The Vaccination Controversy

The Vaccination Controversy: The Rise, Reign and Fall of Compulsory Vaccination for Smallpox

Stanley Williamson
Copyright Date: 2007
Edition: 1
Pages: 256
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  • Book Info
    The Vaccination Controversy
    Book Description:

    Smallpox was for several centuries one of the most deadly, most contagious and most feared of diseases. Williamson’s extraordinary study charts the history of one of the most controversial techniques in medical history that raises much debate to this day. Originating probably in Africa, smallpox progressed via the Middle and Near East, where it was studied around the end of the first millennium by Arab physicians. It arrived in Britain during the Elizabethan times and was well established by the seventeenth century. During the closing years of the 18th Century a most far reaching and ultimately controversial development took place when Edward Jenner developed an inoculation for Smallpox based on a culture from Cowpox. The Vaccination Controversy examines the astonishing speed at which Jenner’s technique of ‘vaccination’ was taken up, culminating in the ‘Compulsory Vaccination Act of 1853’. The Act made a painful and sometimes fatal medical practice for all children obligatory and as a result set an important precedent for governmental regulation of medical welfare. The Act remained in force until 1946 and was only ended after decades of intense pressure from the National Anti-vaccination League, but the issues raised by Williamson’s accessible text remain current today in debates about vaccination programs. Meticulously researched, The Vaccination Controversy highlights the social, political and ethical consequences of compulsory vaccination and the massive repercussions that followed the ending of a policy through argued by many to be the most major medical resistance campaign in European medical history.

    eISBN: 978-1-84631-421-6
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-vii)
    (pp. viii-viii)
  4. Part I The Road to Compulsion
      (pp. 3-7)

      During the early part of 1716 a caravan of coaches and wagons, bearing an English family and their numerous retinue, rumbled across Europe towards Constantinople. The journey could have been more easily and cheaply made by sea, but Edward Wortley Montagu, newly appointed Ambassador Extraordinary to the Sublime Porte, had decided that the special mission he was entrusted with might stand a greater chance of success if he called in at Vienna on the way.

      The Ottoman Empire at that time still thrust deep into south-east Europe. Attempts by the Turks to push the frontier even further westward had been...

      (pp. 8-28)

      Opening their account of the campaign conducted by the World Health Organization that in 1979 finally extinguished, or, as their forerunners might have said, ʹextirpatedʹ smallpox from the earth, the authors remark: ʹThe majority of people – including the majority of physicians – now living have never seen a case of this once dreaded diseaseʹ. In the years since that number will have declined even further, and it therefore seems desirable to recall something of the history and characteristics of the disease which once inspired so much dread.

      The early history of smallpox is one of the areas in which...

      (pp. 29-39)

      By contrast with their outward passage the Wortley Montagus began their homeward journey by sea, admiring the landscapes and antiquities of the Mediterranean shores and islands along the way. But progress in the days of sail, in a naval vessel which had seen better times, was slow, and on reaching Genoa in August 1718 the parents decided to complete their journey overland, leaving their children, then aged respectively six and one, aboard ship with their nurse to face the winter storms of the Bay of Biscay and the English Channel. It was five months before the family was reunited on...

      (pp. 40-47)

      By the end of 1722 the mutual recriminations of the opposing parties had largely died away, chiefly for want of accurate information on which to base their contradictory claims. There was clearly a need for research, conducted at a responsible level, to establish a few reliable facts at least with regard to the success or otherwise of the operation. In December 1723, and in a slightly amended form in 1724, thePhilosophical Transactionscarried an advertisement:

      The practice of inoculating the small pox being now extended into many parts of the Kingdom, and it being highly requisite that the public...

      (pp. 48-73)

      If the language of eighteenth-century figures is to be relied on, a surprising state of affairs is revealed. By the end of the third decade the contentious novelty inoculation had virtually died out, while the number of deaths from smallpox, as recorded in the London bills of mortality, remained at a steady level. Why had inoculation fallen out of favour? In 1749 the physician Frewen looked back over its vicissitudes during the period:

      it is wonderful with how great an expectation it was received, with how much industry it was cultivated, and how soon it became incredibly famous […] Yet,...

