Question

What is a “modern body”? When did the concept arise and how did it represent a change from historical notions of the body? What are the consequences of this definition, particularly as it relates to environmental health?

Anti-vaccinationism has existed since inoculation. Describe at least two examples of anti-vaccination reactions. What were people concerned about? What changed over time? How does this help us understand fears about vaccination today?

Answer 1

Vaccine controversies have occurred since almost 80 years before the terms vaccine and vaccination were introduced, and continue to this day. Despite scientific consensus that recommended vaccines are safe and effective, unsubstantiated scares regarding their safety still occur, resulting in outbreaks and deaths from vaccine-preventable diseases. Another source of controversy is whether mandatory vaccination policies violate civil liberties or religious principles.

Health and medical scholars have described vaccination as one of the top ten achievements of public health in the 20th century. Yet, opposition to vaccination has existed as long as vaccination itself. Critics of vaccination have taken a variety of positions, including opposition to the smallpox vaccine in England and the United States in the mid to late 1800s, and the resulting anti-vaccination leagues; as well as more recent vaccination controversies such as those surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury-containing preservative called thimerosal.

Smallpox and the Anti-vaccination Leagues in the United States
Toward the end of the 19th century, smallpox outbreaks in the United States led to vaccine campaigns and related anti-vaccine activity. The Anti Vaccination Society of America was founded in 1879, following a visit to America by leading British anti-vaccinationist William Tebb. Two other leagues, the New England Anti Compulsory Vaccination League (1882) and the Anti-vaccination League of New York City (1885) followed. The American anti-vaccinationists waged court battles to repeal vaccination laws in several states including California, Illinois, and Wisconsin.

In 1902, following a smallpox outbreak, the board of health of the city of Cambridge, Massachusetts, mandated all city residents to be vaccinated against smallpox. City resident Henning Jacobson refused vaccination on the grounds that the law violated his right to care for his own body how he knew best. In turn, the city filed criminal charges against him. After losing his court battle locally, Jacobson appealed to the U.S. Supreme Court. In 1905 the Court found in the state’s favor, ruling that the state could enact compulsory laws to protect the public in the event of a communicable disease. This was the first U.S. Supreme Court case concerning the power of states in public health law.

The Measles, Mumps, and Rubella (MMR) Vaccine Controversy
Nearly 25 years after the DTP controversy, England was again the site of anti-vaccination activity, this time regarding the MMR vaccine. In 1998, British doctor Andrew Wakefield recommended further investigation of a possible relationship between bowel disease, autism, and the MMR vaccine. A few years later, Wakefield alleged the vaccine was not properly tested before being put into use. The media seized these stories, igniting public fear and confusion over the safety of the vaccine. The Lancet, the journal that originally published Wakefield’s work, stated in 2004 that it should not have published the paper. The General Medical Council, an independent regulator for doctors in the UK, found that Wakefield had a “fatal conflict of interest.” He had been paid by a law board to find out if there was evidence to support a litigation case by parents who believed that the vaccine had harmed their children. In 2010, the Lancet formally retracted the paper after the British General Medical Council ruled against Wakefield in several areas. Wakefield was struck from the medical register in Great Britain and may no longer practice medicine there. In January 2011, the BMJ published a series of reports by journalist Brian Deer outlining evidence that Wakefield had committed scientific fraud by falsifying data and also that Wakefield hoped to financially profit from his investigations in several ways.

A large number of research studies have been conducted to assess the safety of the MMR vaccine, and none of them has found a link between the vaccine and autism.

Although the time periods have changed, the emotions and deep-rooted beliefs—whether philosophical, political, or spiritual—that underlie vaccine opposition have remained relatively consistent since Edward Jenner introduced vaccination.

The passage of the Vaccination Assistance Act exposed long-standing fissures between public health entities and private practitioners over whether it was appropriate for the government to intervene in the “marketplace” of medical care. Although doctors' groups such as the American Academy of Pediatrics provided the authoritative voice that the public trusted, their vision for how vaccines should be administered was often in conflict with that of their counterparts in public health.