Do we want people to take those vaccines?

THURSDAY, DECEMBER 17, 2020

The Post doesn't seem real sure: Covid vaccines have begun to arrive. As they do, the daily death rate across the nation continues to go up.

(Current 7-day average, nationwide: 2,561 Covid deaths per day, according to the Washington Post's numbers.)

Covid vaccines have begun to arrive. Do we want people to take those vaccines?

Reading the Post, it isn't real clear! Once again, we get the sick feeling that we may love our storylines more.

Last week, we thought Michele Norris favored storyline over good, sound advice in the column which bore this headline:

Black people are justifiably wary of a vaccine

Is there any reason why black people should be wary of these vaccines? Norris doesn't seem to think so. But to our ear, she favored current popular storyline over good sound advice.

This morning, it happened again. In print editions, page 1 of the Post's Style section is dominated by Monica Hesse's latest effort. Beneath a giant visual of a plainly worried women, Hesse's headline says this:

Why the vaccine worries women

People, there they go again! Should anyone line up for these vaccines? The Post doesn't seem real sure.

Over here in our failing town, we currently love to stage parades of horribles concerning matters of gender and race. We seem to love these storylines more than we love life itself.

Yesterday, we made a confession. We admitted that we've been thinking about Norris' column ever since it appeared in print last Thursday morning.

Norris recited a parade of horribles, purportedly explaining why black people are "justifiably wary" of these new, life-saving vaccines. 

Some of her collection of (treasured) horribles dated to the early to mid-1800s. Inexcusably, she also offered this wild misstatement about These White Med Students Today:

NORRIS (12/10/20): We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result.

That highlighted statement is horribly wrong. It's depressing to see how many denizens of Our Town were involved in its construction.

For starters, Norris never should have written that fairly obvious groaner. When we checked her link, her obvious error was clear.

Beyond that, her editors should have caught her (inexcusable) error before they put it in print. (In fairness, it promotes storyline.)

That said, Norris' error derives from an extremely slippery report by Professor Sabin about a rather slippery study. The editors who published the original study were also at fault.

We've come to love our tribal stories so much that we're willing to believe whatever claim we think we've read as long as it serves storyline. It's depressing to see this kind of thing transpiring in the streets of Our Town. That's why we've been avoiding a fuller report on the forensics of this gruesome groaner.

Tomorrow, we'll start to unpack that groaner's many strands. In the meantime, what do we in Our Town love more? 

Do we love our storylines more? Or do we love life itself? 

Also this: Should suburbanites fear the vaccines too? Will the Washington Post go there next?


25 comments:

  1. “Do we want people to take those vaccines?”

    Yes, although there are people who object to vaccines in general and exemptions have always been allowed.

    Somerby’s argument makes no sense.

    Reporting on the fact that blacks or women may be more reluctant to get the vaccine and exploring why that is the case isn’t an argument against the vaccine. It is reporting on a fact.

    If a high percentage of blacks are reluctant to get vaccinated, that is a problem, and it is newsworthy. But the report about this doesn’t cause people to be reluctant; the reluctance preceded the news report.

    Does Somerby want the newspaper to propagandize for the vaccine? That’s what it sounds like.

    Also, it may surprise Somerby to know that not everyone lives their life with their head up the Washington Post’s ass.

    ReplyDelete
  2. If you do not acknowledge the problems that blacks and women have had previously in medical treatment, you will not gain sufficient trust to encourage them to take this vaccine.

    Somerby is old enough to remember thalidomide. It produced serious birth defects, including missing limbs in babies. The drug itself was prescribed to pregnant women to reduce morning sickness. The women who took the drug (mostly while in Europe) would never have sacrificed the health of their children for a few months less nausea. Further, the time during which deformities are most likely to occur are also those during which a woman may not yet realize she is pregnant.

    The rush to produce the vaccine does not inspire confidence in groups who have typically not been included in the test cohorts. That is why the federal government now requires women to be test subjects for new drugs aimed at the general public.

    In this situation, blacks and women may wish to wait and see what happens to those who take the vaccine. Or they may believe that the virus itself may be less dangerous than an unproven vaccine. There are arguments against such an approach, but you must first acknowledge what has happened in the past, or no one will believe the assurances of safety. This is especially true given the way Trump has politicized the CDC. Someone who cannot acknowledge past wrongs will seem unlikely to have anticipated problems sufficiently to protect marginalized groups.

