From iatrogenesis to vaccine skepticism: US mothers' negative vaccine perceptions and non-vaccination practices as reverberations of medical harm.

Vaccine skepticism, and the related practices of selective- or non-vaccination, has steadily grown in the twenty-first century, especially among US mothers. The phenomenon has been especially pronounced in Oregon, which ranked first nationally for the number of kindergarteners with nonmedical exemptions in 2018. Based on 12 months of digital research in Oregon in the context of the COVID-19 pandemic, my findings suggest that mothers' vaccine skepticism emerges from experiences of iatrogenesis from childhood through childbirth. While existing literature analyzes medical distrust among BIPOC communities as related to historical and ongoing iatrogenesis, scholars often portray vaccine skepticism among white US mothers as related to "neoliberal parenting" and "intensive mothering." By analyzing mothers' vaccine skepticism as an outgrowth of iatrogenesis, this article underscores the long-term ramifications of systematic medical harm against women in the US. This finding is particularly relevant amid public health crises, when mitigation depends upon vaccine utilization. [vaccines, medical distrust, US mothers, iatrogenesis, autonomy].

'Hawa' and 'resistensiya': local health knowledge and the COVID-19 pandemic in the Philippines.

Understanding people's concepts of illness and health is key to crafting policies and communications campaigns to address a particular medical concern. This paper gathers cultural knowledge on infectious disease causation, prevention, and treatment the Philippines that are particularly relevant for the COVID-19 pandemic, and analyzes their implications for public health. This paper draws from ethnographic work (e.g. participant observation, interviews, conversations, virtual ethnography) carried out individually by each of the two authors from February to September 2020. The data was analyzed in relation to the anthropological literature on local health knowledge in the Philippines. We find that notions of hawa (contagion) and resistensiya (immunity) inform people's views of illness causation as well as their preventive practices - including the use of face masks and 'vitamins' and other pharmaceuticals, as well as the ways in which they negotiate prescriptions of face mask use and physical distancing. These perceptions and practices go beyond biomedical knowledge and are continuously being shaped by people's everyday experiences and circulations of knowledge in traditional and social media. Our study reveals that people's novel practices reflect recurrent, familiar, and long-held concepts - such as the moral undertones of hawa and experimentation inherent in resistensiya. Policies and communications efforts should acknowledge and anticipate how these notions may serve as either barriers or facilitators to participatory care and improved health outcomes.

Cultivating distress: cotton, caste and farmer suicides in India.

Nearly 4,00,000 farmers committed suicide in India between 1995 and 2018. This translates into approximately 48 suicides every day. The majority of suicides were those from 'backwarded' castes including Dalit farmers. This ethnographic study on cotton farmer suicide reports narratives of surviving Dalit families. The results reveal that financial and moral debt when accrued within a web of family and caste-related relationships result in patterns of personal and familial humiliation, producing a profound sense of hopelessness in the Self. This loss of hope and pervasive humiliation is 'cultivated' by a cascade of decisions taken by others with little or no responsibility to the farmers and the land they hope to cultivate as they follow different cultural and financial logic. Suicide resolves the farmers' humiliation and is a logical conclusion to the farmer's distress, which results from a reconfiguration of agricultural spaces into socially toxic places, in turn framing a local panopticon. The current corona virus pandemic is likely to impact adversely on peoples who are culturally distanced.

Compounded Caregiving: Mexican Women in Migrant-Sending Families During COVID-19.

Based on qualitative interviews conducted remotely with twenty-five women heads of migrant-sending households in rural Mexico, we examine the impact of the COVID-19 pandemic on gender inequities in caregiving and social reproduction. Taking medical anthropology's call to attend to the disparate impacts of the pandemic along lines of existing social inequities and vulnerabilities, we describe how women navigated interruptions to remittance flows, social distancing and stay-at-home orders, and the shift to remote schooling for their children, and how all of these transformations compounded women's caregiving responsibilities and negatively impacted their health and well-being.

The unsanitary other and racism during the pandemic: analysis of purity discourses on social media in India, France and United States of America during the COVID-19 pandemic.

