Political and Community Logics of Emergent Disease Vaccine Deployment: Anthropological Insights from DRC, Uganda and Tanzania
DOI:
https://doi.org/10.18357/anthropologica66120242646Keywords:
Tanzania, DRC, Uganda, politics, One Health, vaccines, community, logicsAbstract
With a growing number of emerging infectious diseases and the rapid development of vaccines during epidemics and pandemics, public health officials at the global and national level have reported concerns about vaccine hesitancy, often attributing this to a problem of misinformation and poor understanding of risk. However, social scientists have found that vaccination perceptions are complex and multi-faceted. By focusing on the historical, cultural and political influences that affect vaccine acceptance, as well as social justice questions that examine the fair distribution of vaccines, we explore the political and community logics of vaccine deployment using a case study approach. We found differing logics depending on the vaccine and the context and argue that political and community logics come to the forefront during outbreaks as vaccine strategies often are imposed—in different ways—by the Global North. We suggest that, prior to the development and deployment of new vaccines for emergent diseases in the Global South, political level and community logics must be acknowledged and engaged with.
Downloads
References
Africa CDC. 2023. COVID-19 Vaccination. https://africacdc.org/covid-19/covid-19-vaccination/
Ashraf, M. A., A. Muhammad, and Y. Shafiq. 2021. “The Politics of Covid-19 Vaccine Distribution and Recognition.” Public Health Reviews 42. https://doi.org/10.3389/PHRS.2021.1604343 DOI: https://doi.org/10.3389/phrs.2021.1604343
Biasio, L. R. 2017. “Vaccine Hesitancy and Health Literacy.” Human Vaccines and Immunotherapeutics 13(3): 701–702. https://doi.org/10.1080/21645515.2016.1243633 DOI: https://doi.org/10.1080/21645515.2016.1243633
Bowmer, A., S. Lees, and M. Marchant. 2020. Social Science Research for Vaccine Deployment in Epidemic Outbreaks, SSHAP Practical Approaches Brief 6. https://www.socialscienceinaction.org/resources/social-science-research-for-vaccine-deployment-in-epidemic-outbreaks/
Bowmer, A., J. Ssembatya, M. Okot, R. Bagyenyi, S. V. Rubanga, and G. Kalema- Zikusoka. 2023. “Determining the Acceptability of a Novel One Health Vaccine for Rift Valley Fever prior to phase II/III clinical trials in Uganda.” One Health 16: 100470. https://doi.org/10.1016/j.onehlt.2022.100470 DOI: https://doi.org/10.1016/j.onehlt.2022.100470
Brewster, D. 2011. “Science and Ethics of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Controversies in Africa.” Journal of Paediatrics and Child Health 47(9): 646–655. https://doi.org/10.1111/j.1440-1754.2011.02179.x DOI: https://doi.org/10.1111/j.1440-1754.2011.02179.x
Burns, R., A. Bowmer, L. Enria, and S. Vanderslott. 2020. Clinical and Vaccine Trials for COVID-19: Key Considerations from Social Science. https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/15687
Dada, S., G. McKay, A. Mateus, and S. Lees. 2019. “Lessons learned from Engaging Communities for Ebola Vaccine Trials in Sierra Leone: Reciprocity, Relatability, Relationships and Respect (the four R’s).” BMC Public Health 19(1665). https://doi.org/10.1186/s12889-019-7978-4 DOI: https://doi.org/10.1186/s12889-019-7978-4
Dubé, È., J. K. Ward, P. Verger, and N. E. Macdonald. 2021. “Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health.” Annual Review of Public Health 42: 175–191. https://doi.org/10.1146/annurev-publhealth-090419-102240 DOI: https://doi.org/10.1146/annurev-publhealth-090419-102240
Dungu, B., B. A. Lubisi, and T. Ikegami. 2018. “Rift Valley Fever Vaccines: Current and Future Needs.” Current Opinion in Virology 29: 8–15. https://doi.org/10.1016/j.coviro.2018.02.001 DOI: https://doi.org/10.1016/j.coviro.2018.02.001
Edwards, N. 2021. “Tanzania’s mild response to COVID-19 and its implications for the 2020 elections.” Atlantic Council, 27 March. https://www.atlanticcouncil.org/blogs/africasource/tanzanias-mild-response-to-covid-19-and-its-implications-for-the-2020-elections/
Enria, L., J. S. Bangura, H. Kanu, J. Kalokoh, A. D. Timbo, M. Kamara, M. Fofanah, A. N. Kamara, A. I. Kamara, M. M. Kamara, I. S. Suma, O. M. Kamara, A. M. Kamara, A. O. Kamara, and M. Murray. 2021. “Bringing the Social into Vaccination Research: Community Health Worker-Led Ethnography and Trust-Building in Immunization Programs in Sierra Leone.” PLoSOne. https://doi.org/10.1371/journal.pone.0258252 DOI: https://doi.org/10.1371/journal.pone.0258252
Enria, L., S. Lees, E. Smout, T. Mooney, A. F. Tengbeh, B. Leigh, B. Greenwood, D. Watson-Jones, and H. Larson. 2016. “Power, Fairness and Trust: Understanding and Engaging with Vaccine Trial Participants and Communities in the Setting up the EBOVAC-Salone Vaccine Trial in Sierra Leone.” BMC Public Health 16(1): 1140. https://doi.org/10.1186/s12889-016-3799-x DOI: https://doi.org/10.1186/s12889-016-3799-x
Fairhead, J. and M. Leach. 2012. Vaccine anxieties: global science, child health and society. London: Routledge. DOI: https://doi.org/10.4324/9781849773690
Farmer, Paul. 2020. Fevers, Feuds, and Diamonds. New York: Farrar, Straus and Giroux.
