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Authors: Michael Willrich

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Concerned parents formed the largest recruitment pool for the antivaccination societies. Many American parents, including many who would never formally join a society, viewed school vaccination requirements as an unwarranted usurpation of their domestic authority and an unconstitutional denial of every child's “right” to a public education. More viscerally, many parents feared vaccination would harm their children. Behind almost every antivaccination leader lay a family horror story. J. W. Griggs, president of the Anti-Vaccination Society of St. Paul, recalled how he lost his “faith in the strange practice” of vaccination when his daughter got small-pox, even though she had been vaccinated twice for school. “I began to study the question,” he wrote. “As I looked into it, I began to see the dangers of this process of poisoning the fountain of life, and a little at a time to learn of the disasters and deaths resulting from it—some immediately, and others more remotely; and thus I was stimulated actively to oppose the practice and to work for the repeal of the compulsory vaccination law in this State.” The Pittsburgh industrialist John Pitcairn, already wary of vaccination as an adherent of homeopathy and the Swedenborgian religion, recalled the suffering of his son Raymond from complications of vaccination.
Liberator
editor Lora Little (of Minneapolis) and Louis H. Piehn (an Iowa banker and first president of the midwestern Anti-Vaccination Society of America) each had a child die from the effects, they believed, of state-mandated school vaccination.
35
 
 
C
ritics had trouble making up their minds about the influence of antivaccinationist ideas on American public opinion. Reporting on a meeting of the Anti-Compulsory Vaccination League of Brooklyn in 1901, the
Times
sneeringly commented, “Nine men, one boy, and seven reporters were present.” Of course, the same words attested to the antivaccinationists' talent for getting their message heard. Health officials dismissed them as inconsequential anonymities, but when their own vaccination campaigns came up short, the same men blamed antivaccinationism. “Although the vaccine house is built upon a rock, and is not likely to fall,” declared one Boston health department bulletin in 1902, “the noisy storm has frightened many of our people into a dangerous neglect or opposition to vaccinal protection.”
36
Antivaccinationism was as old as vaccination itself. In the United States, the protest actually preceded the practice. In 1798, two years before Dr. Benjamin Waterhouse of Harvard performed the first American vaccinations, physicians and clergymen in Boston formed the Anti-Vaccination Society, declaring vaccination an act of “defiance to Heaven itself, even to the will of God.” American antivaccinationists owed a heavy intellectual debt to their British counterparts, who generated a vast literature on the subject between the rise of compulsory vaccination in the 1850s and the act of 1898. And the Americans, in their continuing search for evidence to support their views, kept tabs on the experience of compulsion and opposition on the Continent (and, to a far lesser degree, in Asia and Latin America). Some contributors to the American literature of antivaccination did little more than compile the arguments and data of others; if the Springfield, Massachusetts, physician C. W. Amerige had an original thought as he wrote
Vaccination a Curse
(1895), he failed to put it on the page. And even the more original and lively writers, such as J. W. Hodge, tended to grow shrill with time, recycling their own arguments at an ever increasing volume. Still, these were not shortcomings unique to antivaccination writing. Their opponents were guilty of the same excesses.
37
The sharp-penned English polemicist Alfred Milnes observed that the nineteenth-century debate had produced “a double history to vaccination.” To mainstream medical leaders, the introduction of vaccination in 1798 was the greatest gift ever bestowed upon civilization by science. To the antivaccinationists, the record of vaccination was a “history of failures.”
38
The historical debate was really a quarrel about the efficacy of vaccination. Did the practice really deserve credit for causing the sharp decline of smallpox in the West during the first thirty years after its introduction? To antivaccinationists, much of that credit belonged not to the adoption of a new medical practice, vaccination, but to the banning of an old one, inoculation. Inoculation (using actual smallpox virus) had once enjoyed the broad support of the medical profession, notwithstanding the serious risk that a person inoculated with smallpox would infect others. With the arrival of vaccination, the profession discredited inoculation. The abrupt cessation of that perverse practice, antivaccinationists argued, was one key factor in the declining incidence of smallpox. The others were stricter isolation of smallpox patients, rising standards of cleanliness, and the large-scale sanitation projects introduced in European and American cities. Antivaccinationists believed smallpox to be preeminently a “filth disease.” By diverting public attention and government resources from sanitary measures, they argued, the “vaccine nostrum” had been “instrumental in perpetuating the very disease it is supposed to prevent.”
39
Both sides drew upon the discipline of statistics to make their cases. Defenders of vaccination marshaled hospital data to show that unvaccinated individuals were far more vulnerable to smallpox than the vaccinated. Antivaccinationists in England and America accused their opponents of obtaining their data from biased sources (hospitals) and of missing the data's true significance. “Of course the death-rate is greater among the unvaccinated,” said Hodge, building upon an argument made by Wallace. After all, who
were
the unvaccinated? The poor: ill fed, ill housed, ill clothed, and, consequently, just plain ill. The political solution to smallpox was broad-based structural reform to improve the lives of the laboring poor. “It should require no argument to convince a physician that people who live in sanitary dwellings, on clean streets, and who eat wholesome food, drink clean water and breathe pure air are in a better position to resist diseases, small-pox included, than are other people living under opposite conditions.”
40
Statisticians love an army. England's Wallace built much of his case against vaccination in 1898 by citing the incidence of smallpox among the well-vaccinated troops of the British army. American antivaccinationists updated the argument for their own national context, citing the hundreds of smallpox deaths among U.S. soldiers in the Philippines, despite the boast of one Army surgeon that vaccination and revaccination “went on as regularly as the drills at any army post.” American antivaccinationists also Americanized the Leicester argument. Wallace (among other English polemicists) had made much of the fact that in the antivaccination stronghold of Leicester, where health officials emphasized sanitation, the citizens suffered far less smallpox per capita than in “well-vaccinated Birmingham.” The American Leicester was Cleveland, where Friedrich's wholesale disinfection campaign in 1901 had apparently wiped out a smallpox epidemic. The antivaccinationists tended to leave out the inconvenient fact that smallpox soon returned to Cleveland, killing hundreds of unvaccinated citizens.
