Vaccines as populist tropes in the COVID-19 pandemic

Abstract

With lives, livelihoods, and entire societies at stake, immunisation was as a matter of immense political and social importance throughout the global health crisis. Using the framework of medical populism, this paper articulates the emergence of vaccines for COVID-19 as a populist trope by using three countries with diverse contexts and distinct vaccine responses – Brazil, the Philippines, and the United States – as case studies, drawing on the discourses and actions of their heads of states from March 2020 to December 2021. In the Philippines, President Rodrigo Duterte engaged in ‘vaccine messianism’, offering the promise of future vaccines as a simplistic solution to the pandemic. In the US, President Donald Trump dramatised his vaccine project and tied it to his ‘America First’ politics in what has been called ‘vaccine nationalism’. Meanwhile, in Brazil, Jair Bolsonaro’s ‘vaccine skepticism’ helped forge divisions between his constituencies and global elites as well as political opponents. Overall, the case studies show how medical populist performances evolved during the pandemic, and how the use of vaccine as a populist trope was linked to immunological, and often exclusionary, notions of nationalism.

Full text

Vaccines as populist tropes in the COVID-19 pandemic
Gideon Lasco
a,b,c
a
Knowledge, Technology and Innovation Group, Wageningen University and Research, Wageningen,
The Netherlands;
b
Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines;
c
Department of Development Studies, Ateneo de Manila University, Quezon City, Philippines
ABSTRACT
With lives, livelihoods, and entire societies at stake, immunisation was as a
matter of immense political and social importance throughout the global
health crisis. Using the framework of medical populism, this paper
articulates the emergence of vaccines for COVID-19 as a populist trope
by using three countries with diverse contexts and distinct vaccine
responses – Brazil, the Philippines, and the United States – as case
studies, drawing on the discourses and actions of their heads of states
from March 2020 to December 2021. In the Philippines, President
Rodrigo Duterte engaged in ‘vaccine messianism’, oering the promise
of future vaccines as a simplistic solution to the pandemic. In the US,
President Donald Trump dramatised his vaccine project and tied it to
his ‘America First’ politics in what has been called ‘vaccine nationalism’.
Meanwhile, in Brazil, Jair Bolsonaro’s ‘vaccine skepticism’ helped forge
divisions between his constituencies and global elites as well as political
opponents. Overall, the case studies show how medical populist
performances evolved during the pandemic, and how the use of
vaccine as a populist trope was linked to immunological, and often
exclusionary, notions of nationalism.
ARTICLE HISTORY
Received 10 January 2025
Accepted 21 April 2025
KEYWORDS
Medical populism;
vaccination; COVID-19;
pandemics; politics of health
SUSTAINABLE
DEVELOPMENT GOALS
SDG 3: good health and well-
being; SDG 16: Peace, justice
and strong institutions
Introduction
As the coronavirus pandemic ravaged lives and livelihoods around the world, the race for a vaccine
against COVID-19 became the most intense in the entire history of public health, informed by the
consensus that widespread immunisation can put an end to the greatest global health crisis in a cen-
tury. Indeed, vaccines loomed large as the hoped-for end in the ‘global outbreak narrative’ (Leach &
Tadros, 2014) – and the solution to the pandemic itself.
Consequently, the political significance of vaccines reached unprecedented levels, both in geo-
political and local terms, from the early stages of the pandemic until its dissipation in public con-
sciousness. For a time, the vaccine race drew comparisons to the Cold War: Both Russia and US
stoked space race imagery with the former naming its vaccine ‘Sputnik V’ after the Soviet rocket
(Balakrishnan, 2020) and the latter calling its vaccine development program ‘Operation Warp
Speed’ (Kim et al., 2021). Beyond concerns and nationalist sentiments surrounding who will be
the first to develop a vaccine (Zhou, 2022), there were questions of access, cost, and equity,
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this
article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
CONTACT Gideon Lasco pdlasco@up.edu.ph Knowledge, Technology and Innovation Group, Wageningen University and
Research, 032, De Leeuwenborch 201, Wageningen, The Netherlands; Department of Anthropology, University of the Philippines
Diliman, Diliman, Quezon City, Philippines; Department of Development Studies, Ateneo de Manila University, Quezon City 1106,
Philippines
GLOBAL PUBLIC HEALTH
2025, VOL. 20, NO. 1, 2497920
https://doi.org/10.1080/17441692.2025.2497920

prompting the World Health Organization (WHO) and public health experts to warn of ‘vaccine
nationalism’ as the vaccines were about to be rolled out (Weintraub et al., 2020).
This paper documents and analyses the emergence of COVID-19 vaccines as a populist trope
from the pandemic’s beginnings in 2020 to the vaccine rollouts in 2021, using three countries:
the United States, Brazil, and the Philippines, as case studies. Although the political performances
of world leaders in response to the pandemic have already received much attention (Gugushvili
et al., 2020; Sachs et al., 2020) and investigation (Lasco, 2020; Forster & Heinzel, 2021; Crayne &
Medeiros, 2021), I argue that, insofar as health politics is concerned, the emergence of vaccines rep-
resent a distinct phase in the pandemic, and thus requires further analysis and reection.
In interrogating the role of political actors in COVID-19 vaccination and in looking at the role of
vaccination in COVID-19 politics (i.e. its emergence as a ‘trope’ in political policies and discourse),
I use the framework of medical populism, which was introduced by Lasco and Curato (2019, p. 1)
‘to make sense of health emergencies’. Adopted and developed further by scholars as a framework
for understanding political responses to the coronavirus pandemic (Lasco, 2020; Farias et al., 2022),
it calls attention to a repertoire of styles that contain recurrent, familiar elements:
The first, simplification of the pandemic, includes the ways in which politicians downplayed the
seriousness of the crisis and the virus itself (Béland et al., 2021; Roberts, 2024) or oered simplistic
solutions, including wonder drugs and miracle cures like Ivermectin or hydroxychloroquine
(Casarões & Magalhães, 2021; Bharti & Sismondo, 2022).as opposed to relying on medical experts
and ‘expert communities’ and deliberative processes to reassure the public.
The second, dramatisation of the crisis, refers to how politicians ‘spectacularise’ (Lasco & Curato,
2019) either their responses to the crisis or the crisis itself, either through actions or the use of dra-
matic language as part of ‘performative leadership’ (Lacatus et al., 2023; Skonieczny & Boggio,
2023). As Lasco (2020, p. 1419) observed: ‘Political actors also dramatise the pandemic itself as
an exceptional threat as a pretext to gain ‘emergency powers’, while simultaneously casting dra-
matic measures of ‘lockdown’ and declarations of ‘war’ and ‘emergency’ as commensurate and
valid responses to safeguard public safety.’
The third, forging of divisions, involves the dierent ways in which political actors create or
reinforce relationships of antagonism or blame between their publics and dangerous, infectious others.
As Lasco and Curato (2019) note, these can either be vertical divisions aimed at powerful and/or global
entities like ‘Big Pharma’, scientific experts, the WHO, or ‘globalist elites’ (see Lacatus et al., 2023) or
horizontal divisions towards migrants and minorities that often overlap with preexistence prejudice
towards those groups (Ortiz-Millán, 2024; see Channa, 2023 for an example from India).
This present analysis contributes to the above literature by documenting how leaders’ political
styles evolved over time within the same health crisis, broadening the focus of analysis to include
other political actors beyond national leaders. With their diverse geographic, economic, and cul-
tural contexts, and right-wing populist leaders (Trump, Bolsonaro, Duterte) with divergent vac-
cine-related responses, the three countries make for timely and relevant illustrative examples,
especially with – at the time of writing – Donald Trump back in power, both Duterte and Bolso-
naro still holding significant political capital notwithstanding their legal predicaments, and their
brand of populism an enduring presence around the world. Aside from their global resonances,
I chose the above cases based on my own positionality and familiarity with their contexts, having
analysed the three countries’ politics from their beginning of the pandemic (see Lasco, 2020).
On top of the politicisation of health crises, previous scholarship on the politics of vaccination
has recognised how ‘across geographies and political contexts, vaccines are prone to being used as
populist tropes’ (Lasco & Larson, 2020, p. 7) and that vaccine politics is as old as the advent of
immunisation in the nineteenth century (Holmberg et al., 2017). However, much of this pre-pan-
demic scholarship has concerned anti-vaccination scandals, from the boycott of polio vaccines in
Nigeria in early 2000s (Yahya, 2007) and the aftermath of the Wakefield article in the United States
(Lillvis et al., 2014) to the dengue vaccine scandal in the Philippines (Yu et al., 2021) and the Chang-
chun Changsheng vaccine scandal in China in 2018 (Wang, 2020). Insofar as attention to vaccines is
2 G. LASCO

