In 1796, Edward Jenner invented a vaccine that eliminated smallpox from the face of the earth. The idea for how to make it wasn’t his.
Jenner was a country doctor working in the hamlet of Berkeley, Gloucestershire, in southern England. In 1770, a milkmaid noticed that when she milked cows with blisters on their udders—and suffered the same blisters on her hands—she was protected against smallpox during the epidemics that periodically swept across the English countryside. She confided her theory to Jenner, who, after observing the same phenomenon, decided to test it. On May 14, 1796, Jenner took fluid from a blister of another milkmaid named Sarah Nelmes. Then he injected it under the skin of James Phipps, the eight-year-old son of a local laborer. After a few days, Phipps developed a small, pus-filled blister that eventually fell off. To test the milkmaid’s theory, on July 1, 1796, Jenner injected Phipps with pus taken from someone with smallpox; Phipps survived. In a let-ter to a friend, Jenner wrote, “But now listen to the most delightful part of my story. The boy has since been inoculated for the Smallpox which, as I ventured to predict, produced no effect. I shall now pursue my Experiments with redoubled ardor.”
Edward Jenner inoculates his young son with smallpox vaccine. (Courtesy of Time & Life Pictures/Getty Images.)
Two years later, in 1798—after many similar experiments—Jenner published his observations in a monograph titled Inquiry into the Causes and Effects of the Variolae Vaccinae. (The term vaccination is derived from the Latin vaccinae, meaning “of the cow.”) Jenner’s vaccine spread through England with remarkable speed, reaching Leeds, Durham, Chester, York, Hull, Birmingham, Nottingham, Liverpool, Plymouth, Bradford, and Manchester as well as many smaller towns. Within two years, his monograph had been translated into several languages and vaccination had spread to France, Germany, Spain, Austria, Hungary, Scandinavia, and the United States. Universally accepted by all classes, between 1810 and 1820 Jenner’s vaccine halved the number of deaths from smallpox.
Then British government officials did something that launched a movement that has never ended. They required vaccination.
The first pleas for compulsory vaccination came from a relatively unknown medical society. In 1850, a group of prominent British physicians founded the Epidemiological Society of London; their goal was to evaluate epidemic diseases under the “light of modern science.” Like all physicians in medical societies, they had intellectual interests. But unlike those in other societies, they were also political. Society members wanted to influence the state to take a greater role in public health: “to communicate with the government and legislature on matters connected with the prevention of epidemic disease.” And no disease interested them more than smallpox. Society physicians reasoned that the best way to protect the public from the ravages of smallpox was to require vaccination. So they lobbied the British Parliament for a compulsory vaccination act.
On February 15, 1853, the “Bill to Further Extend and Make Compulsory the Practice of Vaccination” was introduced in the House of Lords. The bill required all children to be vaccinated by six months of age; parents who failed to comply could be fined or imprisoned. Passage of the bill was ensured by an outbreak that, from the standpoint of the society’s physicians, couldn’t have come at a better time. Between 1810 and 1850, deaths from smallpox were in a slow, steady decline. But in 1852—the year before the bill was introduced—smallpox deaths in England and Wales increased from four thousand to seven thousand and in London from five hundred to a thousand. As a consequence, the bill passed easily and parents lined up to vaccinate their children. The rush to vaccinate didn’t last long. When parents realized that compulsory vaccination wasn’t enforced, vaccination rates fell. As a consequence, the vaccination act of 1853, described by one historian as “a damp squib,” had limited impact.
The lesson learned in 1853 resulted in a tougher law. This time the government wasn’t going to look away when parents chose not to vaccinate their children. The new act, passed in 1867, clearly defined how vaccination would be enforced and who would do the enforcing. First, medical officers would issue a warning to parents who didn’t have a certificate proving vaccination. If the warning was ignored, officers took parents to court, where they faced a stiff fine plus court costs. Because the law targeted the poor—considered less likely to vaccinate their children due to “ignorance and prejudice”—many parents couldn’t afford the fines. If parents couldn’t or wouldn’t pay, their family assets were seized and sold at public auction. And if enough money couldn’t be raised from these sales, one of the parents (usually the father) could be jailed for up to two weeks. The compulsory vaccine act of 1867 also overturned a court ruling in 1863 that only one penalty could be levied for failure to vaccinate. Now, the cycle of fines, public auctions, and imprisonment could occur again and again.
