The politics of vaccination

A global history

Christine Holmberg, Stuart Blume, Paul Greenough, Christine Holmberg, Stuart Blume, Paul Greenough

• Publisher: Manchester University Press
• Year: 2017
• Print ISBN:
  9781526110886
• eBook ISBN:
  9781526110930
• Topic: Médecine
• Subtopic: Histoire sociale

This electronic version has been made available under a Creative Commons (BY-NC-ND) open access license. Mass vaccination campaigns are political projects that presume to protect individuals, communities, and societies. Like other pervasive expressions of state power - taxing, policing, conscripting - mass vaccination arouses anxiety in some people but sentiments of civic duty and shared solidarity in others. This collection of essays gives a comparative overview of vaccination at different times, in widely different places and under different types of political regime. Core themes in the chapters include immunisation as an element of state formation; citizens' articulation of seeing (or not seeing) their needs incorporated into public health practice; allegations that donors of development aid have too much influence on third-world health policies; and an ideological shift that regards vaccines more as profitable commodities than as essential tools of public health.

II
Nationality, vaccine production and the end of sovereign manufacture

5
Vaccine production, national security anxieties and the unstable state in nineteenth- and twentieth-century Mexico

Ana María Carrillo

Introduction

Since pre-Columbian times, Mexico has experienced notable periods of progress in science and technology. Political, economic and social problems have, however, often interrupted these developments, thus the country has been forced to rebuild its science and technology capacity time and time again. Since 1821, when the country began its independent life, Mexican government investment in education and research has been essential for modern science to flourish. In its search for self-determination, the Mexican state has employed science both to legitimise itself and to serve society.

This chapter deals with the development and production of vaccines in Mexico from the last third of the nineteenth century to 1989, when the erosion of this sector began. Along with discussing Mexican physicians’ reception of discoveries in microbiology and immunology, it highlights the existence of a network of relationships between Mexican institutions and others around the world. The chapter shows that vaccine development and production did not follow a constant ascendant path, but that it also suffered declines and regressions. It describes the field's achievements and limitations and reveals its relationships with the political, economic and social conditions of the country in different historical moments. Finally, the chapter evaluates the importance of attaining national self-sufficiency in vaccine development and production for the building of the state in pre- and post-revolutionary Mexico, and seeks to provide some answers to the questions of how and why the erosion of this strategic field occurred.

For three centuries (1521–1821) Mexico – then, New Spain – was part of the Spanish Empire. In New Spain, the arrival of modern science late in the colonial period was mediated both by the existence of a self-taught community of enlightened individuals interested in progressing towards applied science, and the imperialist economic reform of the Spanish state in the eighteenth century, which created institutions in order to offer scientific instruction, improve economic exploitation and better local conditions.¹

It was in this context that vaccination against smallpox was officially introduced to New Spain in 1804 by the Spanish Royal Philanthropic Expedition – supported by King Charles IV of Spain and led by Francisco Javier de Balmis – though the vaccine had in fact arrived earlier.² That year, officials established the first vaccination centre in Mexico City; according to Miguel E. Bustamante – epidemiologist and historian – this signalled the beginning of governmental action in the area of preventive medicine.³

The War of Independence (1810–21) affected all national institutions, and medical practice was no exception. After 1821, the formation of the modern state began, which included attempts to control economic processes and create a strong political system. Mexican independent governments considered science a matter of public interest, and utilised it to build a national culture in a context of the increasing secularisation of society.⁴

In the case of smallpox, for example, for more than a hundred years only five people managed the vaccine in Mexico, so that its purity was guaranteed.⁵ Public health officials administered the vaccine in areas as remote as Texas⁶ – which was part of Mexican territory until 1836 – but service was not always continuous because between 1810 and 1876 the country suffered constant political instability.