concerned, COVID-19 represented a dierent order of magnitude and encompassed not just anti-
vaxxer ideologies and conspiracy theories but also pro-vaccination projects that tapped into notions
of nationalism and ‘public health optimism’ (Gandy, 2022). As this paper will hopefully make clear,
such a spectrum of divergent and seemingly-paradoxical political responses (Brubaker, 2021) holds
significant implications not just for the pandemic response, but for vaccine confidence (see Harri-
son & Wu, 2020), and thus, for public health in general.
Methods
In keeping with the approaches by other scholars of medical or healthcare populism (e.g. Speed &
Mannion, 2020; Hedges & Lasco, 2021; Casarões & Magalhães, 2021), as well as populism in general
that views political performances as units of analysis (Mott, 2016; Ostiguy & Mott, 2020), this
paper surveyed and analysed political statements, national and state-policies related to COVID-
19 vaccination, and vaccine-related actions (e.g. getting vaccinated) by heads of state and other pro-
minent politicians in Brazil, the Philippines, and the United States from March 2020 to December
2021. The empirical material – which was gathered in an NVivo 11 database – consisted of tran-
scripts of political speeches and remarks, social media posts, and pertinent news coverage in each
country from newspapers of record and major media outlets – was retrieved using site-specific
Google searches (e.g. site:https://g1.globo.com …), using the three countries’ heads of state – Jair
Bolsonaro, Rodrigo Duterte, and Donald Trump – as search keywords alongside ‘vaccine’, ‘immu-
nisation’ OR ‘vaccination’ (vacina, imunização, imunização in Brazilian sources; see Table 1 for the
list of sources). Drawing inspiration from user-based sampling approaches that call for prioritising
methods that people can easily do on their own (see Blassnig et al., 2019), the first 100 entries within
the range of the study period of each of the news outlets were included in the database (n = 900),
while the leaders’ social media accounts were searched using internal website search tools [e.g.
‘vacina (from:JairBolsonaro); vaccine (from:RealDonaldTrump)’ on X, formerly known as Twitter];
notable events identified from this material were also searched online. Crucially, unlike other simi-
lar analyses that mainly involved retrospective database searches, these sources had already been
followed by the authors as part of real-time monitoring of political events in the three countries
throughout the period of study, making the major events already familiar to the authors. In keeping
with the long-term, immersive approach of political ethnography (Vidali & Peterson, 2012), this
method of ‘following’ – like its allusion to social media – involved regularly visiting the above-
mentioned sources (e.g. news websites, social media feeds), allowing the authors to follow the emer-
gent outbreak narratives in each country as well as the political contexts of the events of interests. It
also helped insulate the data gathering from ‘temporal bias’ in which more searchable and proxi-
mate events, relative to the time of study, would figure more prominently.
Secondarily, this paper also drew from and engaged with the significant amount of scholarship
that has since emerged to make sense of pandemic politics in all three countries (e.g. Persson et al.,
2025; Farias et al., 2022; Kenny & Holmes, 2022; Speed & Mannion, 2020; Imran & Javed, 2024),
which were retrieved through PubMed using the search terms (Duterte OR Philippines OR Bolso-
naro OR Brazil OR Trump OR United States) AND (vaccin* OR immuniz*) AND (COVID OR
coronavirus) AND (politics OR populism), yielding 50 results. Aside from oering analytic
Table 1. List of sources ‘followed’.
Reputable media sources Recordings or transcripts of political speeches Social media
Brazil O Globo, G1, Folha da Sao Paulo CanalGov (YouTube channel) (https://www.
youtube.com/@canalgov)
@JairBolsonaro
Philippines Philippine Daily Inquirer, Philippine
Star, Rappler.com
Presidential Communications Office (https://pco.
gov.ph/)
None
United
States
New York Times, Washington Post,
CNN
White House (https://trumpwhitehouse.archives.
gov/)
@RealDonaldTrump
GLOBAL PUBLIC HEALTH 3

engagement, many of these papers also chronicled or referenced the same events in ways that
allowed for comparison and corroboration.
The ensuing coding and thematic analysis, followed a deductive approach that was based on the
preexisting framework of medical populism (simplification, spectacularisation, forging of divisions)
and the author’s familiarity and previous work analysing three settings. The findings were then syn-
thesised and presented using narrative case studies (see Table 2 for a summary), again following the
scholarship (e.g. Speed & Mannion, 2020.)
Findings
Brazil: Jair Bolsonaro’s vaccine skepticism
Brazilian president Jair Bolsonaro’s response to the pandemic has been characterised as tantamount
to a ‘denialism’ (Von Bulow & Abers, 2024), from his early characterisations of the virus as ‘just a
little u’ to his theatrical displays of outing quarantine rules. Despite the strong objections to his
pandemic actions (and inaction) and notwithstanding his eventual electoral defeat, he initially saw
his popularity rise during the first months of the pandemic (see Philips, 2020), and he used his own
bout of COVID-19 infection and eventual recovery, to vindicate his downplaying of the virus
(Lasco, 2020; Burni & Tamaki, 2021). Meanwhile, he expressed antagonism to public health exper-
tise – including those from within his own government even as he endorsed the use of unproven
treatments like chloroquine (Oliveira, 2020).
Bolsonaro’s attitude towards vaccines largely mirrored his pandemic-related outlook: just as he
downplayed the pandemic, he initially did not give much attention to vaccines, only mentioning
them a few times in his tweets and speeches from June to the end of 2020. Eventually, however,
he increasingly used vaccines as a way to forge divisions between the people and global and scientific
elites. Like most other countries, Brazil’s federal government sought international cooperation and
agreements related to vaccine development and acquisition (see Dantas et al., 2020). Bolsonaro, how-
ever, was quick to state, months before any vaccine was approved, that ‘no one can force anyone to get
the vaccine’, strengthening his position vis-a-vis health experts (Carvalho et al., 2020), further reect-
ing his antipathy toward immunisation – and his political support for the ‘individual freedoms’
valued by his base; the same freedoms he had previously defended in light of quarantine measures.
Table 2. Summary of cases.
Characteristics of initial
COVID-19 response
Political and economic
context Vaccine-related response
Opposition
responses
Brazil – Jair
Bolsonaro
Pandemic denialism Bitter political divisions
between federal and
state governments
Vaccine skepticism: Casting
doubt on the efficacy and
safety vaccines, while
using vaccines to forge
divisions between the
public and health experts,
China, and the World
Health Organization
Strong and visible
support for
vaccination from
opposition
governors like Sao
Paulo’s Joao Doria
Philippines –
Rodrigo
Duterte
Downplaying of the
pandemic, then
dramatising responses
through ‘brute force
governance’
Criticism over lack of
pandemic responses
despite having the
‘world’s longest
lockdown’
Vaccine messianism:
Promise of vaccines from
China and Russia; offer to
volunteer for vaccine trials
Skepticism over
vaccines –
especially those
from China
United States
– Donald
Trump
Downplaying of the
pandemic
Trump’s unpopularity
and ensuing bitter
electoral defeat; pre-
existing skepticism
towards vaccines by
his base
Vaccine nationalism: holding
up vaccine development
as an example of American
exceptionalism with
Americans as top priority;
followed by more muted
support for vaccination
Initial skepticism over
Trump’s handling of
vaccines, eventual
strong support for
vaccination
4 G. LASCO