Gagliardone, I., S. Diepeveen, K. Findlay, S. Olaniran, M. Pohjonen, and E. Tallam. 2021. “Demystifying the COVID-19 Infodemic: Conspiracies, Context, and the Agency of Users.” Social Media and Society 7(3). https://doi.org/10.1177/20563051211044233 DOI: https://doi.org/10.1177/20563051211044233
Garett, R., and S. D. Young. 2021. “Online Misinformation and Vaccine Hesitancy.” Translational Behavioral Medicine 11(12): 2194–2199. https://doi.org/10.1093/tbm/ibab128 DOI: https://doi.org/10.1093/tbm/ibab128
Goldenberg, M. J. 2016. “Public Misunderstanding of Science? Reframing the Problem of Vaccine Hesitancy.” Perspectives on Science 24(5): 552–581. https://doi.org/10.1162/POSC_a_00223 DOI: https://doi.org/10.1162/POSC_a_00223
Graham, J. E. 2019. “Ebola Vaccine Innovation: A Case Study of Pseudoscapes in Global Health.” Critical Public Health 29(4): 401–412. https://doi.org/10.1080/09581596.2019.1597966 DOI: https://doi.org/10.1080/09581596.2019.1597966
Haruyama, J. L. 2023. “The Truth Is Not Known.” In Covid Conspiracy Theories in Global Perspective, edited by Michael Butter and Peter Knight, 172–182. Routledge. https://doi.org/10.4324/9781003330769-17 DOI: https://doi.org/10.4324/9781003330769-17
Henao-Restrepo, A. M., A. Camacho, I. M. Longini, C. H. Watson, W. J. Edmunds, M. Egger, M. W. Carroll, N. E. Dean, I. Diatta, M. Doumbia, B. Draguez, S. Duraffour, G. Enwere, R. Grais, S. Gunther, P.-S. Gsell, S. Hossmann, S. V. Watle, M. K. Kondé, […] M.-P. Kieny. 2017. “Efficacy and Effectiveness of an rVSV-vectored Vaccine in Preventing Ebola Virus Disease: Final Results from the Guinea ring Vaccination, Open-label, Cluster-Randomised Trial (Ebola Ça Suffit!).” The Lancet 389 (10068): 505–518. https://doi.org/10.1016/S0140-6736(16)32621-6 DOI: https://doi.org/10.1016/S0140-6736(16)32621-6
Heyerdahl, L. W., F. Le Marcis, T. Nguyen, A. Alenichev, B. Salim Camara, and K. Peeters Grietens. 2023. “Parallel Vaccine Discourses in Guinea: ‘Grounding’ Social Listening for a Non-Hegemonic Global Health.” Critical Public Health 33(5): 579–593. https://doi.org/10.1080/09581596.2023.2245964 DOI: https://doi.org/10.1080/09581596.2023.2245964
Ikegami, T. 2017. “Rift Valley Fever Vaccines: An Overview of the Safety and Efficacy of the Live-Attenuated MP-12 Vaccine Candidate.” Expert Review of Vaccines 16(6): 601–611. https://doi.org/10.1080/14760584.2017.1321482 DOI: https://doi.org/10.1080/14760584.2017.1321482
James, M., J.G. Kasereka, and S. Lees. 2021. “The Politics of the Second Vaccine : Debates Surrounding Ebola Vaccine Trials in Eastern Democratic Republic of the Congo.” Journal of Humanitarian Affairs 3(3): 4–13. https://doi.org/10.7227/JHA.069 DOI: https://doi.org/10.7227/JHA.069
Kasstan, B. 2021. “If a rabbi did say ‘you have to vaccinate,’ we wouldn’t: Unveiling the secular logics of religious exemption and opposition to vaccination.” Social Science and Medicine 280 (114052). https://doi.org/10.1016/j.socscimed.2021.114052 DOI: https://doi.org/10.1016/j.socscimed.2021.114052
