Introduction
COVID-19 vaccines have been at the center of debates across Asian societies and within their diverse religious, nonreligious, medical, and spiritual communities. Vaccine campaigns have been met with various reactions, ranging from embrace to suspicion, and preoccupations about safety, constituent substances, implicit moral implications, and geopolitical hierarchies have framed these varied perspectives. In mainstream media, “vaccine hesitancy” is often discussed as the direct result of irrationality and ignorance, the malicious influence of backward religious leaders, or viral social media posts spreading misinformation. This discourse is dominated by Western and particularly American voices, portraying religious and spiritual communities as the bulk of “antivaxxers” demanding religious exemptions to vaccine mandates. It also implies a false binary between “modern” science and “traditional” religion. A New York Times article discussing the way in which practitioners of Sunda Wiwitan from the Baduy indigenous group in Indonesia employ mantras and rites of protection and purification adopts such a frame, focusing on the relationship between science and religious practice as necessarily antagonistic.1 It describes some recent ways in which the community has opened itself to outside influence, including that “store-bought drugs now compete with natural remedies and with their mantras” (emphasis added), despite quotes in the article from academics and community members that emphasize the flexibility of local wisdom to incorporate different approaches and perspectives.
The collection of seven research articles in this special issue offers empirical and nuanced perspectives on the concept of faith in immunity in order to go beyond this reductionist discourse and interrogate the complex interplay between COVID-19 immunity and preexisting structures of trust, cosmologies of protection, and epistemologies of healing. In the context of the global COVID-19 pandemic, the topic of vaccination has led to debates on the ethics of responsibility, individual freedom, and global inequality. In this special issue, we extend those topics by also exploring the various cosmologies and conceptualizations of immunity mobilized in understanding and responding to the COVID-19 pandemic. One of the areas where these discourses and practices have emerged most prominently is in relation to mass vaccination campaigns. For example, in Bhutan, a successful vaccination campaign was achieved through collaboration with the country’s central monastic body in deciding the most auspicious day for the launch of the vaccination rollout and selecting the first person to be vaccinated in accordance with Buddhist astrology.2 In Pakistan, while local traditions provide ritual immunity and healing rituals, the vaccination campaigns themselves can be understood as a “ritual of containment” and as “major sites of conflict and social drama.”3 Fueling vaccine hesitancy, two well-known political figures in Pakistan claimed that the coronavirus is nothing but a conspiracy against Muslim countries. Other theories in the infodemic of “fake news” claimed that the vaccine would damage or permanently alter one’s genes, that the vaccine allegedly contains chips to monitor the public, and that its side effects include impotency, miscarriage, and infertility.4 While these anxieties are usually dismissed as the product of low literacy and socioeconomic backwardness, mistrust in vaccination campaigns in Pakistan should come as no surprise, as, in 2011, the CIA orchestrated a fake vaccination campaign and administered hepatitis B vaccines to collect DNA samples that would help locate Osama bin Laden. The fake vaccination drive produced a long-lasting vaccine hesitancy that affected the lives of thousands of children who did not receive their DPT, polio, and measles vaccinations, as antivaccine campaigns were started by a number of extremist Islamic groups.5 COVID-19 vaccines, while extraneous to any traditional form of “Asian medicine” per se and administered under the language of biomedicine – couched in the supposedly neutral and universal terms of science – are received, resisted, domesticized, welcomed, or interpreted in diverse ways. This collection of articles underscores that biomedicine and its “indigenization”6 are also part of the plural, contested, and asymmetrical range of Asian medical practices.
While religious responses to COVID-19 have generated innovative ritual practices, they have also tended to engage existing cosmologies, receptive toward making sense of disaster and hardship. Receptive cosmologies and remedies7 also involve religio-medical ideas about immunity and protection that are mobilized to deal with the reality of COVID-19 and engage to varying degrees with biomedical science. Enchantments of hygiene, sanitized sacred spaces, and online remediations of rituals have characterized many religious responses to COVID-19 and led to innovations in ritual procedures in terms of temporality, spatiality, and forms of mediation.8
This collection of articles includes case studies from South, Central, East, and Southeast Asia to explore the entangled themes of vaccination, public health, faith, and trust. They are guided by the questions: What kinds of community relations, power structures, spiritual inclinations, and influential authorities (religious, governmental, and medical, among others) lead people to trust or not trust COVID-19 vaccines and information about them? How are COVID-19 vaccines understood, accepted, and/or supplemented by Asian communities of practice? How are other concepts of immunity mobilized and given authority based on preexisting onto-cosmologies and structures of trust? Protection, as the articles in this special issue suggest, is a historically constituted, experiential, processual, and relational category of knowledge and practice that demands multilayered attention in the face of crises like COVID-19. The disease itself and its causes are not monolithic either. Instead, in most Asian contexts, they are often believed to be historically contingent outcomes of actions and relations among humans, nonhumans, and more-than-human beings.
The articles in this special issue also explore the idea of immunity and vaccination by employing the concept of “structures of trust” in recognition that while biomedical vaccination rollouts have emerged as a nearly universally applied public health practice, there are multiple other ways that groups of people make sense of their bodies, their health, and disease prevention. They interrogate notions of immunity, focusing on the ways in which it is also culturally constructed and socially shaped through processes and practices that involve the intertwined spheres of cosmology, medicine, ritual, and health. Through the intersection of “faith in immunity” and “structures of trust,” the articles in this special issue explore the moral and political implications of immunization practices in general and COVID-19 vaccines in particular. The articles present ethnographically grounded analyses of different conceptualizations of personal and collective responsibility toward COVID-19 resistance. The contexts display various tensions and competitions among the forms of epistemic and epidemic authorities that come from religious, nonreligious, and spiritual traditions in Asia and globally.
In winter 2023, as we write this introduction, COVID-19 has phased out of its global emergency status, and yet the virus is still circulating in a number of variants, in combination with flu and other respiratory pathogens, stretching the capacity of healthcare systems. The World Health Organization recommends getting an additional dose of the new, updated vaccines, geared toward the recent variants, every six to twelve months. In December, COVID-19 cases rose steeply in Singapore, Malaysia. and Indonesia. In Thailand, the number of COVID-19 hospitalizations saw a spike at the beginning of the month. In view of the ongoing health risks, including those associated with post-COVID infection or what is often referred to as “long COVID,” Chinese, Tibetan, and Indian consumers rely upon remedies from traditional medical systems that have been promoted during the pandemic. In China, sales of popular traditional Chinese medicines have surged since the easing of the strict pandemic restrictions. There are more than eighteen recommended Traditional Chinese Medicines to prevent and treat COVID-19, including the patented herbal formulas Jinhua Qinggan capsules, Lianhua Qingwen granules, and Xuebijing injections.9 In Tibetan Traditional Medicine, Bawei Zhuyao powder (BZP) is one of the recommended drugs for the treatment of COVID-19 in the Tibetan Autonomous Region of China. In India, old and new commercial companies of Ayurvedic products have seen stellar revenues because of the increased demand for immunity-boosting products. Together with the unprecedented sales of chyavanaprasha, new research papers proliferated offering scientific investigations of the role of AYUSH-64, a polyherbal Ayurvedic formulation, in the prevention and management of COVID-19 symptoms, and ashwagandha (withania somnifera) for its potential as vaccine-adjuvant.
Vaccination remains an important and timely topic during the ongoing waves of COVID-19 infection. While we are aware of some efforts from social scientists to analyze perspectives on vaccines,10 the dominant discourse reiterated in academic literature pairs religious belief with vaccine hesitancy. Yet, recent scholarship suggests that what public health labels as vaccination “hesitancy” comprises multifaceted opinions and attitudes.11 People who do not trust all COVID-19 vaccines or complement them with other forms of protection and immunization (dietary supplements, ritual, alternative medicine, mantra chanting, etc.) do it for diverse motivations that cannot be reduced to ignorance, irrationality, superstition, or misinformation.12 These views and practices are closely tied to a variety of cultural, political, ritual, theological, and cosmological matters and indicate diverging conceptions of public engagement with state regulations, biomedicine, and ethical considerations of civic responsibility and freedom.13 Therefore, in-depth investigations focusing specifically on notions of faith in immunity are necessary to understand the epistemological and cosmological backdrops (which we are labeling “structures of trust”) that influence individual and communitarian decisions to vaccinate. For example, in Deepsikha Dasgupta’s article on devotees of the goddess Sītalā in the state of West Bengal, India, COVID-19 infection might be interpreted as the grace of Sītalā, yet the devotees had an active demand and not just a passive acceptance of immunization. The article argues that trust in the goddess helped build trust in vaccines. In Carola Lorea’s article on a Dalit religious community called Matua, emerging from Bangladesh, COVID-19 is viewed as a “white-collar disease” that can only afflict the upper-caste layers of the society who sit in air-conditioned offices. For the lower-caste rural dwellers, the multisensory ritual of kīrtan works as a “sonic vaccine” to keep bodies and villages protected.
