“Cotton Mather, You Dog, Damn You.” A History of Vaccine/Public Health Hesitancy (original) (raw)

Background – In November 1721, a small bomb was thrown through the window of the house belonging to Rev. Cotton Mather. Attached to the bomb, which did not detonate, was a note, ‘Cotton Mather, you dog, dam (sic) you! I’ll inoculate you with this; with a pox to you.’ Cotton Mather was a very influential pastor in pre-revolutionary Boston, which was in the middle of a smallpox pandemic, advocated variolation against smallpox, a technique he learned from Onesimus. Methods – Paper is a historical survey of the evolution of the vaccine and vaccine hesitancy. Results – Opposition to vaccination, even violent opposition, is as older the vaccine itself and is part of a larger discomfort about public health mandates. Historical arguments against vaccine are recognizable during the COVID pandemic; the introduction of a disease, even an attenuated version, into the body of a healthy body; assessment of risk from the disease; the injection of chemicals into the body and, lastly, public health versus individual autonomy. Discussion – Public health campaigns have a long and complicated history. In 1771, George Washington ordered inoculation against smallpox, the first time a commanding general required this kind of a public health measure. Smallpox was a significant factor in the failure of the Quebec Campaign. Edward Jenner proved that an attenuated vaccine, cowpox, was effective in preventing smallpox. In 1812, the U.S. Army required vaccination against smallpox. During the Civil War, the massive mobilization led to shortages of the vaccine and soldiers fearing smallpox resorted to self-inoculation inadvertently infecting themselves with syphilis or erysipelas. Although compulsory vaccination doesn’t appear to have been controversial in the military context, while state and local governments efforts to mandate vaccination against smallpox generated opposition. In a similar situation during the Second World War, the public health effort against malaria generated opposition from soldiers who feared the side effects of the then novel antimalarial atabrine, requiring the unit command to enforce compliance. Success of public health campaigns relies on a couple of factors; trust in the leaders and the individuals assessment of risk, comparing the possibility of a catastrophic outcome (high risk) to possible benefits.