Beyond casting doubts on public health experts (see Davis et al., 2023), Bolsonaro also framed
vaccines in nationalistic terms, in ways that somewhat mirror Trump’s antipathy towards China.
The Brazilian president expressed strong disapproval towards Coronavac, from the Chinese com-
pany Sinovac, which had partnered with the Sao Paulo-based Butantan Institute to conduct Phase
III clinical trials. ‘The Brazilian people will not be anyone’s guinea pig,’ he stated in October 2020
(G1, 2020a). While focusing his discourse on Chinese-made vaccines, he also ridiculed the Pfizer
vaccine, saying: ‘If you turn into an alligator, that’s your problem. If you become a Superman, if
a woman grows a beard, or if a man speaks sharp, Pfizer has nothing to do with that’ (Farias et
al., 2022, p. 10).
Brazil rolled out its vaccination program in February 2021, and Bolsonaro’s own vaccination sta-
tus was subject to speculation since he was ocially eligible in April that year. In October 2021,
Bolsonaro would be even stronger in his vaccine skepticism, airing baseless links between vacci-
nation and HIV/AIDS in a live broadcast (Verdelio, 2021) and personally claiming to reject vacci-
nation (G1, 2021b):
I decided not to take the vaccine anymore. I’m seeing new studies, my immunity levels are through the roof. I
am going to get the vaccine for what? It would be the same thing as playing $10 in the lottery to win $2.
Further tapping into people’s concerns over freedom and pre-existing anti-vaccine sentiments (see
Verjovsky et al., 2023), he also expressed opposition to requiring children to get vaccinated, stating
at the end of 2021 that he would not allow his 11-year-old daughter to receive the vaccine (Caldas,
2021; see also Martins-Filho & Barberia, 2022).
In contrast, his political opponents were much more supportive of COVID-19 vaccination. Nota-
bly, former president (and Bolsonaro’s eventual successor) Luiz Inácio Lula da Silva was among the
signatories of a June 2020 initiative to make the coronavirus vaccine a ‘global common good’ (Yunus
Centre, 2020); in his first speech after recovering his political rights, he rhetorically looked for the
Brazilian mascot Zé Gotinha – a beloved symbol of the country’s immunisation campaigns since
the 1980s – in a pointed rebuke of Bolsonaro’s neglect of COVID-19 vaccination (G1, 2021a).
Meanwhile, those at the state level carried out their own procurement eorts independent of the
federal government. One of Bolsonaro’s most prominent opponents, Sao Paulo governor Joao
Doria, embarked on state-level initiatives to procure vaccines and make vaccine deals including
with the Chinese pharmaceutical firm Sinovac Biotech. ‘We will soon be able to immunise Brazi-
lians in Sao Paulo and across the country with the CoronaVac vaccine’ he said in September
2020, notably including citizens beyond his state as among the beneficiaries of his initiative. ‘The
projected delivery date is in December this year’ (G1, 2020b).
Contrasting himself from the federal government further, Doria expressed support for manda-
tory vaccination, saying in response to one of Bolsonaro’s statements above: ‘The vaccine must be
mandatory. There is no reason to make the federal government decide not to take the mandatory
vaccine.’ (G1, 2020b) Unlike Bolsonaro, Doria publicised his receiving doses of Coronavac in May
and June 2021 (Rodrigues, 2021).
Viewed as an extension of his overall pandemic outlook characterised by simplification and divi-
siveness, Bolsonaro’s vaccine skepticism has arguably been encouraged by his political buoyancy –
even as the limits of his political capital were later demonstrated by his electoral and legal
defeats (von Bulow & Abers, 2024). Alongside his opponents’ strong support for vaccination, Bol-
sonaro’s actions reected a resurgent divisiveness around vaccination along political and ideological
fault lines: one that crystalised to further polarisation and stronger distrust of vaccines, much to the
detriment of public health in Brazil (Fernandez et al., 2022; Gramacho et al., 2024).
Philippines: Rodrigo Duterte’s vaccine messianism
Like Bolsonaro, Philippine president Rodrigo Duterte initially downplayed the threat of COVID-19
– at one point he threatened to slap the virus and ridiculed people for ‘believing the fear ’ – but a
GLOBAL PUBLIC HEALTH 5

worsening situation in mid-March led him to impose what some observers call ‘world’s longest
lockdown’ characterised by draconian measures (Lasco, 2020). Faced with a worsening economy
and a barely-improving health situation, his government’s approach was later characterised by
vacillation and lack of clear direction (see Arguelles, 2021).
It is in this milieu that Duterte prominently – and increasingly – used the promise of future
vaccines as the solution to the pandemic, eectively simplifying the health crisis. As early as May
2020, at the height of the initial quarantine, he devoted considerable attention to the prospects
of vaccination: ‘There is a vaccine but the problem is it won’t be ready until 2021, January at the
earliest. If that’s the case, hopefully you don’t die until January, just wait for the vaccine.’
In the coming months, he would repeat strikingly-similar statements that point to vaccines as
forthcoming solution to the pandemic. Responding to an open letter from health professionals call-
ing for stronger action, he said on early August 2020: ‘What can I do? I’ve aways been praying to
God for the vaccine.’ The following week, after Russia announced its regulatory approval of ‘Sput-
nik V’ vaccine despite not yet reaching Phase 3 trials, Duterte volunteered to be the first to take it
(Presidential Communications Oce, 2020):
I’m really happy because Russia is our friend … they will give us the vaccine. Let’s inject first and see the
results. We’ll be given the vaccine and we’ll see if our bodies will accept it. When it comes to the vaccine,
so that the public won’t have any complaints, I will have myself injected in public. I will be the first to be
experimented upon … I will be the first to receive the vaccine.
Beyond simplifying the pandemic, Duterte’s vaccine policies and pronouncements also reinforced
the divisions he has forged in his administration. For instance, he praised vaccines from China and
Russia while expressing skepticism over vaccines from companies based in Western countries, in
keeping with his anti-Western posturing (see Paquin, 2024). ‘The one good thing about China is
you do not have to beg, you do not have to plead,’ he said on September 15, 2020. ‘One thing
wrong about the western countries, it’s all profit, profit, profit … Every Filipino will die I can assure
you.’ (Mendez, 2020). Moreover, Duterte’s vaccine discourses reected his militaristic response to
the pandemic with his declarations that vaccines should be administered in police stations (Aguilar,
2020).
Political opponents for their part, pushed back both against the idea of simply ‘waiting for a vac-
cine’ and in favouring vaccines from China. ‘Since day 1, we have heard nothing but ‘unless there is
a vaccine’ plus China,’ jailed Senator Leila de Lima said in a press release on May 30, adding that
‘any eort by Duterte to help China monopolise the production and supply of such vaccine is ‘tan-
tamount to a death sentence’ for the entire nation.’ (Senate of the Philippines, 2020).
Vice President Leni Robredo – the highest ranking member of the opposition at the time – aired
similar concerns. ‘Watched the regular Monday [press conference] tonight,’ she said on September
22, referring to Duterte’s weekly late night addresses. ‘It seems not enough just to have hospitals,
beds, and funeral parlours and merely wait for a vaccine.’ (Lalu, 2020). Referring to data from a
Lancet Commission report (Sachs et al., 2020), she said on another occasion: ‘This table shows
that it’s possible to suppress [the coronavirus] even while no vaccine is available. If 19 countries
were able to do it, no reason why we can’t. We can do this.’ (Ibid.)
Ironically, notwithstanding how Duterte placed rhetorical importance on vaccination, the Phi-
lippines was one of the last countries in the region to have a vaccine rollout, which was beset by
delays, public skepticism (especially towards vaccines from China) and undermined by a surge
of COVID-19 infections just when the vaccine was initially being made available to the general pub-
lic in April 2021.
Nonetheless, especially when there were neither actual vaccines yet nor end in sight for the pan-
demic, Duterte’s vaccine messianism simplified the pandemic as a vaccine-preventable situation –
even if his pro-vaccination stance was a departure from the populist performances by his own allies
that cast doubts on the dengue vaccine introduced during the term of his predecessor (see Lasco &
Larson, 2020). Indeed, in contrast to such performances that had far-reaching consequences in the
6 G. LASCO

country’s health care system (not least of which was a dramatic decline in immunisation rates; see
Reyes et al., 2021), Duterte’s support for vaccination for mirrored his predecessor’s unqualified sup-
port for vaccines in general. On the other hand, his political opponents, most of whom were sup-
portive of the dengue vaccine, likewise supported the vaccination program, reserving their criticism
towards vaccines from China and Russia, as well as of Duterte’s authoritarian policies around vac-
cines, such as threatening to arrest those who refuse them (Salverria, 2021).
Such switching of vaccine positions suggest that, as in Brazil, the future of vaccination in the Phi-
lippines may filter through political fault lines.
United States: Donald Trump’s vaccine nationalism
While Rodrigo Duterte dramatised his response to the pandemic after downplaying it, Donald
Trump’s performances have seen him simultaneously downplay the pandemic – e.g. by not wearing
a mask and claiming that it will go away – and make a spectacle of his responses, calling the US the
‘King of Ventilators’ and invoking the language of war, describing his response as the ‘greatest
mobilisation of our society since World War II’ (Trump, 2020a).
From the early months of the pandemic until the end of his presidency, vaccine development (i.e.
‘Operation Warp Speed’) can be seen as part of this dramatised response. A clear evolution of the
prominence of vaccines can be seen in his speeches (e.g. from ‘therapeutics and vaccines’ to ‘vac-
cines and therapeutics’). While Duterte used the promise of vaccines to simplify the pandemic,
Trump used it to spectacularise his government’s response, achieving this through the use of
language (‘colossal’, ‘tremendous’, ‘groundbreaking’, ‘Warp Speed’), scale (‘300 million doses’),
and time (‘by the end of the year’), as in this August 2020 speech (Trump, 2020b):
While we have the pandemic, we have a lot of great things happening, in terms of the vaccines and thera-
peutics, as you know. And I think we’ll be making tremendous progress over the next period of a few months.
And certainly, before the end of the year, I think we’ll have a – a vaccine before the end of the year
We currently have three candidates in phase three clinical trials and are on pace to have more than 100 million
doses of a vaccine ready before the end of the year and 500 million doses very shortly thereafter.
Moreover, while Duterte’s vaccine promises were based on international assistance, Trump’s vac-
cine project was explicitly nationalist, appealing to American exceptionalism, invoking the military,
praising American companies, and framing the ‘health and safety of Americans’ (Trump, 2020d) as
the primary goal of the project. Notably, he was initially reluctant to join eorts for global vaccine
distribution, citing his ‘America First’ policy and the involvement of WHO, which he has blamed
for the pandemic. Towards the end of 2020, after his electoral defeat, he continued to pursue the
theme of vaccine nationalism, celebrating the vaccine rollouts as a ‘monumental national achieve-
ment’ (Trump, 2020c):
In order to achieve this goal, we harnessed the full power of government, the genius of American scientists,
and the might of American industry to save millions and millions of lives all over the world.
We are the most exceptional nation in the history of the world. Today, we’re on the verge of another American
medical miracle.
Despite these pro-vaccine performances, however, Trump also showed some ambivalence over the
finer details of vaccination. Following his electoral defeat in the November 2020 presidential elec-
tions, he oated a conspiracy theory that the positive results of the Pfizer vaccine were delayed until
after the elections to favour Joe Biden (Cohen, 2020). Trump was generally (if mildly) supportive of
vaccination in his first year post-presidency, even amid boos from his fans, but he kept his own vac-
cination status secret, revealing it only in March 2021, and refused to have his vaccinations televised
or photographed. Such a balancing act was perhaps exemplified during a rally in Alabama where he
said: ‘You got your freedoms. But I happened to take the vaccine’ (Merica, 2021); he would
GLOBAL PUBLIC HEALTH 7