Articles in this special issue explain the relational, nuanced networks of trust built over time that do not allow for neat boundaries between biomedicine and other medical practices or between vaccine acceptance and hesitancy. Elizabeth M. Elliott, Shogo Kubota, Dimbintsoa Rakotomalala Robinson, and Chankham Tengbriacheu’s article, for instance, shows how confidence in vaccines did not depend so much on indigenous epistemologies of healing in Laos, which are flexible and pragmatic in incorporating different approaches. They argue that trust in vaccines “is not based on abstract concepts” but rather “is highly relational” and so can be intentionally developed through the involvement of local communities, elders, religious leaders, health workers, and government authorities. Furthermore, concerns about the vaccine are related to distrust of the state for some ethnic and religious minority groups due to a history of disparity and inequity.
As the articles collectively demonstrate, “COVID-19 vaccine” is a plural category, elaborated not only in terms of the technologies employed and the labels under which they are produced but also in terms of the ways they are understood to provide immunity or protection. The choice of trusting or avoiding vaccines also depends on factors that transcend notions of immunity or vaccine efficacy. Nicole Charles complicates suspicion toward vaccines by viewing it as a “distributed affective form” that is not just about rational choice but also about affect, shaped by the socioeconomic and power relations that necessarily contextualize vaccine technologies.14 In the case of COVID-19 vaccines, important considerations include the national affiliation of the vaccine developer and/or producer and its entanglement with international politics, the status of the vaccine within international “vaccine diplomacy,” and the very material components of the vaccine’s substances, which may inform its religiously sanctioned status as haram, profane, dangerous, or permissible. During the pandemic, the COVID-19 vaccine emerged as a heterogeneous category with layered hierarchies, each carrying meanings, values, efficacy, and a symbology interweaving the medical, ritual, and political spheres. For example, in Indonesia, the concerns that the Muslim-majority population voiced about the vaccine often wove together disparate dimensions. Fears about the vaccine containing pig parts and therefore not qualifying as halal emerged hand in hand with fears over the effects of the Sinovac vaccine due to distrust in China and, more specifically, communism.15 By September 2022, however, Indonesia had reportedly vaccinated 87 percent of its targeted population, a goal largely achieved through cooperation with religious authorities and the adoption of religious language within vaccination campaigns.16 Even so, Indonesia moved forward to produce its own IndoVac COVID-19 vaccine, launched in October 2022, which has certified halal status from the Indonesian Council of Ulama.17 This move ties together nationalist concerns about vaccine dependency with strategies to encourage local acceptance of vaccines by seeking certification through the relevant religious government body.
As we have witnessed across the world over the past three years, the state is an important actor in constituting structures and cultures of trust in vaccines. The articles in this special issue reflect on this significant and complex relationship between the state and communities that defines health, disease, protection, and the place of vaccination in specific ways. As the articles show, trust or distrust in state initiatives and mandates during the pandemic often reproduces already existing tensions and hierarchies between states and people. In Tatiana Chudakova’s contribution, through an ethnography of the Russian antiviral drug “Arbidol” (umifenovir), the author uses the controversy surrounding the development and testing of the drug and the politics of drug scarcity as a way to engage with notions of conspiratorial thinking, showing how rumors and “conspiracy” in times of social and medical crisis like those brought on by COVID-19 shift the terms on which articulations of efficacy are made possible.
Xuanxuan Tan’s article presents a different configuration of the relationship between citizens and the nation. In her case study, Chinese citizens exercise a form of “immunity nationalism” by taking the vaccine, creating solidarity by invoking individual obligation toward the collective and the state in China. In the Tantric Buddhist state of Bhutan, discussed in Barbara Gerke’s contribution, a high acceptance and fast distribution of the COVID-19 vaccine was accompanied by state-promoted involvement of the monastic community. Vaccines were blessed at the airport upon their arrival. The mantra of the Medicine Buddha was chanted ten million times. An astrologically appropriate date was fixed for the inauguration of the vaccination campaign. In sum, contrary to the mainstream narrative of mass media, medico-religious engagements and ritual practices, in many cases, played a supportive role in vaccination efforts due to the malleability of traditional disease etiologies.
Faith, Immunity, and Religion
In March 2020, the Gayatri Pariwar, a Hindu-adjacent religious movement that promotes a regime of personal and social reform based on modernized Vedic rituals, mantras, and herbal recipes, urged its followers to act as COVID-19 first responders, empowered by ritual practices that render their bodies immune.18 Fire sacrifice (yajña) involving the medicinal smoke of cow dung and herbs such as giloy and tulsi was particularly recommended, together with synchronous chanting of the powerful Gayatri mantra. Both rituals morally and materially purify the adherents’ bodies, their surrounding environment, and society at large. The antibacterial and immunity-boosting properties of the fire sacrifice rely on scientific insights derived from a mixed bag of allopathy, Ayurveda, and naturopathy.19 The ritual immunity did not deter the followers from complying with governmental mandates on hygiene and social distancing. On the contrary, Gayatri Pariwar members were urged to behave like model citizens, respecting all the regulations on COVID-19 prevention and helping those unable or unwilling to do so.20
Our title, “Faith in Immunity,” serves to deliberately unsettle assumed dichotomies between religion and science, ritual and medicine, and sacred versus rational. The faith we refer to does not allude to institutionalized faith and spirituality in clinical practice. Although we are interested in how religion underlies medical and therapeutic knowledge,21 “faith” here does not stand as a more benign word to imply blind acceptance of religious truths. There is nothing particularly religious about faith, just like there is nothing especially scientific about immunity: as the people who populate these articles will show, one can seek immunity through traditional ritual performance and also nurture faith into one or more systems of therapeutics, be it traditional medicine, biomedicine, or any other kind of healing tradition. At the same time, observers have postulated that the COVID-19 pandemic, particularly when compared to previous pandemics, revealed a pervasive and unprecedented faith in science;22 such faith does not come with a secularist disenchantment of the world but rather coexists with a plethora of nonbiomedical techniques to achieve immunity. In Enlightened Immunity (2018), for instance, Paul Ramírez writes that Spanish physicians committed to implementing inoculation against smallpox in Mexico employed the image of Minerva, goddess of wisdom, as the Enlightenment’s muse of medicine; when the time came to promote new public health initiatives, like vaccination, the path would be paved by a host of celestial and terrestrial mediators, including Catholic priests, female healers, Spanish administrators, local “Indian” governors, as well as barber-surgeons and parading statues of saints.23 Faith has been long trapped in the domain of irrational and fatalistic belief, while immunity has been constructed through the dominant attributes and vocabulary of Western medicine. In the field of therapeutics, these domains are blurred.24
During the COVID-19 pandemic, mainstream media revived the science versus religion debate. This binary understanding was exacerbated during the first phases of vaccination rollouts – for example, when white American evangelical Christians, in particular, rejected practices aimed to minimize the spread of COVID-19, like mask-wearing, in view of a long-standing distrust of science.25 In the debate over vaccination, some evangelical Christians and conservative Catholics rejected vaccines on the basis that fetal stem cells acquired from an elective abortion were used for their development. However, fetal cell lines (which do not contain fetal tissue) are used in laboratory testing of a plethora of common, over-the-counter drugs, which are not typically opposed or avoided on religious grounds.26 Anxieties and moral panic generated by the material substances – be it fetal, porcine, or bovine material – employed for the development of vaccines appeared in several Asian religious communities and led to specific deliberations (e.g., the use of certified halal vaccines in Indonesia).27
Alongside vaccines, other methods to achieve protection and immunity have been offered by traditional repositories of knowledge and their authoritative actors, both human (e.g., ritual experts who are often assigned tasks such as curing somatic ailments, fostering spiritual strength, dealing with dying, and dispelling evil entities) as well as nonhuman – ranging from protective deities to apotropaic objects and subtle body energies. For example, Sinhalese Buddhists in Sri Lanka sought immunity through vaccination, Buddhist practices, and Ayurveda. Both Buddhist temples and the national government are institutions providing structures of trust in a time of crisis, and both promoted an assemblage of remedies and strategies; but, during the pandemic, the first emerged as a solid institution that people could rely upon, while the second collapsed.28 In Asian societies, collaborations between goddesses and variolation, monks and physicians, rituals of protection and immunity-boosting herbal pills are far from new. A focus on Asia to understand the fortunes and shortcomings of COVID-19 vaccine responses not only offers an alternative to Western-dominated mediatized and academic accounts of the pandemic. It also offers a privileged platform to scrutinize the mutual shaping of religion and medicine and their global history of differentiation into discrete categories with often fragile yet hotly negotiated boundaries.29
Faith in immunity offers a space of encounter, an epistemic borderland30 where we can abandon the temptation of separating phenomena into neat categories like religious, medical, moral, and political; instead, we can concentrate on how people from various Asian communities have proactively sought or rejected vaccines and/or other means of immunization for COVID-19 contagion in their everyday lives and in accordance with preexisting structures of authority, reliability, and efficacy. This epistemic borderland reveals that entanglements between the unstable categories of religion and medicine can be observed especially well at the margins of both.31 While deliberately destabilizing arbitrary categories, the space of religio-medical encounter is not devoid of hierarchies. The label “faith-healing” may exclude religious therapeutic practices from national healthcare systems, whereas secularized forms of premodern medicine deemed “traditional,” “alternative,” or “integrative” might be sanctioned or subsidized by some states. Due to the specific evolution of Western biomedicine and its worldwide spread with violence, conquest, colonialism, and cultural imperialism, differentiating “religion” and “medicine” has become a global concern.32 Science itself underwent processes of sacralization and fetishization in modernity33 where doctors are the new prophets, science is the new religion, and physical examinations in clinical settings are important rituals.34
