The Politics of Scheduling: Vaccination as Infrastructure, Spectacle, and Market in West Africa, 1960s–1980s

Abstract

Vaccination schedules negotiate the timing of interactions among bodies, vaccines, and pathogens. Yet they do more: they orchestrate the movement of vaccines through factories, business plans, injecting devices, fridges, vehicles, healthcare labour, kinship relations, policy models, government budgets, and so on. This article approaches vaccine schedules as standards that synchronise the varying entities – and interests animating these – that make up vaccination infrastructures broadly defined. What unfolds is an examination of the politics of schedule-setting and implementation, set-out in three debates concerning vaccination in West Africa during a time of fitful, contested expansion in both the delivery of immunizing technologies and the development of basic healthcare infrastructure. The first debate concerns rhythms of vaccination during the US-led and funded West African Smallpox Eradication and Measles Control Program (SEMCP) in the latter 1960s, revealing tensions among this programme’s technopolitical priorities. Two later debates, about the optimal age for measles vaccination, and the minimum total doses/visits required for full immunization, reflect broader contests, from the late 1970s to the late 1980s, over the ultimate goals of the ‘Expanded Programme on Immunization’ (EPI). These three debates provide insight into how multiple actors vied for control over how routine childhood vaccination was to be enacted and imagined in West Africa.