From Farms to Pharma: A "Natural" History of Vaccine Production and Vaccine Skepticism.

In the era of synthetic biology, vaccine skeptics have made claims that vaccines are "unnatural," that the technology used to develop them is risky and untested, and that "naturally acquired" immunity is superior to vaccination. Public health practitioners and physicians alike have attempted to respond to these concerns by reminding patients and the public that vaccines generate a "natural" immune response. These negotiations over the language to describe vaccines are nothing new. This article puts the relationship between vaccines and concepts like "nature" and "natural" in historical perspective. In the mid- to late 19th century, the smallpox vaccine, then the only vaccine available, was propagated on farms. Vaccine farmers-usually enterprising physicians-kept herds of cattle infected with cowpox, cultivating the virus "stock" from which the vaccine was derived. By exploring how vaccine farmers established and maintained public confidence in their products, we can see that debates over vaccine safety have always involved concerted efforts to persuade the public to place their trust in technologies that might at first seem novel, strange, or even dangerous. More broadly, this article encourages readers to think about the shifting valences of the category "natural," particularly in a public health context. (Am J Public Health. 2024;114(2):193-201. https://doi.org/10.2105/AJPH.2023.307508).

Ethics in retrospect: Biomedical research, colonial violence, and Iñupiat sovereignty in the Alaskan Arctic.

Kaare Rodahl, a scientist with the US Air Force's Arctic Aeromedical Laboratory, spent much of the 1950s traveling to villages in the Alaskan Arctic to conduct research on cold acclimatization. Four decades later, it was discovered that during one such study, he had administered radioactive isotopes of iodine-131 to over one hundred Alaska Native research subjects without their knowledge or consent. This news broke just as Alaska Native communities were attempting to recover from a series of revelations surrounding other instances of Cold War radiation exposure. In response, two major federal investigations attempted to determine whether Rodahl had adhered to ethical regulations and whether his actions could be expected to have a lasting health impact on former research subjects. The National Research Council, framing the study as a singular event in the Cold War past, found that research subjects had been 'wronged, but not harmed'. The North Slope Borough, a powerful Alaska Native municipal government, countered this finding with their own investigation, which identified both the study and the subsequent federal inquiries as facets of the still-unfolding process of American settler colonialism in Alaska. In doing so, the North Slope Borough contested the authority of federal agencies to set the terms by which ethics could be retrospectively judged. This article argues that exploring how competing ethical regimes represent the relationship between violence and time can help us better understand how institutionalized bioethics reproduces settler colonial power relations.

Mistrust in Medicine: The Rise and Fall of America's First Vaccine Institute.

In 1813, the American government passed An Act to Encourage Vaccination, the first federal endorsement of a medical practice in American history. The law tasked a federal agent with maintaining a supply of the smallpox vaccine and distributing it nationwide. James Smith, a well-respected physician and proponent of vaccination, was appointed as vaccine agent. Smith was skeptical of claims that only well-trained physicians should be allowed to perform vaccination; he felt it was a simple procedure that should be available to all American citizens. In 1822, he made a tragic error that caused several deaths and left him vulnerable to criticism from political opponents and his medical peers. This ended Smith's professional career and led to the repeal of the act itself. In this article, we use the rise and fall of James Smith to provide a historical perspective on contemporary debates surrounding delayed vaccination schedules. We explain how physicians-in the 19th century and today-have worked to build public trust in vaccination in an American culture suspicious of medical expertise.