Dear Diversity Journal Club,
As we await the recap of our discussion on Monday 9 February about privilege and vaccines refusal, I wanted to post the following email from a dear friend who studying the history of medicine.
Which, by the way, is an insanely interesting field. You should ask Sonic about it. She’s on twitter (@SonicWoytonik).
In any case, I emailed her about potential historical research into vaccines and vaccine refusal, given our conversation. Her response:
So, here are some thoughts. I’m not sure this is exactly up the alley of your group, but I think at the very least you will find this interesting. The first anti-vaxxers in North American history are on the record from 1721, even before vaccination existed (they were protesting inoculation, vaccination’s undeniably more dangerous grandparent). In many ways the 1721 episode is extremely relevant today: it involved physicians, religious leaders, and racial/class diversity. Historians have understood the pro-vaxxers to be folks who simultaneously believed in observational science (“Oh look, people who have smallpox never get it again, how about that…”) and divine intervention (i.e. inoculation is a gift from God). The anti-vaxxers were mostly rich white men who thought their authority to dictate public health was being undermined by a bunch of slaves and clergy. People were beaten in the streets, inoculation was banned, and everyone continued to get smallpox until Edward Jenner burst on the scene in the 1790s with…a vaccination! Vaccination remained controversial until the mid-1800s, when it became mandatory in many countries and totally replaced inoculation as a form of building immunity.
The second article I’m attaching here is much more recent and has to do with HPV. Personal disclosure: I believe that STIs represent the biggest failure in American public health, because controlling them is easy but totally flies in the face of the American obsession with personal responsibility. So in this article, we see how the issue of the HPV vaccine, at the time being debated as to whether it should go on the mandated vaccine register for female adolescents, is deconstructed through a feminist lens of bioethics, academic-code for OMG-levels of privilege. The author makes a lot of good points. Those good points are dripping in privilege. Just putting this one out there as food for thought.
I also learned something: inoculation was first developed in Africa, and used there before white people ever figured it out. In 1721, the pro-vaxxers learned of it from African slaves – which, for them, created significant confusion, and demonstrates that race and privilege were an issue back then too. They couldn’t reconcile their observations that inoculation worked with their belief that good things came as gifts from god, and that African people were inferior. Why would God grant an inferior people such a gift? On the flip side, anti-vaxxers said they were against a dangerous practice (which it was), but really they couldn’t see lowly slaves and clergy infiltrating on the privileged doctrine of medicine. This all also relates back to the ideas about identity – that your physical being (your body, skin color, etc) was directly tied to who you were. That is, the idea that skin color somehow says something about your ability. This gets wrapped up in disease and public health as these are things that actually affect the physical. Don’t think we’re over this today – a friend on Facebook pointed out that another layer to the story is about believing certain groups of people are more likely to carry disease.
The second article she sent along discussed why feminists should be cautious about HPV vaccines (which I actually have and currently think is a good thing). Valid points therein, in my opinion, include the “where are the men??” question – as men carry HPV, so why the f-all aren’t we calling for young men to be vaccinated? Again, ideas about identity, and responsibility (that is, women are responsibility for sexual health – as we are also responsible for pregnancy). HPV is a particularly neat one for male privilege as men don’t show symptoms (or get cancer), so can hide behind that as an excuse – they don’t need to worry about it. Never mind that being so symptom-less means they can spread that around more easily. Also, as the article wonders, shouldn’t men care about women’s health because they likely have moms/sisters/wives/daughters/friends?
So, you see, race and identity are always a confounding factor when we talk about public health. We should better understand that they should always be part of the discussion. As the anti-vaxx controversy of 1721 demonstrates – they can and do lead us astray.