Screenshot of MSNBC story about a teen in a FL supermarket refusing to wear a mask.

Misinformation, Vaccination, and “Medical Liberty” in the Age of COVID-19

Vaccination is of critical importance right now. At this moment, the United States is fighting an uphill battle against COVID-19, reaching over 100,000 cases a day and counting. Hospital systems are strained and the country’s morgues are cracking under the pressure of thousands of corpses waiting in trailers for burial. Meanwhile, the vacuum of national leadership for most of 2020 left states bearing the brunt of mitigation plans to slow the spread, leading to highly unequal strategies across the country. In this context, a vaccine seems like our best hope for some semblance of safety. But the United States faces particular hurdles to successfully enacting public health measures. Anti-mask protesters claim that enforcing mask-wearing is a threat to their liberties. Large numbers of anti-vaxxers and other people hesitant to take a new vaccine risk setting the United States far behind other countries. And logistical problems have thus far been particularly troublesome, especially for harder-to-reach areas of the country. But history shows us that these challenges are nothing new.

During the first decades of the twentieth century, the United States waged a campaign to eradicate smallpox. Smallpox is a viral infectious disease that causes skin rashes, fever, and in some cases, blindness. Some of the first inoculations for the disease were far more rudimentary than modern techniques. Despite the early use of such mitigation measures as rubbing smallpox pus into an open wound, the disease continued to spread well into the 1900s. Indeed, smallpox added particular challenges in the context of the American empire when, after the United States’ bloody campaign in the Philippines after the Spanish-American War, Americans undertook a massive effort to vaccinate the Filipino population. To vaccinate the population, Americans had to safely transport the vaccines across long (and warm) distances in cold enough temperatures to keep it effective.[1] This, of course, has been one of the major focuses of the COVID-19 vaccine, in which the Pfizer variant requires storage at minus 70 degrees Celsius. In the Philippines, logistical problems led public health authorities to build new vaccine manufacturing centers on the islands rather than rely on lengthy transport from the United States.[2]

Paper tube of smallpox vaccine
Ampoule of smallpox vaccine in original carton, England. (Wellcome Collection)

By the time of the Great War, the smallpox inoculation was a pretty routine procedure. To administer the vaccine, the skin was cleaned and disinfected with alcohol and gauze, two small incisions were made into the arm, and the physician applied the vaccine directly into the incisions.[3] American soldiers had to be vaccinated before going overseas. The vaccination campaign was largely successful, as the American Expeditionary Forces reported only 853 cases of smallpox and 14 deaths throughout the entire war.[4] But despite such statistics, Americans were highly skeptical at best, overtly hostile at worst, regarding vaccines, and joined broader efforts to challenge, what some viewed, affronts to civil liberties.[5] The National Anti-Vivisection Federation of New York City, for example, published a pamphlet in April 1918 titled, “Why Is My Soldier Sick?” which argued that widespread disease in the war was in fact due to inoculations. Those who are looking for the truth “will find it in the fact that they have been pumped full of disease by compulsory serum inoculations and vaccinations![6] The organization protested against “poisoning soldiers’ blood” with smallpox and typhoid before sending them to Europe.[7] Such claims of “poisoning” were far from fact.[8] But these wild claims from 100 years ago don’t sound too different from more modern – but equally false – claims that the Covid vaccine would microchip your children, or other myths.

While authorities tried to counter dangerous misinformation in 1918, anti-inoculation movements proliferated across the country. Even as smallpox spread rapidly through the civilian war production economy of Dayton, Ohio, the local Commissioner of Health wrote, “Dayton is a hot bed of anti-vaccination sentiment.” Officials could not enact public health measures there “without arousing such opposition to all our activities in other lines as to seriously jeopardize our efficiency.” The situation, he feared, would get far worse when the estimated 15,000 workers arrived for war work.[9] While Dayton faced resistance among some business owners – a difficulty experienced even today with COVID-19 – there were some in private industry who actively sought to work with public health measures, reflecting varying public understandings and anxieties of modern science.[10]

West Virginia’s Health Commissioner, too, commented about intense anti-vaccination “propaganda” in that state in February 1918, hoping that the Surgeon General might stop the misinformation.[11] And the Arizona State Board of Health appealed to the Surgeon General about local resistance to public health measures: “Unwarranted and ignorant editorials… have a tendency to inspire courage to resist the law in certain high grade morons.”[12] As is clear through the Board of Health’s rhetoric, vaccination debates were not immune from the broader public health culture of the Progressive Era, in this case, eugenic discourse.

Anti-vaccination groups also mobilized wartime rhetoric into their public health claims. In a letter to the Surgeon General, Dr. Charles Page argued that enforcement of compulsory vaccination in the Army “upon our brave soldier [sic] and sailors is a most vicious form of autocracy while they are engaged in this world war for ‘democracy’!” He continued: “there are some who are ‘more afraid of it than of the bullets.’”[13] One father, whose son died of meningitis while serving in the Army, wrote to his United States Senator, “Do you realize… that there is enthroned under our government, an Autocracy compared with which the German culture is mere child’s play?” He argued that there has never been such a despotic regime as that which one saw under US Army medicine.[14] The publication titled “The Open Door” took the theme of war-induced medical autocracy to another level, targeting the New York State Health Commissioner by arguing he was “unscrupulously using the war as an entering wedge to accomplish his ends,” insinuating a more sinister plot.[15] Of course, seeing necessary public health measures as autocratic and targeting the policymakers responsible for keeping the public safe sounds eerily familiar to more modern resistance to mask mandates.

