Public Health in the Age of Anxiety: Religious and Cultural Roots of Vaccine Hesitancy in Canada ed. by Paul Bramadat, Maryse Guay, Julia A. Bettinger, and Réal Roy (review)

The editors of Public Health in the Age of Anxiety announce at the outset that theirs is "the first fully interdisciplinary book" to explore the roots of vaccine hesitancy in Canada. This simple sentence is a clue for historians of medicine wondering whether or not to peruse the volume. Those looking for a wealth of new historical scholarship may wish to skip it; those in search of an interdisciplinary snapshot of contemporary thinking on vaccination in Canada, however, will definitely want to pick it up.

This wide-ranging book's contributors number nearly two dozen – historians, philosophers, anthropologists, pediatricians, nurses, epidemiologists, and health journalist André Picard among them, not to mention many others. The study is the product of two years of "wide-ranging discussion" and "lively debates" among the authors. Unsurprisingly, as editor Paul Bramadat notes in his conclusion, there was much the contributors did not agree on at the outset. They did, however, concur on three points: that vaccine hesitancy and rejection are a challenge to public health, that vaccine proponents can and do alienate certain individuals with vaccine doubts, and that research on the cultural roots of vaccine hesitancy and rejection was not sufficiently "sophisticated" to inform policy and clinical practice. Thus this book, a direct response to the latter problem.

Where do the roots of vaccine hesitancy lie? Bramadat and co-editors Julie A. Bettinger and Maryse Guay provide a concise summary: "culture, religion, legitimate scientific concerns, unfounded rumours, junk science, wishful thinking, fears about the power of corporations and governments, and simple uncertainties about the facts of vaccine science and epidemiology" (355). None of this, however, is new. And as Bramadat's introduction warns, the experience of reading such a diverse collection of methodological perspectives on these issues bound together in one book can be "jarring." But in fact it seems deeply appropriate: the book stands as a neat encapsulation of the broader cultural conversations over vaccination. The approach also serves as a helpful reminder of the insights and revelations that cross-disciplinary conversations reveal. The volume, for instance, presents a frank acknowledgement of the risks of vaccines alongside the repeated recognition of their core value (and the recognition of the harm done by the denial of such risks). Importantly, it also finds commonalities between religious and cultural sources of vaccine hesitancy, a subject that, to date, has received far too little scholarly and professional attention. The growing prevalence in recent generations of "spiritualized" beliefs about nature, personal autonomy, personal health, and even capitalism, for example, ought to be a reminder to approach or analyze those who hold such views with the same tools reserved for those with institutional religious allegiances that inform their vaccine hesitancy.

As noted above, there is not much of use in this volume to historians of medicine generally speaking. For those interested in the history of public health, or the history of vaccination specifically, it might be most useful as a primary source, one illustrative of a moment in time at which the problem of vaccine hesitancy has become so vexing that it has forced into lively conversation a set of specialists who wouldn't ordinarily compare notes.

"History" is in fact the subject of one of the book's four sections; the others include "Introduction and Theory," "Biomedicine, the State, and Vaccine-Hesitant/Rejecting Communities," and "Vaccine Politics in Clinical, Media, and Community Settings." Though history informs more than a few of the book's chapters, only two are devoted to it. Microbiologist Réal Roy's contribution, "Learning from Smallpox Inoculation Refusal," leads to a conclusion that will sound all-too-familiar to historians of medicine (and to readers of analogous volumes, such as Keith Wailoo et al.'s Three Shots at Prevention): "there...