The experimental mRNA vaccine by Pfizer/BioNTech is now being authorized for use by countries throughout the world, and the EU is expected to give authorization soon.
The mRNA vaccine works in a way totally different from traditional vaccines. Parts of the genetic code of the virus are directly injected into the blood stream in the form of messenger RNA (mRNA). This genetic material tells human cells how to make coronavirus spike proteins, and as such primes the immune system.
No mRNA vaccine has ever been approved before. So the question is how responsible it is to roll out this new technology so quickly on a global scale to fight the Covid-19 pandemic. Let’s look at what we know.
Does the vaccine protect you against Covid-19? Yes! There is no doubt about it, as this research summary of the study by Pfizer/BioNTech in the prestigious New England Journal of Medicine shows.
Does this mean it is a good idea to take the vaccine? No! I have some serious concerns about the way in which scientific research is being carried out around this experimental vaccine, based on my 10 years of expertise in Science & Technology Studies.
Pfizer/BioNTech Phase 3 Clinical Study: a Closer Look
Let’s start with some positive remarks about this Phase 3 clinical study of Covid-19 vaccine BNT162b2:
- Over 40,000 participants enrolled in the study, spread out over approximately 150 clinical trial sites. That is a huge number, allowing to make reliable predictions about the effect of the vaccine in protecting against Covid-19.
- Participants are impressively diverse in terms of gender, age, ethnicity and race. This is a huge accomplishment of the research team, as medical studies have a long history of testing primarily on white straight men, causing bias in the outcomes.
- The study is a randomized, double-blinded and placebo-controlled trial. This means the highest standards of quantitative methodology have been met, allowing us to rule out that other factors than the vaccine are responsible for the vaccine’s effectiveness.
- Even the influenza vaccine was never tested amongst so many participants and in such a controlled way, so it is good that we take vaccines more seriously now and at least invest more in studying their efficacy and safety.
However, I still have two major concerns with the study. One has to do with the implicit assumptions the research team has about the workings of the vaccine and the way in which uncertainty is not accounted for, and the other has to do with the relationship between the scientific knowledge and the influence of dubious private interests that have created this knowledge.
The Uncertainty of the mRNA Vaccine
First about the implicit assumptions of the Pfizer research team. They approach the mRNA vaccine merely as what we call an ‘intermediary’, and not also as a ‘mediator’ (Latour, 2005). To see the vaccine as an intermediary means that the research team assumes that the vaccine is a simple ‘input’ with a clear ‘output’, a causal mechanism without any transformative power. Yes, the vaccine protects against Covid.
However, we know that modern technologies, and especially experimental tech like this mRNA vaccine, should also be approached as a mediator. This means that the vaccine not only has a causal effect, but that it also has unpredictable or ‘wicked’ effects that transform, translate, distort, and modify many other related processes. In other words, the vaccine will behave like a full fledged ‘actor’, mediating the world around it.
Modern society is what we call a ‘risk society’: it is so vastly interconnected and technologically complex that interventions like this Covid vaccine will always have unpredictable effects that can never be studied in isolation (Beck, 1992). The vaccine does not have a mere causal effect, but it will act like a ‘wicked whirlwind’ that intervenes in a complex web of already existing interrelated technologies that are in themselves also ‘wicked’ and unpredictable (Tromp, 2018).
This means that we have no idea how this mRNA vaccine will land in the real world, outside of the controlled environment of the Pfizer clinical sites. We do know from science studies that unforeseen, wicked and whirlwind effects of technologies are unavoidable. To be able to take the ‘wicked’ character of the vaccine in consideration and assess its risks in a satisfactory way, a long term study is needed with a mixed method that integrates quantitative data with qualitative and ethnographic data.
Moreover, a good research design also builds a bridge between science and society; this is what we call ‘transdisciplinarity’. This is necessary to account for the vast amounts of layman’s knowledge about viruses and vaccines already present in society outside of the important but small world of scientific biomedical expertise.
