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Stigma, or The Sneetches and the Vaccine Mandate


 Now the Star-Belly Sneetches Had bellies with stars. The Plain-Belly Sneetches Had none upon thars. 
 Those stars weren't so big. They were really so small. You might think such a thing wouldn't matter at all. 
 (Dr Seuss, 1957)

In Erving Goffman’s 1963 book Stigma: Notes on the Management of a Spoiled Identity, the term stigma is explained. 


“The term stigma, then, will be used to refer to an attribute that is deeply discrediting, but it should be seen that a language of relationships, not attributes, is really needed”

(Goffman, p, 13).


What Goffman means by this is that stigma is not an automatic standard response from one person to another, but one determined by context. There is often an automatic stigma about certain indicators of “difference” in society. For instance, if we meet a person in a wheelchair, we may be tempted to treat them differently than others as an automatic response to their perceived inability to perform things as we do,  but we may not discredit them personally. People with physical disabilities we may underestimate or infantilise, but we will not malign or slander them for merely being disabled.


This post will explore the kind of stigma which tempts us to devalue or discard people through the use of demeaning adjectives about them. This is not just a social problem because it divides one group of society from another, it is problematic because the act of stigma can cause reactive behaviour from the stigmatised. The subtitle notes on a spoiled identity gives us some clue of the impact of stigma, for once your identity is spoiled, your behaviour may soon follow. The notion of Stigma is an important consideration in exploring the use of COVID19 vaccine mandates as a public health tool to encourage vaccination, prevent transmission and build a society which adapts to endemic COVID19. 


HIV/AIDS Sexual Ethics vs Social Cohesion


When HIV/AIDS first appeared it had a lot of stigma attached to it due to misunderstandings about the means of transmission, as well as a pre-existing stigma towards homosexual people, who were deemed responsible for its “creation” and certainly its transmission, in the 1980’s.


Whatever your perspectives about sexual ethics, labelling a widely held social behaviour as “deviant” and associated with “disease” can demean and spoil the identity of the so-called “deviant”. This devaluing of a person does not solve the problem but merely divides the person from wider social groups and causes them to find groups where they are accepted. We may disagree with someone and think their deeply held beliefs are wrong, but this does not mean that we need to discard them. The act of discarding a person merely strengthens their cohesion with an accepting group. 


In contrast, the highly publicised act of Princess Diana hugging a man who was being treated in an AIDS hospice was a powerful counter-narrative to the media and health information distributed at this time. This simple human response was hugely empowering for the socially ostracised group and went a long way towards breaking the stigma towards homosexuality, HIV/AIDS and the prompted better education about risks of transmission and protective protocols. There needs to be education designed to prevent transmission of a deadly disease, but ostracism is not beneficial towards this end and can also obscure important information.


Gossip and Social Cohesion 


Fienberg, Willer and Schultz’s article explored the socially cohesive power of gossip in their 2014 article. If we find a group whom we can demean and speak badly of in our own social circles, it increases our social cohesion. We are not “like them”, and therefore we reinforce this truth through derogatory and dehumanising statements. Although the study was attempting to find the positive benefits of gossip for social cohesion, the cohesion itself was at the expense of the excluded person or persons:


“Social exclusion is an effective means of social and economic punishment. Ostracized individuals cannot reap the benefits of group efforts…” (Feinberg, Willer & Schultz, 2014).


A person who demeans another person to a closed group is confident that they will be supported in labelling the particular people as “other”. To simplify his discourse about stigma, Goffman described anyone who “does not depart from negatively from the particular expectations at issue I shall call the normals” (Goffman, p, 15, 1963). 


If someone doesn’t meet the expectations of society, then they are no longer “normal” they are even, Goffman iterates “less than human” (Goffman, p, 15, 1963). The language we use to strengthen our position as normal and human is derogatory commensurate with their perceived breach of social expectations. During the American election in 2016, Hillary Clinton referred to those who were voting for Trump as “a basket of Deplorables” (Reilly, 2016)  whilst Republican commentators referred to Clinton as “Crooked Hilary” (ABC News, 2016). These are both terms which heighten the difference between each group and dehumanise the subject.


