{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:06:47Z","timestamp":1780056407513,"version":"3.54.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T00:00:00Z","timestamp":1703030400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Biosoc. Sci."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Vaccines for COVID-19 began to be available in Africa from mid-2021. This paper reports on local reactions to the possibility of vaccination in one West African country, Sierra Leone. We show that the history of institutionalisation of vaccine is highly relevant to understanding these reactions. Given lack of testing for the disease, medical authorities could not be sure whether there was a hidden epidemic. In addition, many people associate vaccination with care of children under 5 years, and not adults, and an emphasis on vaccinating the old at first seemed strange and worrying. This paper examines evidence from ethnographic studies in two rural areas selected for varying exposure to Ebola Virus Disease (EVD), supplemented by some interviews in two provincial urban centres, Bo and Kenema. We describe local ideas about vaccination (\n                    <jats:italic>maklet<\/jats:italic>\n                    ) and body marking with leaf medicine (\n                    <jats:italic>t\u03b5wi<\/jats:italic>\n                    ). We asked about attitudes to the idea of COVID-19 vaccination both before and after vaccines were available. A number of reasons were given for scepticism and hesitation. These included lack of experience with vaccines for adults and lack of experience of COVID-19 as a severe disease. Medical evidence suggests the vaccination protects against serious illness, but local people had their own views about control of infection, based both recent experience (notably EVD) and the history and institutionalisation of vaccination and public health measures in Sierra Leone more broadly.\n                  <\/jats:p>","DOI":"10.1017\/s0021932023000287","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T05:32:33Z","timestamp":1703050353000},"page":"102-120","source":"Crossref","is-referenced-by-count":3,"title":["\u2018Vaccines are for children only\u2019? Some institutional roots of popular scepticism about vaccines for COVID-19 in Sierra Leone"],"prefix":"10.1017","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6442-7423","authenticated-orcid":false,"given":"Esther Yei","family":"Mokuwa","sequence":"first","affiliation":[{"name":"Wageningen University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,12,20]]},"reference":[{"key":"S0021932023000287_ref30","volume-title":"How Can the Health Systems of Guinea, Sierra Leone and Liberia Be Improved?","author":"Papkalla","year":"2016"},{"key":"S0021932023000287_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(92)90099-C"},{"key":"S0021932023000287_ref25","doi-asserted-by":"publisher","DOI":"10.1080\/01459740.2021.2015591"},{"key":"S0021932023000287_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.114826"},{"key":"S0021932023000287_ref2","doi-asserted-by":"publisher","DOI":"10.3390\/v13112325"},{"key":"S0021932023000287_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.afraf.a093668"},{"key":"S0021932023000287_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3799-x"},{"key":"S0021932023000287_ref43","unstructured":"WHO (2022) Spotlight, history of vaccination, history of smallpox vaccination. https:\/\/www.who.int\/news-room\/spotlight\/history-of-vaccination."},{"key":"S0021932023000287_ref15","volume-title":"A Krio-English Dictionary","author":"Fyle","year":"1980"},{"key":"S0021932023000287_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/maq.12254"},{"key":"S0021932023000287_ref27","volume-title":"Epidemics and Community Conflicts: The Value of Indigenous Institutions in Addressing Development Shocks in Rural Sierra Leone","author":"Mokuwa","year":"2020"},{"key":"S0021932023000287_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114640"},{"key":"S0021932023000287_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.02.032"},{"key":"S0021932023000287_ref28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007666"},{"key":"S0021932023000287_ref31","first-page":"415","article-title":"Epidemics and resistance in colonial Sierra Leone during the Frist World War","volume":"45","author":"Rashid","year":"2011","journal-title":"Canadian Journal of African Studies"},{"key":"S0021932023000287_ref19","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.12.04006"},{"key":"S0021932023000287_ref16","doi-asserted-by":"publisher","DOI":"10.24894\/Gesn-en.2020.77014"},{"key":"S0021932023000287_ref9","first-page":"61","article-title":"Deciphering a meal","volume":"101","author":"Douglas","year":"1972","journal-title":"Daedalus"},{"key":"S0021932023000287_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.04.008"},{"key":"S0021932023000287_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(99)00239-7"},{"key":"S0021932023000287_ref4","doi-asserted-by":"publisher","DOI":"10.1038\/s41426-018-0206-y"},{"key":"S0021932023000287_ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258252"},{"key":"S0021932023000287_ref41","first-page":"4","article-title":"Traditional leaders and the 2014-2015 Ebola epidemic","volume":"82","author":"Van de Windt","year":"2020","journal-title":"Journal of Politics"},{"key":"S0021932023000287_ref18","volume-title":"West African Countries and Peoples","author":"Horton","year":"1969 [1868]"},{"key":"S0021932023000287_ref10","volume-title":"How Institutions Think","author":"Douglas","year":"1986"},{"key":"S0021932023000287_ref32","doi-asserted-by":"publisher","DOI":"10.5040\/9781350219779"},{"key":"S0021932023000287_ref35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265496"},{"key":"S0021932023000287_ref8","volume-title":"Purity and Danger: An Analysis of Concepts of Pollution and Taboo","author":"Douglas","year":"1966"},{"key":"S0021932023000287_ref33","volume-title":"Mary Douglas (Anthropology\u2019s Ancestors Series)","author":"Richards","year":"2023"},{"key":"S0021932023000287_ref17","first-page":"697","article-title":"Smallpox in Sierra Leone: II. 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