Immunization: How Vaccines became Controversial

by Stuart S. Blume

As the world pins its hope for the end of the coronavirus pandemic to the successful rollout of vaccines, this book offers a vital long view of such efforts—and our resistance to them.
 
At a time when vaccines are a vital tool in the fight against COVID-19 in all its various mutations, this hard-hitting book takes a longer historical perspective. It argues that globalization and cuts to healthcare have been eroding faith in the institutions producing and providing vaccines for more than thirty years. It tells the history of immunization from the work of early pioneers such as Louis Pasteur and Robert Koch through the eradication of smallpox in 1980, to the recent introduction of new kinds of genetically engineered vaccines. Immunization exposes the limits of public health authorities while suggesting how they can restore our confidence. Public health experts and all those considering vaccinations should read this timely history.

Genres: Science, Health, Nonfiction

288 pages, Hardcover

Published October 15, 2017

Reviews

[Suzanne · Rating 4 out of 5]

It was slow going at first, but interesting, particularly toward the end where it all comes together. These days, one expects a book on the topic of "how vaccines became controversial" to spend a lot of time on the 20 years since Andrew Wakefield and co-authors' paper claiming the MMR vaccine could cause autism -- but that since-debunked paper isn't mentioned until page 226. Blume goes back much farther into the history of vaccines, the regional differences in how they are applied (rubella/German measles, for example, is most dangerous to fetuses -- so some locales vaccinated all children to reduce pregnant women's exposure, and others only vaccinated girls because they could grow up and get pregnant) and the history of how some vaccination campaigns have been more successful than others. It probably won't convince anyone to change their views on vaccinations, but it might help people understand where people who have different views are coming from.

[Ramana Ayyagari · Rating 4 out of 5]

The book is mostly dedicated to the history of viruses and research to inoculate and protect masses esp kids against polio and other childhood diseases. Eradicating diseases takes years of research and patience and needs backing by government and citizens. The book effectively addresses these issues.

[Fernando Gonzalez · Rating 4 out of 5]

Vacunas. Una historia polémica de Stuart Blume, es un libro de historia social y política de la ciencia, no un texto divulgativo ni un alegato a favor o en contra de la vacunación. Blume analiza cómo las vacunas se convirtieron en una de las intervenciones centrales de la salud pública moderna, y por qué ese proceso estuvo —y sigue estando— atravesado por conflictos científicos, políticos, económicos y sociales.

👉 La “polémica” como categoría histórica. La palabra “polémica” en el título es clave. Blume muestra que la controversia no es una desviación reciente, ni un producto exclusivo de movimientos antivacunas contemporáneos. Desde el siglo XIX, la vacunación:
✅ha generado oposición,
✅ha requerido coerción estatal,
✅ha producido tensiones entre expertos y población.

La tesis central aquí es fuerte pero matizada: las vacunas nunca fueron solo una cuestión médica, sino siempre una práctica social negociada.


Relación entre ciencia, Estado y ciudadanía: Uno de los aportes más sólidos del libro es mostrar cómo la vacunación se consolidó como política pública antes de que existiera una comprensión completa de sus mecanismos inmunológicos.

Blume describe:
✅ la confianza en expertos,
✅ el papel del Estado en imponer o recomendar vacunas,
✅ la escasa participación ciudadana en la toma de decisiones.

Desde esta perspectiva, la vacunación aparece como una tecnología de gobierno, no en sentido conspirativo, sino administrativo: una herramienta para gestionar poblaciones, riesgos y prioridades sanitarias.

👉🏻Crítica a la narrativa del progreso lineal: Blume cuestiona la narrativa clásica según la cual las vacunas se impusieron únicamente porque eran “mejores” o “más eficaces”. En cambio, muestra que su expansión dependió de:
✅ intereses institucionales,
✅ financiamiento internacional,
✅ agendas de erradicación,
✅ simplificación de problemas complejos.

Esto no implica negar el valor sanitario de las vacunas, sino desmitificar su historia: el éxito no fue automático ni inevitable.

Un punto clave —y a menudo malinterpretado— es que Blume no legitima el rechazo a las vacunas, pero sí toma en serio las razones históricas de la resistencia:
- desconfianza hacia el Estado,
- imposición sin diálogo,
- desigualdad en la distribución de riesgos y beneficios.

La resistencia aparece como un fenómeno socialmente inteligible, no como simple ignorancia.

En los capítulos finales, el libro examina el rol de las vacunas en el contexto global:
- campañas verticales,
- prioridades impuestas desde organismos internacionales,
- diferencias entre países del Norte y del Sur global.

Aquí Blume plantea una crítica relevante: las vacunas se convirtieron en símbolo de soluciones técnicas rápidas para problemas estructurales más profundos (pobreza, acceso a servicios, desigualdad).

Conclusión crítica: Vacunas. Una historia polémica es un libro incómodo pero necesario, especialmente para profesionales de la salud pública. Su valor no está en cuestionar la vacunación como práctica sanitaria, sino en obligarnos a pensarla como práctica política y social.

Blume propone una postura exigente:
- defender las vacunas no significa negar sus controversias,
- promoverlas eficazmente requiere confianza, legitimidad y participación, no solo evidencia científica.

Leído con atención, el libro no debilita la vacunación: la fortalece, al mostrar que su sostenibilidad depende tanto de la ciencia como del vínculo entre Estado, expertos y ciudadanía.

[Matthew Luttmann · Rating 3 out of 5]

I can recommend this book even with my reservations about it. I am likely biased toward a public health perspective. I feel the author has a libertarian bias, and that comes through in the introductory and closing sections of the book.
I found value in the history of immunizations. I gained perspective on the varying stories of different diseases, as our culture tends to clump all these diseases together in one ‘dangerous’ category. I appreciated the international perspective. I agree that there is nuance to vaccination policy that does not come through in public messaging (not all these diseases are absolute killers–some are just costly and disruptive).
The author criticized aspects of public health policy and practice and has little sympathy for its practitioners. He seemed to suggest that skepticism is positive even when it has no rational basis. He actually did not make a case that any of the vaccines are, on balance, negative; he just criticized the imperfections of the broader system.

[NCHS Library]

From Follett: One of the most important tools in the public health arsenal, vaccines are to thank for the global eradication of smallpox, and for allowing us to defeat the dire threat of infectious disease for more than one hundred years. Vaccine development is where scientists turn when faced with the frightening spread of new diseases like Zika, SARS, and Ebola. So if vaccines have proven to be such an effective tool, why are growing numbers of people questioning the wisdom of vaccinating children? Why have public-sector vaccine producers almost vanished? And can we trust the multinational corporations that increasingly dominate vaccine development and production?

[Felicia · Rating 3 out of 5]

A dense historical look at vaccines and the culture that surrounds its onset.

[Heather · Rating 4 out of 5]

Excellent discussion on the history of vaccines, how vaccination programs and polices changed in the 1980s, and the complex reasons why people (globally) are hesitant to trust vaccination programs.