On methods, symptoms and subjects A patchwork ethnography on the production of vaccine side effects

This thesis examines how vaccine safety evidence is produced in the post-authorization phase through an ethnographic study of pharmacovigilance — the science and practice of detecting, assessing, and preventing adverse effects of medicines. Focusing on how methods, population characteristics, and symptom narratives shape what becomes recognized as “evidence,” it analyzes two case studies: the evaluation of menstrual disorders following COVID-19 vaccination in the European Union and the controversy surrounding HPV vaccine adverse events in Colombia.
The thesis shows that pharmacovigilance is not merely a technical practice but a socio-political process shaped by institutional logics, epistemic hierarchies, and historical exclusions. Drawing on feminist Science and Technology Studies (STS) and decolonial theory, it examines who and what is “attended to” in vaccine safety monitoring, revealing how gendered and geopolitical asymmetries influence the recognition of side effects and the legitimacy of those who report them.
Through a “patchwork ethnography” combining document analysis, fieldwork, and reflexive writing, the study demonstrates that vaccine side effects are not simply found but actively made through situated practices of observation and interpretation. It argues for an “archipelagic approach” to pharmacovigilance — one that values plurality, dialogue, and epistemic reflexivity across paradigms and disciplines.
Anthropology plays a crucial role in this reimagining: by attending to context, affect, and positionality, it exposes the invisible work and power relations underlying biomedical evidence. This perspective invites pharmacovigilance to become a space of ethical, epistemic, and political engagement toward a more inclusive and just science.