Monolithic medicine: Unsettling vaccine hesitancy in COVID-era Philippines

Abstract

My thesis is an attempt to deepen the discourse surrounding vaccine hesitancy, or why and how people choose to delay their acceptance or rejection of vaccinations. I explore this through the stories of 33 vaccine-hesitant individuals in the Philippines whom I interviewed from August to November 2023. I depart from stereotypical portrayals of people’s hesitancy as the result of their ‘misunderstanding’ of science, susceptibility to misinformation, or passively acquired distrust in institutions. Rather, my thesis deploys the concepts of vaccination trajectories and lifeworlds to demonstrate how vaccine hesitancy can result from living with the constant clash of Western biomedicine, on the one hand, and indigenous, oftentimes heterodox systems of medical knowledge, on the other. Using case studies, I show how vaccination has become emblematic of the ‘monoculture of curing’ through which ordinary people have come to conventionally understand and intimately encounter disease in general and the COVID-19 pandemic in particular. Additionally, I explore the ‘vaccine authoritarianism’ that unfolded in the country by analyzing 1) the widespread use of vaccine cards or passports and 2) the actual implementation of the COVID-19 vaccination campaign in low-income communities. I examine how the contradictory presentation of vaccination as both a ‘choice’ and a ‘responsibility’ actualized a biopolitics of exclusion that only reinforced people’s notions of vaccination as a coercive tool of the state. In sum, my thesis provides an essential theorization of hesitancy for the so-called post-COVID world. It calls for an alternative way of approaching hesitancy: to view it not in terms of discretely identifiable elements, but as an accumulation of parts progressing to a countercultural whole; as the result of living with pharmaceuticals and their corresponding infrastructures of power.