EASA2016: Anthropological legacies and human futures

(P087)
The politics of vaccination: affect, rationality and power
Location U6-1D
Date and Start Time 23 July, 2016 at 09:00
Sessions 2

Convenors

  • Bernhard Hadolt (University of Vienna) email
  • Andrea Stockl (University of East Anglia) email

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Short Abstract

The panel analyses the entanglement of affect, claims of rationality and power as emergent in vaccination regimes. It does so along three strands of issues: the politics of the gap between emotion and rationality, the interplay of biopolitics and geopolitics in global health, and the self and other.

Long Abstract

Ever since the discovery of immunity and vaccines, the implementation of vaccination programmes has been a powerful tool for controlling the health of populations and by thus populations themselves. Vaccination certainly has improved the health status of many, but also has been met with tremendous criticisms concerning side effects, questionable efficacy and hidden agendas of health authorities. Heated public debates were often framed in terms of rationality and emotionality. Ethnographic research on the politics of vaccination has shown that there are at least three strands of anthropological issues that need to be taken into account in order to better understand the entanglement of affect, claims of rationality and power as emergent in vaccination regimes:

• the politics of the gap between emotion and rationality: Why should decision making about health care be solely be based on rational appraisals and free from emotion and affect? Why is there such a strong ideology about leaving out affect in decision making?

• the interplay of biopolitics and geopolitics in global health: How are vaccination regimes shaped by geopolitical forces? Why is vaccination seen as intrusive, why is it taken as a battle field against new and old forms of colonialism?

• The self and other: To what extent has vaccination become a site for debates about care of the self and responsibility towards others and society?

We particularly invite proposals that address questions such as the above on the basis of empirical case studies.

This panel is closed to new paper proposals.

Papers

Politics of the gap: vaccine development in the time of Ebola

Author: Anita Schroven (Max Planck Institute for Social Anthropology)  email

Short Abstract

The negotiations of standard operating procedures (SOP) in the context of vaccine trials conducted during the recent Ebola outbreak, took place between WHO, governments, researchers and clinical staff. Consent and participation posed a challenge, as SOPs and epidemiological needs were not congruent.

Long Abstract

Clinical trials are governed by rational and standard operating procedures (SOPs) to ensure correct procedure, scientific validity - and govern emotional implications of risks and hopes. Powerful hierarchies in personnel and institutions exist to ensure SOPs' application into the routine practices of trials, separating clinicians' and researchers' charges.

This paper examines the negotiations of SOPs in the context of vaccine trials developed and executed during the 2014-15 outbreak of Ebola Virus Disease (EVD). International and national research and clinical staff's debates of "humanitarian use" or epidemiological necessities of trial substances during the heights of the different outbreaks are at the centre of the paper. Questions of limitations of SOPs arose due to an overall perception of "crisis", a highly emotional state that allowed for arguments of exceptionality, necessity and compromise as opposed to the routine rational of clinical trials that these professionals are otherwise signatory to. Informed consent protocols were not easily harmonised with national epidemiological measures, for example in ring trials, resulting in compromising SOPs through harsh security measures.

Making of vaccination in Pakistan, especially in the Sindh province: The politics, evidences and strategies of success!!

Author: Inayat Ali (University of Vienna - Austria)  email

Short Abstract

Pakistan being a signatory of the UN launched the EPI in 1978 to protect the children against the seven infectious diseases. This immunization has seen different types of negotiations and logics by various local to global stakeholders, which this paper will address in a detail.

Long Abstract

Although, Pakistan launched the EPI programme in 1978 against the seven infectious diseases, but as yet it is confronting with a few such as the polio and the measles.

This research paper, therefore, will come up with the making of vaccination programme in the Pakistan, especially in the Sindh Province. It would deal with the various negotiation processes, which take place at various levels. It will highlight the politics and the rationalization involved in this whole process by various stakeholders at the local and the global level in order to make this project successful or unsuccessful. It will address the questions regarding the creating the evidences to justify the vaccine, or to refuse it while considering it as a 'western plot' or something with a specific 'agenda'.

