality).
In other words, the theory is an ideal reproduction of the real movement of matter. As reality is objective, its reflection in the human mind will be more adequate the less it is influenced by the subjectivity of the humans who investigate it – hence the expression “objective reflection”. On the other hand, this does not mean that science is neutral. This classification no longer concerns the ontological content that science describes, but its programmatic orientation, that is, as a social product, in what way and for what purposes it is used.
As science is produced in a society marked by class conflicts and social segments with particular interests, it must be clear that the social use of science is somehow conditioned to such conflicts. Therefore, at the same time that science deals with an objective reality, it has different programmatic orientations as it is appropriated and used by different social segments – in this precise sense, science is not neutral.
Saying that science is not neutral, however, cannot be a statement that by itself seeks to support a disqualification of a certain scientific result that goes against the social or political group to which we belong. On the contrary, it should be no more than a guiding principle to conduct a concrete investigation that seeks to reveal the particular interests that programmatically guide the use of that result in question.
The principle of the non-neutrality of science alone does not authorize the left to disregard studies that show the safety of certain pesticides, as these match the interests of agribusiness. Not even the right can ignore studies that indicate the failure of the current model of the war on drugs and mass incarceration, as this would be in the interest of drug traffickers, for example.
We say this here to return to the issue of the so-called pandemic denialists. Many of those who summarily disregard any and all objections from these citizens seem to disregard that in fact the ultra-massive distribution of vaccines is in full compliance with the interests of the pharmaceutical industry – which, by the way, is one of the largest and most monopolized branches of world capitalism. This is not to say that the pandemic and the mass vaccination campaign are necessarily conspiracies produced by pharmaceutical monopolies or anything along those lines.
On the other hand, it certainly should not be ignored that these interests are real, corporations are indeed powerful and may very well influence governments, the media and the population so that the management of the pandemic follows a specific course according to these interests. This is a set of factors that, again, should not be taken as truth by contrast, but as a guide for investigation.
When it comes to the production, discussion, application of science, we must take a series of precautions. On the one hand, it is evident that technical issues require study and professionals take years of training and research to be able to express an opinion on a given subject, so that it is extremely dishonest to equate the validity of a qualified opinion with the opinion of any layman. On the other hand, every human being is endowed with intellect and therefore is capable of reasoning with his own head – reason is democratic.
Any person, either as a unique representative of the human race or as a legal citizen of his country, has the right to question absolutely anything and obtain answers consistent with the merits of his questioning. Anyone who doesn't want to draw conclusions on their own (not least because no one has time to conduct investigations into absolutely every scientific claim they hear), has the right to simply trust the opinion of the majority of experts. But no one can be wrong to remain skeptical about an issue, and to compare the majority opinion with the opinion of other experts and their own questions. Remember: argument from authority is a logical fallacy. That is to say, something is not true because it was said by an expert, but conversely someone is considered an expert because he says many things that can be verified as true.
Closely related to this is a very important issue, which is the troubled relationship between democracy and technocracy. The regime in force in Brazil and in much of the world is bourgeois democracy, organized with liberal institutions. It is bourgeois because this is the social class that ultimately controls and guides its apparatuses, but it is democracy because it allows, to a certain degree, the participation of the population to elect politicians who, supposedly, represent their interests and govern and legislate based on these.
State management, whether in capitalism or in the future socialism, also requires a degree of technical support, in order to develop public policies that are based not only on the will of representatives and those represented, which in many cases can prove to be superficial and even counterproductive under the light of scientific investigations. However, in democracy, the intellectual and technical strata do nothing more than advise politicians or carry out what they previously defined. If scientists want to do politics (stricto sensu) directly, need to pass through the sieve of popular vote. When the technical bodies decide public policies independently or in spite of the elected authorities, what we have in fact is a technocracy.
This is exactly what many Democrats, in the best of intentions, are today inadvertently flirting with. In the name of expanding the just and necessary measures to control and combat the pandemic, many are fighting the legitimacy of the elected government in taking or not taking decisions, as if ANVISA's word were sufficient and unquestionable. This is what we saw in the recent case of the public hearing on childhood vaccination. There is no doubt that the posture of the federal government and its supporters in creating constraints and threats to ANVISA technicians is completely unacceptable.
We also understand that a public hearing was not strictly necessary for this matter and played a certain delaying role for the government. However, it is also true that, contrary to what the opposition has boasted, it is not absurd to hold a public hearing, it is a legitimate choice of the ruler. Closer to absurdity is in fact ANVISA, a State agency subordinated to the Ministry of Health, having refused to participate in such a hearing because they would have already informed the technical data and therefore would have nothing to add in the space. We repeat: it is inadmissible for a government to sponsor threats to any workers and, at the same time, for the technical body to think that its position dismisses the political debate is a technocratic deviation that we must not let go unnoticed.
