In 1905 the United States Supreme Court issued the landmark decision Jacobson v. Massachusetts that has provided the basis for the broad police powers that local and state public-health officials possess even down to today. Karen L. Walloch’s The Antivaccine Heresy uses this famous case as the basis for a reexamination of the losing side in that case, providing some of the fullest and most detailed analyses of the anti–smallpox vaccination coalition and movement. While focused on Massachusetts, and specifically on Boston and Cambridge, Walloch seeks to complicate the story of the smallpox vaccination controversy at the turn of the twentieth century. As a result, she has produced a sophisticated and meticulously researched study of the contending forces and ideologies that surrounded the debate about vaccination. The author criticizes historians who dismiss the views and activities of those opposed to vaccination as “irrational and antigovernment cranks” (216). Rather, she documents not only that these opponents had rational justifications for their views, but also that they were effective because they based their arguments on traditional American values. Specifically, Walloch shows that, at a time of conflicting medical ideologies and theories, the antivaccinationists did not succumb to the emerging scientific-medicine consensus that was being promulgated by medical elites, but rather sought to preserve a multiplicity of approaches (113–114). Opponents also stressed the anti-democratic nature of compulsion and coercion. In addition, compulsory vaccination was denounced as an attack on individuals’ “bodily integrity,” one that “asserted unwarranted control over the internal private space of the body” (170, 190). Perhaps the strongest argument that the opponents of compulsory vaccination wielded was a practical one: although vaccination against smallpox had been used in Massachusetts and the U.S. for a century by the early 1900s, there was still disagreement about the efficacy of different vaccination techniques and equipment and also about the adequacy of various smallpox strains (14, 27). As a result, the antivaccinationists publicized to great effect every case where a person’s vaccination had possibly led to disease or death. Since, the opponents said, the state could not guarantee the safety of those who were vaccinated, how could it compel citizens to be vaccinated? Thus, opponents were able to build support by questioning the safety of vaccination as well as the political justification and rationale for compelling individuals to do what could be dangerous to their health. Walloch places the controversy over vaccination within the context of the smallpox epidemic in Boston and Cambridge in 1901 and 1902. Building on the work of James Colgrove, Michael Willrich, and others, the author provides an instructive account of how public health actually operated in the two cities under study. Utilizing previously underused sources, Walloch demonstrates that Boston health officials recommended and enforced quarantine and compulsory vaccination for immigrants and itinerant workers but did not do so for long-standing residents of the city or for the middle and upper classes. The discriminatory use of quarantine and isolation and other police powers in Massachusetts was similar to the misuse of these powers in other cities in the late nineteenth and early twentieth centuries. But it is unclear to what extent the existence of compulsory vaccination laws exacerbated the public health problem there or simply refocused opponents’ attention on these laws. On the whole, this is a judiciously argued and extremely well-documented study. There were, however, two areas that could have been explored more, or at least developed to provide more documentation. One is the author’s claim that “Americans at the turn of the century regarded antivaccination as one of the great controversies of their time” (112). Did this issue come up, for example, in presidential campaigns or in the platforms of political conventions? How much coverage of the antivaccinationist cause compared to other issues was there in newspapers and magazines across the country, and during what years did such interest peak? The second area that could have been further explored is the author’s claim that the antivaccinationists were espousing a form of populism. This idea is an intriguing one, but since during the era that the author is writing about the Populist Party was a major force in the U.S., and since it has been the subject of extensive historical interrogation, it would have been useful to know if the Populists themselves embraced this issue, and to what extent the antivaccinationists tried to make alliances with the Populists. Since populism was primarily a movement of the Midwest and the South, and Walloch’s study is of an eastern state and urban centers, it would be instructive to have an exploration of how the Populists and the antivaccinationists related to each other. Despite these quibbles, this is an impressive historical work that has much for historians and public health officials alike to contemplate and learn from. © The Author 2018. Published by Oxford University Press.
The American Historical Review – Oxford University Press
Published: Feb 1, 2018
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