Selective BCG vaccination in postcolonial Britain (1965-2005)
Examination of the history of select vaccination in Britain from the mid-1960s to the mid-2000s.
This presentation examined the history of select vaccination in Britain from the mid-1960s to the mid-2000s. Its target audience are students and staff interested in the history of vaccination, as well as the broader history of health inequalities in post-colonial Britain.
Selective BCG vaccination policies for immigrants and ethnic minorities at risk of tuberculosis have been widely adopted in high-income countries with low incidence of the disease. This paper examines the history of selective vaccination in Britain from the mid-1960s to the mid-2000s. It uses the concept of epistemic injustice in healthcare as a lens through which to analyse the epistemological foundations of selective vaccination, how certain forms of knowledge were granted credibility and authority in its creation and how they defined and delimited the conceptual resources available to those implementing and those targeted by selective programmes. An early adopter of selective vaccination, British policy developed through the changing ethnic, cultural, and epidemiological contexts of post-colonial Britain in which tuberculosis was reframed as primarily a problem of South Asian immigrants. Selective programmes concentrated heavily on these populations and, for reasons this paper explains, especially on South Asian newborns.
By the early 1990s, most health districts had adopted some form of selective neonatal vaccination. But programmes faced multiple uncertainties. The paper highlights and explores two of them: systemic lack of clinical research on BCG efficacy in Asian newborns; and ill-defined selection criteria for identifying at-risk newborns for vaccination. Analysis of programme audits highlights ongoing challenges in managing these uncertainties and their impact on BCG uptake, including concerns that selective policies were discriminatory or racist, and that ethnic minorities’ understanding or experiences of BCG and tuberculosis risks were absent from policy making and implementation.
Examining these lacunae provides insight into how adapting selective vaccine policy in a newly multiracial Britain led to unintentional stigmatization of groups it intended to serve. Attending to the postcolonial history of selective vaccination may, in turn, shed light on dynamics of epistemic injustice in vaccine policy and provide new insight into the roots of vaccine hesitancy in ethnic minorities in Britain.
Speaker
Michael Bresalier
Michael Bresalier is a Senior Lecturer in the History of Medicine at Swansea University. An historian of infections and inequalities, his research advances the use of historical methods to analyse medical, public health, and global health policies on epidemic, infectious, and zoonotic diseases, vaccines, and One Health. He is Specialist Investigator on the Wellcome Discovery Award on Epistemic Injustice in Healthcare (EPIC) for which he leads a case study on the history of selective BCG vaccine policies.
Event notices
- Please note this event is virtual only
- Please note that this session will not be recorded
Admission
Contact
