Although this stimulating book has already been discussed in numerous journals since its publication in 2007, the subject—vaccination—remains an issue that is no less relevant today as the presence of recurring life-threatening epidemics such as Ebola shows. Based on personal letters, government reports, and other historical records, Jannetta's work narrates the worldwide transmission of Jennerian vaccination from its discovery in rural England to Tokugawa Japan with a view to reveal the channels in which this new knowledge was transferred and adopted (4). While Edward Jenner's new vaccination method was quickly disseminated and applied in other countries within a couple of years, the introduction of the vaccine encountered some major obstacles in Japan that were responsible for the country-wide reception taking almost thirty years. The reasons for this delay, she argues, lie in the geographical position of Japan beyond the major world trade routes and the xenophobic policies of the Tokugawa rulers, a conclusion she already drew in her book Epidemics and Mortality in Early Modern Japan in which she cited exactly these factors as being also responsible for the absence of diseases that were common elsewhere, such as bubonic plague or endemic typhus in premodem Europe (vi). Jannetta makes out three essential requirements to control and defeat infectious diseases; namely, the sharing of knowledge among individuals and nations, the holding of evidence-based records, and the recognition and development of public health institutions (4). It is in the lack of any academic medical institutions—as perceived in Europe—and their function to connect physicians from different parts of Japan that she sees one major cause that hindered a quick acceptance of Jenner's new vaccination method. In Japan, she claims, the transmission of medical knowledge was almost entirely a private matter. Yet smallpox was a public matter, therefore a social transformation was necessary to defeat the disease, and this transformation became visible by the conversion of social
