Abstract
How do unpleasant post-vaccination symptoms become recognized as vaccine ‘side effects'? In this paper, we argue that it is not necessarily the logical outcome of scientific verification that it is said to be. The paper draws on an ethnographic study carried out in a small town, El Carmen de Bolivar, on Colombia's Caribbean coast from February through May 2019. In 2014, hundreds of girls in the town reported a range of mysterious symptoms following mass vaccination against the Human Papilloma Virus (HPV). Denying the girls' insistence that their symptoms were due to the vaccine, the official diagnosis was Mass Psychogenic Illness. Comparing these events with studies of controversial responses to other vaccines, we suggest that the pathway from post-vaccination symptoms to ‘side effects’ is cognitively and socially complex. In particular, it is context-dependent. Drawing on research in medical anthropology, sociology and STS, we argue that the official diagnosis was influenced by the subjects' marginal status; by a projection of the region's violent past onto individual inhabitants; by health professionals' commitment to a restricted notion of evidence (devaluing patients' own accounts); and by an institutional inability or unwillingness to stand against ‘global consensus’, which deems HPV safe.
Highlights
Through the second half of the twentieth-century vaccines came to be seen as the most effective, and the most cost-effective, tool of public health
We present the narratives of five girls from El Carmen de Bolivar, which describe how they began to associate their malaise with the vaccine
We draw on the epidemiological study that diagnosed the girls with Mass Psychogenic Illness (MPI) (Martinez et al, 2015), interviews with the health authorities, and a brief presentation of debates in the Colombian scientific community, which was by no means united
Summary
Through the second half of the twentieth-century vaccines came to be seen as the most effective, and the most cost-effective, tool of public health. They became increasingly central to preventive health: the basis for smallpox eradication and the Expanded Program of Immunization established by the World Health Organization in 1974. Worried at the prospect of being held liable for vaccine-related injury, in the United States some pharmaceutical companies abandoned vaccine production. In order to reassure the industry and protect the vaccine supply, in 1986 the United States Congress passed the National Child hood Vaccine Injury Act A few other countries developed similar systems, among them the SiVigila in Colombia
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