Compulsory Vaccination: History Repeating? (Part 1: England)

Regardless of your own personal beliefs regarding vaccination, the idea that a government can mandate a medical procedure without your consent, should be cause for concern to everyone (in addition, it contravenes basic human rights principles, in regards to informed consent, which must be freely given, “without coercion, undue influence or misrepresentation”) [1].

As we see governments around the world moving ever closer to forced vaccination, it behoves us to take a leaf from history, and remember what happens when the State assumes ownership of a person’s physical body.

The truth is that compulsory vaccination is not a new concept. It’s been tried before! In Part 1, we will take a closer look at how it worked out for England, with compulsory smallpox vaccination.

It began innocently enough, with the British Vaccination Act (1840).

Under this law, free vaccination was provided to the poor, to be administered by the Poor Law Guardians (while the original practice of ‘inoculation’ was outlawed). Many ‘poor and uneducated’, though, shunned the offer of free vaccination [2].

Thirteen years later, compulsory vaccination was introduced – despite evidence that smallpox mortality had been declining for many decades [3].

Compulsory Vaccination Act (1853)

This law required all babies up to the 3mths old (or, 4mths in the case of orphans) to be vaccinated. Parents who refused to comply faced fines of £1 (the equivalent of approximately one week’s wages for a skilled tradesman, and todays equivalent of approximately £80), or imprisonment.

Vaccination during those years was not the procedure that we know today. It was painful and inconvenient – for both parents and children, alike. The vaccinator used a sharp surgical knife (known as a lancet), to make incisions into the flesh, in a scored pattern. This was usually done in several different places on the arm. Vaccine lymph was then smeared into the cuts. Infants were to be brought back to vaccination stations, eight days later, in order to have the pus harvested from their blisters, to be used on other waiting infants [2].

In an era where doctors were incensed at the idea that postnatal infections were caused by their failure to wash their hands after handling dead bodies, and drinking and bathing water was often contaminated with raw sewage, it is hardly surprising that deaths caused by infections of the skin, such as erysipelas, increased as vaccinations were increasingly enforced [4].

The routine treatment of smallpox involved mercury or phenol (otherwise known as carbolic acid, which is highly corrosive, and causes blistering of the skin, on its own) applied topically to sores. Mercury gargles in the throat were also employed. If the patient became delirious (which would hardly be surprising, given the frequent use of mercury), they were given morphine or bromides – which also causes pustular eruptions of the skin [5].

Vaccination Act amendment (1867)

The law was extended to include all children up to 14yrs of age (in order to capture all the children who had ‘snuck through the cracks’, during the previous 14 years of compulsory vaccination). This law introduced continuous fines and cumulative penalties.

In other words, parents could be fined continuously with increasing prison sentences for non-compliance. The UK Court Hansard notes the case of a Mr. Pearce of Andover who, up until 1877, had been convicted some 40 times [6].

Also noted, was the case of Mr. Joseph Abel, who was convicted 11 times over a 14mth period, for refusing to have his child vaccinated [7].

Further amendment (1871)

Ironically, the law was further tightened in 1871, the same year a deadly smallpox epidemic raged through Europe and Britain – regarded by many as the most destructive epidemic during that entire century [8]. The UK suffered approximately 42,000 deaths, over the course of two years.

The new law made it compulsory for all local authorities to hire Vaccination Officers, and introduced fines of 20 shillings (the equivalent of 4 days wages for a skilled tradesman) for parents who refused to allow pus to be collected from their children’s blisters, for public vaccination.

The Leicester Mercury reported the case on a Mr. George Banford, who “had a child born in 1868. It was vaccinated, and after the operation the child was covered with sores, and It was some considerable time before it was able to leave the house. Again Mr Banford complied the the law in 1870. This child was vaccinated by Dr. Sloane in the belief that by going to him they would get pure matter. IN that case erysipelas set in, and the child was on a bed of sickness for some times. IN the third case the child was born in 1872, and soon after vaccination, erysipelas set in, and it took such a bad course that the expiration of 14 days the child died.”

It will come as no surprise, that Mr. Banford refused to have his next child vaccinated…and was fined 10 shillings, with the option of seven days imprisonment [9].

Meanwhile, resistance raged on, especially in the town of Leicester, where rallies attracted crowds up to 100,000 [10]. The resistance was such, that some local magistrates and politicians declared their support for a parent’s right to choose, and a Parliamentary Inquiry was eventually held, which sat for 7 years, and finally agreed to amend the laws.