Krimsky, S., and D. Golding. 1994. “Social Theories of Risk.” Bulletin of Science, Technology and Society 14 (4): 226–226. https://doi.org/10.1177/027046769401400422 DOI: https://doi.org/10.1177/027046769401400422
Larson, H. J., R. M. Clarke, C. Jarrett, E. Eckersberger, Z. Levine, W. S. Schulz, and P. Paterson. 2018. “Measuring Trust in Vaccination: A Systematic Review.” Human Vaccines and Immunotherapeutics 14(7): 1599–1609. https://doi.org/10.1080/21645515.2018.1459252 DOI: https://doi.org/10.1080/21645515.2018.1459252
Larson, H. J., L. Z. Cooper, J. Eskola, S. L. Katz, and S. Ratzan. 2011. “Addressing the Vaccine Confidence Gap.” The Lancet 378 (9790): 526–535. https://doi.org/10.1016/S0140-6736(11)60678-8 DOI: https://doi.org/10.1016/S0140-6736(11)60678-8
Larson, H. J., C. Jarrett, E. Eckersberger, D. M. D. Smith, and P. Paterson. 2014. “Understanding Vaccine Hesitancy Around Vaccines and Vaccination from a Global Perspective: A Systematic Review of Published Literature, 2007-2012.” Vaccine 32(19): 2150–2159. https://doi.org/10.1016/j.vaccine.2014.01.081 DOI: https://doi.org/10.1016/j.vaccine.2014.01.081
Lazarus, J. V., S. C. Ratzan, A. Palayew, L. O. Gostin, H. J. Larson, K. Rabin, S. Kimball, and A. El-Mohandes. 2021. “A Global Survey of Potential Acceptance of a COVID-19 Vaccine.” Nature Medicine 27 (2): 225–228. https://doi.org/10.1038/s41591-020-1124-9 DOI: https://doi.org/10.1038/s41591-020-1124-9
Leach, M., H. MacGregor, G. Akello, L. Babawo, M. Baluku, A. Desclaux, C. Grant, F. Kamara, M. Nyakoi, M. Parker, P. Richards, E. Mokuwa, B. Okello, K. Sams, and K. Sow. 2022. “Vaccine Anxieties, Vaccine Preparedness: Perspectives from Africa in a Covid-19 Era.” Social Science and Medicine 298 (114826). https://doi.org/10.1016/j.socscimed.2022.114826 DOI: https://doi.org/10.1016/j.socscimed.2022.114826
Lees, S., and L. Enria. 2020. “Comparative Ethnographies of Medical Research: Materiality, Social Relations, Citizenship and Hope in Tanzania and Sierra Leone.” International Health 12(6): 575 583. https://doi.org/10.1093/inthealth/ihaa071 DOI: https://doi.org/10.1093/inthealth/ihaa071
Long, Cath. 2022. “New report exposes brutal expulsion of Indigenous communities from their ancestral land in DRC.” Forest Peoples Programme, 6 April. https://www.forestpeoples.org/en/news/2022/new-report-brutal-expulsion-batwa
Madani, T. A., Y. Y. Al-Mazrou, M. H. Al-Jeffri, A. A. Mishkhas, A. M. Al-Rabeah, A. M. Turkistani, M. O. Al-Sayed, A. A. Abodahish, A. S. Khan, T. G. Ksiazek, and O. Shobokshi. 2003. “Rift Valley Fever Epidemic in Saudi Arabia: Epidemiological, Clinical, and Laboratory Characteristics.” Clinical Infectious Diseases 37 (8): 1084– 1092. https://doi.org/10.1086/378747. DOI: https://doi.org/10.1086/378747
Magufuli, J. P. 2020. “Magufuli Swears in Nchemba as Minister of Constitutional and Legal Affairs” (Speech, SoeIkulu Tanzania).