Clearly such a method was not chosen here, as the vaccine is produced under huge societal, political and financial pressure. We know from science studies very well that this kind of ‘fast science’ can have disastrous results, especially when applied to the study of an experimental technology like the mRNA vaccine. The main objection to fast science is that it is known for its one-sidedness, which can lead to tunnel vision and blindness to ‘real life effects’.
The Pfizer scientists seem to know a lot, but they have no idea how the vaccine will behave outside the artificial and confined boundaries of their research design. This means that despite the seemingly convincing science — “a vaccine efficacy rate of 95% (p<0.0001)” — many key questions about the vaccine cannot be answered clearly yet.
Examples of such questions are:
- How safe and effective is the vaccine on the long run, i.e. longer than the 28 days of the trial?
- How will the vaccine interact with other existing technologies and medications?
- How will the vaccine interact with pre-existing conditions like chronic illnesses, both mentally and physically?
Remember, whether the vaccine will have unforeseen interactions is not the question; we know it will. The question is: what interactions will it have exactly? The answer is: we have no idea.
To accept all this uncertainty about this experimental technology and roll it out anyway on a global scale could be legitimized under extreme circumstances. Of course a pandemic with a virus like Covid, that causes serious health problems and not in the least amongst the most vulnerable, could be seen as such an extreme circumstance.
Under these circumstances, risk can be compensated with trust. Trust in the medical and pharmaceutical sectors, trust that even though they don’t know everything yet, at least they are honest about that and their genuine and primary interest is public health.
Unleashed Private Interests in a Public Health Emergency
But here I come to my second concern about this mRNA vaccine: the companies that produce them. Recently, I posted a lot on my Facebook timeline (example 1, 2, 3, 4) about the dubious influence of private 'Big Pharma' companies in the production of scientific knowledge and public policy about Covid-19 in general, and the vaccine in specific. From these reports I conclude that the private companies that push the mRNA vaccine technology are not only money grubbers, but also have questionable (or shall we just say “criminal”) ethics, networks and interests.
A clear finding of science studies is that scientific knowledge can never be separated from the interests that produce them: all knowledge is ‘situated’. Facts and innovations are the result of a common quest to seek and sort knowledge, and this quest is always loaded with politics and interests. The current privatization of scientific knowledge around Covid, and the close ties between politics, the pharmaceutical industry and biomedical science, leads to politization, corruption and suppression of science.
For this vaccine to have maximum support in society, a transparant and democratic approach to scientific knowledge production is necessary. Otherwise, a vacuum is created in which polarization and conspiracy can proliferate, undermining the ideal of herd immunity that is essential to end this pandemic.
The technologies resulting in the mRNA vaccine should be developed, owned and controlled by public and transparent institutions that serve public health. If market mechanisms are allowed in this process, measures should be taken to shield the scientific process from private interests and protect scientific standards regarding ethics and transparency. But the contrary is the case: Big Pharma's lobby is so strong that even the neutrality of watchdog institutions like the European Medicines Agency (EMA) is being compromized.
We are now confronted with a situation in which societal, political and financial pressure is so high that corrupt private partners can seize the current pandemic as an opportunity to roll out neoliberal agendas for which there is no public support in normal circumstances. In other words: the risk that the Covid-19 pandemic is used as a 'shock doctrine', a concept so eloquently described by Naomi Klein, is high (Klein, 2007).
The experimental mRNA vaccine is not the only technology now being rolled out in warp speed worldwide, in an attempt to control the Covid pandemic. It also concerns medications, GPS-tracking, drones, surveillance planes, robots, facial recognition software, nanotech and Artificial Intelligence. Critics have warned that this dynamic can lead to dystopian situations that we now only know from fiction like Black Mirror.
We know from Science and Technology Studies that tech is never intrinsically good or bad, but that it all depends on how it is deployed and whose interests it serves. The technologies now rolled out are mostly developed, owned and controlled by either corrupt private companies or authoritarian state apparatuses. In this way, the tech becomes an extension of imperialist and patriarchal structures, strengthening the infrastructure of surveillance capitalism.
As such, doors are opened to extremely dystopian scenarios involving even more profit-driven incentives, mass surveillance and population control than we have now. This is why vigilance is needed. Tech that is normalised and implemented now can be very hard to get rid of later, while it is easy to ‘upgrade’ it later on when the pandemic is over, for example by weaponising it. The tech infrastructure to fight the pandemic today might be the infrastructure of war and manipulation tomorrow.
