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Cholera Epidemics in the 19th Century

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The Boston Smallpox Epidemic, 1721

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Spanish Influenza in North America, 1918–1919

Syphilis, 1494–1923

Tropical Diseases and the Construction of the Panama Canal, 1904–1914

Tuberculosis in Europe and North America, 1800–1922

The Yellow Fever Epidemic in Philadelphia, 1793

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 Vaccinating the Baby, From a sketch by Sol Eytinge, Cut from Harper's Weekly, Feb. 16, 1870, p. 116. From the holdings of Francis A. Countway Library of Medicine—Harvard Medical School
Vaccinating the Baby. From the holdings of Francis A. Countway Library of Medicine—Harvard Medical School.

Vaccination is a celebrated but controversial medical procedure that has been credited with reducing the rates of numerous infectious diseases—and in the case of smallpox, eliminating the disease entirely. However, concerns about safety and protests against compulsory vaccination campaigns have been at the center of vaccination controversies for more than 200 years.

Edward Jenner, 1749–1823

By the mid-18th century, individuals in Europe and Colonial America were being inoculated with smallpox matter to prevent the disease. Because this form of inoculation could cause a severe case of smallpox instead of a mild, immunizing case, inoculation could be controversial.

Late in the 18th century, the English naturalist Edward Jenner, among others, had noticed that milkmaids rarely acquired smallpox—though they were susceptible to the related, but much milder, cowpox. Using “vacca,” which is the Latin word for “cow,” Jenner coined the term “vaccination,” and he popularized the practice of inoculating individuals with cowpox matter to immunize against smallpox. For most of the 19th century, the word “vaccination” referred only to this procedure.

Jenner self–published his 1798 account of his cowpox experiments, An Inquiry into the Causes and Effects of the Variolae Vaccinae, as it had been rejected by the Royal Society. However, by 1801, physicians and politicians were increasingly interested in the procedure, and some believed it had great potential.

Opposition to Compulsory Vaccination

In the 1840s, the first state-sponsored vaccination campaigns appeared in England and, later, in Germany. These campaigns, which came to be associated with reduced rates of smallpox, were passionately promoted as essential for public health. Nonetheless, anti–vaccination sentiments were strong and many pamphlets and books opposing vaccination were published.

When compulsory vaccination began in England began in 1853, critics argued that the safety of vaccination was in doubt and that mandatory vaccination laws were coercive and even violent. Though actual force was rarely used to make people comply, fines and other measures—such as barring school attendance for unvaccinated children—were used, causing great resentment.

Fears about the safety of vaccination during this time were justified. There was no way to standardize, preserve, or sterilize vaccine. Vaccination occasionally resulted in sepsis or the transmission of other diseases, such as syphilis. Because it was not possible to differentiate between cowpox and smallpox matter, vaccination campaigns could actually result in outbreaks of smallpox. Conversely, if the vaccine virus proved to be dead, vaccination would prove completely ineffective.

After reviewing the evidence, even pro-vaccine physicians sometimes changed their minds.

Problems with Vaccine Matter

Vaccination involved taking cowpox matter from one person's body and placing it inside the body of another, usually through a cut in the arm. The matter could be in the form of dried scabs, strings soaked in cowpox “lymph,” or other forms. The poor were sometimes given free vaccinations in order to maintain a viable supply of cowpox matter, since there was no way to generate it outside a human or bovine body. A strain of cowpox could pass through hundreds or even thousands of people.

The mid–19th century also saw much discussion about whether vaccination matter was genuine, how potent various supplies were, and if cowpox was a separate disease from smallpox at all or simply an attenuated form.

Other Forms of Vaccination

Attempts to immunize for other diseases in the mid-19th century were sometimes named for the diseases that they were intended cure or prevent: “syphilization” is an example.

Over time, the word “vaccination” came to refer to all forms of immunization, not just smallpox. In the 1870s, Louis Pasteur, 1822–1895, called his chicken cholera immunization—an artificially weakened strain that he had developed in the laboratory—a “vaccine” in homage to Jenner.

By the time Louis Pasteur famously demonstrated his inoculations for rabies in 1885 on Joseph Meister, a young boy bitten by a rabid dog, the term “vaccination” was becoming generic. This case, usually portrayed as the first demonstration of an effective, laboratory-produced vaccine on a human being, has been considered controversial. Because there was no way to determine if the child would have developed rabies without Pasteur’s vaccine, some have argued that this experiment was meaningless—most people bitten by rabid animals do not actually contract rabies. Pasteur, a chemist and not a physician, had the vaccine administered to a child when it had only been tested on 11 dogs—something that would be considered unethical today. Yet the child lived, and Pasteur is usually regarded as a hero of medicine and public health.