The global rise of populism and concomitant polarizations across disenfranchised and marginalized groups has been magnified by so-called echo chambers, and a major public health crisis like the COVID-19 pandemic has only served to fuel these intergroup tensions. Media institutions disseminating information on ways to prevent the propagation of the virus have reactivated a specific discursive phenomenon previously observed in many epidemics: the construction of a defiled 'Other'. With anthropological lenses, discourse on defilement is an interesting path to understand the continuous emergence of pseudo-scientific forms of racism. In this paper, the authors focus on 'borderline racism', that is the use of an institutionally 'impartial' discourse to reaffirm the inferiority of another race. The authors employed inductive thematic analysis of 1200 social media comments reacting to articles and videos published by six media in three different countries (France, United States and India). Results delineate four major themes structuring defilement discourses: food (and the relationship to animals), religion, nationalism and gender. Media articles and videos portrayed Western and Eastern countries through contrasting images and elicited a range of reaction in readers and viewers. The discussion reflects on how borderline racism can be an appropriate concept to understand the appearance of hygienic othering of specific subgroups on social media. Theoretical implications and recommendations on a more culturally sensitive approach of media coverage of epidemics and pandemics are discussed.

Searching for the 'Trigger': An ethnographic analysis of parental beliefs regarding autism causation and vaccination in Puerto Rico.

This study examines the personal beliefs held by parents of autistic children in Puerto Rico regarding the cause of their child's autism and how these beliefs may influence parental vaccination decision-making. This study seeks to contribute towards diversifying the autism literature by focusing on an autism community living in a relatively lower income, resource-deficit context. These findings expand our understandings of how parents of autistic children may perceive vaccines and how these perceptions are informed by various sources of knowledge. This ethnographic research study was conducted between May 2017 and August 2019. Methods included 350+ hours of participant-observation and semi-structured interviewing of 35 Puerto Rican parents of autistic children. 32 of these 35 parents interviewed believed autism to be the result of genetic risks that are 'triggered' by an unknown environmental factor. Suggested 'triggers' included various environmental contaminants and vaccinations. The subject of vaccination came up in every interview; 18 interviewed parents did not believe vaccines 'triggered' autism, 3 parents attributed their child's autism entirely to vaccines, while 14 considered vaccines to be one of several possible 'triggers'. It is important to note that no parents interviewed perceived vaccinations to be inherently or universally harmful. Rather, they perceived vaccinations to be one of many possible 'triggers' for a child predisposed to develop autism. In some cases, this perception prompted parents to oppose mandatory vaccination policies on the island. Parents shared nuanced, complex understandings of autism causation that may carry implications for COVID-19 vaccine uptake within the Puerto Rican autistic community.

"Whatever They Say I Do the Opposite": Vaccine Resistance in Turkey During the Covid-19 Pandemic.

Following a 2015 ruling in the Turkish Supreme Court, vaccine resistance has increased significantly in Turkey. Where childhood vaccination was once compulsory, it is now voluntary, enabling the transformation of Turkish lay medical culture. This medical culture rose in political importance during the COVID-19 pandemic. Yet, little is known about vaccine hesitancy and resistance in Turkey, and the interconnections with the wider political atmosphere in the country. We draw upon fieldwork conducted during the COVID-19 pandemic and explore the rationales behind people's vaccination choices. We argue that vaccines encouraged by the state offer citizens opportunities for individuation and resistance to the more generalized coercive practices of the Turkish state.

Adapt and Adjust: Doing UK-Based Ethnographic Fieldwork During the Covid-19 Pandemic.

The Covid-19 pandemic has required many anthropologists to do fieldwork differently: research that would otherwise have been done face-to-face has been shifted online, sometimes very quickly. When doing research with people with chronic illnesses, it is important to acknowledge both the histories of online ethnography and the way that disability studies has engaged with the internet over time. This article uses the example of my PhD fieldwork, based in Northeast England, to explore how living in an increasingly digital world may impact how medical anthropologists could, and perhaps should, do ethnography.

"Are You Sure It's Not the Corona Vaccine?" An Ebola Vaccine Trial During COVID-19 in DRC.

The COVID-19 pandemic began as an Ebola epidemic was unfolding in the Democratic Republic of the Congo. In this article, we examine how COVID-19 influenced experiences of an Ebola vaccine trial and attitudes towards medical research in Goma. First, critical debates about vaccine research became a forum in which to contest ineffective local governance and global inequality. Second, discussions about new COVID-19 therapeutics reignited critique of Western biomedical colonialism. Third, rumors were made powerful through everyday observations of the unexpected adaption of Ebola trial procedures in the pandemic. This illustrates the difficulties of maintaining participants' trust, when circumstances dictate protocol alterations mid-trial.