In addition to the War of Independence, Mexico underwent two French interventions (1838–39 and 1862–67), the Mexican–America War – which began in 1846 and ended two years later, culminating in Mexico's loss of more than half of its territory to the United States – as well as indigenous groups’ insurrections and struggles between liberals and conservatives. For all these reasons, in this period at least fifty smallpox epidemics occurred in the country.⁷

The beginning of vaccine production

A relative pacification of the country arrived with the authoritarian regime of Porfirio Díaz (1876–1910), one marked by the modernisation of society and the economy and by a growing concentration of federal political power. Strong central government brought improvements in mining, industry and also public health. Vaccination laws were part of this health policy, and by the end of the Díaz regime smallpox vaccination was mandatory in most states in the Mexican republic.⁸ But, as Stern and Markel have stated, ‘vaccines are powerful medical interventions that induce powerful biological, social and cultural reactions’, including insurrections.⁹ While Mexico does not appear to have experienced any medical movements opposed to smallpox vaccination, a century after its introduction there was still public opposition. Perhaps the most significant case was in the state of Oaxaca, where compulsory vaccination was established in 1903, but five years later a popular rebellion achieved its cancellation.¹⁰

Vaccination in this period was not limited to the prevention of smallpox. Several nineteenth-century Mexican physicians were in direct contact with international scientists, and through them the introduction of bacteriological thinking and practices took place in Mexico in the late nineteenth and early twentieth centuries. Eduardo Liceaga – president of the Superior Board of Health – visited the Pasteur Institute in France in 1888, was given personal instruction, and learned to prepare the rabies vaccine. Early that year, he inoculated a Mexican boy¹¹ and established the Anti-Rabies Preventive Inoculation Service, as a branch of the Superior Board of Health.¹² From 1888 to 1910, the board administered 11,177 inoculations – with only thirteen deaths recorded among the recipients.¹³ By 1909, five states of the Mexican republic had created anti-rabies centres.

In 1895, the Pathological Anatomy Museum was founded. Upon applying for its creation, Rafael Lavista, its first director, assured President Díaz that as well as demonstrating to visitors to the Second Pan-American Medical Congress (to be held in Mexico two years later) that science was being cultivated in the country, it was also required for the study of the symptoms manifested by diseases modified by climate, elevation and other characteristics peculiar to Mexico. Almost from the beginning, the museum had a bacteriology section, which continued working after 1899 when the Pathological Anatomy Museum was transformed into the National Pathology Institute.¹⁴

At the end of 1902, a plague epidemic affected some ports and cities in northwest Mexico. The sanitary campaign organised by the Superior Board of Health to combat the outbreak was a watershed moment, signalling the beginning of modern public health in Mexico.

This was the first sanitary campaign in the country in which a state government ceded public health authority to the federal government, and also the first to be based on the emerging scientific fields of microbiology, immunology, tropical medicine and epidemiology. The sanitary bureaucracy sought to control the outbreak through persuasive methods, but relied mostly on coercion, including a mandatory vaccine policy that generated various forms of popular resistance.¹⁵ M. J. Rosenau, Head of the Hygiene Laboratory of the Marine Hospital Service of the United States, sent two cultures of Bacillus pestis to Mexico free of charge,¹⁶ and the Bacteriology Section of the National Pathology Institute produced and certified doses of the Haffkine and Besredka vaccines, the latter of which underwent its first extensive testing in Mexico (the Haffkine vaccine was first tested in India).¹⁷ The institute also prepared sera for curative purposes, and exported some doses of the Besredka vaccine to Chile and El Salvador.

The Bacteriology Section played such an important role in the sanitary campaign against plague that, along with the Medical Chemistry Section, it was separated from the Pathology Institute in 1905 to create the National Bacteriology Institute. The new institute was made up of ...

Table of contents

• Cover
• Series page
• Title page
• Copyright page
• Contents
• Figures and tables
• Contributors
• Acknowledgements
• Introduction
• I Vaccination and national identity
• II Nationality, vaccine production and the end of sovereign manufacture
• III Vaccination, the individual and society
• Afterword
• Index