Your newborn is not Hepatitis B vaccinated because of wokeness

Being reflexively anti-system is bad

Edit: Someone pointed out that I might be misrepresenting universal Hep B vaccination critics, and that what Inez meant was not to say this is happening due to wokeness. Firstly, I want to acknowledge the word “wokeness” as such was never used in these arguments by the critics of universal vaccination. However, I do not think something needs to be explicitly named in order for it to be referred to.

I begun with Yarvin, whose arguments I think she and many others in these circles are reproducing and I am using context and common sense to integrate this within the broader context of current cultural discourse. I might be wrong though, so readers can judge for themselves. The tweets are all linked and/or screenshotted, so if I am wrong about my interpretation, then let those reading this judge me for it.

I think the evidence is: 1. the argument that universal vaccination is happening due to“Heaven forbid we do not come across as JUDGEMENTAL by acknowledging some life choices have consequences”: this is a typical problem attributed to wokeness, where people do not want to admit that certain trade-offs/life choices are bad and which is often true, but I do not think it applies here. Republicans, who are not known for being non-judgmental of prostitution of degeneracy used to very much be in support of universal vaccination. 2. Her subsequent quote tweet of me in which she adds “Sorry that offends you”, suggesting the only reason why I might be pro-vaccination is because I am a snowflake. 3. Her focus on the supposed desire to protect “degeneracy” by public health officials as a primary motivator (also in this tweet). 4. Yarvin saying in a now deleted tweet that the only reason this exists is because we do not want to do some form of racial screening.

“I am a great negative. I protest. I have the right to say that I do not accept anything.”

(Kirillov - The Possessed)

In Dostoyevsky’s The Possessed, a group of young radicals embrace destruction as an end in itself: “We shall burn everything, we shall destroy everything, we shall let the cry resound: From the ashes we shall build!” But there is no building that follows, only smoke and ruin. In a recent debate with Curtis Yarvin, I argued that his ideology has seeded the same type of nihilism: destroying The Cathedral is not enough. Among rising rates of mental health issues in the youth and a general sense of ennui and lack of purpose that I can sense in my generation, a constructive path forward that avoids devolving into Third Worldism must be carved: a reinvigoration of classical liberalism, I hope.

My points were perfectly illustrated yesterday, when I found out from some of the luminaries of our age that widespread newborn vaccination against Hepatitis B happens because of wokeness. That sounded weird to me, since as a Romanian newborn, I was also vaccinated against Hepatitis B, regardless of my mom’s Hepatitis B status. The policy had been in place since 1995, at a time when Romania was definitely not “woke” (homosexuality, for example, was still illegal up until 2001 in Romania). Could there be another explanation for this state of affairs other than a refusal from health agencies to construct a “whoreness/degeneracy score” and apply it to women before vaccinating their newborns? Or, as Curtis Yarvin put it in a now deleted tweet, a refusal to do some sort of racial screening of mothers?

This situation shows how the illiberal right tends to be innately reactive to whatever happens, as opposed to constructive. They have no agency, they are merely victims (so Nietzschean!): if the “wokes” do something, then the normal response is to become super anti that thing and produce nothing of value instead. Irrationality is defended, as those trapped in a permanent Victim state cannot be expected to use their mental faculties to judge situations on a case by case basis. Vaccination is also a particularly interesting issue because it’s in some ways a crowning achievement of the Enlightenment’s emphasis on science, rationality, and the application of knowledge to improve human welfare. I guess those advocating for a RETVRN to pre-liberal values really mean it and strongly so.

When Edward Jenner introduced the first smallpox vaccine in 1796, he faced widespread resistance. His method involved inoculating people with material from cowpox lesions, and detractors spread rumours that those who received the vaccine would literally turn into cows or grow bovine features. The reluctance to get vaccinated from people of the day is caricatured in drawings like the one below.

Now, getting to the actual debate: we do know that in many other European countries testing for Hepatitis B of the mother is done before vaccinating newborns. However, this does not require any form of racial or “whoreness” screening: you just test every mother and then only vaccinate the babies of those who test positive. There is little connection to wokeness in this approach. But one might still wonder why in the United States all infants are vaccinated.

Having studied medical regulation and written about it, my bet was on some sort of random idiosyncrasy in the system. Medical regulations and systems are often slow and contradictory, not because of woke conspiracies, but rather because bureaucratic processes tend to accrete inconsistencies over time. This is actually a big problem for biotech, especially when it comes to regulatory inconsistency/opacity, which can cause hundreds of millions of dollars lost in revenue, for example if a drug approval is delayed due to manufacturing issues.

I have written about potential fixes to these inconsistency issues (for example, in my piece on how to efficaciously achieve FDA transparency). I wish people spent as much time digging out inconsistent FDA regulations/criteria (you can start with this white paper here) that make the approval of new therapies slow and onerous, as they spend spotting supposed ideological plots in the vaccination system. Oh, how I wish armies of people dedicated themselves to analyzing these much more important inconsistencies to own the libs! But this would, again, require some Nietzchean vitalism from those most obsessed with Nietzsche, some actual desire to constructively and positively impact the healthcare system.

Some tweets from yesterday

I also reasoned that there is probably no way of really knowing what the ideal schedule for vaccinating against Hepatitis B is and since the system works as it is we might just as well stick to it. But in this case, it turns out there are actually potentially good reasons why universal vaccination for hepatitis B happens.