eventually and increasingly become more vocal against vaccine mandates, culminating in his
second presidency when he would sign executive orders against them (e.g. The White House, 2025).
For their part, Trump’s political opponents initially demanded – in the words of presidential
candidate Joe Biden on September 8, ‘full transparency on the vaccine’ while expressing support
for the overall idea of vaccination (Erickson, 2020). Biden sought to dissociate Trump from vac-
cines, saying on September 17 that he cannot be trusted: ‘I trust vaccines. I trust scientists. But I
don’t trust Donald Trump, and at this point, the American people can’t, either.’ Biden also
oered more detail about vaccine distributions, and deferred to experts regarding a timeline, in con-
trast to Trump’s deadlines. Upon winning the elections, Biden wholeheartedly embraced the vac-
cination program, publicising his vaccination in December 2020 and crediting his predecessor
the following year for the program (Vazquez & Carvajal, 2021).
Of the three presidents surveyed in this paper, Donald Trump’s embrace of vaccines represented
the most radical shift – both from his previous pandemic response and his long history of being an
‘extreme vaccine skeptic who not only blamed childhood immunisations for autism – a position
that scientists have forcefully repudiated – but once boasted he had never had a u shot’
(Homan, 2020). Such a shift ‘from skeptic to cheerleader’ (Ibid.) may reect political calculus,
which may also account for his ambivalence and eventual distancing from his own pro-vaccination
stance. By oering an America-made vaccine coming soon without oering specifics, perhaps he
was tapping into people’s hopes for the pandemic to come to an end – while maintaining his appeal
to constituencies that are skeptical of public health policies in general and vaccination in particular
(Allen, 2019; Bolsen & Palm, 2022); it is worth reiterating that even while trumpeting the vaccines,
he was opposed to vaccine mandates. Moreover, even when he diverged from many of his suppor-
ters’ vaccine skepticism, his vaccine-related policies and pronouncements were in line with with
their shared ‘exclusionary nationalism’ (Bieber, 2022) that also saw him blame China for the
virus in a ‘diversionary war of words’ (Saltzman, 2024).
Discussion
Vaccines and the dynamic nature of medical populism
In many ways, the vaccine-related responses by the presidents of the three countries reected their
pre-existing style of dealing with the COVID-19 pandemic, allowing them to continue simplifying
the pandemic, dramatising their responses, and crystallizing the divisions with which they have
framed the health crisis. To a certain extent, they can also be viewed as typical political reactions
to past events, with Trump’s vaccine nationalism echoing how vaccine production became ‘a matter
of national pride’ for Mexico in the 1970s (Carrillo, 2017), and with Bolsonaro’s nationalist-
inected vaccine skepticism mirroring similar sentiments in 1920s India, including by the likes
of Gandhi (Brimnes, 2017; Khan, 2006).
However, we can also see how fast-paced epidemiological, social, and political developments can
aect the mobilisation of vaccines by political actors in ways that hew closer to the medical populist
style. As Donald Trump’s underestimation of the crisis became clearer, and as his touted cures were
refuted by the scientific community, he increasingly turned to vaccines to dramatise his response to
the crisis, thereby moving from simplification to spectactularisation. Duterte, on the other hand,
increasingly turned to vaccine messianism as his ‘brute force governance’ (Thompson, 2022) fell
short of their political and epidemiological ecacy, thus moving his emphasis from spectactulari-
sation to simplification. Although his political standing remained secure through his term and he
was limited to one term anyway, the promise of future vaccines allowed him to lower people’s
expectations of the government while rhetorically maintaining that a solution for the virus is at
hand.
Meanwhile, Bolsonaro, who like both Trump and Duterte downplayed the pandemic and also
touted cures, used vaccines to incite people against political opponents as well as countries like
8 G. LASCO

China and scientific elites, thus moving from simplification to forging of divisions. Indeed, further
reinforcing his divisive performances (while also illustrating the variable instantiations of medical
populism), it was his political opponents – exemplified in the above case by Sao Paulo governor
Joao Doria – that mirrored Duterte and Trump’s vaccine rhetoric.
Taken together, these variable political invocations of vaccines during the same pandemic clarify
the nature and complexity of medical populism. Medical populism, indeed, does not have a fixed
content – only a fixed repertoire of styles (Speed & Mannion, 2020): one that may evolve in char-
acter and emphasis over time. Calling attention to the impulse for authorities to resort to lockdowns
and draconian measures, Tucker (2021) has pointed out how what he calls ‘lockdownism’ (i.e. sup-
port for the use of stay-at-home orders, business and school closures, travel restrictions, etc.)has
become like an ideology in itself (that is, embraced as a necessary response and self-evident solution
to the pandemic), regardless of how its exponents may be placed in the the political spectrum. As
this paper shows, however, even such ideological commitment can give way to other responses, like
vaccine messianism, nationalism, or skepticism as in the case studies. This insight lends credence to
a growing number of works that highlight the evolving nature of political responses to COVID-19
around the world, from ‘pharmaceutical messianism’ (Lasco & Yu, 2022) to ‘spectacularisation of
failure’ (Resende & Reinke de Buitrago, 2022), and underscore the need for sustained scholarship
(Taraktaş et al., 2024).
Moreover, the spectrum and specificity of vaccine-related policies brings into question the
relationship – temporal and otherwise – between populism and technocratic governance. Far
from being a binary (i.e. pro vs. anti), the three examples show a selective deployment of science:
at the very least, the form and rhetoric of science and medicine with varying degrees of substance
(see Buštíková & Baboš, 2020). Similarly, the case studies also evinced a spectrum of stances towards
vaccines – not an either-or between being pro- or anti-vaccination, but being skeptical of vaccine
and stridently against the immunisation of children (Bolsonaro); being supportive of vaccines but
particularly of China (Duterte); vacillating between skeptic and cheerleader (Trump). During the
period of the pandemic covered in this paper, especially in 2020, there was a sense of drama and
triumphalism in the race to develop vaccines: one that Trump capitalised upon (Rajmil et al.,
2024). As the pandemic dragged on, however, and as the perceived value of vaccination became
less clear, what was more in line with the populist logic was to use vaccines (and vaccine mandates)
to forge divisions, which is what Trump did during his second presidential campaign and term,
from reinstating military members who refused mandatory vaccination to cutting federal funding
to schools with vaccine mandates (Mueller, 2025).
Finally, while all three leaders surveyed in this paper – Bolsonaro, Duterte, Trump – exhibited
elements of medical populism, the same can be said of their political opponents, whose vaccine-
related responses range from criticism (as with the opposition in the Philippines) to independent
vaccine development (as with Joao Doria in Brazil) – a range that may be shaped by the kind of
political system (e.g. federal vs. centralised) in a given setting (see Greer et al., 2020), as well as pol-
itical events, like the elections in the US and Brazil that proved decisive for Trump and Bolsonaro,
respectively, owing in part to their COVID-19 responses. Independent of the safety, ecacy, and
actual timeline of vaccine development, politicians on either (or both) sides politicised the country’s
vaccination eorts, and such dynamics both reected and reinforced public attitudes towards vac-
cination (Debus & Tosun, 2021). These dynamics further underscore the ‘definitional diculties’
inherent within the medical populism concept, especially in ‘typologising leaders as either ‘medical
populists’ or ‘medical technocrats’’ (Lasco, 2020, p. 1424). However, there were also key dierences:
While their opponents largely respected scientific authority, the three leaders – Trump, Bolsonaro,
Duterte – expressed disdain for or at least ambivalence towards medical orthodoxy: an attitude that
informed their simplification, spectacularisation, and forging of divisions, even as they embraced
‘medical heterodoxy’ or ‘counter-knowledge’ (De Sá, 2025; Sunnercrantz, 2024). Such dynamics
– and the outsised roles of medical experts in them – should encourage eorts to further make
sense of the ‘processes by which powerful expert knowledge is made’ (Jasano, 2022, p. 34),
GLOBAL PUBLIC HEALTH 9

