The Second World War made vaccination a cornerstone of public health in China. When Japan invaded eastern China in 1937, the Nationalist government moved its wartime capital to Chongqing, in Sichuan. Physicians, biomedical researchers, and medical students fled with the Nationalists to China's southwest borderlands. Many found refuge in Kunming, capital of Yunnan province. While the Nationalist health administration at Chongqing attempted to address a variety of hygienic issues, in Kunming, a biomedical community emerged whose members focused their wartime work on epidemic control and especially the development of vaccines. I argue that this gathering of biomedical professionals in wartime Kunming gave vaccination new meaning as a comprehensive, essential practice in twentieth-century China. It also permitted the post-1949 development of large-scale health programs that immunized at least eighty-five percent of the Chinese population. Wartime experts developed a variety of new vaccines that found widespread use, and distribution systems for these vaccines that became the foundation of later nationwide health policies. At the onset of war, Yunnan's medical infrastructure had only recently become oriented toward the emerging Nationalist nation-state at Nanjing and away from French, British, and indigenous networks spanning Southeast Asia. The politics of vaccination and epidemic control in Yunnan before the war manifested intense power struggles between the British and French empires for a controlling influence there, but also suggested the endurance of Yunnanese warlords' authority over local public health into the wartime period. The war interrupted Chinese research, writing, and translation on immunology and vaccines in the early 1930s. After Japan invaded, the institutes and medical schools that gathered in Kunming included active participants in China's emerging immunological community, notably the staff of the National Epidemic Prevention Bureau (NEPB). The members of this community found that Yunnan's frontier environment, French-influenced medical infrastructure, and warlord government required significant adaptation and accommodation. As a critical tool of epidemic control, vaccination became a central focus for wartime research, manufacturing, and clinical testing during wartime outbreaks of cholera, typhoid fever, and plague. Researchers and physicians in wartime Kunming began to see themselves as participants in the developing field of Chinese immunology. They developed a novel vaccine production and distribution system that sought to vaccinate all members of the public in both rural and urban areas against a host of diseases. Kunming was a major center of research and development in wartime China, but it was not the only site of its kind. A new biomedical network emerged across China's wartime hinterland, and the research and production of vaccines was a common endeavor that linked many cities in this network. International biomedical interest groups facilitated Chinese development of a variety of vaccines. A major wartime project sponsored by the League of Nations enfolded Yunnan and most of western China into a global vaccine supply network that reached as far as Buenos Aires, Bucharest, and Cairo. The people responsible for building this medical network across China's wartime southwest quickly returned to their home institutions once the war ended and the Japanese retreated. While China collapsed into civil war between 1945 and 1949, these figures, especially the staff of the Epidemic Prevention Bureau, remained on the mainland and continued to oversee national vaccine production and distribution. After 1949, the new People's Republic of China (PRC) popularized vaccination on an unprecedented scale. The PRC provided mandatory, universal, free vaccination in mass mobilization campaigns against a variety of diseases. District public health stations in Kunming implemented these procedures and, by the beginning of the Great Leap Forward in 1958, demonstrated the extent to which vaccination had become a basic responsibility of local government and an emergent feature of citizenship in the early PRC. The origin of modern universal vaccination practices in wartime epidemic control therefore demonstrates a significant legacy of the Nationalist state in the early PRC.
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