Compulsory vaccination spawned the first anti-vaccine movement. In 1866, Richard Butler Gibbs co-founded the Anti-Compulsory Vaccination League (ACVL) with his brother George and his cousin John Gibbs. By 1879, the league had a hundred branches and ten thousand members. By 1900, British citizens had formed another two hundred anti-vaccination leagues. Gibbs urged citizens to protest vaccination as an act of patriotism. “Stay then the hand of the vaccinator,” he wrote. “Join us in waging war against a practice fraught with such an amount of disease and death. Let Britannia put her foot on this iniquitous destroying, death-producing interference with nature’s laws and crush it out.”
Anti-vaccine activists produced hundreds of thousands of handbills, posters, pamphlets, and photographs decrying the horror of vaccination and the motives of those who enforced it. In 1881, they published the Vaccination Vampire, which likened doctors to vampires who “hovered over the pregnant woman who waited in the shadow of its wings” and to “raven[s] perched on [pregnant] sheep, waiting to pluck out and devour the eyes of newborn lambs.” Other images were even more dramatic. Anti-vaccine activists declared that vaccination “offer[ed] up annually an indefinite number of human sacrifices to propitiate an imaginary Devil,” and they compared it to “some savage African tribe that every week sacrificed to an idol two children to guard against smallpox.”
The contents of Jenner’s vaccine also came under fire. Anti-vaccine activists claimed that it contained the “poison of adders, the blood, entrails, and excretions of bats, toads and suckling whelps” and that it transformed a healthy child into “a scrofulous, idiotic ape, a hideous foul-skinned cripple: a diseased burlesque on mankind.” Using gothic images, propagandists distributed pictures of vaccinated children turning into minotaurs, hydra-headed monsters, dragons, the incubus, and Frankenstein.
The rallying point of the movement came at public auctions, where the possessions of those who refused to pay fines were sold. Protests took many forms. In 1889, a Mr. Cockcroft plastered a dresser and clothes wringer with anti-vaccine literature, making them unfit for sale. One protester in Charlbury screwed a table to the floor, claiming that it “grew there and we built the house around it.” Because local supporters invariably purchased the furniture and gave it back to the owner, auctions became a joke at the expense of the government.
Public auctions were also a site of violence. In 1887, more than sixty uniformed and plainclothes police fought their way through a mob of angry citizens, broke into the house of a noncompliant resident, and took his furniture. The auctioneer, who was pelted with stones and eggs, required police protection. Auctioneers became increasingly harder to find.
Anti-vaccine rallies took other forms. Mothers staged mock funerals featuring small white coffins symbolizing the death of a child. In 1885, a parade of women marched across London: “There was a brass band playing appropriate music, an open hearse with the child’s coffin, a number of mourning coaches filled with women in black, and a banner inscribed ‘In Memory of 1,000 Children Who Died This Year Through Vaccination.’” Protesters also paraded in front of the House of Commons, played Chopin’s Death March, and carried banners declaring “Murdered by Compulsory Vaccination.�
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To resist vaccination, mothers hid their children. In 1872, a Leeds woman explained that when the vaccine inspector “comes into the neighborhood, we shut our doors, pull down the blinds, and go upstairs until he’s gone; that’s how we trick him.” One father advised, “When the vaccination inspector calls round ‘seeking whom he may devour,’ raise a hue and cry after him, cry shame on him, and both you and your neighbors hoot him out of the neighborhood; drive the wolf from the door and let the authorities know that mothers are mothers still, and that it is a mother’s duty to protect her child.”
Although more than a hundred and fifty years separate the first antivaccine movement from today’s, the two share remarkably similar beliefs and practices—some are so striking that it’s as if nineteenth-century England has sprung to life in twenty-first-century America.
Doctors are evil: In response to the vaccination act of 1853, John Gibbs (who later co-founded the Anti-Compulsory Vaccination League) wrote Our Medical Liberties. “Who could receive with cordiality and respect the Doctor of Physic who should burglariously thunder at the door,” he wrote, “armed with scab and lancet, feloniously threatening to assault the inmates therewith, and, no matter how loudly he should protest that he was bent upon a mission of mercy, who could avoid suspecting that his real objects are power and gain.”