It should be noted here that compulsory vaccination proved to be the ‘thin edge of the wedge’ for governmental incursion of bodily autonomy and personal liberty.

The Contagious Diseases Acts of 1864, 1866, and 1869, were passed very quietly and suddenly, with little fanfare (it was considered unseemly to discuss such matters). The laws were aimed at preventing sexually-transmitted diseases in the Armed Forces where 1 in 3 sick cases were caused by venereal diseases. Instead of targeting members of the Armed Forces, though, the law targeted women who were suspected of prostitution [11].

These women were apprehended by police, and forced to have their genitals inspected by a doctor (no doubt, male), and if found to be infected, confined in a lock hospital for treatment, for up to 3 months. Refusal to co-operate resulted in imprisonment, with possibility of hard labour [12].

Once registered under the Act, she was expected to show up at a designated inspection station, to be inspected, every two weeks [13].

During the 1860’s, there were approximately 26,000 prostitutes known to police, while other estimates say there may have been up to 368,000 prostitutes. The vast majority of these women were poor and uneducated, and resorted to prostitution to survive [13].

After the 1866 amendment, she could be confined to hospital for treatment, for up to 12 months.

The typical treatment for syphilis during that era would most likely have been mercury rubs. Later, the severe side effects of mercury became too obvious to ignore, and it was replaced by injections of arsenic.

Ironically, there were numerous instances reported, whereby syphilis was transmitted via smallpox vaccination [14-15].

The burgeoning feminist movement fiercely opposed the Contagious Diseases Acts, on the basis that they unfairly discriminated against women, and were undertaken in a most humiliating fashion. There was a lot of common ground between the early feminist movement fighting against the Contagious Diseases Acts, and the anti-vaccinationists. Indeed, feminist leader, Josephine Butler, who spearheaded the campaign to repeal the Contagious Diseases Acts, also served in the Mother’s Anti-Compulsory Vaccination League [16].

In addition to the Contagious Diseases Act, the Notification of Infectious Diseases Acts in 1889, and 1899 required that all contagious diseases, except tuberculosis (which is curious, since it was a major killer at the time) be reported to the local medical officer, who could then forcibly remove the patient to hospital, whether they consented or not. Household contacts and doctors who failed to notify the local medical officer were liable for fines of up to 40 shillings [17].

Again, the accepted medical treatment of the time most likely involved mercury or arsenic.

Finally, after forty-five years of protests, fines and imprisonments, the Vaccination Act (1898) promised some respite to parents – it removed cumulative penalties, and allowed for a conscientious clause to be added. This Act introduced the concept of ‘Conscientious Objection’ into English law. However, parents were still required to satisfy, not one, but two magistrates of their legitimate concerns and objections, in order to gain an exemption. For a number of years (until further amendments were made in 1908), many magistrates simply refused to issue the exemption to parents, resulting in continuing fines.

The UK Court Hansard reveals the case of one applicant, who was told by his local magistrate that “such people as the applicant ought to be set on an island by themselves and die of smallpox” [18].

The 1898 law had also outlawed arm-to-arm vaccination, which was replaced by vaccination of calf lymph, which was deemed to be safer. With little government oversight, however, many entrepreneurial types saw it as a way to make easy money, supplying cheap vaccines which, occasionally included dust, hair, and even animal dung [19]. Cases of tetanus, and other infections following vaccination, continued to be reported.

In 1908, when government realized that magistrates were failing to carry out the 1898 law, it was amended further, to allow parents to make a statutory declaration of their objections to vaccination, within four months of birth.

By 1921, only 40% of English infants were being vaccinated [19].

[1] United Nations General Assembly, 64th Session, 10th August, 2009. Available at: https://www.refworld.org/pdfid/4aa762e30.pdf. Accessed September, 2019.

[2] Durbach N. They Might As Well Brand Us: Working Class Resistance to Compulsory Vaccination in Victorian England, Soc Social Hist Med, 2000, 13:45-62.

[3] McCulloch JR. A Descriptive and Statistical Account of the British Empire, Longman, Brown, Green and Longmans, London, 1854. Available online at: https://archive.org/details/adescriptiveand00mccugoog/page/n654. Accessed September, 2019.

[4] Deaths from Erysipelas After Vaccination, 1859-1880, Vaccination Inquirer, Vol 5, p.84.

[5] Blumgarten AS. A Textbook of Medicine – For Students in Schools of Nursing, Macmillan, 1937.