Makoni, M. 2021. “Tanzania refuses COVID-19 Vaccines.” The Lancet 397(10274): 566. https://doi.org/10.1016/S0140-6736(21)00362-7 DOI: https://doi.org/10.1016/S0140-6736(21)00362-7
Meek, L. A. 2023. “Africa Out of the Shadows.” In Covid Conspiracy Theories in Global Perspective, edited by Michael Butter and Peter Knight, 158–171. Routledge. https://doi.org/10.4324/9781003330769-16 DOI: https://doi.org/10.4324/9781003330769-16
Ministério da Saúde Brasil. 2016. SI-PNI - Sistema de Informação do Programa Nacional de Imunizações [SI-PNI – National Immunization Program Information System]. http://pni.datasus.gov.br/
Mohamed, M., F. Mosha, J. Mghamba, S. R. Zaki, W. J. Shieh, J. Paweska, S. Omulo, S. Gikundi, P. Mmbuji, P. Bloland, N. Zeidner, R. Kalinga, R. F. Breiman, and M. K. Njenga. 2010. “Epidemiologic and Clinical Aspects of a Rift Valley Fever Outbreak in Humans in Tanzania, 2007.” American Journal of Tropical Medicine and Hygiene 83(2 SUPPL.): 22–27. https://doi.org/10.4269/ajtmh.2010.09-0318 DOI: https://doi.org/10.4269/ajtmh.2010.09-0318
Mtani, F. A., and J. Ngohengo. 2023. “Africa at the Crossroads: An Overview of the Covid-19 Pandemic and its Drama in Tanzania.” African Journal of History and Geography 2(1): 1–16. https://doi.org/10.37284/ajhg.2.1.1088 DOI: https://doi.org/10.37284/ajhg.2.1.1088
Nkengasong, J. N., and P. Onyebujoh. 2018. “Response to the Ebola Virus Disease Outbreak in the Democratic Republic of the Congo.” The Lancet 391(10138): 2395– 2398. https://doi.org/10.1016/S0140-6736(18)31326-6 DOI: https://doi.org/10.1016/S0140-6736(18)31326-6
Ozawa, S., and M. L. Stack. 2013. “Public Trust and Vaccine Acceptance-International Perspectives.” Human Vaccines and Immunotherapeutics 9(8): 1774–1778. https://doi.org/10.4161/hv.24961 DOI: https://doi.org/10.4161/hv.24961
Raballo, A., M. Poletti, and A. Preti. 2022. “Vaccine Hesitancy, Anti-Vax, COVID- Conspirationism: From Subcultural Convergence to Public Health and Bioethical Problems.” Frontiers in Public Health 10(877490). https://doi.org/10.3389/fpubh.2022.877490 DOI: https://doi.org/10.3389/fpubh.2022.877490
Richards, P. 2016. Ebola: How a People’s Science Helped End an Epidemic. Zed Books. DOI: https://doi.org/10.5040/9781350219779
Richardson, E. T. 2021. Epidemic Illusions : On the Coloniality of Global Public Health. Cambridge, Mass: The MIT Press. DOI: https://doi.org/10.7551/mitpress/12550.001.0001
Roberts, C. H., H. Brindle, N.T. Rogers, R. M. Eggo, L. Enria, and S. Lees. 2021. “Vaccine Confidence and Hesitancy at the Start of COVID-19 Vaccine Deployment in the UK: An Embedded Mixed-Methods Study.” Frontiers in Public Health 9(1711). https://doi.org/10.3389/fpubh.2021.745630 DOI: https://doi.org/10.3389/fpubh.2021.745630
Siegrist, M., and A. Zingg. 2014. “The Role of Public Trust During Pandemics.” European Psychologist 19 (1): 23–32. https://doi.org/10.1027/1016-9040/a000169 DOI: https://doi.org/10.1027/1016-9040/a000169
Stedman, A., D. Wright, P. J. Wichgers Schreur, M. H. A. Clark, A. V. S. Hill, S.C. Gilbert, M.J. Francis, L. van Keulen, J. Kortekaas, B. Charleston, and G. M. Warimwe. 2019. “Safety and Efficacy of ChAdOx1 RVF Vaccine Against Rift Valley Fever in Pregnant Sheep and Goats.” Npj Vaccines 4(44). https://doi.org/10.1038/s41541-019-0138-0 DOI: https://doi.org/10.1038/s41541-019-0138-0
Tarimo, C. S., and J. Wu. 2020. “The First Confirmed Case of COVID-19 in Tanzania: Recommendations based on Lesson Learned from China.” Tropical Medicine and Health 48 (1): 0–2. https://doi.org/10.1186/s41182-020-00214-x DOI: https://doi.org/10.1186/s41182-020-00214-x
