(Photo by AARON CHOWN/POOL/AFP via Getty Images)

Vaccination narratives

The evolution of vaccine rollouts and the reliance on mass-media, advertising and celebrity cameos

Artillery Row

On April 4 1959, England footballer Jeff Hall died of polio aged 29. Hall was young and healthy and had played for his club, Birmingham City, just days before. In both age and health, he was considered an unlikely victim of the disease. In the annals of vaccination history, Hall’s tragedy is seen as a turning point for demand in the Polio vaccine amongst his age group and beyond. The weekend following Hall’s death, national media lined up to capture entire squads of footballers being vaccinated while the press lauded him as a national hero. But another, different demand emerged from Hall’s death: the public health celebrity whose fortunes become intertwined – and emblematic of – the vaccination drive.

Vaccination was established not simply as a right of citizenship but also as one of its duties

To compare the April of 1959 with that of 2021, is to see our current moment more clearly. In terms of scale and impact, the Covid-19 pandemic vastly outstrips comparisons with that of polio but likenesses emerge, notably in the government marshalling of advertising and media to drive vaccination demand. How the State sells the story of vaccination is as important as the scientific efficacy of the vaccines it produces. Now, as in past public health emergencies, this story has three familiar motifs: fear, blame and shame. During the polio era, pre-emptive shame was directed towards the parents of children who sought to avoid vaccinating their vulnerable charges.

Vaccination was established not simply as a right of citizenship but also as one of its duties. Duty established, the messaging became darker, foretelling of reproach and shame for those who ignored the directives: “Parents should not hang back […] If they do, they may have cause to reproach themselves later on.” No longer was nature alone culpable for polio’s scourge. Risk and blame were thus neatly transferred from nature, the Health Service and government onto the public. Clearly, this was a public open to persuasion through fear and shame; rational but wayward. The polio pandemic marked a turning point in public health messaging not least because it coincided with the creation of the welfare state. In a narrative of dazzling futurity, vaccination against polio was seen as part of the social rights of citizenship and the so-called “gift” of modern technocratic medicine.

Fast forward some sixty-odd years and the welfare state does not seem so glistening to us. Gone is the optimism which must have once greeted the NHS with its rows of iron lungs and syringes neatly lined up. And yet some things have not changed at all. Fear and shame are still the primary tactics used to enforce lockdown measures and behavioural habits around the pandemic. In a series of highly emotive adverts, social media videos and posters, guilt is transferred from the government onto us, the wicked, rule-breaking public. “Look her in the eyes and tell her you never twist the rules” the advert shouts, as I go about my essential business or, more directly, “Look her in the eyes and tell her you really need to go to the shop”. Apart from the obvious contradiction that going to the shops is permitted under lockdown rules, the underlying assumption of guilt speaks to the strained relationship between the public and the welfare state, now imagined as vulnerable and decrepit. Narrative of the future this is not.

How different countries narrate their vaccine efforts has become hopelessly embedded in their national and political story

When it comes to the vaccination story, things get jollier, in this country at least. In 1959 an “injections-while-you-dance” vaccination effort began in Manchester and Bristol in the hope of attracting the overlooked demographic of under 25s to the party. In our generation’s case, it is the elderly who are set within advertising’s sights. In an NHS video released in January, Elton John and Michael Caine – both reassuringly geriatric – mock-up an audition in which they parody themselves before getting down to business: the vaccine doesn’t hurt and, what’s more, it is safe and effective. As befits Europe, where the ghost of Brexit rears its head behind every vial and syringe, the narrative is more perfunctory, and certainly less celebratory. Germany’s vaccination campaign entitled “Germany Pulls Up Its Sleeves” shows doctors and nurses looking firmly at the camera, their sleeves rolled neatly and efficiently up, make no joke about it. In France, as you might expect, there is no vaccination advertising drive but rather a series of national televised updates given by Alain Fischer, known to the public simply as Monsieur Vaccin. As Freud would have no doubt agreed, a vaccine is never, ever simply a vaccine. How different countries narrate their vaccine efforts has become hopelessly embedded in their national and political story.

In 1955 there was just one polio vaccine, pioneered by Jonas Salk. Salk went on to become a national hero in America, his name synonymous with medical miracles. For we of the Covid-19 generation, just as there is no single vaccine, there is no centralised medical hero to idolise. Scientists we have in the shape of Chris Whitty, Neil Ferguson et al. Heroes they are not, or at least not to us, the lowly public. Victims, yes, we have plenty of those too. Think Captain Tom, taken by the disease in the service of which he had been knighted or Boris Johnson, whose brush with the illness symbolically coincided with an unprecedented period of national vulnerability. Jeff Hall was a victim. But his victimhood fell in the arc of a different story, perhaps a more intelligible one, a morality tale of old. The Covid story is more confusing. This is in part because the lines between the perpetrators and the victims have been blurred but also because scientists and politicians – the high priests of certainty – cast doubt on the vaccine as the story’s end. It is up to the government to give us a story we can read. Let’s hope it has a happy ending.

Enjoying The Critic online? It's even better in print

Try five issues of Britain’s newest magazine for £10

Critic magazine cover