especially during times of crisis, given how populism is ‘knowledge phenomenon’ (Nawrocki,
2024).
Nationalism, vaccines, and public health
The immediate implications of vaccines as populist tropes have been raised by various scholars but
some points related to nationalism are worth re-articulating in light of this paper’s findings:
First, while the linkages between vaccine hesitancy and populism are well established, including
their shared rootedness in distrust towards elites, experts, and institutions (Recio-Román et al.,
2021; Bolsen & Palm, 2022), the findings gesture towards a more fundamental basis for this
relationship: one that involves the nation-state. Beyond just enabling and reinforcing conspiracy
theories around vaccines, the populist performances around vaccination involves the constitution
of the nation-state as an ‘immunological community’, that is, as a body politic with distinct immune
system-related properties. Both Bolsonaro and Duterte, for instance, hinted at their constituents
having some of kind of specific attributes that made them immune to the vaccine, and Trump at
one point supported the view, championed by his allies, that Americans already had ‘natural immu-
nity’ or ‘herd immunity’ to the coronavirus. Trump also linked his vaccine project with American
exceptionalism, calling ‘American vaccines’. Such intersections between immunological issues,
nationalism, and the body politic resonate with the scholarship that has underlined the emergence
of an ‘immunitary paradigm’ (Ajana, 2021) where immunity functions not just a metaphor but a
guiding principle in contemporary society and politics (see Esposito, 2006). If so, then this can
also explain (and anticipate) the enduring value of vaccines as a populist trope; particularly their
vulnerability to being used to forge divisions along ethnic and national divides.
Relatedly, the case studies complicate the notion of ‘vaccine nationalism’, showing that it is more
than just a nation prioritising their citizens (e.g. ‘America first’) at the expense of the rest of the
world. To be sure, vaccine nationalism holds consequences for global health equity; as Speed and
Mannion (2020, p. 1969) have warned, ‘The populist logic is that it is the job of the government
to serve only the people and to ensure that those who are not deemed to comprise the people
have more restricted access to services and public resources.’ However, as the US example
shows, vaccine nationalism can also involve vaccine projects with a nationalist dimension. More-
over, nationalist imperatives can shape the reception of certain vaccines, as with the Philippines
and Brazil both rejecting vaccines from China – with the participation and encouragement of pol-
itical actors. Regardless of the political ecacy of such nationalist framings, they can translate to
further vaccine hesitancy (Hornsey et al., 2020; Corcoran et al., 2021) – as well as a resort to unpro-
ven treatments including those that Bolsonaro, Trump, and Filipino politicians aligned with
Duterte promoted: chloroquine and ivermectin (Casarões & Magalhães, 2021; Lasco & Yu, 2022;
Bharti & Sismondo, 2022). More broadly, by constituting the nation as an immunological commu-
nity and the rest of the world as the ‘others’, they also reect and reinforce the age-old xenophobic
nature of infectious disease outbreaks, leading to racist, exclusionary policies and quarantines (see
Bieber, 2022).
In light of the above, the findings echo other scholars in arming the need for vaccine processes
to be credible and trustworthy, and thus, for transparency and accountability on the part of govern-
ments and public health agencies (Giubilini et al., 2025), especially those that can easily fall within
the fault-lines of nationalism, such as the WHO (see Murhula & Singh, 2022). Given the pressures
of vaccine messianism and nationalism, utmost vigilance is required – especially on the part of vac-
cine developers, regulators, and implementers – to resist the intense political pressure to deliver
safe, eective, and equitable vaccines, and whenever possible, to encourage bipartisan – or non-
partisan – support for them. However, such tactical measures will not be enough, given the pre-
existing milieu of mistrust towards experts, and nationalistic fault lines. Indeed, the politicisation
of COVID-19 vaccines is a sobering reminder that while pandemics can be pro-vaccination
moments, they can just as likely stoke anti-vaccinations sentiments and whatever political shifts
10 G. LASCO

towards vaccination there might be – like Trump and other Republicans endorsing vaccines (see
Pink et al., 2021) – may be short-lived.
Conclusion
This paper identified a distinct phase of medical populism in the COVID-19 pandemic: one during
which at least one political side in local politics focused on the promise of vaccination. This emer-
gence of vaccines as populist tropes in the COVID-19 pandemic followed a familiar script of sim-
plifying health crises, spectacularizing responses, and forging divisions – but there were notable
shifts in these elements that characterised this distinct phase of the health crisis. Trump’s vaccine
nationalism, Duterte’s vaccine messianism, and Bolsonaro’s vaccine skepticism illustrate the diver-
sity of responses around the world and their contingency on local political, social, and epidemio-
logical contexts.
As stressed by other scholars, it bears emphasising that the focus on political actors should not
detract attention from the ‘broader conditions that lend resonance to the populist style’ (Lasco &
Curato, 2019, p. 8). Particularly for COVID-19, in the words of Gurunathan and Mishra (2023,
p. 1): ‘it becomes imperative to understand where the people stand within the controlled geo-pol-
itical boundaries of lockdown spaces, that is, to ask where the people position themselves within the
“performance of the crisis” of the medical populist framework’. Indeed, there is a need to look at
heterodox medical actors (Lasco et al., 2024), health inuencers, alt-science ‘knowledge commu-
nities’ (Sacco et al., 2021), all of which reect and reinforce vaccine related sentiments; as Casarões
and Magalhães (2021, p. 198) noted, ‘Rather than being an individual endeavour, medical populism
addressing the coronavirus crisis [led] populists to build an alt-science network that serve[d] as a
platform for doctors, lobbyists, businesspeople, and religious leaders … linked to far-right move-
ments across the world.’ Beyond the pandemic, vaccination has had a long history of politicised
scandals (see Lasco & Larson, 2020), in which populist performances are inexorably linked with
‘local vaccine cultures’ (McKnight & Holt, 2014).
However, especially during times of emergency, and as perhaps illustrated by recent events in the
US, with Donald Trump’s decision to appoint Robert F. Kennedy Jr. as secretary of Health and
Human Services (HHS) secretary (Emanuel & Ozisik, 2024), national leaders hold great power in
shaping public health, making a continued focus on the logics behind their actions still a vital exer-
cise to complement more ethnographic and grounded approaches, both in making sense of the
COVID-19 pandemic and preparing for pandemics to come.
Disclosure statement
No potential conict of interest was reported by the author(s).
Funding
The author(s) reported there is no funding associated with the work featured in this article.
References
Aguilar, K. (2020, September 22). COVID-19 vaccination will be done in police stations, Duterte repeats earlier state-
ment. Philippine Daily Inquirer. https://newsinfo.inquirer.net/1338145/covid-19-vaccinations-to-be-facilitated-
by-doctors-in-police-stations-once-available.
Ajana, B. (2021). Immunitarianism: Defence and sacrifice in the politics of Covid-19. History and Philosophy of the
Life Sciences, 43(1), 1-31. https://doi.org/10.1007/s40656-021-00384-9
Allen, A. (2019, May 27). How the anti-vaccine movement crept into the GOP mainstream. Politico. https://www.
politico.com/story/2019/05/27/anti-vaccine-republican-mainstream-1344955.
GLOBAL PUBLIC HEALTH 11

