From Farms to Pharma: A "Natural" History of Vaccine Production and Vaccine Skepticism.

In the era of synthetic biology, vaccine skeptics have made claims that vaccines are "unnatural," that the technology used to develop them is risky and untested, and that "naturally acquired" immunity is superior to vaccination. Public health practitioners and physicians alike have attempted to respond to these concerns by reminding patients and the public that vaccines generate a "natural" immune response. These negotiations over the language to describe vaccines are nothing new. This article puts the relationship between vaccines and concepts like "nature" and "natural" in historical perspective. In the mid- to late 19th century, the smallpox vaccine, then the only vaccine available, was propagated on farms. Vaccine farmers-usually enterprising physicians-kept herds of cattle infected with cowpox, cultivating the virus "stock" from which the vaccine was derived. By exploring how vaccine farmers established and maintained public confidence in their products, we can see that debates over vaccine safety have always involved concerted efforts to persuade the public to place their trust in technologies that might at first seem novel, strange, or even dangerous. More broadly, this article encourages readers to think about the shifting valences of the category "natural," particularly in a public health context. ( Am J Public Health . Published online ahead of print January 4, 2024:e1-e9. https://doi.org/10.2105/AJPH.2023.307508).