Vaccination and Stigma

The issue of mandatory vaccination against COVID19 is a complicated issue prompted by a number of factors. Although I am pro-vaccine and am fully vaccinated, there are many who are unwilling to be for a number of reasons. As a non-medical doctor, I won’t pretend to explore the mechanisms of vaccination here.  My interest is in understanding the perspectives and the “social facts'' of the situation through a brief ethnography of a slice of social and mainstream media. The social response to the mandate represents to me an opportunity to consider how we could move forward socially and examine the explosion of fear, anger and unrest in Australia. 


COVID19 is a deeply emotive virus and its outbreak has transformed our perceptions about disease. Unlike HIV/AIDS, the transmission of COVID19 is widely known and the risk of being infected is far higher. The protocols for preventing transmission have been particularly stringent in Australia, a country in which many adults remember being in cars without seatbelts as children. The contrast between this less regulated upbringing with the rigid CHO directives we currently live under is striking for this generation. This urgent impetus for protocol is besides the point, however, so now let us consider the language used to describe the virus and the urgency this conveys to society.


The stigma of labels


When the Delta variant was first detected in Australia, a whole new level of urgency was ascribed to coronavirus and its management across formal media channels. The concern about the variant escalated and created division amongst experts about its infectivity, severity and morbidity.

“Highly contagious” (ABC News, 2021, June 17)


“Professor Sutton said the Indian variant of the virus was “an absolute beast” because “it has moved faster than any other strain we’ve dealt with”. (ABC News, 2021, June 1)


Although Sutton’s statement was challenged by James McCaw:

“There is no epidemiological evidence that this virus spreads faster,” he said. “There is no clear reason to think this virus is spreading in different ways. (ABC News, 2021, June 2).


This intensely urgent language used by Sutton created a sense of fear and justified the description of the vaccine hesitant as in some cases, criminal. This is where we begin to see strong language to describe people who for whatever reason, do not wish to become vaccinated. This is not to say that the vaccine hesitant are not also using language that Zizek would argue is a kind of violence, prompted by “the fear of the excessive state” , but let us take some time to explore the terms used to describe people who choose not to vaccinate in the face of mandates (Zizek, 2009).


The “Anti-Vax Movement”

Prior to 2019, the so-called anti-vax movement was mainly composed of groups of people who were unwilling to receive any vaccination, or objected to various ingredients in the vaccinations, preferring alternative treatments. This posed a very small threat to public health due to the relatively small size of these groups and their lack of traction in public debate. Currently the so-called “Anti-vax” movement includes many people who were formally considered “normals” and had received all their usual schedule of shots prior to 2020, alongside the original “anti-vaxers”.


The group itself is extremely diverse, comprised of people who are waiting for a different vaccine that they have specifically researched, people who do not ever intend to be vaccinated for reasons of freedom, and those who object to vaccination in general. Hence, this broad brush of the “Anti-vax movement” is somewhat disingenuous. Also, like any movement, there are many people who have joined the cause to further their own interests, in a group that appears open to their alternate ideas. 


The Conversation article title itself “The anti-vax movement is being radicalized by far-right political extremism” assumes a cohesive movement is being further mobilised and radicalised. Although Chen argues that “A distinction must be drawn between vaccine hesitancy and the current anti-vax movement, as the latter’s agenda has been hijacked by far-right groups”, the headline implies that the entire group is given over to these “extreme” views (Chen, 2021).


Vaccine Mandate “labels” dissenters


The ethical issues of vaccination mandates arise not because there are necessarily any genuine issues with the vaccines currently available in Australia, ( although some groups would contest this) but due to the removal of agency from the citizens expected to comply. A recent interview with Krystal Mitchell, former Acting Senior Sergeant at Victoria Police, showed that this removal of agency is not only labelling police who disagree with mandates as dissenters or “anti CHO”, but has transformed the identity of a police officer in general to one enforcing CHO orders or excluded from the force ​​(Estcourt, 2021, October 9). 


