The 130th Annual Meeting of APHA

Abstract #52008

James Colgrove, MPH, MA, Center for the History and Ethics of Public Health, Columbia Mailman School of Public Health, 722 West 168th Street, 9th Floor, New York, NY 10032, 212-305-0561, jc988@columbia.edu

Two major outbreaks of smallpox occurred in Brooklyn and New York around the turn of the 20th century. Health officials moved aggressively to contain the disease, conducting mass vaccination programs house to house and in workplaces. Although these programs were ostensibly voluntary, the manner in which they were conducted was often coercive, and gave many people the impression they had no choice but to submit. Nevertheless, officials portrayed their programs as voluntary because they lacked a clear legal basis for their actions and because they believed this was the most effective strategy for gaining public cooperation. During these outbreaks both the public and the public health profession vigorously debated whether citizens could or should be forced to submit to vaccination and quarantine. This presentation will examine the tactics used by health officials to encourage cooperation with their vaccination programs and the varied public responses to their actions, ranging from enthusiastic cooperation to evasion, concealment, and active resistance. The events of this period reveal deep ambivalence among the public about how far the government should go in limiting individual liberty to protect the common good. As the United States confronts difficult policy choices about whether to reinstate universal smallpox vaccination, these events remind us of the careful line health officials have had to tread between persuasion and compulsion within a civic culture hostile to overt government paternalism.

Learning Objectives:

• Recognize the practical and ethical implications of compulsory and voluntary vaccination policies through a historical case study of samples in New York City at the turn of the 20th century

Keywords: History,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.