    ReplyDelete
  3. I was not permitted to list the pain research published in scientific journals showing that blacks are undertreated for pain, not in the past, but in the near present (1990s & 2000's) until standards for pain assessment were changed. They come from the lit review I did for my own funded half-million NSF grant in which I studied pain expression among four ethnic groups, including black subjects. We found no physiological differences in pain experience or tolerance, but considerable differences in expressivity, consistent with the literature on emotional expression among black people compared to other ethnicities (white, Asian, Hispanic). Because of negative stereotypes that exist in our culture, doctors are more likely to think that pain expression is being faked as part of medication seeking. So they undertreat them (refuse pain meds or offer lower doses or inappropriate meds, less than the standard of care, especially if the patient complains about pain). This happens regardless of medical context (dental pain, cancer pain, broken limbs and other emergency injuries).

    Somerby doesn't know this because he doesn't care to know it. He also doesn't know about the difficulties women have with their doctors when seeking relief from pain syndromes such as fibromyalgia. Doctors are too ready to consider a woman who complains of pain as having psychosomatic or psychiatric problems, in other words, they think women are faking it too. They do not similarly undertreat male patients, even when they too have a likelihood of being medication seeking and abusing opioids.

    But Somerby dismisses these documented, well-studied problems with medical treatment as PC hooey. And that reflects his bigotry. So Somerby is the last person who should be writing today about covid vaccine and patient reluctance. He is not qualified because he doesn't know anything about the subject.

    And he owes Michele Norris and Monica Hesse an apology.

    ReplyDelete
    Replies
    1. The difference between women's and men's symptoms and the tendency of doctors to dismiss women's pain are two of the main reasons why heart attacks are overlooked in emergency rooms and women die more often than men of heart attacks.

      Delete
  4. Somerby seems to dismiss legitimate disparities as "storyline". What an asshole.

    ReplyDelete
  5. If we want people to take the vaccine, just tell them that it will make them taller, wealthier, smarter and more beautiful (or handsome). What difference does a lie or two make?

    ReplyDelete
  6. I am thinking that maybe I will be able to provide those references if I break them up into smaller groups:

    Barak, E. & Weisenberg, M. (1988). Anxiety and attitudes toward pain as a function of ethnic grouping and socioeconomic status. Clinical Journal of Pain, 3, 189-196.

    Bonham, V.L. (2001). Race, ethnicity, and pain treatment: Striving to understand the causes and solutions to the disparities in pain treatment. Journal of Law and Medical Ethics, 29, 52-68.

    Breitbart, W., McDonald, M.V., Rosenfeld, B., Passik, S.D., Hewitt, D., Thaler, H. & Portenoy, R.K. (1996). Pain in ambulatory AIDS patients. I: Pain characteristics and medical correlates. Pain, 68, 315-321.

    Brena, S.F., Sanders, S.H. & Motoyama, H. (1990). American and Japanese chronic low back pain patients: Cross-cultural similarities and differences. Clinical Journal of Pain, 6, 118-124.

    ReplyDelete
  7. Here is the second bunch:

    Cleeland, C.S., Gonin, R., Baez, L., Loehrer, P., Pandya, K. (1997). Pain and treatment of pain in minority patients with cancer: The Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Annals of Internal Medicine, 127, 813-816.

    Cleeland, C.S., Gonin, R., Hatfield, A.K., Edmonson, J.H., Blum, R.H., Stewart, J.A., & Pandya, K.J. (1994). Pain and its treatment in outpatients with metastatic cancer. New England Journal of Medicine, 330, 592-596.

    Edwards, R.R. & Fillingim, R.B. (1999). Ethnic differences in thermal pain responses. Psychosomatic Medicine, 61, 346-354.

    Faucett, J., Gordon, N. & Levine, J. (1994). Differences in postoperative pain severity among four ethnic groups. Journal of Pain Symptom Management, 9, 383-389.

    Hoffman, D.E. & Tarzian, A.J. (2001). The girl who cried pain: A bias against women in the treatment of pain. Journal of Law & Medical Ethics, 29, 13-27.

    ReplyDelete
  8. Here is the third bunch:

    Lipton, J.A. & Marbach, J.J. (1984). Ethnicity and the pain experience. Social Science & Medicine, 19, 1279-1298.

    McCracken, L., Matthews, A., Tang, T. & Cuba, S. (2001). A comparison of blacks and whites seeking treatment for chronic pain. The Clinical Journal of Pain, 17, 249-255.

    McDonald, D. (1994). Gender and ethnic stereotyping and analgesic administration. Research in Nursing & Health, 17, 5-49.

    Pletcher, M.J., Kertesz, S.G., Kohn, M.A. & Gonzales, R. (2008). Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA, 299,70-78.

    Sheffield, D., Biles, P.L., Orom, H. Maixner, W., & Sheps, D.S. (2000). Race and sex differences in cutaneous pain perception. Psychosomatic Medicine, 62, 517-523.