      (pp. 74-97)

      Edward Jenner was, until recent years, badly served by his biographers. The first choice, although to all appearances well equipped for the task, ʹentered upon itʹ as he confessed, ʹwith a degree of anxiety in which I can scarcely expect any to sympathiseʹ, and predictably made rather a hash of it. John Baron, a qualified physician and surgeon, first met Jenner in 1808 when he was fifty-nine and Baron twenty-three. They became and remained close friends and Baron was possibly the last person to see Jenner alive before his death in 1823. In view of their long and intimate acquaintance...

      (pp. 98-106)

      After the great surge of smallpox during the last quarter of the eighteenth century the disease relaxed its grip somewhat in the earlier years of the nineteenth, and the efforts of the medical profession were directed largely to weaning the lower classes away from variolation and selling them vaccination. The task was not easy; as Baron commented, the adoption by so many reputable medical men of vaccination left the field clear for the more unscrupulous practitioners who ʹtook up the small-pox lancet and disseminated the disease in a very frightful mannerʹ.

      The profession did its best to fight back. In...

      (pp. 107-119)

      Even when the complex series of alliances and wars against the French ended with the final overthrow of Napoleon (an ardent admirer of Jenner), social unrest and the urgent need to contain it remained a constant preoccupation of successive governments. The year of the serious epidemic of smallpox in Norwich, 1819, was also the year of the Peterloo massacre in Manchester, with all that it implied for the current state of the nation, and there can be little doubt as to which event ranked as the more important in ministerial minds. During these years, when smallpox appeared, albeit slowly, to...

      (pp. 120-134)

      For many years isolated voices had been hinting, some more discreetly than others, at the need for some kind of state intervention to enforce vaccination of the lower classes, but seldom using the blunt word ʹcompulsionʹ. The fear that inhibited stronger pressure was that enforcement might fail, not on medical but on political grounds. Warning that ʹJohn Bull is jealous of the liberty of the subjectʹ, theLancet, ʹon the low ground of expediency, irrespective of rightʹ, called upon hasty legislators to pause. The legislators scarcely needed the warning: in spite of the manifest inadequacy of the Acts of 1840/41...

      (pp. 135-141)

      In his life of Leslie Stephen,The Godless Victorian, Noel Annan describes ʹthe new expertsʹ, the reformers and administrators who dominated and defined the emerging society of early and mid-Victorian Britain:

      They were men of inexhaustible energy, of disinterested probity, of indefatigable industry; but tact, compromise and suavity were foreign to their natures. They had the strength of mind to establish principles for dealing with the problems they were set, but once formed they could admit no other and closed their minds because the administrative structures they had invented seemed to them the only feasible way of dealing with the...

      (pp. 142-154)

      Some years after Simonʹs death a former colleague wrote of him that he never took part personally in any ʹclose epidemic inquiryʹ, and failed to understand how much time and work was called for. This judgement was presumably based on personal observation, yet it is difficult to believe, studying the reports of the investigations carried out by his team of four vaccination inspectors, that he could have remained unaware of the labour involved in collecting the information.

      One inspectorʹs annual report showed that during the year under review his inquiries had extended over the counties of Cambridge, Derby, Huntingdon, Leicester,...

      (pp. 155-162)

      Simonʹs assessment of the four-year campaign of inspection was that it provided ʹan account of the working of our present vaccination laws which […] offers such a basis as there has never yet been for effective legislation against small-poxʹ. Stevens, speaking for those who, like himself, had been doing the arduous leg-work, took the less complacent view that it was entirely hopeless to attempt to secure to the people ʹsuch an amount of protection as they have the right to claim […] from the law as at present administeredʹ. The cause lay with no one person or with any one...