Tengbeh, A., L. Enria, E. Smout, T. Mooney, M. Callaghan, D. Ishola, B. Leigh, D. Watson-Jones, B. Greenwood, H. Larson, and S. Lees, S. 2018. “‘We are the heroes because we are ready to die for this country’: Participants’ Decision-making and ‘Grounded Ethics’ in an Ebola Vaccine Clinical Trial.” Social Science and Medicine 203: 25–42. https://www.sciencedirect.com/science/article/pii/S0277953618301011 DOI: https://doi.org/10.1016/j.socscimed.2018.03.008
The Citizen. 2020. “Pawpaw, goat test positive for COVID-19, says Magufuli.” The Citizen, 4 May. https://www.thecitizen.co.tz/tanzania/news/national/pawpaw-goat-test-positive-for-covid-19-says-magufuli-2708672
The Citizen Reporter. 2020. “Tanzania bans all public gathering, closes schools, suspends the Premier League over Coronavirus.” The Citizen, 17 March. https://www.thecitizen.co.tz/news/1840340-5494476-agwmfd/index.html.
Thomson, A., G. Vallée-Tourangeau, and L. S. Suggs. 2018. “Strategies to increase vaccine acceptance and uptake: From behavioral insights to context-specific, culturally-appropriate, evidence-based communications and interventions.” Vaccine 36 (44): 6457–6458. https://doi.org/10.1016/j.vaccine.2018.08.031 DOI: https://doi.org/10.1016/j.vaccine.2018.08.031
Vanderslott, S., Enria, L., Bowmer, A., Kamara, A., & Lees, S. (2022). Attributing public ignorance in vaccination narratives. Social Science & Medicine, 307, 115152. https://www.sciencedirect.com/science/article/pii/S0277953622004580?via%3Dihub DOI: https://doi.org/10.1016/j.socscimed.2022.115152
Warimwe, G. M., J. Gesharisha, B. V. Carr, S. Otieno, K. Otingah, D. Wright, B. Charleston, E. Okoth, L. G. Elena, G. Lorenzo, E. B. Ayman, N. K. Alharbi, M. A. Al-dubaib, A. Brun, S. C. Gilbert, V. Nene, and A. V. S. Hill. 2016. “Chimpanzee Adenovirus Vaccine provides Multispecies Protection against Rift Valley Fever.” Scientific Reports 6(20617). https://doi.org/10.1038/srep20617. DOI: https://doi.org/10.1038/srep20617
Woods, A. 2015. “One Health, One Medicine: Reconnecting Humans and Animals Within Medical History.” Western Humanities Review 24 2(2): 148–169. https://kclpure.kcl.ac.uk/portal/en/publications/one-health-one-medicine-reconnecting-humans-and-animals-within-me
Wynne, Brian. 1998. “May the sheep safely graze? A reflexive view of the expert-lay knowledge divide.” In Risk, Environment and Modernity: Towards a New Ecology, edited by Scott Lash, Bronislaw Szerszynski and Brian Wynne, 44–83. Thousand Oaks: Sage Publications. https://doi.org/10.4135/9781446221983 DOI: https://doi.org/10.4135/9781446221983.n3
Yaqub, Ohid, Sophie Castle-Clarke, Nick Sevdalis, and Joanna Chataway. 2014. “Attitudes to Vaccination: A Critical Review.” Social Science and Medicine 112: 1-11. https://doi.org/10.1016/j.socscimed.2014.04.018 DOI: https://doi.org/10.1016/j.socscimed.2014.04.018
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Shelley Lees, Lys Alcanya-Stevens, Alex Bowmer, Mark Marchant, Luisa Enria, Samantha VAnderslott
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to Anthropologica agree to release their articles under the Creative Commons Attribution-Noncommercial 4.0 Unported license. This licence allows anyone to share their work (copy, distribute, transmit) and to adapt it for non-commercial purposes provided that appropriate attribution is given, and that in the event of reuse or distribution, the terms of this license are made clear.
Authors retain copyright of their work and grant the journal right of first publication.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