On November 5, 2006, Barbara Loe Fisher, in an article titled “Doctors Want Power to Kill Disabled Babies,” echoed the writings of John Gibbs: “The tragic consequences of allowing one small group of individuals in society—those who choose to become medical doctors (M.D.’s) or scientists (Ph.D.’s)—to make life and death decisions for others [are] that they can become drunk with power and end up exploiting people. Those elitists who would force people to take medical risks or even kill people in the name of the greater good of society cannot and should not be trusted. If the birthing rooms and newborn nurseries of the world become killing fields and those who practice science and medicine become the executioners, then it will be a very short time before nursing homes, doctors’ offices, and public-health clinics are legally allowed to stock lethal injections.”
Public rallies: Anti-vaccine rallies peppered the English countryside for much of the late 1800s. The most dramatic—and the one that garnered more media attention than any other—took place in Leicester in 1885. Organizers made travel arrangements for a hundred thousand people to attend; as a consequence, it was the largest rally of its kind. Actors entertained protesters by playing “doctors riding cows and holding on by the tail, and mothers at upper windows clasping their infants, while policemen were trying to commit a legal burglary at the keyhole in the street below.” The highlight of the show was an effigy of Edward Jenner, hanged, decapitated, and taken to the local police station for arraignment.
The spirit of the Leicester rally—a rally described at the time as “a perfect carnival of public merriment,” can be found in today’s anti-vaccine protests. In June 2006, organizers staged a rally in front of the CDC in Atlanta. People carried signs and children wore T-shirts bearing anti-vaccine slogans; many dressed in costumes, such as prison outfits. It was like a scene out of Monty Hall’s television game show, Let’s Make a Deal—except for the angry, threatening undertone. Protesters with megaphones screamed epithets at CDC employees as they drove through the crowd on their way to work. Others carried placards with pictures of Walter Orenstein, former director of the CDC’s National Immunization Program, and Marie McCormick, chairman of the Institute of Medicine’s committee to evaluate vaccine safety. Mimicking the defacement of Edward Jenner’s effigy, both images were circled in red, a crude slash across their faces, above the word TERRORIST in bold, black lettering.
Paranoia: In the days following passage of the vaccination act of 1853, anti-vaccine activists likened government officials meeting in a late-night parliamentary session to a coven of witches preparing destruction: “In a dark midnight hour, when evil spirits were abroad, when nearly all slept save a few doctors, who were rather awake, whose dictum and nostrum carried the night, this Act was passed, this deed was done. It was a deed worthy of the night, dark as the night.”
In 2007, Barbara Loe Fisher described an anti-vaccine rally at a Maryland courthouse: “I talked with a mother hundreds of yards from the front of the Courthouse door. I was about twelve inches inside a row of large cement balls that apparently were erected as a barrier to prevent terrorist attacks. I did not know I wasn’t supposed to be talking with this Mom inside the barrier. All of a sudden, out of the corner of my eye I saw an armed guard with a dog emerge from the Courthouse and walk toward us. I got a sick feeling in the pit of my stomach. It was the dread that any citizen of any country in any century has ever felt when an armed guard with a dog starts advancing. As if we were common criminals or terrorists, he yelled and gestured for us to move behind the stones. We moved without a word. And the sick feeling in the pit of my stomach told me we were being shown the power of the State wielded by that armed guard with the dog, just as parents inside the Courthouse were being shown the power of the State wielded by doctors with syringes.”
The popular notion of extreme coercion by public health officials took yet another form. Following the vaccination act of 1867, colorful accounts abounded of parents watching helplessly as their children were taken away and vaccinated without their consent. Actually, it never happened. Although the act of 1867 talked tough, in practice—apart from the occasional property auction—it didn’t act tough. The system literally paid vaccinators to listen to parents’ concerns. Some vaccinators bribed parents with beer, baked goods, money, and medicine. Others were perfectly willing to cater to the parents’ desire to have the child vaccinated in the home, instead of having to suffer the indignity of a public-vaccine station. Still, rumors that children were taken away and vaccinated persisted. And they persist today.
