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The Politics of Vaccination

The Politics of Vaccination: Practice and Policy in England, Wales, Ireland, and Scotland, 1800-1874

Volume: 11
Copyright Date: 2008
Published by: Boydell and Brewer,
Pages: 268
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  • Book Info
    The Politics of Vaccination
    Book Description:

    The introduction of public vaccination was among the greatest of public health triumphs. By the end of the nineteenth century, legislation framed and implemented by medical experts in Britain's government brought smallpox under control for the first time.

    eISBN: 978-1-58046-748-3
    Subjects: History of Science & Technology

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. List of Tables
    (pp. vii-viii)
  4. Acknowledgments
    (pp. ix-x)
  5. Abbreviations
    (pp. xi-xii)
  6. Introduction
    (pp. 1-10)

    The history of vaccination in nineteenth-century Britain is curiously fragmented. The first two decades are well-covered through biographies of Edward Jenner. These works, most of which cast Jenner as a hero, describe his discovery and his efforts to spread vaccination through an extensive correspondence with other practitioners and through charitable enterprises.¹ Vaccination in the late nineteenth century is explored in a cluster of works on the antivaccination movement; these works analyze how strong, vocal opposition in the 1870s and 1880s forced the government to pass legislation allowing parents to declare their conscientious objection to the practice. The focus on antivaccination...

  7. Chapter One Vaccination in Early Nineteenth-Century England and Wales
    (pp. 11-19)

    Histories of public vaccination in Britain usually begin with the passing of the 1840 and 1853 Vaccination Acts. However, vaccination had been in use for over forty years before it became the subject of legislation and was popular, if not universally practiced. Parliament repeatedly expressed its approval of the new procedure. In 1803 and 1808, MPs awarded grants to Edward Jenner for his discovery of vaccination. In 1809, parliament approved the creation of an institute to provide free vaccination and to distribute vaccines. Though willing to speak in favor of vaccination, MPs repeatedly refused to sanction any action against smallpox...

  8. Chapter Two The Creation of a Public Vaccination Service
    (pp. 20-38)

    In 1840, parliament passed the first vaccination act. The 1840 act usually receives only a brief mention in most histories of public health, and most authors see it as a preliminary step toward compulsion.¹ However, it is important legislation in its own right, setting up an effective public vaccination service, which survived virtually unchanged until the end of the century, for the whole population in England and Wales. Under the act, boards of guardians established stations, manned by public vaccinators in every union in the country, where a large proportion of the infant population received vaccination.

    The 1840 act is...

  9. Chapter Three Compulsory Vaccination and Divisions among Practitioners
    (pp. 39-53)

    The 1853 Vaccination Act, which introduced compulsory vaccination to England and Wales, is often seen as the most important single piece of legislation in the control of smallpox in Britain. Both Anthony Wohl and Dorothy Porter stress the wider significance of the act in introducing the general population to state medicine and in heralding other compulsory health measures.¹ Historians and demographers suggest that the 1853 act produced a significant, long-term increase in infant vaccination and point to it as a milestone in the decline of smallpox mortality.² However, close examination of the 1853 Vaccination Act shows that although it was...

  10. Chapter Four Central Control over Public Vaccination
    (pp. 54-70)

    Until 1854, vaccination acts had their origins in private member’s bills and were aimed at increasing the numbers of children vaccinated. Thereafter, all public vaccination bills for England and Wales were drawn up within government departments or by practitioners with close ties to Whitehall. The goals of legislation also changed: toward enforcing compulsion and to imposing close and active supervision of vaccination by medical experts within central government. In this respect, public vaccination policy therefore followed wider patterns of government growth: in the 1850s and 1860s, a range of government departments employed experts to assist their administration and to inspect...

  11. Chapter Five The Failure of Central Supervision
    (pp. 71-90)

    John Simon has been portrayed as an architect of the implementation of state medicine, who fundamentally changed the character and extent of public health policy in Britain. However, as his biographer, Royston Lambert, has shown, Simon experienced considerable difficulties when trying to put his sanitary policies into practice.¹ The same problems arose with vaccination. On paper, the regulations issued by the Medical Office of the Privy Council in the early 1860s fundamentally changed the relationship between central and local government over the running of public vaccination. They gave the Medical Office a role alongside the Poor Law Board in supervising...

  12. Chapter Six Challenges to Vaccination Policy
    (pp. 91-105)

    By the late 1860s, the overt opposition to John Simon’s efforts to establish systematic supervision of all aspects of public vaccination had died away. The Poor Law Board was, albeit reluctantly, passing on regulations to local authorities. Adverse comments from practitioners had died away, although few were willing to express their support for expert inspection, and advice from the Medical Office inspectors was often quietly ignored by vaccinators and boards of guardians. The early 1870s saw a new wave of attacks on Simon’s vaccination policy. An increasingly vocal antivaccination movement objected to laws that allowed parents to be repeatedly prosecuted...

  13. Chapter Seven Ireland: The Failure of Poor Law Vaccination 1840–50
    (pp. 106-121)

    Public vaccination in England and Wales is generally assumed to have provided the blueprint for the development of the service in Ireland. At first glance, this analysis appears to fit the facts. In both countries, vaccination was first provided free of charge to the whole population through the poor law under the 1840 Vaccination Act. This was followed up by the introduction of compulsory vaccination—in England and Wales in 1853, in Ireland in 1863. Looked at in more detail, it is clear that after 1840, public vaccination followed a distinctive path in Ireland. Unlike England and Wales, where there...

  14. Chapter Eight Failure and Success: Irish Public Vaccination 1850–80
    (pp. 122-140)

    The fate of the 1840 Vaccination Act highlights the striking differences between public vaccination in different parts of the United Kingdom. The same piece of legislation that successfully established universal provision of free vaccination across England and Wales signally failed to do so in Ireland because of the different conditions of their systems of poor relief. In the years following, public vaccination in Ireland continued to have a distinctive form and character. Between 1851 and 1879, four acts relating to vaccination were instituted. The legislation fell into two phases. The acts passed in 1851 and 1858 created a national system...

  15. Chapter Nine Vaccination in Scotland: Victory for Practitioners
    (pp. 141-162)

    Public vaccination was completely different in Scotland to the rest of the United Kingdom. Where a succession of acts and bills applying to England and Wales appeared before parliament, and Ireland had four acts relating to vaccination, Scotland had only one vaccination act. The legislation passed in 1863 introduced compulsory vaccination. No further laws were passed to amend this legislation in the remainder of the century.¹ This measure established a division of vaccination between public and private practitioners quite different to that in England and Wales or Ireland. There, the poor law authorities conducted the bulk of all vaccinations—between...

  16. Conclusion
    (pp. 163-170)

    By 1864, compulsory vaccination backed by free public provision was operating throughout the United Kingdom. The process by which this legislation was put in place was complex. Although vaccination acts across Britain shared the same broad goals—to make vaccination compulsory for infants and to ensure that the poor had access to free vaccination—the measures devised for England and Wales did not serve as models for those applied in Scotland and Ireland. In each part of the United Kingdom, different acts were devised to fix vaccination into existing systems of administration. The failure of the 1840 Vaccination Act in...

  17. Appendices
    (pp. 171-176)
  18. Notes
    (pp. 177-222)
  19. Bibliography
    (pp. 223-248)
  20. Index
    (pp. 249-256)
  21. Back Matter
    (pp. None)