41
Antivaccinationists everywhere had the greatest impact when their arguments resonated with pressing public concerns. In turn-of-the-century America, the “noisy storm” ultimately had less to do with vital statistics than vital issues. The antivaccinationists spoke to three of the Progressive Era's core public concerns: antimonopoly, child protection, and the uncertain meaning of liberty in a modern, urban-industrial society.
The turn of the century was the heyday of federal trust-busting prosecutions and muckraking exposés of the corporate “octopuses” that dominated vital industries such as the railroads, steel, oil, and sugar refining. Antimonopoly and an acute awareness of the role of business interests in corrupting politics at every level were among the most widely resonant reform issues of the era. The antivaccinationists tapped into the pervasive antimonopoly resentments of their day.
42
Beneath the aura of public service surrounding vaccination policy, charged the antivaccinationists, lay an unholy conspiracy of self-dealing health officials, profit-seeking vaccine makers, and regular physicians bent on monopoly: the “cowpox syndicate.” “Vaccination yields fees to lymph-peddlers and baby-slashers,” declared the Belgian-born American physician Felix Oswald in his 1901 book,
Vaccination A Crime
. Who could deny the interest of vaccine makers in a policy that generated artificial demand for their product? The interests of private physicians were not much more subtle. During epidemics, many local governments still contracted with private physicians to vaccinate the public. Porter F. Cope of Philadelphia, a banker's son and champion of “medical freedom,” estimated the total salaries paid to American public health officials at $14 million. Throw in the $20 million invested in vaccine farms (again, according to antivaccinationists), and compulsory vaccination constituted a substantial interest. “As long as the golden eggs of that goose can be squeezed out by proper manipulation,” wrote Oswald, “Dr. Edward Jenner will continue to be classed with the chief benefactors of the human race.”
43
The profit-seeking of the “vaccine trust,” antivaccinationists argued, was a natural result of the regular physicians'
place
-seeking campaign for a “medical monopoly.” The prospect of fees was probably far less important to the regulars than the government imprimatur conferred by legislatures and health boards upon vaccination—a measure closely identified with the mainstream physicians' struggle for authority. The return of medical licensing troubled Americans who had nothing personally at stake in the matter. “I don't know that I cared much about these osteopaths,” Mark Twain testified before the New York legislature, “until I heard you were going to drive them out of the State; but since I heard this I haven't been able to sleep.” For William James, the licensure problem ran deeper still. The power to license doctors was the power to grant a monopoly over belief itself.
44
The distinguished Harvard psychologist (and older brother of Henry James) testified in March 1898 before a “tremendous throng of men and women” at the Massachusetts State House. The legislature's committee on public health was holding hearings on a bill that would make it a criminal offense to practice medicine without being certified by a state medical board. As everyone understood, the state exam would test for knowledge of allopathic medicine. The bill's framers touted it as “a blow at charlatanry—at medical quacks.” The crowd of spiritualists, Christian Scientists, mind curers, and antivaccinationists in the room understood that meant them. “Ostensibly an act to protect the community from malpractice,” said William Lloyd Garrison, Jr., “this is really meant to secure the monopoly of treating a disease to those who bear the credentials of a recognized school.”
45
James agreed. His quarrel with the bill reflected a set of ideas about the contingency of truth that he would later develop in his famous lectures that became
The Varieties of Religious Experience
(1901–2) and
Pragmatism
(1907). He noted that of the therapeutic methods presently in good repute, many had arisen from outside the regular medical profession. Successful treatments “appealed to experience for their credentials”—not to some state board. In an age of medical hubris, the professor asked for some professional humility. “The whole face of medicine changes unexpectedly from one generation to another in consequence of widening experience; and as we look back with a mixture of amusement and horror at the practice of our grandfathers, so we cannot be sure how large a portion of our present practice will awaken similar feelings in our posterity.” To the lawmakers he warned, “You dare not convert the laws of this Commonwealth into obstacles to the acquisition of truth.” The committee voted unanimously to reject the bill.
46
Few antivaccinationists were as open-minded as William James. But like him, the antivaccinationists who railed against medical monopoly saw licensure as a threat to personal beliefs and to scientific progress. Three years later, in April 1901, the Massachusetts General Court debated another medical licensing bill. This time, Immanuel Pfeiffer testified. Though himself a registered physician, Pfeiffer demanded an amendment that would prevent the state from interfering with the practice of “any cosmopath, clairvoyant, hypnotist, magnetic healer, mind curist, masseur, osteopath or Christian Scientist.” The lawmakers assented—but only so long as no such healer held himself out as a bona fide “practitioner of medicine.”
47
Antivaccinationism also spoke to the era's heightened social concern for children. Twelve-year-olds tending dangerous machines in textile mills, little boys playing unsupervised in city streets, fourteen-year-old delinquents tried as if they were grown men in municipal police courts: these once familiar sights became unthinkable in a relatively few short years around the century's turn. Infant and child mortality emerged as major social issues, with reformers pushing for better maternal and infant health care. Even as health officials promoted vaccination as a boon to childhood, antivaccinationists reached out to parents with their message that mandatory childhood vaccinations endangered the young, a modern-day reprise of Herod's “Slaughter of the Innocents.” “There is a great cry of ‘Save the children,'” said Harry Bradford of Kensington, Maryland. “Let us begin by stopping the infliction of compulsory disease on the defenseless.”
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