"I Think I Have Enough for Now": Living with COVID-19 Antibodies in the Philippines.

Drawing on face-to-face and virtual fieldwork in the Philippines, I document the emergence of antibody testing as a popular practice among Filipinos during the COVID-19 pandemic, helping them make decisions about vaccines and other life choices. Antibodies gave people a sense of agency and control amid a health crisis for which political and medical authorities failed to offer certainty and hope, particularly at a time of vaccine scarcity and viral surges. However, by diverting attention from the health care system to individual immune systems, antibodies also reinforced the individual "responsibilization" that has characterized the Philippine government's pandemic response.

Covid-19 Riskscapes: Viral Risk Perceptions in the African Great Lakes.

In this article we explore Covid-19 riskscapes across the African Great Lakes region. Drawing on fieldwork across Uganda and Malawi, our analysis centers around how two mobile, trans-border figures - truck drivers and migrant traders - came to be understood as shifting, yet central loci of perceived viral risk. We argue that political decision-making processes, with specific reference to the influence of Covid-19 testing regimes and reported disease metrics, aggravated antecedent geographies of blame targeted at mobile "others". We find that using grounded riskscapes to examine localised renditions of risk reveals otherwise neglected forms of discriminatory discourse and practice.

Responsibilities of Risk: Living with Mental Illness During COVID-19.

Following the COVID-19 pandemic, Denmark introduced repeated lock-downs of society, including outreach services and visits from social workers for people living with mental illnesses. Based on ethnographic fieldwork, in this article we explore how people with mental illness react to and manage their lives amid COVID-19 mitigations, focusing on how they experience and negotiate vulnerability at personal and community level. We argue, that the subjective management of restrictions implicated in their personal lives notions of risk, vulnerability and agency, and shows a diversity and heterogeneity of responses to the pandemic that allowed the mentally ill to perform good citizenship.

Viral Entanglements: Bodies, Belonging and Truth-claims in Health Borderlands.

This article contributes to anthropological debates surrounding borderlands and biosecurity by tracing the multiple pursuits of protection that emerge between the state and minorities during infectious disease outbreaks. Drawing on an ethnographic study of child health in Jerusalem following epidemics of measles and COVID-19, the article demonstrates how responses to public health interventions are less about compliance or indiscipline than a competing pursuit of immunity to preserve religious lifeworlds. The voices of Orthodox Jews are situated alongside printed broadsides that circulated anonymous truth-claims in Jerusalem neighborhoods. These broadsides cast state intervention against historical narratives of deception and ethical failures. Borderland tensions, like a virus, mutate and influence responses to authority and biosecurity, and they reconfigure vernacular entanglements of religion, state, and health. The article encourages anthropologists to consider responses to public health interventions and non-vaccination beyond a COVID-19 silo, as part of situated relations between states and minority populations.

Negotiating Intersecting Precarities: COVID-19, Pandemic Preparedness and Response in Africa.

This article shares findings on COVID-19 in Africa across 2020 to examine concepts and practices of epidemic preparedness and response. Amidst uncertainties about the trajectory of COVID-19, the stages of emergency response emerge in practice as interconnected. We illustrate how complex dynamics manifest as diverse actors interpret and modify approaches according to contexts and experiences. We suggest that the concept of "intersecting precarities" best captures the temporalities at stake; that these precarities include the effects of epidemic control measures; and that people do not just accept but actively negotiate these intersections as they seek to sustain their lives and livelihoods.

Are There Global Syndemics?

In this article, we address the nature of syndemics and whether, as some have asserted, these epidemiological phenomena are global configurations. Our argument that syndemics are not global rests on recognition that they are composed of social/environment contexts, disease clusters, demographics, and biologies that vary across locations. These points are illustrated with the cases of syndemics involving COVID-19, diabetes mellitus, and HIV/AIDS. We draw on theoretical discourse from epidemiology, biology, and anthropology to present what we believe is a more accurate framework for thinking about syndemics with shared elements.

