By Beth Folsom
In our current era of COVID-19, heated discussions of vaccine mandates and the class and racial tensions inherent in these conversations may seem like a contemporary dilema, but an examination of Cambridge at the turn of the 20th century reveals that the city engaged in similar debates around the issue of smallpox vaccination and public accommodation more than one hundred years ago. Although smallpox had been present in the city for almost three centuries by this point, a series of localized outbreaks beginning in the 1890s brought it back into the public spotlight and sparked sometimes heated debates about the safety and efficacy of vaccines, racial, ethnic and class disparities, and the role of government in public health.
As early as 1893, the Cambridge Board of Health was offering free smallpox vaccinations to the public at three locations in the city. Newspaper advertisements encouraged the public to avail themselves of these services, describing the vaccines as “the best that can be obtained,” and assuring readers that “the vaccination is done by experienced physicians.”1 By 1898, the School Board had adopted a resolution stating that “[n]o child who has not been duly vaccinated shall be admitted to a public school except upon presentation of a certificate signed by a regular practicing physician that such child is an unfit subject for vaccination.”2 In fact, it was not just the schools who were mandating vaccination for attendance; a 1900 Cambridge Chronicle article cites a Massachusetts statute “which provides that parents and guardians shall cause their children to be vaccinated before they are two years old, unless a physician shall certify that the child is physically unfit.”3 The article’s author quotes city officials as confirming that “there is strict enforcement of the vaccination law in Cambridge. The statute in regard to compulsory vaccination is carried out to the letter, especially so in connection with the public school system.”4
By 1902, another smallpox outbreak had led the city to enact its own vaccination mandate; the Board of Health divided Cambridge into 17 districts, each with at least one physician whose responsibility it was to “report every day the number of streets covered, the number of people vaccinated and the names and residences of those who refuse to be vaccinated.”5 A notice in the Cambridge Chronicle in March of 1902 states that all Cantabrigians who had not been vaccinated in the past five years were required to get a smallpox inoculation or face a $5 fine (equivalent to about $150 today).6 During the first few months of this city-wide vaccination effort, thousands of residents received their shots, but the presence of physicians in a wide variety of Cambridge neighborhoods revealed class, racial, and ethnic tensions simmering just below the surface. In a letter to the editor of the Cambridge Chronicle in April of 1902, an anonymous reader stated that “[s]ome of the vaccination agents of the board of health are badly lacking in tact. It may be necessary, in some cases, to refer to the legal requirement, but it is not in good taste to use it as a threat. More Cambridge citizens need only have their attention called to the matter in a gentlemanly way. The agents should discriminate between different classes in the choice of the terms of their message.”7 The letter writer expresses the belief that those who have not been vaccinated can be divided into the upper classes, who need only to be reminded of the mandate and its importance, and the lower classes, whose presumed deliberate flouting of the law makes acceptable the use of legal and pecuniary threats for noncompliance.
In May of 1902, the Cambridge Tribune published the firsthand account of a junior physician acting as one of the agents for the Board of Health. The author describes his encounters with Cambridge residents during a day when he was accompanying a more senior doctor – one who had become exasperated with what he saw as vaccine resistance among the population of his city sector. Noting that the senior physician was clear about the potential legal consequences of refusing the vaccine, the junior doctor describes some of the residents they encountered in their travels, revealing clear biases along the way. He notes that much of their work was in tenement-style apartment buildings, and his description of the inhabitants of those neighborhoods is tinged with both racial and anti-immigrant sentiments. He refers to a family of Irish immigrants as “the MacSomebodys,”8 noting that they were all very close in age. In this way, he both removes the importance of their individual name and identity, and also reinforces the common stereotype of Irish immigrants as both ignorant and fertile, their numerous offspring contributing to their poverty. In the same neighborhood, the doctors encountered several other families who consented to be vaccinated en masse; in his description of this process, the author expresses his reproach for a Black family, stating that “[t]here was more wailing in a colored family consisting of a mother and two children than there was in a Swedish family of six, who were an altogether delightful lot – light-haired, pretty children, every one. Even the baby smilingly suffered her arm to be meddled with, and dropped not a single tear when the point was applied.”9 Describing the Black family as noisy and overly dramatic, the author juxtaposes them with the Swedish family, whose “light-haired, pretty children” were both attractive and good-natured as they received their vaccinations. It is important to note that, for many readers of the Cambridge Tribune, this type of “behind-the-scenes” narrative may have been one of their only glimpses into the world of Cambridge’s poorer residents. By reinforcing stereotypes rooted in class, race and ethnic identity, writers such as this physician further perpetuated the discriminatory attitudes that had long been present in the city; doing so as an official city agent gave added credence to these stereotypical portrayals.
Not all Cantabrigians accepted the authority of the Board of Health and its designated agents, however; in response to both the state and city vaccine mandates, anti-vaccination societies sprang up in Cambridge and across the state. A Cambridge Chronicle article from April of 1902 states that “[a]n organization is being formed in this city, to oppose compulsory vaccination. The majority of the members do not oppose vaccination. They are perfectly willing that those who wish to be inoculated shall submit to the treatment; but they seek legislation to the end that the matter may not be forced upon those who do not desire it.”10 Indeed, most of those who joined such societies were not against vaccination itself, only the laws making it compulsory. But a small contingent of anti-vaccinationists were vocal about their belief that smallpox itself was of relatively little danger compared to what they saw as the evils of the vaccine. A 1902 speech given by an anti-vaccine crusader and reprinted in the Cambridge Chronicle warns that “[l]ockjaw, blood poisoning, bodily distortions are only a few of its most frightful results…Save your own blood and the blood of your child from the vaccination pollution.”11 The speaker also endeavors to explain the origins of smallpox, arguing that “[s]mallpox is only possible to those who clothe heavily, bathe infrequently, eat very heartily and exercise rarely. It is the accumulation of impurities in the blood, and the inability of the inactive pores of the skin to assist in its elimination that gives the disease its victims.”12 Because they assigned smallpox infection to certain voluntary behaviors, vaccine opponents were able to both assign blame to victims for their own sickness and oppose vaccination as an appropriate public health tool.
