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  • Mass Vaccination: Citizens' Bodies and State Power in Modern China by Mary Augusta Brazelton
  • Wayne Soon
Mary Augusta Brazelton. Mass Vaccination: Citizens' Bodies and State Power in Modern China. Studies of the Weatherhead East Asian Institute, Columbia University. Ithaca, N.Y.: Cornell University Press, 2019. 258 pp. Ill. $47.95 (978-1-5017-3998-9).

Mary Augusta Brazelton has written an impressive history of vaccination in twentieth-century China. Through a sophisticated analysis of English, French, and Chinese archival materials, correspondences, scientific reports, consular documents, and speeches, Brazelton argues that mass vaccination was central in constructing the modern Chinese citizen. Not only did immunization campaigns entail collective participation as a means of identity building, but they also established the expectation that Chinese people would subject their bodies to the dictates of the state. This process accelerated during the Second World War between 1937 and 1945, when Yunnan province in Southwest China emerged as a critical site for vaccine experiments and the development of vaccination ideas and techniques. Scientists and physicians affiliated with the Chinese Nationalist Party (Kuomintang, KMT) and their local allies led wartime expansion of immunization. Their efforts left critical legacies for the post-1949 Chinese Communist Party–led People's Republic of China (PRC) utilization of vaccination for state building and medical diplomacy. [End Page 533]

Chapter 1 highlights how Chinese physicians were limited by the financial and logistical limitations of prewar public health administration, even as they accumulated knowledge and experiences from fellow microbiologists around the world. Arriving in wartime Yunnan, Chinese doctors, as chapter 2 shows, encountered medical systems shaped by competing French, British, and Chinese forces. Chapter 3 describes how Chinese physicians finally received the support needed to enact mass vaccination from multiple health care organizations that emerged during the Second World War. These institutions were backed by a variety of overseas patrons, such as the League of Nations. Chapter 4 delineates how the Chinese government prioritized the production and dissemination of vaccination in wartime Kunming. They sometimes used coercive methods to compel immunization and thereby expanded the power of the state. Chapter 5 shows how the KMT and local government officials shifted their attention from disseminating cholera vaccines in wartime Southwest China to promoting Bacille Calmette-Guerin (BCG) vaccination in coastal China to combat tuberculosis during the Civil War period from 1945 to 1949. Chapters 6 and 7 show how the PRC state used vaccination to improve China's rural public health in the 1950s, setting the stage for touting its success in its global medical diplomacy in the 1960s and 1970s.

Mass Vaccination, curated carefully from diverse sources, illustrates the negotiations over vaccination on the ground. We encounter officials in Yunnan who insisted on receiving bribes from custom duties on imported drugs and medical supplies before allowing them into the province (p. 61). We meet cafeteria workers who did not want injections because they were too painful (p. 94). We see mothers who rejected vaccination on the grounds they were too occupied with child-rearing (p. 139). We shudder that a prominent microbiologist committed suicide in 1958 after being hounded for being an "anti-rightist" by the PRC government (p. 168). One wonders if these cumulative acts of resistance and failure effectively challenged the expansion of state-led biopolitics (pp. 7–9). Or were they merely casualties of an unstoppable modern Chinese state, bent on inoculating patients at will for the sake of the greater good? In light of the global race to develop an effective COVID-19 vaccine quickly in 2020, one wonders too whether vaccinators resisted the Chinese state's calls to rapidly develop new vaccines. It is critical to ask if mass immunization (as opposed to barefoot doctors or commune-style healthcare) really underpinned the PRC's rural health advances, as these claims later formed the basis of international experts' promotion of the PRC model in resolving global health issues. As Brazelton points out, underpinning this global desire for the PRC's model is a much more complex history, ironically, that began with its principal rival, the KMT, which sought to immunize its way to victory against the Japanese during the Second World War.

This book will undoubtedly...

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