'COVID containers' in pandemic mediascapes: discursive economies of health, bodies, and race in North America.

Bringing an ethnographic sensibility to pandemic mediascapes, this article critically examines three media artifacts that assembled around COVID-19 - as an entity that is viral, social, and political - in the early months of the pandemic in North America. Focusing on the household, the cruise ship, and the body-with-underlying-conditions as 'COVID containers', the author argues that material and discursive responses to the pandemic, articulated through imaginaries of containers and containment, uphold notions of risk, order, and health that garner meaning through implied racial intertexts. The article analyzes COVID-19-related data, graphics, talk, and news stories to show how logics of inside/outside, safety/risk, and comfort/fear that animate efforts to contain a viral threat intensify the pathologization, harm, surveillance, and risk of groups long imagined as 'threats' to social order. Throughout, The author demonstrates how idioms of containers and containment make 'the body' a key locus of health, diverting attention from systems and histories complicit in producing ill-health. A coda reflects on Scheper-Hughes and Lock's influential essay ' The mindful body', re-reading their articulation of the 'Western body' through lenses drawn from scholarship in Black studies, queer studies, and disability studies that are central to understanding COVID-19 as relation(s) - borne from racial capitalism - that differentially distribute risk, health, and care.

Collective Care Amid US Individualism Through COVID-19 Vaccine Trial Participation.

We analyze interviews with participants in a COVID-19 vaccine trial to show how Americans navigate conflicting discourses of individual rights and collective responsibility by using individual health behavior to care for others. We argue that interviewees drew on ideologies of "collective biology" - understanding themselves as parts of bio-socially interrelated groups affected by any member's behavior - to hope their participation would aid collectives cohering around kinship, sex, age, race and ethnicity. Benefits (protecting family, representing one's group in vaccine development and modeling vaccine acceptance) existed alongside drawbacks (strife, reifying groups), to illustrate the ambivalence of caregiving amid inequality.

Deviant Swedes in the Global Covid-19 Media Environment.

During the early COVID-19 pandemic, many countries took compulsory measures to combating the virus's spread, while Sweden took a more voluntary approach. This led to polarized reactions in the international media, with some praising it and others proclaiming it disastrous. Using the concept of "moral panic" I examine how actors within the global media environment portrayed Swedes as a deviant population, using persuasive language, exaggeration, and selective reporting, and how an amplification of media attention served to solidify the deviant label. I also argue that Sweden was made deviant partly to justify restrictive measures in other countries.

Covid-19 and social stigma in hospitals:a new epidemic of signification?

Little is known about COVID-19 related stigma and its specific impact both on medical staff and on the care they provide in hospitals in Mexico. In this article I highlight the stigma that doctors who treat COVID-19 in Mexico City hospitals both experience and practice; explore the impact of that stigma on the care they provide and on their own suffering; and describe and discuss how they respond to it. Anthropological knowledge elucidates opportunities to encourage this new "epidemic of signification" related to stigma to become a pandemic of dignity.

Consciously quarantined: a review of the early anthropological response to the global COVID-19 lockdown.

Whilst quarantine has been experienced in a multitude of ways around the world, for some anthropologists the quietening of public movement was met with a flurry of attentive typing. For those who were consciously quarantined, a social science response to COVID-19 was sought at University College London through a call for posts as part of the UCL Medical Anthropology blog; capturing the real-time observations and scholarly reflections on the unfolding pandemic situation as it reached its height across the globe. The global flow of coronavirus - both as a literal microbial agent and as an idea - has played out on the 'coronascape' in multiple ways since it exploded onto worldwide consciousness in early 2020. From an anthropological perspective, concerns have oscillated around a number of crucial themes, from (micro)biopolitics, governance, and sovereignty; the defence of borders from foreign bodies and post-colonial Others; a strengthening of medical pluralism and the global biomedical hegemony, and concerns over where to go from here as second-waves and the social consequences of such loom large. Such themes have often interrelated and tangoed with one another as individuals have reflected upon their significance. In this review we provide a critical overview of the first fifty-seven posts that were sent to the blog in the initial months of the pandemic; with contributors exploring the developing pandemic in over twenty countries, and with posts visited daily by over two thousand visitors from across the world during the months of the UK lockdown (March-May).