Although Krystal was expected to be “a-political” by her own account in her full interview, she was also expected to enforce a state government’s directives which is in itself inherently political (Wong, 2021 Oct 8 ).  This expectation tests those who find it ethically untenable to enforce Victorian CHO directives. If police refuse to enact these directives, they are effectively diverging from their identity as a police officer into a dissenting person, who opposes the state. This label of dissenter evokes anger, fear and derogatory remarks from “normal”people, against those who were formerly known as “normals”. This kind of labelling justifies violence of language and in more volatile protests, undue force.


Which Sneetches are the best on the beaches?

In conclusion, the division caused by vaccination mandates reinforces the very human, but anti-social habit of moral panic. In Dr Seuss’s children’s fable, the Star Bellied Sneetches, believing themselves elite, are appalled when the plain bellied Sneetches join their ranks, and promptly have theirs removed in a frenzy of social disgust. They are whipped up into a fear of losing their social position by appearing the same as those they believe inferior by a peddler of panic, who becomes rich in the process (Dr Seuss, 1957).


The Sneetch metaphor breaks down in vaccination, as one cannot become unvaccinated, but the sense of moral panic and social disgust towards those who choose not to vaccinate, or those who defend the unvaccinated or dissenters, is a powerful divider in Australian society. No matter which group one is in, the people in the other group are sure to be deviants of lower intelligence, social status, education or moral value.

The saddest part about this moral polarisation in our society is that it is both preventable and repeatable. We find among our kindred spirits the vaccinated, or the unvaccinated, depending on our convictions, and those on the other side our enemies. However, what we are dealing with is a lack of awareness of our own cognitive bias, reactivity and black and white thinking and an inability to empathise with those we disagree with. Our enemies today will be our allies tomorrow during a war with China, or a disaster recovery.  When will we learn to discuss our positions rationally with respect for the inherent value of other human beings, who happen to think differently to us?






References:


ABC News. (2018, March 21). Cambridge Analytica bosses claimed they invented “Crooked Hillary” campaign, won Donald Trump the presidency. https://www.abc.net.au/news/2018-03-21/cambridge-analytica-claimed-it-secured-donald-trump-presidentia/9570690


ABC News. (2021, June 17). What is the Delta variant of COVID-19 that has been detected in both Sydney and Melbourne? https://www.abc.net.au/news/2021-06-17/what-is-the-delta-variant-sydney-covid-outbreak-explained/100223048


Chen, S. (2021, September 19). The anti-vax movement is being radicalized by far-right political extremism. The Conversation. https://theconversation.com/the-anti-vax-movement-is-being-radicalized-by-far-right-political-extremism-166396


​​Estcourt, D. (2021, October 9). ‘Troubled me greatly’: Senior Victoria Police officer quits enforcing CHO directions. The Age. https://www.theage.com.au/national/victoria/senior-victoria-police-officer-quits-over-discomfort-enforcing-cho-directions-20211009-p58yl3.html

Dr Seuss, 1957. The Sneetches and other stories,. HarperCollins Children’s Books, Random House Inc, New York, USA.

Feinberg, M., Willer, R., & Schultz, M. (2014). Gossip and Ostracism Promote Cooperation in Groups: Https://Doi.Org/10.1177/0956797613510184, 25(3), 656–664. https://doi.org/10.1177/0956797613510184

Grand, C. L. L. M. (2021, June 2). Scientists find no evidence strain is fast-moving ‘beast.’ The Sydney Morning Herald. https://www.smh.com.au/national/scientists-find-no-evidence-strain-is-fast-moving-beast-20210602-p57xfk.html


Reilly, K. (2021, April 29). Read Hillary Clinton’s “Basket of Deplorables” Remarks About Donald Trump Supporters. Time. https://time.com/4486502/hillary-clinton-basket-of-deplorables-transcript/


Smethurst, A. P. S. (2021, June 1). Longer lockdown likely as alert raised over positive case who visited NSW. The Sydney Morning Herald. https://www.smh.com.au/national/victoria/longer-lockdown-likely-amid-stranger-to-stranger-transmission-20210601-p57x6a.html


Wong, Matt. (Host) EXCLUSIVE: Ethical Policing in Victoria. (2021, October 8). YouTube. https://www.youtube.com/watch?v=0Kn6AFl5G1c

Zizek, S. (2009). Violence (Big Ideas) (Main ed.). Profile Books.







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