Moreover, this paper will present the stories from my PhD research work on the measles and the available secondary material on the vaccination, specifically which has been emerged regarding the polio and the measles. This data will present the standpoint of the stakeholders involved, and address the ongoing interplay between the bio-politics and the geo-politics.

Citizenship and public acceptability in routine vaccination

Authors: Jean-Yves Durand (CRIA-UMinho)  email

Short Abstract

Distrust towards vaccination is not restricted to specific cultural scenes and bounded systems of ideas. Its analysis must also reach beyond the frame of health and risk management and be articulated with that of different forms of dissent that are expressed in other areas of social life.

Long Abstract

Far from being residual anachronisms, certain contemporary phenomena of distrust or dissent towards vaccination - whether in the form of objection, active resistance, or circumspection - are part of emergent forms of assertive citizenship that are now also arising in the field of health and affect the way people deal with biomedical institutions.

Scrutinizing the type of attitudes they reveal and the decision processes that shape them helps in avoiding the hasty misconception that restrict them to alternative niches defined by specific cultural scenes and internally coherent philosophies or lifestyles. Fending off this error further requires a thorough examination of the basis for vaccine acceptance and consensus. An ethnographic research in different Portuguese contexts (Cunha & Durand 2013), set against the comparative backdrop of various countries, stresses the necessity of such a perspective, guided by a notion of "acceptance" that simultaneously encompasses consent and dissent, for a penetrative look at the biocommunicability (Briggs) and behaviors related to vaccination.

In fact, their analysis needs to reach beyond the frame defined by health and risk management. Patterns of production of dissent that are similar to the ones arising around vaccination can be observed in other domains of social life. Their political implications shed light on specific forms of citizenship that value critical stances as responsible social involvement.

CUNHA Manuela Ivone; DURAND Jean-Yves: 2013, Anti-bodies. The production of dissent", Ethnologia Europaea, 43 (2).

Biopolitical entanglements of vaccines in La La Land: Disney to SB 277.

Author: Melissa Medich (University California Los Angeles)  email

Short Abstract

This paper examines the 2015 measles outbreak in Los Angeles. It explores the entanglement of affect and rationality in mandatory vaccination as produced in television, social media and public policy.

Long Abstract

In April 2015 California public health officials declared the end of the measles outbreak that sickened 150 people and was linked to one visitor to Disneyland in December 2014. However, the outbreak also ignited a political push for mandatory immunization in the State of California that met with a contentious pull back by middle class communities in affluent areas of Los Angeles County. Governor Jerry Brown signed the SB 277 in July 2015; one of the nation's strictest mandatory vaccination bills. It revoked parents' ability to cite religious or personal beliefs in seeking exemptions.

This paper analyses the public debate over mandatory vaccination as it was produced and performed in television, the media, and social media settings. It examines the entanglements of affect and rationality in the specific vaccine regime of the State of California and Los Angeles County. It discusses pro- and anti-vaxer arguments of liberty and morality as they position themselves against each other in verbally aggressive campaigns via social media and popular television programs. Their arguments are grounded in their notions of moral and ethical debates over autonomy, liberty and power.

The politics of responsibility: problematizing vaccination in Austrian public health discourse

Author: Bernhard Hadolt (University of Vienna)  email

Short Abstract

I examine the ways of how the appeal to one’s responsibility for ‘innocent’ others was used for mobilising feelings of duty, victimhood and deservingness in Austrian public discourses on vaccination. I argue that the reference to responsibility can be understood as a ‘technique of problematisation’.