Technology is crucial to get out of this global health crisis, but it is just as crucial to ensure it serves public interests and public health. Currently the most extreme measures are legitimised with the argument of saving lives. At the same time, more conventional and less controversial ways to fight the virus are not properly discussed and considered in societal debates and public policy.
To summarize: the two concerns I have about Pfizer vaccine BNT162b2 are: 1) the science done on it is proper but also one-sided in terms of disciplinarity and methodology: it incorrectly assumes the vaccine to be an ‘intermediary’ instead of a ‘mediator’, not accounting for the many uncertainties around the vaccine, and 2) the science is pushed by dubious and corrupt private interests, undermining the public trust necessary for the embracement of experimental technology and opening the door for a 'shock doctrine' that will push a dystopian technological agenda.
I am not saying that everyone who will take the mRNA vaccine will drop dead. Of course not. There might be big chunks of the population for whom it will work just fine. I only say that there will be unforeseen effects, and as of yet we have no idea who will be affected and how.
The mRNA vaccine is only one example of a broader problem. The speed with which major decisions about tech implementations are currently being made is way too high, sacrificing transparency, democracy and safety. Basic ethics are under threat. We need technology, yes, but only if it serves the people and not the corrupt imperialist, capitalist and patriarchal status quo.
This is why we need a critical assessment of the technological revolution around Covid, not only from an anticapitalist perspective, but also from a feminist perspective, an antiracist/anticolonial perspective and a general human rights perspective.
We desperately need critical debate, but we are not having it. I miss a serious and critical debate in our political institutions and media outlets. But also academia and my own field of Science and Technology Studies is way too silent. We know the importance of the democratization of technology. We should be way more critical of the current tech revolution and the science and politics that boost it.
When it comes to the vaccine, I would recommend not to take any mRNA vaccine before further testing has been done that conceptualizes the vaccine as an actor in the complex interconnected risk society. Such research can only be done satisfactory on the longer term, protecting public interests and basic ethics, and using modern scientific techniques like transdisciplinarity, interdisciplinarity, and triangulation. In other words, the research process around the experimental mRNA vaccine should be slowed down to protect proper science.
I know this is depressing, but there are also upsides:
- Oxford/AstraZeneca produced a vaccine without experimental technology and shielded the process of knowledge production from private interests. AstraZeneca signed a no profit pledge, although with a time limit. Although the vaccine is still produced by 'fast science', its underlying technology is a lot less experimental and therefore a lot less risky to take.
- Better medications against Covid are currently being produced as we understand the virus better, using technologies that are often a lot less experimental and controversial than the mRNA tech. A regular and conventional vaccine without mRNA tech developed by Leuven University is to be expected in 2022.
- We have still not explored many relatively innocent and conventional ways to fight a pandemic properly, such as the vast knowledge available about the power of supplements in staying healthy and/or prevent serious illness. The same can be said about diet, lifestyle and alternative medicine. That means that there is lots of room for improvement in our pandemic response, even without new tech.
There is no reason whatsoever to be pressured now into a rushed, dubious and experimental mRNA vaccination scheme that will make a small and corrupt group of Big Pharma CEO’s and investors even richer and more powerful than they already are. You can be an educated, responsible and scientific person and still refuse the mRNA vaccine without any shame or guilt.
- Beck, Ulrich (1992). Risk Society. Towards a New Modernity. Munich: SAGE Publications Ltd.
- Klein, Naomi (2007). The Shock Doctrine: The rise of disaster capitalism. Metropolitan Books/Henry Holt and Company.
- Latour, Bruno (2005). Reassembling the Social — An Introduction to Actor-Network-Theory. Oxford: Oxford University Press.
- Stengers, Isabelle (2018). Another science is possible: A manifesto for slow science. Cambridge: Polity Press.
- Tromp, Coyan (2018). Wicked Philosophy. Philosophy of Science and Vision Development for Complex Problems. Amsterdam: Amsterdam University Press.