In the regional and national contexts addressed in this special issue (India, Bangladesh, Sri Lanka, Bhutan, eastern Siberia, China, and Laos), the rush to procure COVID-19 vaccines and the effort to promote their acceptance and inoculation coexisted in diverse ways with sources of immunity generated by vernacular healing systems, religious leaders, and traditional medicines. Responses have unfolded in accordance with loyalty, or mistrust, toward the nation-state apparatus. Throughout the regional spectrum, mass vaccination has been legitimized by state policies and governmental plans for immunity. But which vaccine? Paths to immunity in this collection emerge as plural and relational. The COVID-19 vaccine itself was not lived as a single fact. Anxieties and suspicions about multiple COVID-19 vaccines, their material components, and geopolitical provenance revealed another instance of the continuous entanglement of religious, medical, and political spheres. As we write this introduction, for example, Nepal has announced that four million doses of the Chinese-made Sinovac will be destroyed as it has been declared unfit for the inoculation of booster doses.35
What is meant by immunity might be profoundly different depending on historical contingencies, cultural settings, geographical location, and social dimensions like age, gender, class, ethnicity, and caste. The understanding of immunity in the articles presented in this collection encompasses the performance of good citizenship, the reliance upon salvific soundscapes, religious rituals, astrology, and Ayurvedic tonics. The building of relationships with the “other” – the virus, the state, the community – features more centrally than the protection of the “self” from contagion. In times of social and medical crisis, pharmaceutical and political efficacies are mutually co-constituted.36
In tandem with faith and accompanied by structures of trust, the endeavor to achieve and enhance immunity during a global health crisis emerges not only as protection from but also as “exploration” and engagement with the other.37 The immunity-seeking journey in Asian societies has thus manifested in multiple ways of engaging others. On the one hand, it has involved invocation and propitiation of nonhuman, invisible others, such as spirits, deities, and healing energies. On the other hand, it engaged the cultivation of selflessness, for example, by meditating upon the ontological absence of self or by prioritizing the good of the community, offering organized aid and charity, or forging new ties of solidarity.38
It is in the reconsideration of the medical and philosophical categories of self and other that thinkers like Roberto Esposito have questioned traditional categories of the political (e.g., community) in light of the emergence of biopolitics.39 Esposito’s idea of immunity, resonating closely in the everyday practices and narratives of immunization presented in the articles in this special issue, is not a function of separation but a function of relation. Community and immunity ought to be placed in a reciprocal relation rather than in opposition (Esposito does so by recuperating their common root – the Latin munus signifying debt, duty, obligation, or gift).40
Conceptualizations of immunity in the case studies presented in this issue only peripherally deal with medically efficacious technologies that protect from outsider invaders; rather, multilayered representations of immunity emerge at the confluence of specific cosmologies, identity narratives, building of relationships, structures of trust, and negotiations of epistemic authority. This is of particular significance if compared to the Western scholarship that has taken the assumedly secular Global North as the sole and self-referential point to theorize the meanings of immunity and its relation to body, nation, biopolitics, and community.
The variety of narratives and processes of immunity detailed in this issue and the lack of frameworks to discuss them beyond the hegemonic model of secular modernity in the Global North suggest that we need a more inclusive understanding of faith in immunity. Rather than “mental vaccines”41 against infectious ideas, we need tools to describe, understand, and explain diverse responses to clinically tested COVID-19 vaccines, motivations behind hesitancy, alternative immunity-seeking behaviors, as well as the unproblematic acceptance of state-led vaccination campaigns. Like any kind of treatment or pattern of resorting to body ailments, vaccines involve hoped-for results and create expected results. Hopes and expectations are not merely derived from the physical and biological matters composing a vaccine but are emplaced in broader social and cultural constellations. Therefore, a COVID-19 vaccine might be efficacious because the nurses are channeling the grace of the smallpox goddess Sītalā42 or because consultation with the royal astrologers has ensured that they are distributed at the most auspicious time.43 In the case of treatment as well as prevention, the therapy “reflects the level of culture, and the moral and cosmological assumptions” of the society that offers it, thus “providing an assurance that the attempt to restore health, reduce pain,” – or slow down the spread of a novel coronavirus, we might add – “is in harmony with the world-view of the sufferer.”44
COVID-19 Vaccination
Protecting oneself from afflictions and diseases has been the fulcrum of medical knowledge and practice since ancient times. In “Airs, Waters, and Places,” Hippocrates begins his treatise by alerting practitioners of medicine to the significance of seasons and the nature of winds, especially in strange and unknown cities, in determining disease or predicting which epidemics might arrive in a place at a given time.45 The “constitution” of people in cities that are exposed to hot winds, he writes, will be “humid and pituitous,” where men will experience diarrhea, dysentery, and chronic fevers in winter, and women will be prone to excessive menstruation and miscarriages. Similar ideas about the porosity of the body and its intimate relation with the seasons, environment, and the cosmos have existed and continue to exist in most medical systems in Asia and beyond, including ancient Persian medicine, Ayurveda, traditional Chinese medicine, and Malay medicine. In Ayurveda, the body incorporates elements from the environment like earth, fire, water, air, and space, and in that, it is a microcosm of the environment. In ancient Greek and ancient Chinese medicine, bloodletting as a common remedy for several diseases was based on assumptions about plethora/excess or lack (of blood, semen, etc.) that, in turn, was rooted in ideas of the body constantly interacting with the environmental elements that it is embedded in.46 Although there were divergences and similarities in these forms of medicine as they were conceptualized and practiced at different historical moments, a significant idea to remember and that our special issue explores is the multiplicity and polyvalence of concepts like “bodies,” “good health,” “protection,” and “immunity.” Ancient Greek and ancient Chinese medicine were both robust forms of knowledge, but in the former, the body was approached through muscles and organs as they emerged through studies in anatomy where primarily dead bodies were studied, whereas in the latter, the body was conceptualized through channels through which the qi flowed, and that was based on the study of living human beings.47
“Good health” and physical fitness in biomedicine, as Joseph Alter argues, even from a holistic perspective, are still regarded as “bounded, predetermined, natural states of balance” that can be reached and maintained by treating illness, and this “epistemological hegemony of remedial bias” dominates most institutionalized medical practice.48 In Ayurveda, on the other hand, instead of maintaining and returning to a preestablished notion of body and health by curing oneself from disease, the goal is “a radical, often forceful, often struggling mode of metabolic, humoral body-building and cosmic self-improvement – a quest for equipoised perfection in an inherently and naturally imperfect world.”49 Understood that way, approaches to immunity from a disease take different shapes than administering a vaccine. One of the underlying themes of the special issue is to unsettle the idea that immunity and health are stable, singular ideas that are rooted in biomedicine, where any other conceptualization is an “alternative” or another “perspective” on the same thing. Along with opening up some of these concepts in biomedicine – provincializing biomedicine, if you will – we want to see the epistemological possibilities when ontologically different concepts and forms of knowledge come together, interact, and interreact in complex ways. As Catherine West and Kanchana Dodan Godage’s article in this issue shows, the national government in Sri Lanka and the prominent Narada temple might initially seem like they will have mutually exclusive ontologies of immunity, but they in fact had similar pathways to immunity.
In the past two hundred years, there has been a steady increase in the number of diseases that are covered by vaccines. Vaccines have historically mirrored varied and often conflicting ideas about health and disease. As much as vaccines have been considered one of the most significant achievements in biomedicine, there has been consistent hesitancy in their adoption for various reasons, including mistrust toward the state, religious preoccupations, uncertainty around the long-term impacts of vaccination on bodies, and the role of large corporations in producing and disseminating the vaccines. Vaccines, in their most general description of containing weakened or killed microbes resembling the microorganism of the disease that it aims to protect against, are recent in the history of biomedicine. However, the assumption that transferring materials from the body of a diseased person to a healthy person might protect them from the disease has been prevalent in medical thinking and practice since at least the fifteenth century. Long before the discovery and use of the smallpox vaccine in the late eighteenth and early nineteenth centuries, there were attempts to expose healthy people to smallpox and other diseases to protect them from the disease through a process known as variolation. Dried scabs were taken from the skin of affected people and blown into the nose of healthy ones. Yet immunity, in the way it gets deployed as a concept in biomedicine in the present moment, is often anchored on ideas about a contained, bounded self that is protected against nonself through vaccines. Medical anthropologists have revealed the predominance of war metaphors to make sense of the body’s immunity system.
