Editorial: This is a final post in the current vaccine series.
In 1798 Edward Jenner in Britain demonstrated that vaccination with cowpox was a safer way to confer immunity to smallpox than variolation with smallpox. It quickly spread. In Britain, variolation was banned in favor of vaccination in 1840. In 1853, vaccinations were made compulsory with fines for refusal. Enforcement was in the hands of a new set of Welfare Officers.
The first vaccine wars broke out in Britain soon afterwards. Just as with variolation, there were ethical, religious and epidemiological doubters.
- The vaccine came from cows – hence the name.
- Vaccination sessions introduced pus from one person into a scarification produced on another. There were claims syphilis, tuberculosis and other diseases were transmitted in this way – with good evidence for syphilis.
- Middle class mothers had difficulties when their babies were inoculated with pus from a working class child – in public sessions.
- While vaccines could be got for free from the medical officers linked to workhouses, many felt this was pauperising.
Many of the Welfare Officers turned a blind eye to non-compliance. Resistance grew. It came from the ranks of Abolitionists (abolition of slavery) or supporters of the Temperance or Co-operative movements.
The visible scarification and link to cows were portrayed as the Mark of the Beast as foretold in the Book of Revelation. Links were made between food and blood adulteration.
- Anti-vaccinators threw the full range of sanitarian arguments for the importance of hygiene and role of constitutions into the mix. Vaccinators deployed germ theory.
- Anti-vaccinators saw germ theory being used to justify a Treaty with Dirt. Vaccinators talked about the feckless negligence of the labouring classes.
- Anti-vaccinators claimed the upper classes didn’t contract smallpox because of their better food, and air.
Everyone viewed the problem in moral terms and as coming from below.
An Anti-Compulsory Vaccination League (ACVL) was set up in 1866 followed by a National ACVL in 1874, after an 1871 Act made non-compliance impossible. Vaccinations were required for some employment. Refusing to have a child vaccinated led to a fine or jail in the event of being unable to pay. In jail, vaccine refusers found themselves yoked to felons and prostitutes. Some vaccination officers went to jail rather impose the Act.
There were mass demonstrations against government policy, with up to 100,000 at a demonstration in Leicester in 1885 at which an effigy of Edward Jenner was decapitated.
This was a replay of the English Civil War of the 1640s. The protesters were non-conformists. Compulsory vaccination they claimed was indistinguishable from compulsory baptism or circumcision. What was needed was tolerance of belief and a Medical Reformation to deliver Free Trade rather than a medical monopoly – although homeopathy saw vaccines as a vindication.
The Liberal Party (then the progressive party) was split down the middle between those who held to traditional beliefs and those who thought a party prepared to intervene to control child labour could also intervene to protect children with vaccines.
A review commission was convened in 1892. The government branded the anti-vaccine lobby as soft-headed, spiritualists, over-influenced by journalism and public opinion.
But by 1898, unlike for other infections no-one had identified a smallpox bug. The ideas of the later Nobel Prize winner Elie Metchnikoff were picked up by orthodox medicine and gave rise to talk about optimising immune responses with Opsonin – an idea lampooned in The Doctors Dilemma by George Bernard Shaw. Shaw, an anti-vaccinationist, portrayed medicine in Adam Smith’s terms as a conspiracy against the laity.
Between the lack of a bug, and clear lies about adverse effects such as syphilis, there were grounds to doubt medical and government bona fides.
A new Vaccination Act was adopted in 1898 that continued the policy of compulsion but allowed for conscientious objection provided a parent could Satisfy a magistrate they had grounds to opt out. But what is a conscience? There were no X-rays to demonstrate its existence. This provoked a Liberal crisis.
The idea of Conscientious Objection was also contagious. It became an even bigger issue a decade later when the Great War broke out.
The socialists were anti-vaccination and a founding principle of the Labour Party formed in 1900 was the abolition of compulsion – the socialists were against State Medicine.
In practice magistrates could issue a certificate of exemption but many had a conscientious objection to conscientious objectors.
The objectors didn’t like a law that made them licensed law-breakers rather than equal citizens. They invoked the 1689 Tolerance Act that brought the Civil War to an end by giving Dissenters the right to legally affirm allegiance.
Liberals were on both sides of the argument. The Liberal Party returned to power in 1906 and introduced a new act in 1907. This continued compulsory vaccination, and exemptions. But it removed the word Satisfy. This took discretion out of the hands of magistrates. Within two years, it was estimated that 25% of the children in Britain were unvaccinated, with 50% in some regions, and 90% in pockets. Smallpox never returned.
In 1930, the smallpox germ was detected – see image.
In 1936, the concept of herd immunity was born, but little was heard of it before the development of measles and rubella vaccines in the 1960s.
In the 1946 NHS Act, the Labour Party abolished compulsion for vaccinations.
The Torch of State Medicine passed to the American Centers for Disease Control (CDC) who chasing smallpox in South East Asia in 1975 conducted “an almost military style attack on infected villages”:
“In the hit-and-run excitement of such a campaign, women and children were often pulled out from under beds, from behind doors, from within latrines… People were chased, and when caught vaccinated… We considered the villagers to have an understandable though irrational fear of vaccination… We just couldn’t let people get smallpox and die needlessly. We went from door to door and vaccinated. When they ran we chased. When they locked their doors, we broke down their doors and vaccinated them”.
There are times we prefer to take our chances with what the universe might have in store for us rather than run with the herd. This risks reprisals from the herd. Regardless of what name the community puts on the religion it believes in, community beliefs are conservative and favor civic duty, and loyalty. Having occasional animals stray from the herd is one thing, having the herd split is another, especially when a technical system appears to offer an efficient solution to a significant problem. In this case, splits can almost only be permitted on “religious” grounds.
Technical systems, especially in healthcare, do not tolerate pluralism. They reach for guidelines and standards. The vaccination controversies are emblematic of this. Today more than ever the System is working mightily to understand vaccine resistance – in order to “manage” it.
Despite the latest in consumerology and public relations, objectors in 2016 are dismissed in terms almost identical to those in use in 1906.
At the heart of this debate is the question – Who Chooses?