Having said all these preliminary questions, we can properly move on to the discussion on the merits of the questions regarding the strategies adopted globally to combat the pandemic. In the West, this strategy consisted, at first, basically of confinement and social distancing with compulsory use of masks. In some Asian countries such as China, Korea, Vietnam, such tools were combined with a massive and comprehensive testing structure, so that new cases were soon identified, isolated and, therefore, the distancing strategy could be relaxed, being applied at the same time to a comparatively smaller amount of people.
As of 2021, to this strategy was added the beginning of mass inoculations of vaccines of different technologies being produced by pharmaceutical companies in different countries, producing a geopolitical dispute for markets within the pandemic. The heterogeneous global distribution of industrial capacity and the maintenance of patents meant that doses were produced at a pace far below demand. With this scenario configured, we had a movement of world division, in which rich countries advanced in the immunization of their populations, while poor countries embitter the continuity of the pandemic with very low immunization rates.
Alongside this, another thing that is important to note is that despite so many vaccines being developed, very little is said about the production of drugs to treat COVID-19, something that, if it were also available, would bring a very different aspect to the form that we face the pandemic. We are unable to say whether the neglect of the development of treatments is due to technical or political-financial reasons, but it is worth remembering that there was and still is a very strong campaign against any attempt to use existing drugs to try to treat the disease.
There is certainly a lot of hacking, both from industries that want to sell their medicines as treatment, and from denialist governments like ours that irresponsibly supported the application of medicines as a way to mitigate the seriousness of the pandemic and the necessary isolation measures. However, without wishing to back a statement that is beyond our technical reach, we should know that there is evidence (therefore not final proof, but indications) that, for example, ivermectin can protect people from the adverse effects of COVID-19 when it is administered as prophylaxis or early treatment.
at the address https://ivmmeta.com A platform is hosted that registers in real time a meta-analysis of, so far, 81 studies around the world on the use of ivermectin, showing generally positive results. We reiterate that we are not here putting our hand in the fire in favor of statements that we do not have the technical conditions to evaluate, we just want to show that things are not so black and white, as if any mention of ivermectin as a medicine for COVID-19 was necessarily pseudo-science and denialism, as the media (mainstream and alternative left) makes it seem.
Putting these two reflections together (unequal distribution of vaccines in the world and lack of official treatment), we obtain a perfect recipe for the profit of large corporations. The world's population without access to the vaccine continues to produce new variants that prolong the pandemic, while countries with access to resources continue to buy doses and doses of vaccine, with more and more reinforcements. They, which are sponsored as the only legitimate way to protect against the virus, unlike several vaccines we are used to, have the health inconvenience of not drastically attenuating the transmission rate. In this way, they become very convenient financially, since they are administered throughout the population, but they do not completely eliminate the pandemic, in order to prolong its demand.
It may indeed be a coincidence, or even due to the characteristic of the virus, that with so many different manufacturers, using several different technologies, all vaccines produced so far have this characteristic. But when it comes to financial interests of such magnitude, we must rather maintain a certain reservation in believing wholeheartedly in everything that corporations (pharmaceuticals and media) tell us. Having a critical sense and a healthy skepticism does not make anyone a conspiracy theorist or a denialist.
Nothing said here is to call into question the effectiveness of vaccines in protecting people – they are essential. We want, however, to show the reader that there is a lot of room for contestation about its safety without entering the field of denialism. Unfortunately, there is a lot of bad faith in groups resistant to the vaccine, so that they often convey their suspicions through gross manipulations and false news. This practice needs to be repudiated and fought, but one must have the discernment to see that not every questioning of vaccines against COVID-19 is part of the anti-vaccine movement in general (which in fact is an outgrowth), nor are they necessarily moved by false information.
Coming to the merits of the vaccines that are available in Brazil, it is important to highlight that not only do they come from different manufacturers, but in some cases they are produced with different technologies. Coronavac uses the conventional and already much studied technology of the inactive virus. Astrazeneca employs the new technology (employed since some 10 years ago) of the weakened virus (adenovirus). Pfizer employs the brand new (first in history) technology to transport a lipid nanoparticle containing a messenger RNA molecule corresponding to the protein needed to identify and combat SARS-Cov 2. It is an innovative technology that allows for a very fast and has nothing to do with genetic alteration as some false news maliciously spread. Despite the genius of the innovation, we still do not know its primary and long-term side effects. We will discuss a little bit about the real evidence that is available on the internet for citizens to do their research and draw their conclusions.
