by Venla Oikkonen, Academy Research Fellow (University of Tampere)
In the decades following World War II, vaccines were widely considered a routine method of preventing illness. Childhood vaccinations appeared to have eradicated infectious diseases that had killed and harmed children during the previous decades. However, since the late 1990s, arguments challenging vaccines have gained considerable media presence in many wealthy and technologically advanced societies. While vaccine skeptics and critics have always existed, British doctor Andrew Wakefield’s claims about a connection between the MMR (measles, mumps, rubella) vaccine and autism placed the safety and rationale of childhood immunization programs in the public spotlight with a new intensity. Although Wakefield’s claims have been discredited, the idea of the MMR vaccine – and by association other childhood vaccines – as potentially harmful lives on in cultural debates. Recent epidemics of presumably defeated diseases such as measles, mumps and pertussis (whooping cough) in Europe and North America attest to the critically low vaccination rates in many places in the global north.
A number of social scientists have addressed vaccine hesitancy and refusal. For example, Samantha D. Gottlieb (2016) and Jennifer A. Reich (2016) have recently published nuanced ethnographic analyses of the complexities and ambiguities involved in how parents make decisions about vaccines. In Finland, Johanna Nurmi and Pia Vuolanto are currently leading a project titled Health, Knowledge and Expertise which examines the rationales of vaccine skepticism and complementary and alternative medicine. These projects shed important new light on how individuals make decisions about vaccinations within the social, cultural and historical contexts in which they live.
I have just begun a five-year Academy Research Fellow’s project that approaches recent and ongoing vaccine debates from the viewpoint of cultural studies of science. The project is funded by the Academy of Finland and located in Gender Studies at the University of Tampere. Titled Affect and Biotechnological Change: Three Vaccine Debates in Europe, the project positions vaccine skepticism and acceptance within the larger patterns of biotechnological change. It asks how cultural emotions (“affect” in the project title) structure how biotechnologies such as vaccines become contested, rejected or accepted. Instead of focusing on individuals’ experiences or decisions, the project traces how public debates about vaccines invoke and move emotions in culture and society.
The project approaches vaccines as an intersectional phenomenon, that is, as a phenomenon that takes shape through mutually entangled categories of difference such as gender, sexuality, class, age, and ethnicity. For example, immunization programs often assume that some demographic groups (based, for example, on gender, sexuality, age, or immigration history) are in a particularly high risk of contracting or spreading an infectious disease. The project traces the affective underpinnings of this logic across cultural texts. It approaches vaccines as technologies through which boundaries between nations, continents and communities, or between “risky” and “healthy” groups, are drawn and negotiated. Inspired by feminist science and technology studies, the project conceptualizes vaccines as bodily technologies that involve material processes such as the manipulation of inactivated or attenuated viruses, immunological responses triggered by the vaccine, as well as points of contact and possible contagion between bodies perceived as gendered or racialized.
The project centers on three case studies, which each sheds light on different aspects of affect, intersecting differences and biotechnological change. The case studies approach vaccines through analysis of public and popular texts, ranging from bioscientific articles, institutional reports and vaccination policies to media coverage of vaccines, popular blogs and online discussion forums.
I am currently working on the first case study, which focuses on the link between the 2009 H1N1 (“swine flu”) vaccine Pandemrix and the appearance of narcolepsy among vaccinated children and adolescents in several European countries. I place the case within the larger phenomenon of pandemic preparedness, as well as view it as an event that has shaped public attitudes towards national childhood immunization programs. I explore how cultural emotions surrounding a specific vaccine may change quite dramatically within a few months, and, at the same time, how the 2009 H1N1 virus strain became nevertheless routinized as part of the seasonal influenza vaccine during the following influenza seasons. I ask how culturally circulating emotions around the 2009 H1N1 vaccine emerged through discourses of childhood, disability, and ethnic difference – especially the assumed Mexican origins of the pandemic, and the initial framing of vaccine-associated narcolepsy as a “Nordic” condition.
The second case study focuses on the debates about the potential inclusion of boys into national HPV (human papillomavirus) vaccination programs in Europe – currently most European HPV immunization programs cover only girls. The study asks why HPV has been slow to emerge as a vaccine for boys in Europe despite the current licensing of HPV vaccines for use in all genders to protect against a range of conditions including cervical cancer, anal cancer and genital warts. I trace how the debated inclusion of boys in vaccination programs emerges in relation to assumptions of masculinities, queer sexualities, and gendered sexual practices. This focus sheds new light on the role of gendered and heteronormative assumptions about agency and “risky” behavior in cultural responses to a vaccine against a sexually transmitted infection.
My third case study approaches debates about mandatory MMR vaccinations following a number of local measles epidemics across Europe. The study focuses on how ongoing debates about MMR mobilize discourses of immigration and travel within and into Europe. I am particularly interested in how the MMR vaccine has re-emerged as an object of political debate in relation to the movement of people within the EU, on the one hand, and the rise of right-wing anti-immigration populism, on the other. Focusing on debates about measles, travel and migration, I ask how an already affectively charged technology becomes entangled with new cultural emotions that may contradict the earlier ones, and how responsibility and risk become reconfigured as racialized and nationalist issues.
I hope the project may help us understand why vaccines raise particular emotional responses on a collective cultural level. By focusing on issues such as embodiment, agency and diversity, the project provides a useful addition to the public health and economic framework within which vaccination programs are usually envisioned and designed. By theorizing ideas of “risk” and “responsibility” as intersectional issues, the project also highlights the importance of developing nuanced and ethically accountable vaccination campaigns and communication.
You can read more about Venla’s research here: https://research.uta.fi/oikkonen/
Samantha D. Gottlieb (2016) Vaccine resistances reconsidered: Vaccine skeptics and the Jenny McCarthy effect. Biosocieties 11(2): 152–174.
Jennifer A. Reich (2016) Calling the Shots: Why Parents Reject Vaccines. NYU Press.