The notion of the immune “system” as an organized and synchronized system of antibodies, macrophages, and lymph nodes, according to Emily Martin, was first made popular in the US media through magazines like Reader’s Digest in 1957 and later through films like the Fantastic Voyage (1966).50 The immune system response is compared to eliminating foreign, nonself intruders as a defensive response against attacks from the outside. This Cold War-induced vocabulary is still dominant in the way viral contagion and epidemics are socially understood and how responses are conceived.51 Images of the vaccine bottle and an injection against the backdrop of the iconic gray-and-red spiky ball representing the SARS-CoV-2 virus will perhaps stay in the public imagination for several decades to come. Socially, doctors and nurses are described as being busy in the trenches, “fighting” against an invisible invasion from the front lines in the same way that political leaders strategize to win the “battles” against COVID-19 and beating the “enemy,” that is, the virus. Military lexicon and war metaphors are as profuse as they are situated, ethnocentric, and responsible for cocreating cultural prejudice.52 Taking on Donna Haraway’s view that “the immune system is both an iconic mythic object in high-technology culture and a subject of research and clinical practice of the first importance,” anthropologists have analyzed the imaginaries of the immune system as science’s frameworks for describing alterity.53 In Haraway’s words, “myth, laboratory, and clinic are intimately interwoven.”54 In the myth narrated in scientific and popular literature on immunology, the body has absolute and rigid boundaries, and the immune system is characterized by the ability to distinguish between self and nonself.55 The immune system also acts as the body’s own police force, programmed to distinguish between bona fide citizens and illegal residents.56 Thus, the racialized and xenophobic language that is written into the scientific knowledge on viral contagion and immunity trickles down the popular perceptions of and preconceptions on the coronavirus, including the anti-Asian and anti-Chinese prejudice that virally spread during the COVID-19 pandemic.
Like many other biomedical interventions, vaccines tread the slippery slope of immunity. Protection against the COVID-19 virus implies, at the same time, catching up with the mutability of the virus and the resulting instability it causes in bodies affected by it, and the fortified place of biomedicine in most of Asia and arguably most of the world. In drawing a strict line between the self and nonself that is otherwise fluid, changing, and liminal, COVID-19 has been yet another moment when the social, biological, and biomedical have been entangled in perverse and complex ways. Building on Ilana Lowy’s argument that immunology is a “boundary concept”57 – “one that is lose [sic], imprecise, open to interpretation and open to the demands of the changing world” – Talieh Mirsalehi, using ethnographic examples from immigrant communities in Sweden, argues that “in the context of migration, the notions of risk and immunity are also fluid, boundary and imprecise concepts that are diversely defined and internalized by different groups.”58 Immunity, in Mirsalehi’s work, cannot necessarily be ensured through a vaccine, but it is a long process where the body learns how to heal as it moves through the difficult social and material conditions of being an immigrant. In other examples, structures of othering created “riskscapes” that can be understood as “shifting landscapes of networked risks – both individual and collective – that shape the way people act,”59 where otherness was imagined and constructed through mobility and the mobile bodies of truck drivers and traders.60 In some parts of Africa, for instance, the low rates of COVID-19 cases toward the beginning of the pandemic drew on narratives of scientific racism attributing “‘magical immunity’ for illness” to “[defective] biological differences.”61
Along with the lack of certainty about the vaccine itself, especially in the Asian context, there were other social, political, and economic relations that led to the emergence of individualized ideas of immunity. Personal conversations and social media were flooded with indecisions around choosing the right vaccine for oneself and one’s community. Whether it was the choice between Covishield (an adenovirus vector-based vaccine) or Covaxin (which contained weakened viral material) in India or the choice between the US- or China-produced vaccines in Singapore, Philippines, and other Asian countries, building immunity often got tied to individual bodies, practices, and decisions. Antibodies became the index for measuring immunity that “gave people the agency and control during a period of deep frustration, anger,” and antibody-related practices in places like the Philippines became “biosocial practices” that reinforced the “responsibilization of the individual that characterized contemporary public health.”62 Antibodies blurred the boundary between the human self and the viral nonself and, instead, created a “multispecies sociality”63 where antibodies interfaced between the two.64 This special issue interrogates immunity as a material-semiotic terrain that blurs neat boundaries between categories like social, biological, and biomedical by reproducing the historically grounded othering of bodies, communities, and practices, as well as by locating the responsibility of being immune to individuals deeply embedded in neoliberal frameworks.
Structures of Trust
Although vaccine hesitancy is often characterized from a public health perspective as stemming from a misunderstanding of science to be fixed with better education and access to information, trust has increasingly been acknowledged as an essential and foundational component of this equation.65 Elements of trust or distrust in scientific institutions, the pharmaceutical industry, and those who hold political power all play into decisions about vaccination and shape the way that people assess risk and seek to protect themselves. Maya Goldenberg emphasizes the importance of trust in public health interventions like vaccination campaigns and applies a framework that puts moral responsibility for vaccination not only on the public – she also argues that scientific institutions and governing bodies must earn public trust. Accordingly, she argues that “public resistance to vaccines is a demand for institutional structures that are responsive to issues and justice and equity.”66 Notably, researchers have already correlated trust with COVID-19 resilience in various national contexts.67 As comparative studies conducted across nations show, trust in vaccines or science during COVID-19 mirrored trust in the already existing political structures of those nations.68
A policy brief about vaccine hesitancy in South Asia identifies trust as a critical factor in vaccination campaigns, pointing out that policy measures put in place early on in the COVID-19 pandemic that targeted minority groups threaten to undermine vaccination efforts because of the way they have already fueled distrust.69 Pandemic restrictions on movement, gatherings, and other activities were not equally applied and felt across different social categories and statuses. One extreme example is the cremation mandate implemented in Sri Lanka, which was argued on the basis of concerns about contamination of groundwater and enforced despite official WHO guidelines that would allow either burial or cremation.70 Of course, this policy significantly impacted Muslims, as cremation is against Islamic burial practice and considered sacrilegious, jeopardizing the deceased’s salvation in the afterlife. Such policies, often products of already established patterns of marginalization and distrust, need to be considered in analyses of vaccination campaigns, as memories of these experiences can contribute to multilayered feelings of distrust and suspicion that endure for generations. Feelings of suspicion toward the HPV (Human papillomavirus) vaccine articulated by parents in Barbados were explicitly linked to embodied feelings shaped by race, slavery, and “sordid legacies of biomedical injustice.”71 Such contextualizing histories demonstrate how the cultivation of distrust necessarily shapes responses to vaccine campaigns.
Minority ethnic and religious groups across Asia often have uneven relationships and interactions with the state that necessarily impact feelings and decisions about vaccination. Hmong in Laos, through previous interactions with the state and healthcare institutions, have experienced inequities that have cultivated distrust. In Elliott, Kubota, Robinson, and Tengbriacheu’s contribution to this special issue, trust is approached not as something that can be taken for granted but as something that can be actively cultivated between healthcare officials and those in Hmong communities. It also underlies the relationality that ties together healthcare workers, patients, and their families and a broader link to the state, which all relate to “gradients of trust” in vaccines.
Misinformation is consistently characterized as one of the most persistent challenges to vaccination campaigns, dovetailing with the assumption that vaccine hesitancy must be fixed through better education. A study that finds a strong association between belief in COVID-19 misinformation and low trust in science also argues for the importance of science initiatives for the public as a “prophylaxis” against misinformation.72 In the age of social media, this has presented particular challenges, as posts with unverified information can easily “go viral” and gain legitimacy by virtue of their repetition with unprecedented speed. In response, the WHO released a statement about the “infodemic” paralleling the pandemic, characterized not by lack but an overabundance of information that can “undermine the public health response and advance alternative agendas of groups or individuals.”73 Across Southeast Asia, as governments have taken various approaches to weed out misinformation spread online, this has also raised serious questions – also related to trust – about the abuses of power related to censorship, such as in Myanmar, where the primary websites blocked on the basis of spreading “fake news” are ethnic minority websites.74
The discourses about COVID-19 and vaccines that circulate in mainstream and social media can provide vernacular interpretations of viral infection, protection, and immunity. Within what has been dubbed the infodemic, the focus has largely been on diligently debunking misinformation. Heidi Larson’s work emphasizes that this approach mischaracterizes the issue, as she states: “We don’t have a misinformation problem, we have a relationship problem.”75 Rumors spread information (whether true or not), and understanding the broader ecosystem that makes them stick is important for vaccination campaigns, which depend on trust and a “social contract whose fabric is eroding in a broader context of anti-globalization, nationalism, and populism.”76 Furthermore, within these analyses, it is important to consider how people might simultaneously hold various beliefs that are not mutually exclusive. In Ethiopia, where interpretations of the COVID-19 pandemic among Christians and Muslims were based on a framework of divine judgment and where recipes for popular remedies involving ginger tea were circulated on social media, these did not negate the general acceptance of and compliance with biomedical interventions and government-implemented pandemic restrictions.77 Ethnographic approaches are particularly informative in these analyses to help understand how social media posts, rumors spread by word of mouth, and directives from public health officials are actually interpreted and enacted.