Although the members of organized anti-vaccination societies remained small, stories about the dangers of the smallpox vaccine began to spread, giving some members of the public pause about having themselves and their families vaccinated. An article in the Cambridge Chronicle describes the “attempted suicide” of a 34-year-old Cambridge man who had previously been healthy in both body and mind: “Albert E. Hall, of 166 Green street, attempted suicide while temporarily insane, yesterday morning, at his home, by drinking nitric acid. He is now at the Massachusetts general hospital, dying. Members of his family attribute his derangement to vaccination.”13 New of the death of a young girl in Buffalo, New York, also reached readers of the Cambridge Chronicle, which reported that the girl’s parents were in a legal battle over the inscription on her gravestone, which read, “Lucile Sturdevant died May 28, 1902, aged 6 years. Vaccination poisoning at School 35.”14 The Buffalo Health Department was attempting to remove the inscription, arguing that it was inaccurate, but the Sturdevant family was embroiled in a lawsuit against the health department for damages due to what the family saw as criminal negligence in their daughter’s death. Although the Sturdevants ultimately lost their lawsuit, Lucile’s gravestone was allowed to remain intact, and the story of her death spread far beyond Buffalo, adding fuel to the anti-vaccine fire.
By June of 1902, the rate of smallpox infection had reached a level that prompted Cambridge officials to close the schools and the public library, and to order church services to be cancelled. Prior to this point, Cambridge had been reluctant to enforce the legal penalties associated with vaccine non-compliance, but following these closures, the Cambridge Tribune quoted Mayor John McNamee as declaring that “[t]he first person who refuses to be vaccinated will be immediately called into court.”15 Little did McNamee know that it would be one of his own coworkers who would be among the first to be prosecuted under the city’s crackdown. Albert Pear was the assistant Cambridge city clerk; in July of 1902 Pear, along with several other codefendants, received a summons to appear in court for refusing to be vaccinated. Described as “very highly respected by all who know him,”16 Pear declined vaccination in large part because a family history of muscular rheumatism made both him and his person physician wary of the effects of the smallpox vaccine. Although he appeared in court with a signed certificate from his doctor declaring him unfit for vaccination, Pear was nevertheless held to account by the board of health, who “decided to bring him into court, as such defiance of their authority right in city hall should not, they thought, be allowed to continue.”17
At the end of July, Pear’s case was decided on the local level and he was fined $5 for failure to comply with the vaccine mandate. An appeal by his attorney sent his case to the Supreme Court and, while Pear awaited that trial, he became a lightning rod for both supporters and opponents of mandatory vaccination in Cambridge and beyond. In April of 1903, the Supreme Court handed down its decision, declaring that compulsory vaccination laws are constitutional. In reaching this conclusion, the full court bench agreed that “it was within the power of the legislature to enact this law; that plainly its object, the prevention of small pox is worthy of the intelligent thought and earnest endeavor of legislators, and for the common good; that it comes within the police power of the legislature, and that the application of a good law to an exceptional case may work hardship, but there is no reason to suppose that the enforcement of the requirements in the present cases was conducted harshly.”18 Although there may be individual cases in which vaccination causes illness or even death, their small numbers in comparison to the overwhelming public good of requiring smallpox vaccination far outweighs the danger of allowing segments of the population to remain unvaccinated.
The resurgence of smallpox in Cambridge during the decade from 1893-1903, and the subsequent response by public health and legal officials echoes many of the themes of our current debates over the safety, efficacy, and mandating of vaccines in the era of COVID-19. From the race- and class-based language used to describe the residents infected with the disease, to urban legends blossoming out of individual stories, to the rejection of medical and political authority on the issue of vaccines, Cambridge at the turn of the 20th century bears more than a passing resemblance to Cambridge – and America at large – in our own day. As we move toward 2022 with COVID still looming large on the horizon, what can we learn from our city’s experiences over a hundred years ago, and how can understanding the complex social dynamics of the smallpox era help us to better navigate the current pandemic as residents of a dynamic and diverse community?
- “Free Vaccination,” Cambridge Chronicle, December 30, 1893.
- “School Committee,” Cambridge Chronicle, December 17, 1898.
- “Vaccination in Cambridge,” Cambridge Chronicle, September 15, 1900.
- “Compulsory Vaccination,” Cambridge Chronicle, March 8, 1902.
- “Advertisements,” Cambridge Chronicle, March 8, 1902.
- “Be More Tactful,” Cambridge Chronicle, April 5, 1902.
- “Vaccination Tour: What Two Public Vaccinators Saw and Heard in One Day’s Trip Right Here in Cambridge,” Cambridge Tribune, May 10, 1902.
- Advancing,” Cambridge Chronicle, April 5, 1902.
- “Attempted Suicide,” Cambridge Chronicle, December 14, 1901.
- “Vaccination ‘Points,’” Cambridge Chronicle, August 16, 1902.
- “Small-Pox at Work,” Cambridge Tribune, June 21, 1902.
- “Anti-Vaccinationists Must Go Into Court,” Cambridge Chronicle, July 19, 1902.
- “Constitutional,” Cambridge Chronicle, April 4, 1903.