Arguelles, C. V. (2021). The populist brand is crisis: Durable Dutertismo amidst mismanaged COVID-19 response.
Southeast Asian Aairs, 2021(1), 257–274. https://doi.org/10.1355/9789814951753-016
Balakrishnan, V. S. (2020). The arrival of Sputnik V. The Lancet Infectious Diseases, 20(10), 1128. https://doi.org/10.
1016/S1473-3099(20)30709-X
Béland, D., Rocco, P., Segatto, C. I., & Waddan, A. (2021). Trump, Bolsonaro, and the framing of the COVID-19
crisis: How political institutions shaped presidential strategies. World Aairs, 184(4), 413–440. https://doi.org/
10.1177/00438200211053314
Bharti, N., & Sismondo, S. (2022). Political prescriptions: Three pandemic stories. Science, Technology, & Human
Values, 49(2), 371–402. https://doi.org/10.1177/01622439221123831
Bieber, F. (2022). Global nationalism in times of the COVID-19 pandemic. Nationalities Papers, 50(1), 13–25. https://
doi.org/10.1017/nps.2020.35
Blassnig, S., Engesser, S., Ernst, N., & Esser, F. (2019). Hitting a nerve: Populist news articles lead to more frequent
and more populist reader comments. Political Communication, 36(4), 629–651.
Bolsen, T., & Palm, R. (2022). Politicization and COVID-19 vaccine resistance in the US. Progress in Molecular
Biology and Translational Science, 188(1), 81–100. https://doi.org/10.1016/bs.pmbts.2021.10.002
Brimnes, N. (2017). Fallacy, sacrilege, betrayal and conspiracy: The cultural construction of opposition to immunis-
ation in India. In C. Holmberg, S. Blume, & P. Greenough (Eds.), The politics of vaccination (pp. 51–76).
Manchester University Press.
Brubaker, R. (2021). Paradoxes of populism during the pandemic. Thesis Eleven, 164(1), 73–87. https://doi.org/10.
1177/0725513620970804
Burni, A., & Tamaki, E. (2021). Populist communication during the Covid-19 pandemic: The case of Brazil’s presi-
dent Bolsonaro. Partecipazione e Conitto, 14(1), 113–131.
Buštíková, L., & Baboš, P. (2020). Best in Covid: Populists in the time of pandemic. Politics and Governance, 8(4),
496–508. https://doi.org/10.17645/pag.v8i4.3424
Caldas, J. (2021, December 27). Bolsonaro diz que não vai vacinar filha de 11 anos, contrariando indicações da
ciência. G1. https://g1.globo.com/sc/santa-catarina/noticia/2021/12/27/bolsonaro-diz-que-nao-vai-vacinar-filha-
de-11-anos-contrariando-indicacoes-da-ciencia.ghtml.
Carrillo, A. M. (2017). Vaccine production, national security anxieties and the unstable state in nineteenth-and twen-
tieth-century Mexico. In C. Holmberg, S. Blume, & P. Greenough (Eds.), The politics of vaccination (pp. 121–147).
Manchester University Press.
Carvalho, D., Uribe, G., & Cancian, N. (2020, September 2). Nobody can force anyone to get a vaccine, says
Bolsonaro. Folha de Sao Paulo. https://www1.folha.uol.com.br/internacional/en/scienceandhealth/2020/09/
nobody-can-force-anyone-to-get-a-vaccine-says-bolsonaro.shtml.
Casarões, G., & Magalhães, D. (2021). The hydroxychloroquine alliance: How far-right leaders and alt-science
preachers came together to promote a miracle drug. Revista de Administração Pública, 55(1), 197–214. https://
doi.org/10.1590/0034-761220200556
Channa, S. M. (2023). Negotiating power over human bodies: Populism, people and the politics of health in Delhi. In
I. Prato, & G. B. Pardo (Eds.), The Legitimacy of Healthcare and Public Health: Anthropological Perspectives (pp.
131–149). Palgrave Macmillan Cham.
Cohen, J. (2020, November 11). Fact check: No evidence supports Trump’s claim that COVID-19 vaccine result was
suppressed to sway election. Science. https://www.science.org/content/article/fact-check-no-evidence-supports-
trump-s-claim-covid-19-vaccine-result-was-suppressed.
Corcoran, K. E., Scheitle, C. P., & DiGregorio, B. D. (2021). Christian nationalism and COVID-19 vaccine hesitancy
and uptake. Vaccine, 39(45), 6614–6621. https://doi.org/10.1016/j.vaccine.2021.09.074
Crayne, M. P., & Medeiros, K. E. (2021). Making sense of crisis: Charismatic, ideological, and pragmatic leadership in
response to COVID-19. American Psychologist, 76(3), 462–474. https://doi.org/10.1037/amp0000715
Dantas, A. C., Mascarello, J., & Sant’Anna, N. D. R. (2020). Brazil’s international cooperation in science, technology,
and innovation in the context of the Covid-19 pandemic. Boletim de Economia e Poli

tica Internacional, 27, 55–
76. https://doi.org/10.38116/bepi27art4
Davis, S., Ozawa, J. V., Straubhaar, J., & Woolley, S. (2023). When right-wing populism becomes distorted public
health communication: Tracing the roots of jair bolsonaro’s epidemiological denialism. International Journal of
Communication, 17, 1818–1836.
Debus, M., & Tosun, J. (2021). Political ideology and vaccination willingness: Implications for policy design. Policy
sciences, 54(3), 477–491. https://doi.org/10.1007/s11077-021-09428-0
De Sá, G. S. R. (2025). Populism and medical advocacy: The case of hydroxychloroquine prior the 2020 US presiden-
tial election. Social Science & Medicine, 367. 117726. https://doi.org/10.1016/j.socscimed.2025.117726
Emanuel, E. J., & Ozisik, M. L. (2024). Health policies under Trump. BMJ, 387(8450). q2587. https://doi.org/10.1136/
bmj.q2587
Erickson, B. (2020, September 8). Biden says he would take COVID vaccine “tomorrow”. CBS News. https://www.
cbsnews.com/news/biden-covid-vaccine-take/.
Esposito, R. (2006). The immunization paradigm. Diacritics, 36(2), 23–48. https://doi.org/10.1353/dia.2008.0015
12 G. LASCO

Farias, D. B. L., Casarões, G., & Magalhães, D. (2022). Radical right populism and the politics of cruelty: The case of
COVID-19 in Brazil under President Bolsonaro. Global Studies Quarterly, 2(2), 1–13. https://doi.org/10.1093/
isagsq/ksab048
Fernandez, M., Matta, G., & Paiva, E. (2022). COVID-19, vaccine hesitancy and child vaccination: Challenges from
Brazil. The Lancet Regional Health–Americas, 8, 100246. https://doi.org/10.1016/j.lana.2022.100246
Forster, T., & Heinzel, M. (2021). Reacting, fast and slow: How world leaders shaped government responses to the
COVID-19 pandemic. Journal of European Public Policy, 28(8), 1299–1320. https://doi.org/10.1080/13501763.
2021.1942157
G1. (2020a, October 21). ‘Não compraremos a vacina da China’, diz Bolsonaro em rede social. G1. https://g1.globo.
com/bemestar/vacina/noticia/2020/10/21/nao-compraremos-a-vacina-da-china-diz-bolsonaro-em-rede-social.
ghtml.
G1. (2020b, November 16). Doria diz que garante compra de 100 milhões de doses da CoronaVac mesmo se não tiver
verba federal. G1. https://g1.globo.com/sp/sao-paulo/noticia/2020/10/28/doria-diz-que-garante-compra-de-100-
milhoes-de-doses-da-coronavac-mesmo-se-nao-tiver-verba-federal.ghtml.
G1. (2021a, March 24). Após período de ‘sumiço’, Zé Gotinha participa de evento com novo ministro da Saúde. G1.
https://g1.globo.com/bemestar/coronavirus/noticia/2021/03/24/apos-periodo-de-sumico-ze-gotinha-participa-
de-evento-com-novo-ministro-da-saude.ghtml.
G1. (2021b, October 13). Bolsonaro diz que não tomará vacina; ciência recomenda imunização de quem já teve
Covid. G1. https://g1.globo.com/politica/noticia/2021/10/13/bolsonaro-diz-que-nao-tomara-vacina-ciencia-
recomenda-imunizacao-de-quem-ja-teve-covid.ghtml.
Gandy, M. (2022). The zoonotic city: Urban political ecology and the pandemic imaginary. International Journal of
Urban and Regional Research, 46(2), 202–219. https://doi.org/10.1111/1468-2427.13080
Giubilini, A., Gur-Arie, R., & Jamrozik, E. (2025). Expertise, disagreement, and trust in vaccine science and policy.
The importance of transparency in a world of experts. Diametros, 22(82), 7–27. https://doi.org/10.33392/diam.
1871
Gramacho, W., Turgeon, M., Mundim, P. S., & Pereira, I. (2024). Why did Brazil fail to vaccinate children against
COVID-19 during the pandemic? An assessment of attitudinal and behavioral determinants. Vaccine, 42(2),
315–321. https://doi.org/10.1016/j.vaccine.2023.11.064
Greer, S. L., King, E. J., da Fonseca, E. M., & Peralta-Santos, A. (2020). The comparative politics of COVID-19: The
need to understand government responses. Global Public Health, 15(9), 1413–1416. https://doi.org/10.1080/
17441692.2020.1783340
Gugushvili, A., Koltai, J., Stuckler, D., & McKee, M. (2020). Votes, populism, and pandemics. International Journal of
Public Health, 65(6), 721–722. https://doi.org/10.1007/s00038-020-01450-y
Gurunathan, T., & Mishra, B. (2023). Medical populism and lockdownism. In J. Chacko Chennattuserry, M.
Deshpande, & P. Hong (Eds.), Encyclopedia of new populism and responses in the 21st century (pp. 1–4).
Springer Nature Singapore. https://doi.org/10.1007/978-981-16-9859-0_386-1
Harrison, E. A., & Wu, J. W. (2020). Vaccine confidence in the time of COVID-19. European Journal of Epidemiology,
35(4), 325–330. https://doi.org/10.1007/s10654-020-00634-3
Hedges, K., & Lasco, G. (2021). Medical populism and COVID-19 testing. Open Anthropological Research, 1(1), 73–
86. https://doi.org/10.1515/opan-2020-0109
Homan, J. (2020, March 11). President Trump on Vaccines: From Skeptic to Cheerleader. New York Times. https://
www.nytimes.com/2020/03/09/health/trump-vaccines.html.
Holmberg, C., Blume, S., & Greenough, P. (2017). The politics of vaccination: A global history. Manchester University
Press.
Hornsey, M. J., Finlayson, M., Chatwood, G., & Begeny, C. T. (2020). Donald Trump and vaccination: The eect of
political identity, conspiracist ideation and presidential tweets on vaccine hesitancy. Journal of Experimental Social
Psychology, 88. 103947. https://doi.org/10.1016/j.jesp.2019.103947
Imran, S., & Javed, H. (2024). Authoritarian populism and response to COVID-19: A comparative study of the
United States, India, and Brazil. Journal of Public Aairs, 24(1), e2898. https://doi.org/10.1002/pa.2898
Jasano, S. (2022). The discontents of truth & trust in 21st century America. Daedalus, 151(4), 25–42. https://doi.org/
10.1162/daed_a_01942
Kenny, P. D., & Holmes, R. (2022). The Philippines: Penal populism and pandemic response. In N. Ringe, & L. Renno
(Eds.), Populists and the pandemic (pp. 162–172). Routledge.
Khan, S. (2006). Systems of medicine and nationalist discourse in India: towards “new horizons” in medical anthro-
pology and history. Social Science & Medicine, 62(11), 2786–2797. https://doi.org/10.1016/j.socscimed.2005.10.039
Kim, J. H., Hotez, P., Batista, C., Ergonul, O., Figueroa, J. P., Gilbert, S., … Bottazzi, M. E. (2021). Operation Warp
Speed: Implications for global vaccine security. The Lancet Global Health, 9(7), e1017–e1021. https://doi.org/10.
1016/S2214-109X(21)00140-6
Lacatus, C., Meibauer, G., & Lömann, G. (2023). Political communication and performative leadership: Populism in
international politics. Springer International Publishing.
GLOBAL PUBLIC HEALTH 13