Within this relationship of trust that is significant for decisions people make about vaccination and protection, the state emerges as an important actor. Here, “the state” must be understood beyond its narrow meaning as a formal political entity to consider people’s everyday interactions with manifestations of state power and its relationship with biomedicine. In postcolonial contexts, colonial histories of vaccination with an eye toward maintaining a working labor force and maximizing resource extraction continue to shape contemporary attitudes toward international vaccination campaigns, often funded by international donors.78 Neither should the state be restricted to its understanding in a purely national sense since geopolitical hierarchies also shape popular perceptions of the desirability and efficacy of pharmaceutical products, as is further explored by Tatiana Chudakova in her contribution to this issue. To cite an earlier example provided in this introduction, the CIA operation in Pakistan disguised as a vaccination campaign has also made subsequent vaccination campaigns subject to suspicions about “hidden interests” and vaccination as a front for the sterilization of Muslims on a global scale.79 Gideon Lasco outlines the way in which “medical populism” as exhibited by leaders in the Philippines, Brazil, and the United States during the COVID-19 pandemic impacted the framing of the pandemic, with long-lasting consequences.80 He notes that while in each case, the response was seen as anomalous, the responses actually exhibited patterns that should be documented and anticipated for future pandemics, including the way in which all of the leaders focused on oversimplifying the pandemic and also exploited the opportunity to forge divisions for political gain.81
Although Japan is characterized as a country with high vaccine hesitancy, there is also a significant history of vaccine promotion by the state and acceptance by the general public in Japan, indicating a more complex relationship with rising and falling trust over time.82 A complicated history with vaccines continues to shape present attitudes, including vaccine mandates in post-World War II Allied-occupied Japan and cases of death due to defective vaccines, such as a toxic diphtheria vaccination administered to infants that led to eighty-four deaths.83 More recently, the government decided to suspend the recommendation for the HPV vaccine in 2013 after the media began reporting adverse events and questioning the vaccine’s safety.
Ideas about immunity and protection that influence vaccination practices are also intertwined with understandings of citizenship. Bernice Hausman outlines the way in which somatic individualism, as a form of biological citizenship, underlies some attitudes of vaccine resistance.84 For example, families in the United States who were skeptical of H1N1 flu vaccines held common understandings about immunity as needing to be built up naturally through becoming ill and then recovering, an understanding that “may include a tolerance for illness that does not match the goals of the state to protect communities against infectious diseases.”85 Taking a historical view, in late nineteenth-century England, the notion of “good citizenship” was used to justify both pro- and antivaccination positions, as the former argued that it was necessary to protect other citizens from disease and the latter argued that being a good citizen should also mean respecting the rights of other citizens.86 In Xuanxuan Tan’s article in this special issue, she investigates how Chinese citizens articulated the importance of vaccination against COVID-19 as becoming a good citizen specifically through taking action to avoid becoming a burden on state resources.
In addition to state actors, religious leaders have been recognized as having particular authority to shape public reception of COVID-19 vaccination. While a minority of global religious leaders have spread antivaccination messages, these messages can become disproportionately influential.87 The potential impact of religious leaders in many areas of the world also means that the government and public health actors have worked to engage with religious authorities as influential components of a vaccination campaign.88 Scholars of religion in the Philippines wrote to the Journal of Public Health about the necessity for the Catholic Church in the Philippines to work with the government and public health institutions to help win over public trust in COVID-19 vaccines.89 In addition, religious groups and scholars have been vocal about issues of equity in the global distribution of vaccines,90 also arguing for the suspension of patents based on an application of religious ethics.91
Overall, this special issue identifies structures of trust, and the ecosystem of trust shaped by notions of immunity and protection and the political and spiritual relationships that influence them, as central in understanding responses to COVID-19 vaccines across Asia. Going beyond a popular (and Western) association between religiosity and vaccine exemptions, the articles in this issue draw attention to the elements of ritual practice, religious belief, and natural and biomedical remedies that have shaped various approaches toward health and immunity in the context of a global pandemic.
Articles
Elizabeth M. Elliott, Shogo Kubota, Dimbintsoa Rakotomalala Robinson, and Chankham Tengbriacheu contribute an understanding of trust as relational and recount successful strategies employed during the COVID-19 vaccination campaign in Laos to intentionally cultivate trust. Their contribution implicitly challenges analyses that assume that lower vaccination rates among select religious groups must be due to religious doctrines or beliefs that categorically reject vaccination. They focus on the COVID-19 vaccine campaign in Laos and in particular among the Hmong, a predominantly animist highland ethnic group with a growing Christian minority. They argue that local notions of immunity and healing epistemologies remain flexible and accommodate biomedical strategies. Instead, the main factor that explains lower vaccination rates among the Hmong is patterns of inequity and a more tenuous relationship with the state that has fostered distrust. Through ongoing engagement with and ethnographic research among Hmong and Lao communities in Laos, the authors provide rich material documenting the rollout of the CONNECT approach, intentionally designed to help foster trust between those providing and receiving vaccines in Laos.
Also dealing directly with the intersection between vaccination and the state, Xuanxuan Tan’s contribution investigates how the concept of “not burdening the state” became an expression of national identity during China’s COVID-19 vaccine implementation program. The study shows how vaccination provides a pathway for some Chinese citizens to practice what she identifies as “immunity national identity,” creating solidarity with the state by performing individual obligations toward the collectivity. In this process, the science of vaccines is politicized, contributing to the building up of national identity. By showing how the immunized and vaccinated body works as a place generating national identity, this article argues that immunity, residing beyond the healthy body and entangled in narratives and attitudes toward the state, also becomes a means of strengthening and imagining “us.” Here, national identity interacts with vaccine-related information, influencing individuals’ willingness to accept vaccines. This contribution shows how the act of vaccination and public knowledge about vaccines further shape national identity.
Similarly related to issues of the perception of the state as an issuer of vaccination and in contrast with Tan’s article, Tatiana Chudakova explores mistrust and the relationship between medical and political efficacy, using as a case study the Soviet-made antiviral drug “Arbidol” (umifenovir). Her contribution draws attention to the ways in which global pharmaceutical hierarchies and international political flows get taken up by Russians in Buryatia as meaningful in terms of assessing the efficacy of biomedical pharmaceuticals. She analyzes the way in which Arbidol was deployed in cultural responses to the H1N1 outbreak in 2009–10 and during the COVID-19 pandemic. Chudakova examines how rumors and “conspiracy” in times of social and medical crisis shift the terms on which articulations of efficacy are made possible, showing how the drug came to be perceived as highly desirable despite the way in which it also became an index for state incompetence and Russia’s marginalized position on the global stage.
Deepshika Dasgupta provides a historically contextualized ethnographic article based on fieldwork conducted in West Bengal, India. She argues that Sītalā’s place as a “lesser” or “lower-caste” Hindu deity worshipped by marginalized sections of society makes their active demand for vaccination an act of assertion. Drawing on the work of David Arnold, who has analyzed other vaccination campaigns in India in tandem with the colonial exercise of control over imperial subjects,92 Dasgupta reveals how the history of smallpox vaccination is entangled with devotional and therapeutic regimes in relation to a smallpox goddess, like the Sītalā in Bengal and Mariamman in the Tamil south. The disease is understood as the presence of the goddess in the body of the devotee, “graced” by the deity and bound to provide cooling offerings that are at once a ritual obligation and a medically efficacious response. Like other epidemics past and present, COVID-19 was understood by these religious groups as falling under the jurisdiction of Sītalā, whom they worshipped to seek protection. Rather than juxtaposing faith in the goddess and trust in biomedical science, Dasgupta shows that Sītalā devotees are informed by a plurality of understandings of body, disease, and prophylaxis in the Covidian age. She argues that when COVID-19 vaccines became available, Sītalā devotees proactively sought the injection and the booster jabs, sometimes embarking on long journeys to reach the nearest vaccination center. Devotees interpreted the agency of the medical personnel and the work performed by the COVID-19 vaccines as inspired and enabled by the power of the goddess. Far from discouraging her ritual community from seeking biomedical remedies, Sītalā practices and faith in the goddess have helped build trust in biomedical interventions like vaccines among her devotees.
In Carola Lorea’s contribution, we learn about narratives of immunity that are embedded in the social and religious context of the Matua community, who adopt the concept of a sonic vaccine – the practice of kīrtan – and a kind of power (śakti) accumulated through physical agricultural labor. She explains how members of the large Matua religion, a displaced Dalit community from Bengal, believe that the coronavirus can affect only the upper-caste/class layers of society, those who sit in air-conditioned offices and live in big cities. Matua devotees, on the other hand, as a predominantly rural community inhabiting multiple fringes (the borderlands of India and Bangladesh, the peripheries of unorthodox Vaishnavism, and the social margins of untouchability), have unique forms of immunity based on this social location and spiritual conceptualization. Immunity is achieved with collective rituals that involve loud sound, strenuous dance, and inwardly felt vibrations of a sacred drum. At the same time, the physical agricultural labor in contact with mud, water, and harsh sunrays guarantees that Matua bodies have heightened strength and resilience. These paths to immunity are proudly declared and articulated with the support of Anglophone biomedical terminology. The article presents these insistent narratives of immunity and the recurrent interpretations of the pandemic that fit into the broader onto-cosmology and sociocultural imagination of the Matua religious movement spanning West Bengal, Bangladesh, and the Andaman Islands, challenging the hegemony of Western biomedical concepts of immunity and vaccine.