Long Abstract

The use of immunization programmes is a key area in the standard repertoire of interventions that states (and increasingly so supranational agencies and humanitarian NGOs) resort to with the aim of averting individual suffering and improving the health status of their populations. In spite of the remarkable success of vaccination programmes in the past, the so called 'vaccination gap', the gap of people who are not or are not fully vaccinated, in most industrialised countries is on a dramatic rise; this is in particular the case among members of the well-educated, middle class. The corresponding growing concern of many public health authorities and vaccination experts fuelled recent public debates about sense and senselessness of vaccination programmes.

Based on empirical material from media accounts, webpages and interviews with policy makers, experts in the field, and lay people, this presentation examines the lines of arguments and discursive devices that surfaced in the recent public health discourse on vaccination in Austria. In particular, I look at the ways of how the appeal to one's responsibility for 'innocent' others was used for mobilising feelings of duty, victimhood and deservingness. I argue that the reference to (personal) responsibility is a 'technique of problematisation' by which certain spheres of activity are structured and normatively charged in particular ways.

From consecrating the self to an imagery of the kill: the anthropology of smallpox vaccination

Author: Harish Naraindas (Jawaharlal Nehru University)  email

Short Abstract

This paper suggests that smallpox eradication may be seen as a charismatic adventure, thus making affect a central impetus of its success. But this affect is to be located in the state and its bureucracy rather than locating it only in recalcitrant patients in the face of state imposed vaccination.

Long Abstract

This paper suggests that smallpox eradication may be seen as a charismatic adventure, thus making affect a central impetus of its 'success'. But this affect is to be located in the state and its bureucracy, rather than in recalcitrant patients in the face of state imposed vaccination. It will argue that while recalcitrant patients may have resisted vaccination for perfectly rational reasons, the state, through an imposed language of crisis and emergency, with the leitmotif of a charismatic adventure of virtuosos and of a radically restructured health bureaucracy, transmuted smallpox in India from a deity to a demon. Captured well through the concept of triage, it made for a singularity of intent and an imagery of the kill. The language of crisis and charisma, and the accompanying rhetoric of disgrace, goading everyone to rise from a state of fall, allowed the state to see itself as being privy to an act of ritual purging for which any price was worth paying. In the bargain, the state and global institutions like the WHO not only renewed their contract but were also consecrated. This leaves us with two models of consecration in the passage from the eighteenth to the twentieth century. If the eighteenth-century was marked by an individualised ethic of consecrating the self, as a strategy to both solicit and purge in an attempt to mitigate the disease, the twentieth century imagery locates the object to be transformed in the other: an other which is merely a detour to the virus.

Preventing their ills: an ethnographic study on vaccination in a multi-ethnic context

Author: Mohammed Tabishat (American University in Cairo)  email

Short Abstract

Ethnographic study, subjective views on vaccination by parents of diverse ethnic backgrounds. Focus is on the notion of disorder as both a physical and socio-political category within post-colonial contexts and globalized systems of hegemonic meanings.

Long Abstract

This paper is an ethnographic study based on fieldwork in an international school in Cairo. It is concerned with issues of subjectivity and vaccination within contexts of globalized discourses of health care. The data consist of observations, participation and detailed narratives collected in open-ended interviews with mothers and fathers of the pupils who come diverse national/ethnic/religious backgrounds. The ethnographic questions focus on how different subjects live with the idea and practice of vaccination. The aim is to examine how the respondents describe vaccination in terms that escape the divide between the rational and emotional. I aim at exploring the various ways these subjects speak, feel and remember the time when they received vaccination. Meanwhile, I focus on their feelings and thoughts regarding the immunization of their own children. Next, this study situates these descriptions within supposedly globalized/universalized discourses of working for the good of the people by "preventing their ills." Then it examines the results in terms of four theoretical claims suggested by Byron Good for the study of the relationship between subjectivity, the post-colonial and the notion of disorder. Finally, it raises methodological questions regarding the significance of conventional ethnographic data as opposed to issues that are "unspeakable" or "unspoken."

This panel is closed to new paper proposals.