Lalu, G. P. (2020, September 22). There’s more to fighting COVID-19 than pesticides, masks, Robredo answers
Duterte. Philippine Daily Inquirer. https://newsinfo.inquirer.net/1338168/robredo-disputes-duterte-theres-
more-to-fighting-covid-19-than-masks-pesticides.
Lasco, G. (2020). Medical populism and the COVID-19 pandemic. Global Public Health, 15(10), 1417–1429. https://
doi.org/10.1080/17441692.2020.1807581
Lasco, G., & Curato, N. (2019). Medical populism. Social Science & Medicine, 221, 1–8. https://doi.org/10.1016/j.
socscimed.2018.12.006
Lasco, G., & Larson, H. J. (2020). Medical populism and immunisation programmes: Illustrative examples and con-
sequences for public health. Global Public Health, 15(3), 334–344. https://doi.org/10.1080/17441692.2019.1680724
Lasco, G., & Yu, V. G. (2022). Pharmaceutical messianism and the COVID-19 pandemic. Social Science & Medicine,
292, 114567. https://doi.org/10.1016/j.socscimed.2021.114567
Lasco, G., Yu, V. G., & Bharti, N. (2024). Pharmaceutical messianism and the politics of COVID-19 in the United
States. Global Public Health, 19(1), 2350656. https://doi.org/10.1080/17441692.2024.2350656
Leach, M., & Tadros, M. (2014). Epidemics and the politics of knowledge: Contested narratives in Egypt’s H1N1
response. Medical Anthropology, 33(3), 240–254. ttps://doi.org/10.108001459740.2013.842565
Lillvis, D. F., Kirkland, A., & Frick, A. (2014). Power and persuasion in the vaccine debates: an analysis of political
eorts and outcomes in the United States, 1998–2012. The Milbank Quarterly, 92(3), 475–508. https://doi.org/10.
1111/1468-0009.12075
Martins-Filho, P. R., & Barberia, L. G. (2022). The unjustified and politicized battle against vaccination of children
and adolescents in Brazil. The Lancet Regional Health–Americas, 8, 8100206. https://doi.org/10.1016/j.lana.2022.
100206
McKnight, J., & Holt, D. B. (2014). Designing the Expanded Programme on Immunisation (EPI) as a service:
Prioritising patients over administrative logic. Global Public Health, 9(10), 1152–1166. https://doi.org/10.1080/
17441692.2014.972967
Mendez, C. (2020, September 16). Philippines won’t pay vaccine reservation fee – Duterte. Philippine Star. https://
www.philstar.com/headlines/2020/09/16/2042785/philippines-wont-pay-vaccine-reservation-fee-duterte.
Merica, D. (2021, December 14). Trump met with boos after revealing he received Covid-19 booster. CNN. https://
www.cnn.com/2021/12/20/politics/donald-trump-booster-shot-boos/index.html.
Mott, B. (2016). The global rise of populism: Performance, political style, and representation. Stanford University
Press.
Mueller, B. (2025, February 14). Trump will withhold money from schools that require Covid vaccines. New York
Times. https://www.nytimes.com/2025/02/14/health/trump-schools-covid-vaccine-mandates.html
Murhula, P. B. B., & Singh, S. B. (2022). The impact of COVID-19 vaccine nationalism on Global Health and human
rights to health standards. The Oriental Anthropologist, 22(1), 93–101. https://doi.org/10.1177/
0972558X221096263
Nawrocki, M. (2024). After the epistemological turn: A framework for studying populism as a knowledge phenom-
enon. The British Journal of Politics and International Relations, 26(2), 444–465. https://doi.org/10.1177/
13691481231202636
Oliveira, K. (2020, March 9). Guedes diz que resposta à crise são as reformas. Agência Brasil, 9 March, https://
agenciabrasil.ebc.com.br/economia/noticia/2020-03/guedes-diz-que-resposta-crise-sao-reformas.
Ortiz-Millán, G. (2024). How populism aects bioethics. Cambridge Quarterly of Healthcare Ethics, 1–15. https://doi.
org/10.1017/S0963180124000161
Ostiguy, P., & Mott, B. (2020). Who would identify with an “empty signifier”?: The relational, performative
approach to populism. In P. Ostiguy, F. Panizza, & B. Mott (Eds.), Populism in global perspective (pp. 47–
72). Routledge.
Paquin, J. (2024). The United States facing allies’ populist blackmail: Why the Philippines and Turkey threatened to
realign with China and Russia. European Journal of International Security, 9(2), 160–179. https://doi.org/10.1017/
eis.2023.29
Persson, E., Ferlie, E., & Baeza, J. (2025). This is just a little u’: Analysing medical populist discourses on the Covid-
19 pandemic in Brazil. Public Policy and Administration, 40(1), 94–125.https://doi.org/10.1177/
0952076722114112
Philips, D. (2020). “’He became a hero’: Bolsonaro sees popularity surge as Covid-19 spreads”. The Guardian, 11
October. https://www.theguardian.com/global-development/2020/oct/10/jair-bolsonaro-brazil-coronavirus-aid.
Pink, S. L., Chu, J., Druckman, J. N., Rand, D. G., & Willer, R. (2021). Elite party cues increase vaccination intentions
among Republicans. Proceedings of the National Academy of Sciences, 118(32), e2106559118. https://doi.org/10.
1073/pnas.2106559118
Presidential Communications Oce. (2020, August 2). Talk to the people of President Rodrigo Roa Duterte on
Coronavirus Disease 2019 (COVID-19). Presidential Communications Oce. https://mirror.pco.gov.ph/
presidential-speech/talk-to-the-people-of-president-rodrigo-roa-duterte-on-coronavirus-disease-2019-covid-19-
17/.
14 G. LASCO

