chapter  10
Vaccinations in South Asia: False Expectations and Commanding Metaphors
WithMark Nichter
Pages 26

In this chapter, the author draws on data from his own fieldwork in South India and Sri Lanka, regions having relatively low and relatively high rates of immunization coverage, respectively. He discusses vaccination programs with mid-level health personnel and their superiors in South Asia, it was clear that their frame of reference was that of a military campaign. The success of an immunization effort depended almost exclusively on a reliable supply of the vaccine, enough manpower to vaccinate, the following of a schedule, and compliance as guaged by people’s uncritical acceptance of immunization. Extension of the military metaphor as a cognitive model underscores certain features of vaccinations while obscuring others. The author shows that “communication underdevelopment” in health education and paternalistic approaches to immunization that rely on social control lead to the propagation of false expectations which may in turn undermine confidence in public health programs.