The core issue is that perinatal hepatitis B infection is uniquely dangerous: up to 90% of infected newborns go on to get chronic infection, which carries high lifetime risks of cirrhosis, liver failure, and hepatocellular carcinoma. Preventing that single moment of transmission at birth can avert decades of downstream suffering and cost. So not vaccinating has a very high potential downside risk and pretty surely no upside potential.

The United States initially tried risk-based approaches, but experience showed that relying on maternal testing and selective prophylaxis left too many babies unprotected. In 1991, the Advisory Committee on Immunization Practices (ACIP) issued its first recommendation for universal hepatitis B vaccination of all infants. In 2005, ACIP went further, recommending that every medically stable newborn receive a hepatitis B vaccine dose within 24 hours of birth, regardless of maternal status. Basically, it was concluded that it was just easier to recommend universal vaccination for everyone. That this is not the result of some refusal to condemn “degeneracy” is clearly showcased by the fact that the 1991 recommendations were supported by both parties with George W Bush Sr for example being very pro-immunization. I am pretty sure Republicans are not a party that has historically been afraid to judge “degeneracy”; on the other hand, pretty much everyone whom I consider a decent human being would agree that it’s better for children to not get liver cancer, regardless of what their parents did. Senator Bill Cassidy himself, a Republican and liver doctor, and someone who has taken socially conservative stances throughout his career, finally declared himself against this entire anti-vaxx non-sense:

This safety-net logic is especially important in the fragmented American health system. Prenatal care, hospital delivery, pediatrics, and public health reporting are often handled by entirely different providers, with no single national electronic health record or centralized tracking system. A woman might be screened for hepatitis B in one clinic, deliver at a different hospital, and bring her newborn to yet another pediatrician. Each handoff is an opportunity for data to be lost or delayed. In countries with unified national health services, selective strategies can sometimes work more reliably. But even in such countries, this is not entirely efficacious: in 2020, among the 25 EU countries with universal antenatal screening policies, only 77% had achieved ≥90% coverage among pregnant women.

Some argue you could simply test mothers right before birth and only vaccinate the babies who need it. In fact, in the U.S. this is recommended if a mother’s hepatitis B status is unknown at delivery: hospitals can run “STAT” tests with results in a few hours. But in practice, this doesn’t fully solve the problem. Testing at the moment of labor is vulnerable to delays in turnaround time, limited lab availability in smaller hospitals or rural clinics, and false negatives if a mother has only recently been infected. Birth itself is also a chaotic, high-pressure moment, where adding another test-result-communication-action chain increases the chance of error. There is also the chance of false negatives. And if results come back too late, you miss the critical 12-hour window in the vaccine is maximally effective.

That is why countries from Romania to the United States adopted a universal birth-dose strategy. It acts as a safety net: every newborn is protected immediately, regardless of maternal records or testing logistics. Now, I am not entirely sure if this is the platonic ideal of a vaccination strategy, but it works pretty damn well and in any case, it does not happen due to wokeness.

Ok but what if I deliberately want to get a whoreness score assigned to every woman at birth?

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“What is your body count?” — asks the doctor attending to your birth, looming over you. You are stressed, in pain, and can barely think: but this is an important part of defeating wokeness via “whoreness score” pre-screening for Hepatitis B. Now, some might really, really want to embed incel internet discourse into medical practice and instantiate such a reality (would they get the whoreness score qualified as a biomarker under the Biomarker Qualification Program?)

Fine. But even then, I want to explain to these people that this might be bad for THEM, since uncontained Hepatitis B can be bad in the long-run for everyone, not just high-risk populations.

While hepatitis B infections may be concentrated in certain high-risk populations NOW (or those high in degeneracy score), due to widespread vaccination, the virus may NOT stay confined to those groups in the long run. In the end, hepatitis B, given its high rate of infectiousness, might not be something that can be kept neatly contained within a few groups we label as “high risk” if it becomes prevalent enough in the “high risk” groups. And if your “high risk” population is large enough, which in the U.S. it might very well be, it might become an actual widespread problem. Viruses don’t respect categories. They move in quiet, ordinary ways: through families, through partners, through the accidents and medical encounters that touch all of our lives.

A Chinese follower of mine, Dr Dale Wren, summarized this well in a tweet copied below. She also provided some links to papers showing how easily transmissible (via saliva in toddlers in daycare) hepatitis B can be:

And she is totally wrong scientifically. Hepatitis B is highly highly transmissible, at least before the vaccine. In 1980s, about 10% of Chinese were carriers. Even though drug use and prostitution were almost unexistent under the communists. My father died from Hepatitis B at age 53. He got it by eating with my uncle, a known patient. When he got diagnosed, my whole family got tested and everyone of us tested positive for antibodies. Meaning we all got exposed but fortunately our immune system fought it off successfully . But my father was not so lucky. There are also academic papers showing toddlers transmit hepatitis B to each other, by sharing saliva. It is the vaccine that changed the tragic situation in China. Today only 3 % Chinese are carriers, despite the fact there are much more drug use and prostitution in China today than in 1980s. Hepatitis B is only transmissable through sex and drug use is a lie pushed by patient activists, because they don't want to be discriminated. Fortunately it has largely become true because most people are vaccinated. If most people are no longer vaccinated, it will no longer be true, as the case in 1980s China.