Whereas Lorea’s article reveals how community-based ideas of sonic vaccination can have their own legitimacy alongside mass vaccination campaigns, Barbara Gerke’s article explores the supportive relationship between Buddhism, traditional Tibetan medicine (Sowa Rigpa), and COVID-19 vaccine responses in a different context. Gerke’s multisited ethnography of the exiled Tibetan government in Dharamsala and the Tantric Buddhist kingdom of Bhutan shows that Vajrayana Buddhist communities have a remarkably high acceptance rate of biomedical approaches to COVID-19, including vaccination. For example, Bhutan vaccinated almost all of its adult population within two weeks. In both scenarios, the medical personnel collaborated closely with Buddhist leaders, ritual specialists, and astrological insights to promote vaccination. The contribution demonstrates that medico-religious and Buddhist ritual engagements, as well as astrological calculations, played a supportive role in the success of the vaccination campaign. After a discussion of Sowa Rigpa textual explanations of infectious disease transmission and ideas around contagion, Gerke unfolds a layered argument. On the one hand, long-established confidence in religious (high lamas) and governmental authorities (in Bhutan, the king) and existing public health structures (e.g., mother-child vaccination programs) has guided people’s acceptance of vaccinations. On the other hand, medico-religious and ritual engagements, including wearing a rimsung odorous pill and involving astrological ideas of temporal auspiciousness, have created additional layers of trust and played a supportive role. However, the status and role of Sowa Rigpa in fighting COVID-19 manifested in divergent ways in the two countries. Practitioners in Bhutan showed disappointment at the lack of official therapeutic engagement with Sowa Rigpa during the pandemic, which they also attributed to the increased trust in the hard sciences in a phase of economic reconstruction in Bhutan. In comparison, Sowa Rigpa in Dharamsala experienced a revival, with many Tibetans relying on Tibetan formulas when contracting COVID-19. After some initial tensions with Indian government authorities, Men-Tsee-Khang physicians were allowed to treat COVID-19 symptoms and distribute preventive formulas. Sowa Rigpa institutions in Bhutan, however, were only allowed to engage with preventive, noninvasive remedies, potentially indicating a shift in the governmental attitude toward Sowa Rigpa if compared to previous decades.
Finally, Catherine West and Kanchana Dodan Godage’s article ethnographically demonstrates the quotidian ways of negotiating and building structures of trust in the Buddhist nation of Sri Lanka. By focusing on the practices adopted by the Sinhala Buddhist Sri Narada temple in Narahenpita and conducting a textual analysis of the Sinhala Buddhist national government’s response to the pandemic, the article shows that even though both these organizations adopted similar symbolic and practical pathways to immunity, like combining vaccination, Ayurveda, and Buddhism, the outcome was significantly different leading to the formation of differential structures of trust at local and national levels. Established in 1971 and funded by wealthy donors from Sri Lanka, Singapore, Malaysia, the United Kingdom, the United States, France, and Australia, Sri Narada temple, along with performing religious and ritual practices, is a place of teaching religious texts to young students as well as providing material support to devotees who need it. Balancing spiritual aspirations with material circumstances – a foundational ethic in the temple – mirrors the head Venerable Samitha Thero’s personal dilemma of balancing life in aranya, a secluded life in the forest, with grama or village life. No wonder that these quandaries became even more complex in the face of COVID-19. The question, in these situations, is not which of biomedicine, ritual, mantras, or Ayurveda is more trustworthy but rather what are the material conditions of their deployment, what endows them with trust, and what are the contexts of administering and circulating knowledge about them.
As the article shows, members of the Sri Lankan government used similar methods to the ones used by the temple, albeit sometimes more punitive, to create symbolic and material immunity from the virus, but their actions were critiqued by people as self-serving, and the president’s status as the morally upright and cosmologically appropriate “good Buddhist king” was compromised through the process.
Authors’ Biographies
Carola E. Lorea is Junior Professor of Rethinking Global Religion at the University of Tübingen. Her work on oral traditions and popular religious movements in South Asia was supported by research fellowships at the Asia Research Institute (National University of Singapore), the International Institute for Asian Studies and the Gonda Foundation (both Leiden), the South Asia Institute (Heidelberg), and the University of Rome. Her monograph, Folklore, Religion and the Songs of a Bengali Madman (2016), discusses the intersections of religion, displacement, and sacred sounds through the lens of performance.
Erica M. Larson is a research fellow at the Asia Research Institute, National University of Singapore, and is a coeditor of CoronAsur: Asian Religions in the Covidian Age (2023). Her anthropological research focuses on religious pluralism in contemporary Indonesia, and she is the author of Ethics of Belonging: Education, Religion, and Politics in Manado, Indonesia (2024).
Ashawari Chaudhuri is a visiting assistant professor in the Department of Science and Technology Studies at Cornell University. Her historically grounded ethnographic research stands at intersections of the environment, agriculture, and health in South Asia.
Emily Hertzman is a research associate in the Department of Anthropology, University of Toronto. Previously, she was a research fellow at the Asia Research Institute, National University of Singapore. She is a coeditor of CoronAsur: Asian Religions in the Covidian Age (2023). Her research focuses on mobilities, identities, religious practices, and politics in Indonesia.
Acknowledgments
This special issue emerged from an online workshop titled “Faith in Immunity: Religion, COVID-19 Vaccines and Structures of Trust” (see https://ari.nus.edu.sg/events/faith-in-immunity/) held at the Asia Research Institute, National University of Singapore, on 27–28 October 2022. We are very thankful to the Asia Research Institute for the financial and technical support that made the workshop and this publication possible. Other scholars who were involved in the workshop but did not participate in this special issue have contributed blog articles on our research blog CoronAsur on religions and the COVID-19 pandemic, which can be accessed at https://ari.nus.edu.sg/coronasur-home/. We express our sincere thanks to the anonymous peer reviewers, the journal editors, and Saharah Abubakar, who helped us with copyediting and formatting the articles.
Bibliography
Agley, Jon, and Yunyu Xiao. 2021. “Misinformation about COVID-19: Evidence for Differential Latent Profiles and a Strong Association with Trust in Science.” BMC Public Health 21, no. 89: 1–12.
AHA! (Awareness with Human Action!). 2022. “Research Brief: Vaccine Hesitancy in South Asia: Debates, Dilemmas, and Developments.” https://jliflc.com/wp-content/uploads/2022/05/Vaccine-Hesitancy-In-South-Asia-Debates-Dilemmas-And-Developments.pdf.
Alanna, Eloise, prod. 2021. “‘The Gospel Truth?’ Covid-19 Vaccines and the Danger of Religious Misinformation.” BBC News, March 17, 2021. Video, 4:39. https://www.bbc.com/news/av/health-56416683.
Ali, Inayat. 2020. “The COVID-19 Pandemic: Making Sense of Rumor and Fear.” Medical Anthropology 39, no. 5: 376–379.
Ali, Inayat. 2021. “Rituals of Containment: Many Pandemics, Body Politics, and Social Dramas During COVID-19 in Pakistan.” Frontiers in Sociology 6: 1–8.
Alter, Joseph. 1999. “Heaps of Health, Metaphysical Fitness: Ayurveda and the Ontology of Good Health in Medical Anthropology.” Current Anthropology 40, no. 51. https://doi.org/10.1086/200060.
Arnold, David. 1993. Colonizing the Body State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press.
Arnold, David. 2000. Science, Technology, and Medicine in Colonial India. Part 3, Vol. 5 of The New Cambridge History of India. New York: Cambridge University Press.
Azak, Nalan A., and Einar Wigen. 2022. “‘Whatever They Say I Do the Opposite’: Vaccine Resistance in Turkey During the Covid-19 Pandemic.” Medical Anthropology 41, no. 8: 778–793.
Ballano, Vivencio O. 2022. “COVID-19 Vaccines, Public Health Goods, and Catholic Social Teaching: Why Justice Must Prevail Over Charity in the Global Vaccination Distribution.” HTS Teologiese Studies/Theological Studies 78, no. 4: 1–9.
Benziman, Yuval. 2020. “‘Winning’ the ‘Battle’ and ‘Beating’ the COVID-19 ‘Enemy’: Leaders’ Use of War Frames to Define the Pandemic.” Peace and Conflict: Journal of Peace Psychology 26, no. 3: 247–256. https://doi.org/10.1037/pac0000494.
Brilyana, Yayan A. 2022. “Officially Launched, IndoVac Halal Covid-19 Vaccine Made by PT Bio Farma.” Bandung official government website, October 13, 2022. https://www.bandung.go.id/news/read/7121/resmi-diluncurkan-indovac-vaksin-covid-19-halal-buatan-pt-bio-farma?lang=en#:~:text=IndoVac%20has%20been%20safely%20tested,easily%20distributed%20throughout%20the%20country.
Brown, Julia. 2023. “In God We Trust: Community and Immunity in American Religions During COVID-19.” Religions 14, no. 3: 428. https://doi.org/10.3390/rel14030428.
Charles, Nicole. 2018. “HPV Vaccination and Affective Suspicions in Barbados.” Feminist Formations 30, no. 1: 46–70.
Corpuz, Jeff Clyde G. 2021. “Multisectorial Approach on COVID-19 Vaccination: A Proposed Solution on Vaccine Hesitancy.” Journal of Public Health 42, no. 2: e370–e371.
Costanzo, Cari, and Abraham Verghese. 2018. “The Physical Examination as Ritual: Social Sciences and Embodiment in the Context of the Physical Examination.” Medical Clinics of North America 102, no. 3: 425–431. https://doi.org/10.1016/j.mcna.2017.12.004.
