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  • Mass Vaccination: Citizens' Bodies and State Power in Modern China by Mary Augusta Brazelton
  • Sarah Yu (bio)
Mass Vaccination: Citizens' Bodies and State Power in Modern China By Mary Augusta Brazelton. Ithaca: Cornell University Press, 2019. Pp. 237.

Mary Augusta Brazelton's Mass Vaccination is intricately researched, comprehensive, persuasive, and a welcome addition to the recent scholarship on medical networks and governmental legitimacy in twentieth-century China by John Watt (Saving Lives in Wartime China, 2015), Nicole Barnes (Intimate Communities, 2018), and Wayne Soon (Global Medicine in China, 2020). China's governments and scientists were central contributors to, not merely recipients of, medical and public health advancements in the twentieth century. The author shows how with each step—laboratory construction, launch of wartime patriotic propaganda campaigns, and integration with political institutions as a tool for international diplomacy—this system of mass vaccination determined China as "an exemplar of the modern biopolitical state" (p. 11). Students of the history of public health will find Mass Vaccination a concrete, jargon-free illustration of how this non-Western state developed its biotechnological system in which "immunization … exemplifies the symbiotic relationship between hygiene and social control" (p. 7).

Chapter 1 details how medical professionals determined mass vaccination as the priority public health intervention out of logistical and financial necessity at the start of the Sino-Japanese War (1937–45). By 1937, they arrived in the southwestern province of Yunnan and added vaccination to its precociously robust, culturally "hybrid" medical infrastructure (ch. 2). Chapters 3 and 4 are set during the war, and chronicle the development and distribution of vaccines, deemed necessary for defense. Chapter 5 follows Chinese immunologists' work during the Civil War (1945–49) as both sides, concerned with political legitimacy, embraced vaccination to promote their ideological visions. In the early People's Republic of China (PRC) of the 1950s and 60s, mass vaccination became a crucial component of state biopower, and Chapter 6 shows how vaccination, political campaigns, and citizen identity became integrated symbiotically. The last chapter reveals how China promoted the successes of its vaccination program as a model health system to the nonaligned countries to which it provided aid (ch. 7).

The book stresses continuity over rupture, a welcome change from both state-centric public health histories focused on national infrastructure and regime-centric histories of twentieth-century China that see the establishment of the PRC in 1949 as a watershed. Certain themes run throughout. For one, mass vaccination remained simultaneously a legitimate form of health provision, the state's consummation of biopower, and the individual's ticket to greater political participation, regardless of which regime was in charge. For another, Brazelton's rigorous and original research in [End Page 1237] local Kunming archives demonstrates that local autonomy was crucial to vaccination's success, even while the central governments consolidated their power. What ultimately made mass vaccination legitimate was not the number of people who were immunized, but the widespread, profound buy-in to the "patriotic" endeavor by local mediators as they adapted national directives to local conditions. Finally, Brazelton shows that mass vaccination as biopower preceded other, more overtly political, social control tools that we associate with the PRC. The work unit (danwei) and household registration (hukou) institutions of the early PRC tightened social control and enhanced legitimacy through providing health services to schools, workplaces, and neighborhoods. Meanwhile, health authorities took advantage of these governmental structures to systematically seek out those who were noncompliant and redefined vaccination as an act of Chinese citizenship.

Mass Vaccination is not scientific medical history, but the history of how governments effectively used vaccination for social control. While vaccinators were trained to gather immunization data as "scientific work" and authorities used technical vocabulary in promotional materials, mass vaccination propaganda was always overtly political. Policymakers needed people to believe in vaccinators' "scientific" authority to fulfill their ideological obligations, not to improve their knowledge of biomedical details. In fact, during the Cultural Revolution (1966–76), prominent scientists were denounced and biomedical institutions abandoned. Still, laws and infrastructure were established, many were vaccinated, and China's bio-power system was strengthened. Reading the monograph in a post-COVID-19 context, we see that China's...