Despite these differences, we must remember that the public authorities prevented people from choosing the vaccine that would be inoculated into their bodies. Not only did it prevent it, but a whole prejudice was created, as if the person wanting to choose that substance with which they felt safer made them a denialist, responsible for delaying the vaccination of others and other nonsense.
Much had repercussions with the approval of vaccines in phase III of their tests, allowing them to start being commercialized, but little is said that after this stage the scientific protocol, to consider the vaccine fully tested, phase IV is still required. This is when after a drug or diagnostic or therapeutic procedure is approved and brought to the market, follow-up tests of its use are designed and implemented in thousands of people, allowing the knowledge of additional details about the safety and effectiveness of the product. One of the important goals of phase IV trials is to detect and define previously unknown or incompletely qualified side effects, as well as related risk factors.¹
We don't have any news about how phase IV vaccine testing is going. The reason for this must be that all the vaccines we use here were approved by ANVISA and began to be applied to the population before the completion of phase III testing. Coronavac is concluding its tests of this phase now in 2022², while those of Pfizer and Astrazeneca only in 2023³.
Therefore, for all intents and purposes, they are all experimental vaccines, as recognized by ANVISA itself, in Article 3 of its Resolution RDC 475 of 10/03/2021: “The medicines and vaccines against Covid-19 temporarily authorized for emergency use for prevention of Covid-19 will be intended for use on an experimental basis, preferably in public health programs of the Ministry of Health”.4
And, in fact, looking at the opinion5 from ANVISA that authorized the Comirnaty vaccine (the one from Pfizer) we see statements that may shock those who have been informed only by the conventional and alternative left-wing media, such as: “Effectiveness and safety in the pediatric population, pregnant women and immunosuppressed individuals: Safety and effectiveness of Comirnaty vaccine in participants <16 years of age has not been established at the time of health registration. Experience with the use of the Comirnaty vaccine in pregnant women is limited.” […]
“Concomitant administration with other vaccines: There are no data on the concomitant administration of Comirnaty vaccine with other vaccines”.
"Efficacy against asymptomatic infection and transmission of the SarsCov-2 virus: There is no evidence that the Comirnaty vaccine prevents asymptomatic infection and transmission of the SarsCov-2 virus from person to person."
“Efficacy against severe Covid-19: It was not possible to conclude how effective the Comirnaty vaccine is against severe Covid-19”.
"Long-term efficacy and safety: The long-term efficacy and safety of the Comirnaty vaccine have not been established.”
As if that were not enough, all over the world there are more and more case reports, although few in absolute number, of myocarditis and pericarditis after the inoculation of the mRNA vaccine, mainly in young people. It should be noted that this phenomenon is receiving increasing attention from researchers.6, making it possible to easily find studies on the subject popping up on the internet. However, none of this was reported by the manufacturers in their clinical trials, leaving it up to agencies such as the US FDA7 and the Brazilian ANVISA8 make this publicity (which, by the way, did not have great repercussions in the media). In February 2022, a UK government agency published a study9 which points out that for every million doses applied to children aged 5-11 years, the number of ICU admissions avoided is quantitatively equivalent to the cases of myocarditis it produces.
Despite all that we have exposed, it is important to emphasize that the intention here is not to promote distrust in the reader about vaccines or to discourage him from getting immunized. To make this very clear, it is interesting to reproduce the initial part of ANVISA's conclusion in the aforementioned opinion: "Despite the incompleteness of development data expected for the registration of a biological product, due to the rapid development of vaccines against Covid-19 and the need for its urgent availability to the population and also considering the data presented so far on the product on display, it can be concluded that, despite the need to complement important quality data, there is no risk to the health of the population related to missing data at the time that is greater than not using the vaccine”.
The clinical data presented demonstrate that the Comirnaty vaccine induces robust immune responses and confers protection against COVID-19 in individuals ≥16 years of age, with demonstrated efficacy of 95,0% from 7 days after Dose 2, as per data clinical trials presented, from the pivotal clinical study.
Therefore, the whole issue here revolves around demystifying prejudice against those people who chose not to get vaccinated. There are the stupid and bad faith denialists, there are those uninformed being manipulated by fake news and there are those who have done their research and concluded that for them it was not worth the risk of taking the experimental vaccines. Understanding the situation in this way, would it be prudent to make vaccination against COVID-19 mandatory, including it in the National Immunization Program? Considering that, as mentioned, the vaccines have not yet completed their third phase of testing, let alone the fourth, perhaps it is right to wait a little longer. Even from a pragmatic point of view, the population's vaccination rates are already considerably high and, historically, the success of vaccination in Brazil has been linked much more to convincing the population than to imposition.