      (pp. 163-176)

      Allen v. Worthyopened the floodgates. Parents objecting to the vaccination of their children found themselves in court time and time again, paying fines and costs that for many of them amounted to a severe financial burden. Refusal or inability to pay could result in their possessions being seized or sold off, or even a prison sentence. Typical of those who faced what was for them a desperate moral dilemma was a parent who ascribed his eldest childʹs death to vaccination, no doubt without justification, and felt he must resist the compulsory vaccination of a second child. He was summoned,...

  5. Part II The Reign of Compulsion
      (pp. 179-187)

      As has been noted, condemnation of compulsory vaccination dates from shortly after the passage of the Act of 1853, with the letter from John Gibbs to the President of the Board of Health. Born in Ireland in 1811, Gibbs was described by an acquaintance as ʹsagacious, bright, earnest and independentʹ, with a passion for ʹsuch things as made for human welfare and improvementʹ. He became interested in hydropathy and in particular in its use in cases of smallpox. In later life he made his home in St Leonards, in Sussex. His influential letter to the Board of Health was based...

      (pp. 188-201)

      Among the most prominent opponents of vaccination were two members of the medical profession, one more eminent than the other. Edgar Crookshank, Professor of Comparative Pathology and Bacteriology and Fellow of Kingʹs College, London, wrote aHistory and Pathology of Vaccinationin two volumes (1889). The Preface to the first volume described how, following some investigations into an outbreak of cowpox, he became convinced that

      the commonly accepted descriptions of the nature and origins of Cow Pox were purely theoretical […] I gradually became so deeply impressed with the small amount of knowledge possessed by practitioners concerning Cow Pox, and...

      (pp. 202-213)

      By 1906, when Shaw published his heterodox version of events, much of the steam had gone out of the vaccination controversy, as will be described in the proper place. In the heyday of White, Garth Wilkinson and others, who were caught up in it emotionally and in the law courts, it was still a burning issue. A hitherto slowly gathering movement of resentment erupted finally into open conflict with, at its heart, the ʹcat-and-mouseʹ persecution of anti-vaccinationists that even Simonʹs biographer found difficult to excuse.

      The effective starting point was the little-noticed Act of 1861, which empowered but did not...

      (pp. 214-222)

      Following the mass demonstration the Leicester guardians voted by 26 to eight to cease prosecutions. There was no response from the Local Government Board, but a carefully worded passage in a report by its Medical Officer of Health, written before the demonstration took place, illustrated clearly the Board’s awareness of the dilemma with which the advocate of compulsion was confronted:

      Whether or not, in face of the accumulated evidence of the importance of vaccination to children, who cannot judge for themselves of its value, it may be expedient to relax those provisions of the Compulsory Vaccination Acts which allow of...

      (pp. 223-230)

      If there was one source of danger that ranked above even erysipelas in the minds of anti-vaccinationists it was syphilis – the Great Pox, the ʹdisease of diseasesʹ. The argument dated as far back as the years when Lady Mary Wortley Montagu was in the vanguard of advocates of the ʹByzantine Operationʹ. In one of the earlier adverse comments William Wagstaffe suggested in 1722 that an inoculator might seriously reflect

      that when he injects matter into the blood in this way it may be possible and even probable to communicate another Distemper, besides the Small Pox. Suppose the person the...

  6. Part III The Retreat from Compulsion
      (pp. 233-238)

      Although no legislation on the subject of vaccination was enacted between 1871 and 1898, apart from the short Act of 1874, which was designed to clarify the Act of 1871, the anti-vaccination movement continued to bring the opposition to compulsion before the House of Commons, concentrating mainly at first on the question of repeated penalties for default. Three attempts in six years to amend the law ʹso far as accumulating penalties are concernedʹ made no progress. There was considerable astonishment and derision when in 1880 J. G. Dodson, President of the Local Government Board in Gladstoneʹs second administration, appeared to...

  7. NOTES
    (pp. 239-246)
    (pp. 247-255)
  9. INDEX
    (pp. 256-264)
  10. [Illustrations]
    (pp. None)