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
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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.”48
The vaccine safety issue was always the most politically promising of the antivaccinationists’ arguments. Even the staunchest defenders of vaccination had to concede, as did Dr. William Welch of Philadelphia Municipal Hospital, “this measure is not entirely devoid of some danger.” The appalling record of American-made vaccines during the 1898–1903 epidemics lent the issue a new urgency. Vaccine safety concerned everyone, especially parents. In most communities, children were the segment of the population most vulnerable to compulsory vaccination and thus to whatever dangers attended the procedure. Many antivaccination texts featured photographs of children—deformed, disabled, or lying dead in their coffins—identified by their captions as “Victims of Vaccination.”49
The finest American example of the victims-of-vaccination genre was Lora Little’s 1906 book, Crimes of the Cowpox Ring: Some Moving Pictures Thrown on the Dead Wall of Official Silence. The culmination of Little’s work as editor of The Liberator, the book delivered on the muckraking promise of its title. Little was the Ida Tarbell of the antivaccination movement, a dogged reporter driven by a powerful vision of the injustices committed by business interests in collusion with corrupt or feckless state governments. Little drew upon the most effective tactics of the contemporary muckraking genre. Hers was a journalism of exposure, built from interviews, affidavits, and the public record, and written in the sensational style that made Lincoln Steffens a household name. And like thousands of muckraking pieces that appeared in American magazines between 1900 and World War I, Little’s book narrated a clash of “the people” against organized economic interests through affecting portraits of individuals. With its short profiles of 336 “victims” of vaccination, most of them fatal, Crimes of the Cowpox Ring was not just an indictment of vaccination and its perpetrators. The book was a compendium of pain and loss. The most moving story in it was Little’s own.50
Born in 1856, in a log cabin in the Minnesota Territory, Lora Little had worked as a seamstress, teacher, printer, and homemaker. In Crimes of the Cowpox Ring, she described her painful decision to allow her only child, seven-year-old Kenneth, to be vaccinated in 1895 so he could attend public school in Yonkers, New York. “He must go to school, and he could not go to school until he was vaccinated,” she recalled. “Here was a risk. Children had died from vaccination. Why subject my only darling to this thing?” But all the other children were getting vaccinated. “He needed the association that school life afforded. If I were to keep him at home and teach him myself, and he miss the common lot, and be marked as an exception, perhaps as queer, with a freakish mother who would not let him be vaccinated—how would all this affect his life?” It was a dilemma shared by countless mothers and fathers. Little feared not only the loss of the privilege of a public education but social ostracism, for her child and herself. Ultimately, she consented. Kenneth was vaccinated. Soon after, he suffered an attack of “catarrh of severe and stubborn kind,” followed by measles, and then diphtheria “without known exposure.” It was the diphtheria that killed him. Though she could never prove it, Little was convinced the vaccination was to blame. “My child was as really torn from me by the vaccinator, as tho he had died the day his arm was punctured.” Three years later, Little was living with her husband, a civil engineer, in Minneapolis, speaking out against the local school board’s vaccination rule and criticizing the Army’s system of vaccination.51
In Crimes, Little argued that vaccination persisted, in the face of great opposition, because it served the economic interests of its “agents and producers.” The “cowpox ring” had always been willing to face down the statistical evidence that vaccination was no preventive of smallpox. But they responded with a “conspiracy of silence” to the “other side of the statistical question, the ruin wrought by vaccine virus.” This silence was the ring’s “last and most impregnable stronghold.”52
She began collecting cases on January 1, 1902, culling newspapers and conducting interviews with “the afflicted” or a surviving parent or relative. Even though she was unable to investigate all of the reports and rumors she received, she went to press with the stories of 336 confirmed (to her satisfaction) victims of vaccination from across the United States. She provided names, dates, and locations for each case (including many verifiable in surviving local newspapers). Most of the accidents had happened during the epidemics of 1898–1903. The “victims” suffered postvaccination complications including anemia, blindness, blood poisoning, cancer, diphtheria, erysipelas, impetigo, lockjaw, meningitis, and tuberculosis.53
There is no way to confirm that vaccination caused all of this hurt and heartache. It is possible to dismiss Little’s project as an exercise in overly simplistic post hoc reasoning: the children died following vaccination, therefore vaccination must have been the cause. Still, many of Little’s “victims” had suffered complications acknowledged by medical scientists as possible, if rare, results of vaccination, whether caused by impure vaccine or secondary infection of the vaccine wound.
But Lora Little’s book is most powerful at its least rational, as a dutifully compiled archive of belief and grief—not just hers, but of the hundreds of parents who told her their sad stories. “91. Death. Henry C., son of H.C. Petterson, St. Paul. Vaccinated Aug. 1901 to go to school. Three vaccinations in succession were necessary to get a take. Child then took sick, and was never able to go to school. Was not confined to bed, but gradually grew weaker til he died, Nov. 2, 1901. He was a fat, healthy little fellow all his life until vaccinated. The sore that formed on his arm never healed. Three doctors tried to save his life.” Little patiently recorded hundreds of such stories. Neither doctors nor city health officials nor his boss could persuade railroad conductor Homer E. Sturdevant of Buffalo that his daughter’s death from blood poisoning in May 1902 was not caused by the vaccine that had been scraped into her arm thirteen days earlier. Sturdevant paid to have the cause of death, as he saw it, inscribed on Lucille’s tombstone in Forest Lawn Cemetery: “Lucille Sturdevant died May 28, 1902, aged 6 years. Vaccination poisoning at School 35.”54
Like its antimonopoly and child protection arguments, the distinctive libertarian thrust of American antivaccinationism engaged an area of broad public concern. A robust language of personal liberty, anchored in the Anglo-American common law tradition and the state and federal constitutions, lay at the heart of antivaccinationist ideology. “Every man’s house is his castle,” wrote the San Diego spiritualist Jam
es Martin Peebles in 1900, “and upon the constitutional grounds of personal liberty, no vaccination doctor, lancet in one hand and calf-pox poison in the other, has a legal or moral right to enter the sacred precincts of a healthy home and scar a child’s body for life.” The passage illustrates the rhetorical range of these unlikely radicals: their righteous mixture of religion and constitutionalism, masculine prerogative and republican domesticity, a faith in clean living and a suspicion of state medicine, old-fashioned populism and a new libertarianism that might have startled old John Stuart Mill himself.55
The American antivaccinationists were personal liberty fundamentalists. They quoted chapter and verse from Mill’s On Liberty (1859): “Over himself, over his own body and mind, the individual is sovereign.” They reached past Mill to Sir William Blackstone, the eighteenth-century commentator on the common law whose Commentaries on the Laws of England (1765–69) formed part of the ideological bedrock of the American Revolution. Blackstone wrote (as Pitcairn reminded his early twentieth-century audiences), “The right of personal security consists in a person’s legal and uninterrupted enjoyment of his life, his limbs, his body, his health and his reputation.” So precious were the personal rights to life and limb, that the laws of England and America pardoned “even homicide, if committed in defense of them.” Compulsory vaccination—the only medical procedure required by the state—trampled upon these elemental liberties. The antivaccinationists found support for their beliefs in the fundamental law of their nation. As the New England freethinker George E. Macdonald commented, “The law under which [the vaccinators] operate should carry a clause providing that all sections of the Constitution guaranteeing the security of person or property are hereby repealed.”56
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