The Controversy Continues

Vaccination continues to be a controversial procedure. Recognizing that this controversy has a long history may help parents, physicians, and public health officials to increase their understanding of arguments for and against vaccination.


Selected Contagion Resources

This is a partial list of digitized materials available in Contagion: Historical Views of Diseases and Epidemics. For additional materials on the topic “Vaccination,” click here or search the collection’s Catalog and Full Text databases.

Web Pages

Germ Theory
James Jackson, 1777–1867
Robert Koch, 1843–1910
Public Health
Syphilis, 1494–1923
Tuberculosis in Europe and North America, 1800–1922
Benjamin Waterhouse, 1754–1846


Arlington Street Church Records.
Boston Overseers of the Poor Records.
Papers of Benjamin Waterhouse, 1786–1836 (inclusive).


An Only Child Killed by Vaccination! Lawrence, Mass., Nov. 23, 1918. Boston: Medical Liberty League, 1918?
Constable, H. Strickland. Doctors, Vaccination, and Utilitarianism. London: Simpkin, Marshall and Co.; York, England: J. Sampson, 1873.
Dolan, Thomas M. Hydrophobia: M. Pasteur and His Methods: A Critical Analysis. London: H.K. Lewis, 1886.
Fry, Danby P. Fry’s Law of Vaccination: Containing the Vaccination Acts 1867, 1871, 1874, and 1898; The Local Government Board Act 1871; The Order of the Local Government Board of the 18th October 1898; The Circulars of the Local Government Board of the 10th August and 21st October 1898; Hints to Public Vaccinators and Vaccination Officers &c.: With Introduction, Notes, and Indexes, by A.F. Vulliamy. London: Knight and Co., 1899.
Dolan, Thomas M. Hydrophobia: M. Pasteur and His Methods: A Critical Analysis. London: H.K. Lewis, 1886.
Jenner, Edward. An Inquiry into the Causes and Effects of the Variolae Vaccinae: A Disease Discovered in Some of the Western Counties of England, Particularly Gloucestershire, and Known by the Name of the Cow Pox. London: Printed for the Author by Sampson Low...: and sold by Law...: and Murray and Highly…, 1798.
A Physician. A Popular Essay on the Value and Present Condition of the Practice of Vaccination: Embracing a Consideration of All the Points Important to be Understood by the Heads of Families, and Particularly of Re–vaccination. New York: Henderson Greene, 1835.
Pickering, John. Which? Sanitation and Sanatory Remedies, or Vaccination and the Drug Treatment? London: E. W. Allen, 1892.


The following sources were used in writing this page.

Allan, Arthur. Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver. New York and London: Norton, 2007.
Baldwin, Peter. Contagion and the State in Europe, 1830–1930. Cambridge, UK: Cambridge University Press, 1999.
Brunton, Deborah. The Politics of Vaccination: Practice and Policy in England, Wales, Ireland, and Scotland, 1800–1874. Rochester: University of Rochester Press, 2008.
Colgrove, James. “‘Science in Democracy’: The Contested Status of Vaccination in the Progressive Era and the 1920s.” Isis, 2005, 96: 167-191.
Geison, Gerald L. The Private Science of Louis Pasteur. Princeton: Princeton University Press, 1995.
Hansen, Bert. “America’s First Medical Breakthrough: How Popular Excitement About a French Rabies Cure in 1885 Raised New Expectations for Medical Progress.” American Historical Review, Vol. 103, No. 2. (Apr., 1998), pp. 373–418.
Henderson, D.A. “The Deliberate Extinction of a Species.” Proceedings of the American Philosophical Society, Vol. 103, No. 2. (Apr., 1998), pp. 373–418.
Leavitt, Judith Walzer. The Healthiest City: Milwaukee and the Politics of Health Reform. Princeton, N.J.: Princeton University Press, c1982.
Razzell, P. E. “Edward Jenner: The History of a Medical Myth.” Medical History, July 1965; 9(3): 216–229.
Rigau-Perez, Jose G. “The Introduction of Smallpox Vaccine in 1803 and the Adoption of Immunization as a Government Function in Puerto Rico.” The Hispanic American Historical Review, Vol. 69, No. 3 (August, 1989), pp. 393–423.
Schibuk, Margaret Danielle. “The Search for Vaccinia.” PhD diss., History of Science, Harvard University, 1986.


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