疫苗市場的建構：關於疫苗的採用、供應與使用之社會研究

Abstract

本專題研究計畫以三個維度來理解疫苗市場的建構，包括疫苗的採用、供應、以及使用。疫苗的採用主要反映在防疫制度如何選擇決定將特定的疫苗納入其中。疫苗供應主要表現在在地或跨國疫苗產業的型構與過程。疫苗的使用態度則紮根於社會文化中，透過疫苗的社會意義呈現出來。研究的主要目的在於瞭解在疫苗後進國如台灣與韓國，疫苗市場的形貌如何，又這些形貌是如何建構出來的。本研究主張疫苗市場是社會建構的結果。但建構的歷程不是單向度的創造出疫苗需要而已，也不是庸俗的利益結盟所產生的結果。疫苗的社會建構必須在歷史情境、權力圖像以及行動者理性的考量下，針對每一支新疫苗提出絕無僅有的描述。之前發生過的事件，或者會再發生，但結果會是不一樣。這樣的研究並不是在尋找一種一般化或普遍化的疫苗市場形式，也不是在建立規範性的市場模型，而是用以產生具有啟發性的知識，一方面幫助研究者掌握田野的邏輯，另一方面也回饋給田野中的行動者，而發揮啟蒙的作用。在新興疫苗不斷推陳出新的情況下，疫苗市場的建構意涵更具有迫切的時代意義。本研究將以傳統疫苗如日本腦炎疫苗以及新興疫苗如肺炎鏈球菌疫苗、人類乳突病毒疫苗、和腸病毒疫苗等，作為研究對象。計畫將從疫苗技術物與商品、個人行動者、以及組織三個層級進行分析。全計畫預定以三年時間完成，每一年將以一個維度為主題，並從第二年起，透過韓國之移地研究加入跨國比較的向度，期能使結果更具有啟發性。

For latecomers like Taiwan or South Korea, how can a vaccine market be constructed? To answer the question, this research project establishes a three-dimensional conceptual framework, including vaccine adoption, vaccine supplies and vaccination acceptance, to do field work. It is the process of selection and inclusion of a vaccine in the immunization program that stands for vaccine adoption. Vaccine supplies depend on the configuration and dynamics of vaccine industry which is situated in domestic and global contexts. As to vaccination acceptance, it is the construction of social meaning of a vaccine that takes place in everyday life. The research argues that vaccine markets are fruits of social construction. However, to construct a vaccine market is neither a process of creating unilaterally the needs of vaccine in the society, nor an outcome of general alliance of interests from different parts of the society. The process depends on historical contexts, power structure and rationality of actors. For each new vaccine, the process is idiosyncratic and unique. What happened in the history will happen again, but the consequences will no more be the same. Such research is not to establish a generalized or universal market model. Instead, it is to seek heuristic knowledge for, on the one hand, helping the research to mastering the basic logic in the field and, on the other hand, giving feedbacks to the actors in the field so as to have an enlightening effect. Traditional vaccine such as Japanese Encephalitis vaccine and new vaccines, including pneumococcal vaccine, human papillonmavirus vaccine, and entervirus vaccine are chosen for studies. The research is three levels: vaccine level, i.e., vaccine as a good and an artifact, individual actor and organizational level. The project is planed to carry out in three years, so that each one of the three dimensions of the market framework can be studied in one year. Moreover, a foreign research in Korea is scheduled starting from the second year. The international comparison is critical to the validity of the findings in the research.