Dang, Hoang Linh. 2021. “Social Media, Fake News, and the COVID-19 Pandemic: Sketching the Case of Southeast Asia.” Austrian Journal of South-East Asian Studies 14, no. 1: 37–57.
Dias, Elizabeth, and Ruth Graham. 2021. “White Evangelical Resistance is Obstacle in Vaccination Effort.” New York Times, April 5, 2021.
Durand, Jean-Yves, and Manuela Ivone Cunha. 2020. “‘To All the Anti‐vaxxers Out There …’: Ethnography of the Public Controversy about Vaccination in the Time of COVID‐19.” Social Anthropology/Anthropologie Sociale 28, no. 2: 259–260.
Ellis-Petersen, Hannah. 2020. “Muslims in Sri Lanka ‘Denied Justice’ over Forced Cremations of Covid Victims.” Guardian, December 4, 2020. https://www.theguardian.com/world/2020/dec/04/muslims-sri-lanka-justice-forced-cremations-covid-victims.
Esposito, Roberto. 2013. Terms of the Political: Community, Immunity, Biopolitics. New York: Fordham University Press.
Evans, Robert. 2021. “‘Following the Science’ in Times of Epistemic Uncertainty.” Social Studies of Science 52, no. 1: 53–78.
Feldman-Savelsberg, Pamela, Flavien T. Ndonko, and Bergis Schmidt-Ehry. 2000. “Sterilizing Vaccines or the Politics of the Womb: Retrospective Study of a Rumor in Cameroon.” Medical Anthropology Quarterly 14, no. 2: 127–186.
Ferngren, Gary B. 2014. Medicine and Religion: A Historical Introduction. Baltimore, MD: John Hopkins University Press.
Goldenberg, Maya J. 2019. “Vaccines, Values, and Science.” Canadian Medical Association Journal 191, no. 14: E397–E398. https://doi.org/10.1503/cmaj.181635.
Goldenberg, Maya J. 2021. Vaccine Hesitancy: Public Trust, Expertise, and the War on Science. Pittsburgh: University of Pittsburgh Press.
Goldenberg, Maya J. 2022. “A Feminist Take on Vaccine Hesitancy.” International Journal of Feminist Approaches to Bioethics 15, no. 1: 180–182.
Goldenberg, Maya J. 2023. “Review of Stuck: How Vaccine Rumors Start – and Why They Don’t Go Away, by Heidi J. Larson.” Journal of Medical Humanities 44: 417–419.
Gopez, Jose Ma W. 2021. “Building Public Trust in COVID-19 Vaccines through the Catholic Church in the Philippines.” Journal of Public Health 43, no. 2: e330–e331.
Gordon, Andrew, and Michael R. Reich. 2021. “The Puzzle of Vaccine Hesitancy in Japan.” Journal of Japanese Studies 47, no. 2: 411–436.
Hausman, Bernice L. 2017. “Immunity, Modernity, and the Biopolitics of Vaccination Resistance.” Configurations 25, no. 3: 279–300.
Hertzman, Emily, Natalie Lang, Erica M. Larson, and Carola Lorea, eds. 2023. CoronAsur: Asian Religions in the Covidian Age. Honolulu: University of Hawai‘i Press.
Hippocrates. 1849. “On Airs, Waters, and Places.” In The Genuine Works of Hippocrates, vol. 1, translated by Francis Adams, 179–222. London: Printed for the Sydenham Society.
Irons, Rebecca. 2021. “CALL FOR SUBMISSIONS – Vaccines in View: Social Science Perspectives on COVID-19 Vaccinations.” Medical Anthropology at UCL, February 22, 2021. https://medanthucl.com/2021/02/22/call-for-submissions-vaccines-in-view-social-science-perspectives-on-covid-19-vaccinations/.
Jasanoff, Sheila, and Stephen Hilgartner. 2021. “A Stress Test for Politics: Insights from the Comparative Covid Response Project (CompCoRe) 2020.” Verfassunsblog On Matters Constitutional. https://verfassungsblog.de/a-stress-test-for-politics-insights-from-the-comparative-covid-response-project-compcore-2020/.
Jones, David, and Stefan Helmreich. 2020. “The Shape of Epidemics.” Boston Review, June 26, 2020.
Kanozia, Rubal, and Ritu Arya. 2021. “Fake News, Religion, and COVID-19 Vaccine Hesitancy in India, Pakistan, and Bangladesh.” Media Asia 48, no. 4: 313–321. https://doi.org/10.1080/01296612.2021.1921963.
Kasstan, Ben. 2021. “If a Rabbi Did Say ‘You Have to Vaccinate,’ We Wouldn’t: Unveiling the Secular Logics of Religious Exemption and Opposition to Vaccination.” Social Science & Medicine 280: 114052.
Kasstan, Ben. 2022. “Viral Entanglements: Bodies, Belonging and Truth‐Claims in Health Borderlands.” Medical Anthropology Quarterly 36, no. 1: 119–138.
Kirksey, Eben. 2020. “The Emergence of COVID-19: A Multispecies Story.” Anthropology Now 12, no. 1: 11–16.
Kitta, Andrew. 2012. Vaccinations and Public Concern in History: Legend, Rumor, and Risk Perception. New York: Routledge.
Lahav, Eyal, Shosh Shahrabani, Mosi Rosenboim, and Yoshiro Tsutsui. 2022. “Is Stronger Religious Faith Associated with a Greater Willingness to Take the COVID-19 Vaccine? Evidence from Israel and Japan.” European Journal of Health Economics 23, no. 4: 687–703.
Lambert, Helen. 2014. “The Management of Sickness in an Indian Medical Vernacular.” In Disease, Religion and Healing in Asia, edited by Ivette Vargas-O’Bryan and Zhou Xun, 9–21. London: Routledge.
Lasco, Gideon. 2022. “‘I Think I Have Enough for Now’: Living with COVID-19 Antibodies in the Philippines.” Medical Anthropology 41, no. 5: 518–531.
Lenton, Timothy M., Chris A. Boulton, and Marten Scheffer. 2022. “Resilience of Countries to COVID-19 Correlated with Trust.” Scientific Reports 12, no. 75: 1–15.
Levin, Jeff. 2020. Religion and Medicine: A History of the Encounter Between Humanity’s Two Greatest Institutions. New York: Oxford University Press.
Lorea, Carola, Neena Mahadev, Natalie Lang, and Ningning Chen. 2022. “Religion and the Covid-19 Pandemic: Mediating Presence and Distance.” Religion 52, no. 2: 177–198. https://doi.org/10.1080/0048721X.2022.2061701.
Lowe, Celia. 2010. “Viral Clouds: Becoming H5N1 in Indonesia.” Cultural Anthropology 25, no. 4: 625–649.
Lowy, Ilana. 1992. “The Strength of Loose Concepts – Boundary Concepts, Federative Experimental Strategies and Disciplinary Growth: The Case of Immunology.” History of Science 30, no. 4: 371–396.
Lüddeckens, Dorothea, and Monika Schrimpf. 2018. “Observing the Entanglement of Medicine, Religion, and Spirituality Through the Lens of Differentiation.” In Medicine – Religion – Spirituality: Global Perspectives on Traditional, Complementary, and Alternative Healing, edited by Dorothea Lüddeckens and Monika Schrimpf, 9–21. Bielefeld: Transcript.
Lyu, Ming, Guanwei Fan, Guangxu Xiao, et al. 2021. “Traditional Chinese Medicine in COVID-19.” Acta Pharmaceutica Sinica B 11, no. 11: 3337–3363. https://doi.org/10.1016/j.apsb.2021.09.008.
Marshall, Katherine. 2021. “COVID-19 Vaccine Hesitancy: Can Faith Engagement Make a Difference?” Viewpoints, August 3, 2021. https://blog.g20interfaith.org/2021/08/03/covid-19-vaccine-hesitancy-can-faith-engagement-make-a-difference/.
Martin, Emily. 1990. “Toward an Anthropology of Immunology: The Body as Nation State.” Medical Anthropology Quarterly 4, no. 4: 410–426.
McKay, Alex and Dorje Wangchuk. 2005. “Traditional Medicine in Bhutan”. Asian Medicine 1, no. 1: 204–218.
Mirsalehi, Talieh. 2023. “Rethinking Immunity: An Ethnography of Risk and Migration in Sweden.” Medical Anthropology 42, no. 5: 493–505.
Müller-Mahn Detlef, Mar Moure, and Million Gebreyes. 2020. “Climate Change, the Politics of Anticipation and Future Riskscapes in Africa.” Cambridge Journals of Regions, Economy and Society 13, no. 2: 343–362.
Najmah, Kusnan, and Sharyn Graham Davies. 2023. “From COVID-19 Vaccine Hesitancy to Acceptance in South Sumatra, Indonesia.” CoronAsur, February 4, 2023. https://ari.nus.edu.sg/20331-117/.
Najmah, Sharyn Graham Davies, and Kusnan. 2021. “What’s Behind Vaccine Hesitancy in Indonesia?” New Mandala, May 25, 2021. https://www.newmandala.org/whats-behind-covid-19-vaccine-hesitancy-in-indonesia/.