    ReplyDelete
  9. Final bunch:

    Sternbach, R.A. & Tursky, B. (1965). Ethnic differences among housewives in psychophysiological and skin potential responses to electric shock. Psychophysiology, 1, 241-246.

    Todd, K.H., Deaton, C, D’Adamo, A, & Goe, L. (2000). Ethnicity and analgesic practice. Annals of Emergency Medicine, 35, 11-16.

    Todd, K.H., Samaroo, N., & Hoffman, J.R. (1993). Ethnicity as a risk factor for inadequate emergency department analgesia. Journal of the American Medical Association, 296, 1537-1539.

    Tursky, B. & Sternbach, R.A. (1967). Further physiological correlates of ethnic differences in responses to shock. Psychophysiology, 4, 67-74.

    Weisenberg, M., Kreindler, M.L., Schacht, R., Werboff, J. (1975). Pain, anxiety and attitudes in black, white, and Puerto Rican patients. Psychosomatic Medicine, 37, 123-135.

    Weisse, C., Sorum, P. & Dominguez, R. (2003). The influence of gender and race on physician’s pain management decisions. The Journal of Pain, 4, 505-510.

    My study was done in 2006-2008, so there are likely to be more recent cites but none of these is from the 1800s.

    ReplyDelete
    Replies
    1. Those links don't show that blacks are under treated for pain though. The last one says "These findings challenge a fairly extensive literature suggesting that physicians treat women and minorities less aggressively for their pain."

      That is not a list of studies that show blacks are under treated for pain. Many of them don't directly address it at all and some, as I have proven, directly refute that claim. You are either lying or stupid or both. You're an asshole.

      Delete
    2. Back at you...about the lying or stupid part.

      You cannot have actually read these links (especially not in the time since I posted this list) and come away with that understanding. Sounds like you skimmed the titles and at most, read a few abstracts.

      First, this was a judgment study using medical vignettes to compare recommended prescriptions for pain, not a chart study of what physicians actually did. No physicians were actually interacting with any patients in this study. Thus expressivity would not be a factor, nor would practical concerns about dispensing pain medications (such as "is this patient faking").

      Second, physicians are now receiving different training and the percentage of recently trained physicians in a study makes a difference in pain treatment practices.

      Third, there were several differences based on gender and race, as noted in the abstract. The results for renal colic show an interaction that would cancel out a main effect (that's why it is mentioned).

      Fourth, notice that these authors say, just as I have, that there is a fairly extensive literature reporting different results than this study does. One study cannot cancel out an entire literature, and this one does not.

      Here is the abstract: "This study set out to examine whether gender or race influences physicians' pain management decisions in a national sample of 712 (414 men, 272 women) practicing physicians. Medical vignettes were used to vary patient gender and race experimentally while holding symptom presentation constant. Treatment decisions were assessed by calculating maximum permitted doses of narcotic analgesic (hydrocodone) prescribed for initial pain treatment and for follow-up care. No overall differences by patient gender or race were found in decisions to treat or in maximum permitted doses. However, for persistent back pain, female physicians prescribed lower doses of hydrocodone, especially to male patients. For renal colic, lower doses were prescribed to black versus white patients when the patient was female, whereas the reverse was true when patients were male. These findings challenge a fairly extensive literature suggesting that physicians treat women and minorities less aggressively for their pain, and results offer further evidence that pain treatment decisions are influenced physician gender."

      I posted everything I cited about pain treatment for minorities. You do not omit a study in a literature review because its findings are not what you wanted.

      The studies I listed that don't address black pain treatment are about women. One of them defines ethnicity as different nationalities, and one includes Puerto Ricans as one of the ethnicities.

      It is a bankrupt tactic to seize on a single study and claim that "that is not a list of studies that show blacks are under treated for pain" when that is what the remaining studies do show.

      Delete
    3. Sorry, you have not provided a list of studies that show blacks are under treated for pain. It is a list that shows maybe they are and in some cases not at all.

      And none of them back up the original claim half of white medical students believe that black patients have a higher tolerance for pain.

      You can't change the facts sweetheart. Sorry! I know you are very neurotic about it.

      Delete
    4. OK, now you have said enough for everyone to see who you are and what you are about.

      Delete
    5. In the words of the immortal PeeWee Herman, "I know you are, but what am I?"

      Delete
    6. The claim about medical students is backed up by the study cited in the article, which Somerby misrepresented and then claimed he would explain, but has yet to do so.

      Furthermore, there is this, the result of a study commissioned by Congress:

      Unequal Treatment
      Confronting Racial and Ethnic Disparities in Health Care

      Delete
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