Perhaps one of the more comical instances of wartime resistance to vaccination was a play created by anti-vaccination activists. It featured “Dr. John Dillpickle,” who was a Commissioner of Health and “strongly Prussian in his ideals.” Dr. Dillpickle lived in a large American city and was “supported by a pro-German mayor in his anti-democratic attempt to establish medical autocracy or State medicine.” The second character was “Herr Doctor… Carl Schmidt, M.D.” Schmidt, who was Dillpickle’s health officer, was a “failure in the practice of medicine” and was “thoroughly trained in the methods of dogmatic autocracy” in German medical schools where he was educated in all the “erroneous…forms of government” and “medicine… so characteristic of the Prussian mind.” Finally, there was James Brown. Brown was a “plain American citizen,” who was born and educated in the United States. Echoing modern claims about mask mandates that supposedly infringe on individual liberty, Brown believed that “an American citizen is as much entitled to medical freedom as he is to religious freedom,” calling attention to the time individuals have spent studying “so-called nature cure systems.”

The play takes place at James Brown’s manufacturing company, where Dr. Carl Schmidt hopes to force Brown to vaccinate all of his employees. Schmidt responds to Brown’s protests, arguing that Dillpickle “vill send der police down und close you up if you do not haf dem vaccinated.” Brown then confronts Dr. Dillpickle himself, claiming that he has no right to vaccinate his employees against their will, calling it an “illegal and un-American practice.” Dillpickle, Brown, and Schmidt squabble about the legality of compulsory vaccination, leading Brown to challenge Dillpickle about just how many people really die from smallpox, compared to automobile accidents. “If you are so anxious to conserve human life,” Brown says, “why don’t you vaccinate all the automobile speed fans with anti-speed serum, or prevent the use of automobiles entirely?” Schmidt responds, “Ach, you anti-vaccination cranks can’t teach me nudding.” To which Brown valiantly concludes, “But we can teach the thinking and long-suffering American citizen. I hope the American public will not have to give our would be medical autocracy the same treatment the swell head that they are now giving the Kaiser.”[16]

James Brown’s charismatic defense of “American liberty” in the face of the supposedly autocratic and Germanic medical regime hell-bent on compulsory vaccination is but one example of how seemingly innocuous public health measures can become mired in political platitudes. Should we be surprised that so many Americans still challenge public health guidelines, from gym owners violating mask protocols to vaccine misinformation campaigns on social media? Should we be surprised that a Florida supermarket owner mocked mask guidelines by printing a poster showing government officials wearing World War I German Pickelhaube helmets? Probably not. But we can surely look to history to see that these things are not so out of the ordinary. Understanding such histories could even lessen resistance to collective health measures by highlighting that rather than adhering to an ideology of rugged individualism, such collective measures might actually be in our best interests. But, isn’t this just another reason why a better knowledge of the humanities – and the medical humanities in particular – is so vital for Americans to have?

Notes

    1. The Surgeon General to Dr. William C. Woodward, January 9, 1923, RG 112, Series 29, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, US National Archives.
    2. J.F. Siler to Dr. L.C. Potter, December 23, 1921, RG 112, Series 29, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, US National Archives.
    3. Surgeon General’s Office to the Surgeon, 5th Corps Area, Fort Sam Houston, Texas, September 19, 1922, RG 112, Series 29, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, US National Archives.
    4. The Surgeon General to Dr. William C. Woodward, January 9, 1923, RG 112, Series 29, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, US National Archives.
    5. For more on historical resistance to vaccination, see Michael Willrich, Pox: An American History (New York: Penguin Press, 2011), 14; Bruce L. Hausman, Anti/Vax: Reframing the Vaccination Controversy (Ithaca: Cornell University Press, 2019); John Fabian Witt, American Contagions: Epidemics and the Law from Smallpox to Covid-19 (New Haven: Yale University Press, 2020).
    6. The National Antivivisection Federation, “Why Is My Soldier Sick?” RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    7. Medical Record: A Weekly Journal of Medicine and Surgery 93 (February 2, 1918), 197; “A Fair Question” Life, March 14, 1918, 424.
    8. The Surgeon General to Dr. William C. Woodward, January 9, 1923, RG 112, Series 29, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, US National Archives; The Surgeon General’s Office to Dr. J. Boone Wintersteen, September 29, 1921, Box 412, Folder 720.3-1: Vaccination, Immunization, Inoculation, General (1921), US National Archives.
    9. A.O. Peters to the Surgeon General, February 20, 1918, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    10. F.W. McKee to the Surgeon General, November 23, 1920, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    11. M.B. Williams to the Surgeon General, February 20, 1918, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    12. Arizona State Board of Health to the Surgeon General, April 10, 1918, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    13. Charles Page to the Surgeon General, October 19, 1917, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    14. S.H. Matron to Senator Henry F. Hollis, March 4, 1918, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    15. War Department Judge Advocate General to the Adjutant General, April 19, 1918, RG 112, Series 29, Box 413, Folder 720.3.1, US National Archives.
    16. “Scenario: The Logic of Compulsory Vaccination,” RG 112, Series 29, Box 413A, Folder: Vaccination, September 1918 to October 1918, US National Archives.

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