Certainly, the Ministry of Health of the Bolsonaro government is not guided by such rational considerations by so far not including vaccination against COVID-19 as mandatory, but this choice is a legal prerogative of the executive branch. Those who think it should be mandatory have every right to press for it, but it is incorrect, as some groups and institutions want, to treat this vaccine as mandatory just because ANVISA accepted them as part of the national strategy to combat the coronavirus – again , this is a technocratic deviation.
Directly related to this is the issue of requiring proof of vaccination to access certain spaces in the city. This is a way of making vaccination mandatory, circumventing the proper procedures of the Republic, after all, access to the city is beginning to be restricted more and more for citizens who have exercised their right to choose not to be vaccinated. In this regard, it is important that we understand the relationship between collective and individual rights well so as not to endorse a liberal view.
We understand that the interests of the majority must prevail over those of the individual, but this must be done formally and deliberately, not arbitrarily, otherwise what we will have is a dictatorship – and in the concrete case in question, it would not be a regime commanded by the working people, but by a juridical-technocratic consortium. Moreover, the situation is even more complicated when it comes to restricting access not to a bar or stadium, but to educational institutions, in which people have their place guaranteed as a constitutional right. It is absurd to want to support in the vague (but unquestionably important) concept of university autonomy (constitutionally delimited as “didactic-scientific, administrative and financial and asset management”) the decision to prevent unvaccinated students from studying with their colleagues and public servants from exercising their craft.
More absurd than this is the restriction imposed on non-immunized children, even at the beginning of the childhood vaccination process, from attending schools and being served by policies as essential as food. Such exclusion risks even increasing the vulnerability of families, by transferring to them the cost of feeding the children and the responsibility for their care during the working day.
In addition to legal issues, we also have the question of the ineffectiveness of such a requirement to effectively contain the spread of the virus. As already mentioned here, ANVISA itself declared that Pfizer's vaccine did not provide proof of preventing the transmission of the virus – this in mid-2021, now we have the dominance of omicron, which is even more transmissible. That is, all that the vaccination requirement does is allow vaccinated and infected people to enter the premises smoothly. Much more effective and democratic would be a complex of protocols for distancing, periodic cleaning, ventilation, testing and isolation of those infected.
What seems to be behind this wave of adherence to the model requiring proof of vaccination is often a feeling of revenge against the unvaccinated, who are implicitly and simplistically identified as all Bolsonarists and denialists. As said, there is intersection between these groups, but they are not identical. Even if they were, supporting the bourgeois State to promote the restriction of civil rights of our political opponents is not an interesting thing to do, as this strengthens not us, but the State’s apparatus and legitimacy of social control, opening dangerous precedents .
Finally, it must also be considered that the defense of the vaccine passport is yet another element that contributes to the crooked social polarization dynamics that Brazil has experienced in recent years. Crooked because it presents itself as a fight between “progressives” versus “conservatives” and therefore does not correspond to the fundamental and inescapable social polarization of the capitalist mode of production – there are bourgeois and proletarians on both sides of this apparent polarization. In this sense, let us note who this current polarization is serving, if not for Bolsonaro to keep his ultra-conservative base mobilized and cohesive. More than for Bolsonaro personally, this dynamic is functional for bourgeois domination in our country as it fragments the social fabric, with high internal tensions that do not identify with, and make fun of, the class struggle, and in particular imperialist domination. .
The management of the pandemic in Brazil was indeed disastrous and we did the right thing in demanding that the federal, state and municipal governments comply with sanitary protection measures, but the vaccine passport has little to do with that. The essential thing now is to continue with protocols that actually mitigate the circulation of the virus and accompany what tends to be the end of the pandemic, with the drastic reduction in the virulence of SARS-CoV-2.
*Henrique Amador Puel Martins is a doctoral candidate in mathematics at the Federal University of Santa Catarina (UFSC).
*Cauê Baasch de Souza is a programmer analyst at the Federal University of Santa Catarina (UFSC).
Notes
[2] https://clinicaltrials.gov/ct2/show/NCT04456595
[3] https://clinicaltrials.gov/ct2/show/NCT04516746; https://clinicaltrials.gov/ct2/show/NCT04368728
[4] https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-475-de-10-de-marco-de-2021-307999666
[5] https://consultas.anvisa.gov.br/#/medicamentos/25351023179202157/
[6] https://pubmed.ncbi.nlm.nih.gov/34877217/
