It would be an understatement to say I rushed to the Jerusalem Arena stadium to receive the COVID-19 vaccination last week. Rolling down my sleeve after the jab, I felt as if I’d been marked with privilege while very conscious of the entrenched global public health inequalities that prevent the same timely access for others. I also thought about the parents I had met in recent years as part of my research around vaccine decision-making in Britain and Jerusalem, and how some would not be joining the vaccine queue and were working to prevent others from doing so. I imagined the plurality of their voices in my head, why hurry? Why wait? Taking urgency and cautiousness together, I suggest that the surge in anthropological interest in vaccination may benefit from slowing down and carefully engaging with the foundation of work concerned with vaccine relations and tensions.
Waiting amidst urgency?
In carving out an anthropology of urgency, Lenore Manderson has called for ‘the urgency of bringing to the surface anthropological knowledge of other infections and other disasters, structures and systems. Anthropological theory and critical analysis help anticipate, illuminate and interpret the pandemic.’ Vaccination is emblematic of such an anthropology of urgency. Vaccines point to a global (technological) strategy of protecting lives and economies, yet COVID-19 vaccination programmes are being played out according to local conditions and global inequalities. Urgency is evident in the time taken to produce and deliver the vaccines, and is also evident in attempts to enforce compliance. Never has there been a more urgent or fascinating time to study vaccination – as this call for blog submissions indicates.
Since governments began rolling out COVID-19 vaccine programmes (or remain prevented from doing so), anthropologists have been re-orienting their interest to vaccination with a sense of academic urgency. Yet, as Manderson signals in her definition of an anthropology of urgency, there is a pulsating body of research to draw upon and help inform current tensions around vaccination and immunity. What does immunity mean and how is it perceived in situated ways? How do vaccines operate within a covenant of trust, and to what extent does non-vaccination reflect a breakdown in trust? How are immunisations navigated amidst plural and opposing ideas of immunity and protecting life? How do top-down global health efforts to eradicate certain diseases through vaccination cause speculation? Is it helpful to use the term ‘anti-vaccination’ and collectivize it as a movement?
These are some of the past questions that anthropologists have reckoned with, and which raise striking continuities for understanding the COVID present. To not fully engage with this foundation risks limiting anthropological analysis and generating an incomplete picture of how the development and deployment of innovative vaccine technologies are playing into evolving and entrenched issues.
Drawing on the case of Israel helps to illustrate these micro and macro considerations around vaccination. The coronavirus pandemic and vaccination programme arrived on the heels of devastating measles epidemics, which led to the highest rates of measles infection in a quarter century in the US and Israel. Amidst this public health crisis, I found that non-vaccination activists transformed and tuned their messages into ‘local moral worlds’ by drawing on historical, social and religious references to exploit the fears of religiously Orthodox parents. Looking at non-vaccination in a COVID silo, and not as part of this recent as well as longer-running history of individual decision-making and doubt in public health and governance, may lead anthropologists to miss the underlying anxieties and disputes that are at play in the cultural politics of welfare. It goes without saying that such considerations are not specific to Israel, and will play out within situated public health dynamics in every area on earth.
In recent days, reports emerged of an Israeli woman crossing into Syria and being repatriated in a Russian-brokered exchange that saw Israel provide $1m dollars worth of Sputnik V vaccines for the Syrian regime. This urgent mobilization of vaccine resources is striking given that the two countries remain in a de facto state of war, and further highlights the stark vaccine inequity between Israelis and Palestinians. Israel’s vaccination programme, considered a model intervention by policy-makers in the US, is counterbalanced by dramatically poorer coverage in the Occupied Palestinian Territories. COVID19 vaccines are then figuring into regional and global diplomacy, and vaccine relations exemplify how innovative and life-saving technological advancements are being factored into relations of exchange, influence and exploitation.
Taking urgency and cautiousness together will benefit anthropologists as they grapple with the vaccine rush and how they consider the situated ways that coronavirus vaccines will come to shape almost every area of social, political and economic life in the years to come.
ABOUT THE AUTHOR:
Ben Kasstan is a medical anthropologist at the University of Bristol and Hebrew University of Jerusalem. His research explores the points where health, religion and state meet, and his recent publications explore the discursive strategies of non-vaccination activists.