Field of research:
History of Medicine
CESR – Centre d’Etudes Supérieures de la Renaissance (University François-Rabelais of Tours/CNRS) and VALLOREM (University François-Rabelais of Tours)
The acceptability and risk perception of biomedical innovation: a historical approach
The aim of my project is twofold. On the one hand, it consists in showing the historical origins of one of the first French serial and international production of biopharmaceuticals (vaccine) established by a biomedical laboratory in Tours. Indeed, Edmond Chaumier (1853-1931) founded in 1887 the Institut Vaccinal of Tours to locally produce from heifer calves a vaccine against smallpox through an original technique known as “vaccin de conserve” (vaccine preserves or canned) consisting in glycerin vaccine stored in refrigerators, which turned out to be more effective, safe and storable —the latter being an important feature during outbreaks— than the “vaccin frais” (fresh vaccine) then available in France. Produced during 1910-1920’s in collaboration with the “Istituto Vaccinogeno” of the University of Rome, directed by Dante De Blasi (1873-1956), the Chaumier’s vaccine de conserve conquered the European markets spreading to France, United Kingdom, Italy, and elsewhere in Europe and outside. The international expansion and network development of the early Touraine biomedical market still needs to be told, first of all by delving into historical archives of Rome and Tours in order to understand the economic size of the market and the mass of vaccine production, being the analysis and acceptability of the economic costs of biomedical innovations a primary goal of the SHS project.
On the other hand, the research aims at offering a historical analysis of the social perception of risk applied to biomedical innovation. In scientific literature there are solid evidences suggesting that education and income have a positive causal effects on health outcomes. Economics literature, in particular, demonstrates that more educated individuals have better understanding of, and more quickly absorb, information in medicine and health care, as clearly revealed by the fact that education and income correlate to longevity. Less is known about the channels through which such a causal relationship occurs. The controversy raised by vaccine against measles, mumps, and rubella (henceforth MMR) provides a useful case for studying individual behavioral responses to new information about risks or new medical technologies. This case study suggests that information processing, rather than access, education and income, is the key driver. Indeed, experimental evidences confirm that more educated (and seldom more affluent) parents were more selective and more often chose not to take vaccine for their child (typically MMR). Also the uptake of other uncontroversial childhood immunizations (HPV, whooping cough) declined in relative terms in areas with more educated adults, suggesting a “spillover” effect from the MMR-controversy. The history (of medicine) of social resistance of vaccination could be very instructive concerning the reaction by different groups to emerging health risk information under uncertainty. The basic hypothesis of this second part of the research suggests to look at the recent literature of the risk perception in biomedical field (Gerd Gigerenzer, Dan Kahan, Daniel Kahneman), which explains that individuals making decisions under uncertainty and risk give undue weight to information indicating a high risk, while information indicating low risk, also when provided by the government or institutions, is under-weighted. The analysis of this specific literature should be taken into account for a project concerning the social acceptability of innovative biomedical treatment, especially for the monoclonal antibodies which are a very expensive treatment and have raised some risk issue relating to recent cases of severe unexpected adverse reactions during first-in-man clinical trials.
Prof. Véronique Des Garets and Dr Concetta Pennutto