Napier, David. 2013. “A New Sociobiology: Immunity, Alterity and the Social Repertoire.” Cambridge Journal of Anthropology 31, no. 2: 20–43.
Norman, Andy. 2021. Mental Immunity: Infectious Ideas, Mind Parasites, and the Search for a Better Way to Think. New York: HarperCollins.
Office of Assistant to Deputy Cabinet Secretary for State Documents & Translation. 2022. “Gov’t to Use Certified Halal Vaccines for Muslims.” Cabinet Secretariat of the Republic of Indonesia, April 28, 2022. https://setkab.go.id/en/govt-to-use-certified-halal-vaccines-for-muslims/.
Østebø, Terje, Kjetil Tronvoll, and Marit Tolo Østebø. 2021a. “God’s Wrath in the Era of the Digidemic: Religious Interpretations of Covid-19 in Ethiopia.” Journal of the American Academy of Religion 89, no. 4: 1334–1359.
Østebø, Terje, Kjetil Tronvoll, and Marit Tolo Østebø. 2021b. “Religion and the ‘Secular Shadow’: Responses to Covid-19 in Ethiopia.” Religion 51, no. 3: 339–358.
Ramírez, Paul. 2018. Enlightened Immunity: Mexico’s Experiments with Disease Prevention in the Age of Reason. Stanford, CA: Stanford University Press.
Rocha, Ian Christopher. 2021. “Employing Medical Anthropology Approach as an Additional Public Health Strategy in Promoting COVID‐19 Vaccine Acceptance in Bhutan.” Journal of Health Planning and Management 36: 1943–1946.
Salguero, Pierce. 2020. “Buddhist Responses to the COVID-19 Pandemic in Historical Perspective.” Buddhist Door Global, August 20, 2020. https://www.buddhistdoor.net/features/buddhist-responses-to-the-covid-19-pandemic-in-historical-perspective/.
Shah, Karina. 2021. “CIA’s Hunt for Osama bin Laden Fuelled Vaccine Hesitancy in Pakistan.” New Scientist, May 11, 2021. https://www.newscientist.com/article/2277145-cias-hunt-for-osama-bin-laden-fuelled-vaccine-hesitancy-in-pakistan/.
Shapin, Steven. 2007. “Science and the Modern World.” In The Handbook of Science and Technology Studies, 3rd ed., edited by Edward J. Hackett, Olga Amsterdamska, Michael E. Lynch, and Judy Wajcman, 433–448. Cambridge, MA: MIT Press.
Shigehisa, Kuriyama. 1999. The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine. New York: Zone Books.
Singh, Abinav. 2024. “Nepal Set to Destroy 4 Million Sinovac COVID-19 Vaccines, 2.5 Years after Buying Them from China.” Wion, Jan 2, 2024. https://www.wionews.com/south-asia/nepal-set-to-destroy-4-million-sinovac-covid-19-vaccines-25-years-after-buying-them-from-china-675913.
Stanley-Baker, Michael. 2023. Situating Religion and Medicine in Asia: Methodological Insights and Innovations. Manchester: Manchester University Press.
Storer, Elizabeth, Kate Dawson, and Kristin A. Fergus. 2022. “Covid-19 Riskscapes: Viral Risk Perceptions in the African Great Lakes.” Medical Anthropology 41, no. 4: 387–403.
Suhartono, Muktita. 2022. “Where Mantras Trump Medicine, Vaccines are a ‘Violation.’” New York Times, July 12, 2022. https://www.nytimes.com/2022/07/11/world/asia/indonesia-java-buduy-sunda-wiwitan.html.
Syed, Uzma, Jim Wallis, Katherine Marshall, David Saperstein, Adam Taylor, and Mohamed Elsanousi. 2022. “The US Has a Moral Obligation to Help Vaccinate the World.” Religion News Service, May 5, 2022. https://religionnews.com/2022/05/05/the-u-s-has-a-moral-obligation-to-help-vaccinate-the-world/.
Tackes, Nick. 2021. “COVID-19 First Responders: The Gayatri Pariwar and the Immune Ritual Body.” Journal of the American Academy of Religion 89, no. 3: 1006–1038.
Throop, Susanna, and Morgana Olbrich. 2020. “Analyzing the Past in the Present: The Black Death, COVID-19, and the Ursinus Quest.” Ursinus, May 11, 2020. https://www.ursinus.edu/live/news/4682-analyzing-the-past-in-the-present-the-black-death.
Vargas-O’Bryan, Ivette, and Xun Zhou. 2014. Disease, Religion and Healing in Asia: Collaborations and Collisions. London and New York: Routledge.
Vaughn, Leona, Allen Kicono, Nii Kwartelai Quartey, Collins Seymah Smith, and Isabel Zattu Ziz. 2020. “‘Colonial Virus?’ COVID-19 and Racialised Risk Narratives in South Africa, Ghana, and Kenya.” University of Liverpool COVID-19 ODA Rapid Research Report. https://www.liverpool.ac.uk/media/livacuk/humanitiesampsocialsciences/documents/COVID-19,and,Racialised,Risk,Narratives,in,South,Africa,Ghana,and,Kenya.pdf.
Welch, John S. 2003. “Ritual in Western Medicine and its Role in Placebo Healing.” Journal of Religion and Health 42, no. 1: 21–33.
WHO (World Health Organization). 2020. “Managing the COVID-19 Infodemic.” September 23, 2020. https://www.who.int/news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation.
Wicke, Philipp, and Marianna M. Bolognesi. 2020. “Framing COVID-19: How We Conceptualize and Discuss the Pandemic on Twitter.” PLoS ONE 15, no. 9: e0240010. https://doi.org/10.1371/journal.pone.0240010.
Suhartono 2022.
Rocha 2021.
Ali 2021.
Kanozia and Arya 2021.
Shah 2021. DPT = diphtheria, pertussis, and tetanus.
McKay and Wangchuk 2005, 206.
Hertzman et al. 2023.
Lorea et al. 2022; Hertzman et al. 2023.
Lyu et al. 2021.
Irons 2021.
Kasstan 2021, 2022.
Ali 2021; Rocha 2021.
Durand and Cunha 2020.
Charles 2018, 54.
Najmah, Davies, and Kusnan 2021.
Najmah, Kusnan, and Davies 2023.
Brilyana 2022.
Tackes 2021.
Ibid., 1022.
Ibid., 1028.
Levin 2020, 12–16.
Throop and Olbrich 2020.
Ramírez 2018, 1–21.
Lambert 2014.
Dias and Graham 2021.
Brown 2023.
Office of Assistant to Deputy Cabinet Secretary for State Documents & Translation 2022.
See West and Dodan Godage in this issue.
On the mutual shaping of the spheres of religion and medicine, see Ferngren 2014; Levin 2020. For Asian contexts, see Vargas-O’Bryan and Zhou 2014; Stanley-Baker 2023.
Stanley-Baker 2023, 3.
Lüddeckens and Schrimpf 2018, 11.
Ibid., 10.
Shapin 2007.
Welch 2003; Costanzo and Verghese 2018.
Singh 2024.
See Chudakova in this issue.
Napier 2013, 25.
Hertzman et al. 2023. For an accessible piece on the manifold Buddhist ways to achieve protection and manage the pandemic, including the dimensions of ritual, meditation, and charity mentioned here, see Salguero 2020.
Esposito 2013.
Ibid.
Norman 2021.
See Dasgupta in this issue.
See Gerke in this issue.
Ferngren 2014, 10–11.
Hippocrates 1849.
Kuriyama 1999.
Ibid.
Alter 1999, 44.
Ibid., 45.
Martin 1990.
Benziman 2020; Wicke and Bolognesi 2020.
Napier 2013.
Haraway 1991, 205.
Ibid.
Martin 1990, 412.
Ibid.
Lowy 1992.
Mirsalehi 2023, 497.
Müller-Mahn, Moure, and Gebreyes 2020; Storer, Dawson, and Fergus 2022.
Storer, Dawson, and Fergus 2022.
Vaughn 2020, 11.
Lasco 2022, 519.
Lowe 2010.
Kirksey 2020; Lasco 2022.
Goldenberg 2019, E397.
Goldenberg 2022, 181.
Lenton, Boulton, and Scheffer 2022. In this particular study, however, it is interesting that generalized trust on an interpersonal level seemed to be more significant than trust and confidence in political and governmental organizations, which the authors state were only modestly correlated with resilience in the contexts analyzed (p. 12).
See Jasanoff and Hilgartner 2021.
AHA! 2022.
Ellis-Petersen 2020.
Charles 2018, 56.
Agley and Xiao 2021, 1.
WHO 2020.
Dang 2021, 50.
Quoted in Goldenberg 2023, 418.
Ibid., 126.
Østebø, Tronvoll, and Østebø 2021a, 2021b.
Feldman-Savelsberg, Ndonko, Schmidt-Ehry 2000, 172.
Ali 2020.
Lasco 2022.
Ibid.
Gordon and Reich 2021, 434.
Ibid., 419–20.
Hausman 2017.
Ibid., 299.
Kitta 2012, 14.
Alanna 2021.
Marshall 2021.
Corpuz 2021; Gopez 2021.
Syed et al. 2022.
Ballano 2022.
Arnold 1993, 2000.