Rajmil, D., Morales, L., & Aira, T. (2024). COVID-19 vaccine race–the shadow of political and multinational inter-
ests. Cogent Social Sciences, 10(1), 2384186. https://doi.org/10.1080/23311886.2024.2384186
Recio-Román, A., Recio-Menéndez, M., & Román-González, M. V. (2021). Vaccine hesitancy and political populism.
An invariant Cross-European perspective. International Journal of Environmental Research and Public Health,
18(24), 12953. https://doi.org/10.3390/ijerph182412953
Resende, E., & Reinke de Buitrago, S. (2022). Populism in times of spectacularization of the pandemic: How populists
in Germany and Brazil tried to ‘own the virus’ but failed. Societies, 13(1), 9. https://doi.org/10.3390/soc13010009
Reyes, M. S. G. L., Dee, E. C., & Ho, B. L. (2021). Vaccination in the Philippines: Experiences from history and lessons
for the future. Human Vaccines & Immunotherapeutics, 17(6), 1873–1876. https://doi.org/10.1080/21645515.2020.
1841541
Roberts, K. M. (2024). Performing crisis? Trump, populism and the GOP in the age of COVID-19. Government and
Opposition, 59(4), 1052–1070. https://doi.org/10.1017/gov.2022.30
Rodrigues, R. (2021, May 7). Doria toma a primeira dose da vacina CoronaVac contra a Covid-19, em São Paulo. G1.
https://g1.globo.com/sp/sao-paulo/noticia/2021/05/07/doria-chega-a-posto-de-saude-na-zona-oeste-de-sp-para-
tomar-a-primeira-dose-da-vacina-contra-a-covid-19.ghtml.
Sacco, P. L., Gallotti, R., Pilati, F., Castaldo, N., & De Domenico, M. (2021). Emergence of knowledge communities
and information centralization during the COVID-19 pandemic. Social Science & Medicine, 285, 114215. https://
doi.org/10.1016/j.socscimed.2021.114215
Sachs, J. D., Karim, S. A., Aknin, L., Allen, J., Brosbøl, K., Barron, G. C., … Bartels, J. G. (2020). Lancet COVID-19
commission statement on the occasion of the 75th session of the UN general assembly. The Lancet, 396(10257),
1102–1124. https://doi.org/10.1016/S0140-6736(20)31927-9
Saltzman, I. Z. (2024). Diversionary words: Trump, China and the COVID-19 pandemic. Chinese Political Science
Review, 9(1), 85–109. https://doi.org/10.1007/s41111-023-00235-x
Salverria, L. (2021, June 3). Amid jab scarcity, Duterte wants COVID-19 vax refusers jailed. Philippine Daily Inquirer.
https://newsinfo.inquirer.net/1449691/amid-jab-scarcity-duterte-wants-vax-refusers-jailed.
Senate of the Philippines. (2020, May 30). Dispatch from Crame No. 809: Sen. Leila M. de Lima on Duterte’s
announcement that China will be the first to produce an anti-COVID vaccine. Senate of the Philippines.
https://legacy.senate.gov.ph/press_release/2020/0530_delima2.asp.
Skonieczny, A., & Boggio, G. D. (2023). Saying the unspeakable: Populism, performance and the politics of Covid-19.
In C. Lacatus, G. Meibauer, & G. Lömann (Eds.), Political communication and performative leadership: Populism
in international politics (pp. 179–199). Springer International Publishing.
Speed, E., & Mannion, R. (2020). Populism and health policy: Three international case studies of right-wing populist
policy frames. Sociology of Health & Illness, 42(8), 1967–1981. https://doi.org/10.1111/1467-9566.13173
Sunnercrantz, L. (2024). Experts and populism in the context of COVID-19. In Y. Stavrakakis, & G. Katsambekis
(Eds.), Research handbook on populism (pp. 551–562). Edward Elgar Publishing.
Taraktaş, B., Esen, B., & Uskudarli, S. (2024). Tweeting through a public health crisis: Communication strategies of
right-wing populist leaders during the COVID-19 pandemic. Government and Opposition, 59(1), 207–228. https://
doi.org/10.1017/gov.2022.34
Thompson, M. R. (2022). Brute force governance: Public approval despite policy failure during the COVID-19 pan-
demic in the Philippines. Journal of Current Southeast Asian Aairs, 41(3), 399–421. https://doi.org/10.1177/
18681034221092453
Trump, D. (2020a, April 14). President Donald J. Trump Has Led A Historic Mobilization To Combat The
Coronavirus.. Trump White House (Archived). https://trumpwhitehouse.archives.gov/briefings-statements/
president-donald-j-trump-led-historic-mobilization-combat-coronavirus/.
Trump, D. (2020b, August 14). Remarks by President Trump in Press Briefing. Trump White House (Archived).
https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-press-briefing-august-14-
2020/.
Trump, D. (2020c, December 8). Remarks by President Trump at the Operation Warp Speed Vaccine Summit.
Trump White House (Archived). https://trumpwhitehouse.archives.gov/briefings-statements/remarks-
president-trump-operation-warp-speed-vaccine-summit/.
Trump, D. (2020d, December 8). President Donald J. Trump’s Eort To Provide Americans With A Safe And
Eective Vaccine Is Delivering Results. Trump White House (Archived). https://trumpwhitehouse.archives.
gov/briefings-statements/president-donald-j-trumps-eort-provide-americans-safe-eective-vaccine-delivering-
results/.
Tucker, J. (2021). Lockdown: the new totalitarianism. AIER. https://aier.org/article/lockdown-the-new-
totalitarianism/.
Vazquez, M., & Carvajal, N. (2021, December 22). Biden oers rare praise of Trump during Covid speech. CNN.
https://www.cnn.com/2021/12/21/politics/biden-trump-covid-vaccine-booster/index.html.
Verdelio, A. (2021, October 25). Facebook takes down video where Bolsonaro links COVID-19 shot to Aids. Agencia
Brazil. https://agenciabrasil.ebc.com.br/en/saude/noticia/2021-10/facebook-takes-down-video-where-bolsonaro-
links-covid-19-shot-aids
GLOBAL PUBLIC HEALTH 15

Verjovsky, M., Barreto, M. P., Carmo, I., Coutinho, B., Thomer, L., Lifschitz, S., & Jurberg, C. (2023). Political quarrel
overshadows vaccination advocacy: How the vaccine debate on Brazilian Twitter was framed by anti-vaxxers
during Bolsonaro administration. Vaccine, 41(39), 5715–5721. https://doi.org/10.1016/j.vaccine.2023.07.075
Vidali, D. S., & Peterson, M. A. (2012). Ethnography as theory and method in the study of political communication.
In H. A. Semetko, & M. Scammell (Eds.), The SAGE handbook of political communication (pp. 264–265). SAGE
Publications.
von Bülow, M., Abers, R. N. (2024). Denialism and populism: Two sides of a coin in Jair Bolsonaro’s Brazil.
Government and Opposition, 59, 998–1016. https://doi.org/10.1017/gov.2022.14
Wang, G. (2020). Legitimization strategies in China’s ocial media: The 2018 vaccine scandal in China. Social
Semiotics, 30(5), 685–698. https://doi.org/10.1080/10350330.2020.1766262
Weintraub, R., Bitton, A., & Rosenberg, M. L. (2020, May 22). The danger of vaccine nationalism. Harvard Business
Review. https://hbr.org/2020/05/the-danger-of-vaccine-nationalism.
The White House. (2025, February 14). Fact Sheet: President Donald J. Trump Prohibits Federal Funding for
COVID-19 Vaccine Mandates in Schools. The White House. https://www.whitehouse.gov/fact-sheets/2025/02/
fact-sheet-president-donald-j-trump-prohibits-federal-funding-for-covid-19-vaccine-mandates-in-schools/.
Yahya, M. (2007). Polio vaccines—“no thank you!” barriers to polio eradication in Northern Nigeria. African Aairs,
106(423), 185–204. https://doi.org/10.1093/afraf/adm016
Yu, V. G., Lasco, G., & David, C. C. (2021). Fear, mistrust, and vaccine hesitancy: Narratives of the dengue vaccine
controversy in the Philippines. Vaccine, 39(35), 4964–4972. https://doi.org/10.1016/j.vaccine.2021.07.051
Yunus Centre. (2020, June 28). COVID-19 vaccine global common good: Appeal from 100 Inuential Global Leaders.
Yunus Centre. https://www.muhammadyunus.org/news/2168/covid-19-vaccine-global-common-good-appeal-
from-100-inuential-global-leaders.
Zhou, Y. R. (2022). Vaccine nationalism: Contested relationships between COVID-19 and globalization.
Globalizations, 19(3), 450–465. https://doi.org/10.1080/14747731.2021.1963202
16 G. LASCO