On October 14, 1999, Jane Orient, a prominent anti-vaccine spokesperson in Tucson, Arizona, appeared on ABC’s Nightline with Ted Koppel. Orient had just finished likening vaccines to scientific experiments in Nazi Germany. Koppel responded: “Dr. Orient, you raised before that sort of dramatic analogy to the Nuremberg Laws, in which people were required to undergo medical procedures against their will. It’s a horrible analogy, and I’m sure you are aware of just how horrible it is. Do you really think that’s an appropriate one?” Orient didn’t back down. “Yes, I do,” she said, “because I think that the CDC is not being honest with people. They are saying these vaccines are safe and to save the world from hepatitis B you have to be vaccinated. If parents want to refuse consent, they may be threatened with having their children taken away from them.” Koppel, at a loss for words, turned to Dr. Sam Katz, a professor of pediatrics and infectious diseases expert at Duke University School of Medicine. “Address if you would, though, what Dr. Orient said about if parents refuse,” asked Koppel, “[namely] that the child would be taken away from them, because I’ve never heard of that.” Katz responded: “There’s no such event that’s ever been recorded to my knowledge or that I’ve ever heard from anyone else. That’s just not true.” Orient held her ground. “I have heard of cases,” she said. “Well, I have heard of cases of parents.” Pressed again, Orient refused to elaborate.
False claims of vaccine harm: In 1802, James Gillray penned a cartoon that captured the spirit of the time. Titled “The Cow-Pock or the Wonderful Effects of the New Inoculation,” it featured Edward Jenner standing among a group of people, a needle in hand, ignoring the horror around him. Jenner’s vaccine had apparently turned people into cows; they bore horns, had snouts, or suffered small cows growing like tumors out of their mouths, arms, faces, and ears. Looking at this cartoon two hundred years later, one would assume that Gillray was merely representing the public’s concern about the source and purity of Jenner’s vaccine. But he wasn’t. People were actually scared they were going to turn into cows. In the early 1800s, “those opposed to the new practice of vaccination had reported terrible side effects su
ch as the ox-faced boy or children who ran about on all fours, bellowed, coughed, and squinted like cows.” In 1890, at a meeting of the British Medical Association, one speaker produced a child whom he claimed was “covered with horn-like excrescences, which had resulted from vaccination.” In 1891, a father said he resisted vaccination because “it is well known that the bulls go mad every seven years, and that the cows make them mad.” He reasoned that because cows were used to make vaccine, “the madhouses [were] full of vaccinated children.” During an epidemic of smallpox in Gloucester in 1895, some parents refused vaccination because they were unwilling to have “a beast be put into their children” for fear that it would cause them to “low and browse in the field.”
Cartoonist James Gillray depicts the fear of British citizens in 1804 that Jenner’s smallpox vaccine could turn people into cows. (Courtesy of Time & Life Pictures/Getty Images.)
Other false notions about vaccines were common. George Gibbs, co-founder of the Anti-Compulsory Vaccination League, claimed that it was “statistically demonstrated that Vaccination causes very many more deaths than, even in the worst of times, result from Small-Pox.” The National Anti-Compulsory Vaccination League Occasional Circular reported that a child became “spotted over the whole of the body with black, hairy marks ... as in the negro”; vaccination, according to some, was turning white children into black children. In Westminster, a father tried to exempt his children from vaccination, claiming that it caused diphtheria. Similarly, in New York City in 1916, residents claimed that smallpox vaccine caused polio. Ironically, both the bacterium that causes diphtheria and the virus that causes polio had already been identified at the time these claims were made.
Today’s fears of vaccines are far more sophisticated than those of the past. But their biological underpinnings are about the same. It makes as much sense to say that the MMR vaccine causes autism as to say that the smallpox vaccine turns children into cows. The only difference is that today’s claims are couched in scientific jargon, so they sound better. During the Omnibus Autism Proceeding, fringe doctors and scientists claimed that thimerosal weakened the immune system, allowing measles vaccine virus to damage the intestine. Because the intestine was now leaky, brain-damaging proteins could enter the bloodstream and cause autism. These hypotheses sound perfectly feasible, except that not a single aspect of them is correct.
Deadly Choices: How the Anti-Vaccine Movement Threatens Us All Page 13
