Putting Up a Fight

BRIAN: So, with that in mind, we want to take a look at how people dealt with an outbreak of smallpox in the past. We’ve already heard how impotent government was when disease struck in early America. But by the 20th century, the pendulum swings back. Not only have public officials decided that it’s their job to protect the public from smallpox. They’ve also decided that it’s OK to use force to carry out that job.

Michael Willrich is in an historian at Brandeis University, and he described one episode in particular to me. It was a 1901 night raid on an immigrant neighborhood in New York City.

MICHAEL WILLRICH: Smallpox had been discovered up in the Italian neighborhood on the Upper East Side, where Italian laborers and their families were living in very, very close quarters. So they assembled– the health department, that is, assembled a vaccine squad, as they called it, of 125 physicians accompanied by 125 police officers.

BRIAN: Wow.

MICHAEL WILLRICH: And they cordoned off this city block of tenement dwellings in the middle of the night, because they understood that the working people would be at home and asleep, hopefully. And they burst through doors demanding that everybody move into corners so that they could be inspected to see if they had, see the scars from a previous case of smallpox or had the visible vaccine scar on their arm.

And if they didn’t, they had to be vaccinated at once or they would be arrested. And it was just a really chaotic scene with mothers trying to hide sick babies from the health officials, with men actually brawling with health officials and police to prevent them from scraping their arms and rubbing the vaccine into their arms. It was a scene of almost extraordinary violence, all in the name of protecting New York City from an epidemic of smallpox.

BRIAN: And did New York City need to be protected? I mean, what was the danger here?

MICHAEL WILLRICH: So smallpox was really the deadliest killer in human history as far as diseases go. It killed as many as 300 million people in the 20th century alone. Typically–

BRIAN: Well, time out, 300 million people?

MICHAEL WILLRICH: That’s correct, worldwide.

BRIAN: That’s incredible.

MICHAEL WILLRICH: In a typical outbreak, 25 to 30% of the population afflicted would die of the disease. And this was a very serious outbreak. About 800 people died in the city of New York. So yes, it’s quite serious.

BRIAN: And where did it actually– am I remembering this correctly that the vaccine actually came from cows, infected cows?

MICHAEL WILLRICH: That’s where a vaccine gets its name. The vaccine material is live cowpox or vaccinia virus that is essentially harvested from infected sores on the underbellies of calves. So yeah, this stuff was pretty disgusting to contemplate.

BRIAN: That’s attractive, yes.

MICHAEL WILLRICH: It’s an attractive image. The vaccine itself that was used at the turn of the century was an unregulated commercial product. That is, the government compelled people to get vaccinated during epidemics in order to serve the public good. But the government did nothing at all to ensure that those vaccines used were safe and effective. That’s an enormous contradiction.

BRIAN: So if I’m understanding this correctly, Michael, you’re saying that those people who resisted might have had some legitimate reasons for doing so? Or is that–

MICHAEL WILLRICH: That’s exactly right. Even when it worked well and was not riddled with impurities, smallpox vaccine caused people to have a fever, to have a swelling and soreness of the arm, to feel seriously sick for a couple of days. Workers had good reason to fear that if they took the vaccine, they would lose their capacity to earn for a period of days or even weeks, thus depriving their family of their earnings.

BRIAN: I’m now going to appeal to the legal historian in you, Michael, and also I should say an expert on the progressive era, that period at the beginning of the 20th century where expertise and scientific knowledge was brought to bear on a whole host of social problems. How did this change your understanding of progressivism? And let’s limit it to this police raid in New York. How did that change your understanding of what progressivism was all about?

MICHAEL WILLRICH: Well, compulsory vaccination is kind of a emblematically progressive intervention, right?

BRIAN: Right.

MICHAEL WILLRICH: You are asking individuals to sacrifice some part of their liberty on behalf of the general public, on behalf of the welfare of the many.

BRIAN: Employing science to do it.

MICHAEL WILLRICH: And using science to do it, right? This is the science being practically applied for the good of society, a classic progressive innovation. And I expected there to be some resistance. I knew that there had been some lawsuits generated around smallpox vaccination at the turn of the century, some legal challenges.

I had no idea the extent of resistance. There were dozens of court cases, legal challenges to compulsory vaccination that took place at the state, local, and ultimately the federal level. There were candidates who ran for local school board offices on a platform of resistance to compulsory vaccination. Granted, many of their arguments were sort of anti-scientific, but they were arguing for an expansive idea of their legal and constitutional rights.

And we would see these kinds of arguments surface again in the 1950s and ’60s in the era of the so-called rights revolution. They are arguing for bodily integrity as a fundamental right of human beings under the Constitution. They are arguing for the rights of parents to make choices for their children without interference from the state.

They are arguing for religious liberty. They are arguing for bodily autonomy and medical freedom. Many of these kinds of arguments would come to the fore again in the realm of what we now call reproductive choice.

BRIAN: And we would label all of that very progressive today.

MICHAEL WILLRICH: We might. We might. And what it helped me to appreciate was the extent to which the modern administrative and welfare state, this new sort of social state that’s being created in the progressive era, and that we have all benefited from was nonetheless quite controversial in its own times and involved a lot of control over ordinary people that inspired a kind of reaction.

BRIAN: That’s Michael Willrich, professor of history at Brandeis University. He’s the author of Pox, an American History. It’s time for a short break. When we get back, 4 million people are granted their freedom. But that freedom leaves them very, very sick. You’re listening to BackStory. Don’t go away.