[6] Hansard, Deb 17 April 1877 vol 233 cc1267-8, Available at: https://api.parliament.uk/historic-hansard/commons/1877/apr/17/vaccination-acts-prosecutions-case-of-mr#S3V0233P0_18770417_HOC_12. Accessed September, 2019.

[7] Hansard, Deb 11 June 1877 vol 234 cc1569-71, Available at: https://api.parliament.uk/historic-hansard/commons/1877/jun/11/vaccination-act-prosecutions-case-of. Accessed September, 2019.

[8] Lankester E. The Smallpox Epidemic, Nature, 1871, 3:341-342.

[9] Leicester Mercury, 10th March, 1884.

[10] Porter D, Porter R. The politics of prevention: anti-vaccinationism and public health in nineteenth-century England. Med Hist. 1988;32(3):231–252.

[11] Walkowitz JR. Prostitution and Victorian Society: Women, Class and the State, Cambridge University Press, 1982.

[12] Hamilton M. Opposition to the Contagious Disease Acts, 1964 – 1886, Albion: A Quarterly Journal Concerned With British Studies, 1978, 10(1):14-27.

[13] Ibid. See #11.

[14] Syphilis conveyed by the vaccine lymph to 46 children, The Lancet, Nov 16. 1861.

[15] Lee H. Lectures on syphilitic inoculation in 1865,1866, The Lancet, 87(2224):391-394.

[16] Johnston RD. The Radical Middle Class: Populist Democracy And The Question of Capitalism, Princeton University Press, 2013, p185.

[17] Mooney G. Public Health versus Private Practice: The Contested Development of Compulsory Infectious Disease Notification in Late-Nineteenth Century Britain, Bulletin of the History of Medicine, 1999, 73(2):238-267.

[18] Hansard, HC Deb 06 March 1902 vol 104 c588 https://api.parliament.uk/historic-hansard/commons/1902/mar/06/bakewell-anti-vaccinationists#S4V0104P0_19020306_HOC_119. Accessed September, 2019.

[19] Ibid. See #16.

Vaccine Concerns in the Developing World

Are people in developing countries really desperate for vaccines? Do they really walk for hours to get their children vaccinated. Maybe they do. But clearly, not everyone in the developing world is a believer. In fact, as you’re about to read, some are vaccinated at gunpoint…

Philippines

In 2015, more than 80% of people in the Philippines strongly agreed with the statement that vaccines are safe. A more recent poll in 2018, found that only 20% of people in the Philippines agreed with the statement. In 2015, 82% of people were confident in the effectiveness of vaccines, but in 2018, only 22% felt that vaccines are effective [1]

What happened in the Philippines between 2015 and 2018, that so badly shook people’s faith in vaccines?

It seems the main driver was a disastrous dengue vaccine trial for Dengvaxia, which was given to more than 800,000 school-children (although numbers from different media outlets vary – from 720,000 up to 830,000), from early 2016 through to early 2018 [2].

The program was then suspended, but not before more than 3000 children were hospitalized [3] – some for dengue fever. As of September 2018, at least 150 deaths had been reported among children who received the vaccine, but authorities declared that many of those were due to pneumonia, leukemia, asthma, central nervous system infections, and therefore ‘occurred naturally’ [4].

More than 190,000 of those vaccinations were given without parental consent [5].

The public confidence in vaccines was so severely shaken by the disaster, that routine vaccination rates in children fell to 50%-60% in 2018. Seventy-seven percent of schoolgirls had received the first shot of HPV vaccine, but only 8% of schoolgirls got the second shot.

A supplemental vaccine drive, to raise measles vaccination rates, saw health workers going from door to door, and many mothers hid their babies. As little as 36% of babies in metro Manila region received the vaccine. The Department of Health Undersecretary remarked that “health workers would spend up to 30 minutes trying to convince parents to have their children vaccinated” [6].

Health secretary Francisco Duque III declared “If needed, they (health workers) must woo the parents to allow the DOH to administer vaccines on their kids” [7].

Thailand

In some provinces in Southern Thailand, vaccination rates are below 50%, as Muslim believers refuse vaccinations. Islamic leaders addressed the issue, by saying that “though some vaccines contain ingredients derived from pigs, which are forbidden for Muslims, it was more important for a good Muslim to remain in good physical health at all times”.

“Therefore, until alternative vaccines that do not contain haram ingredients are invented, Muslims may use vaccines without having to worry that they are violating the Islamic doctrine” [8].

The messages of support from religious leaders are displayed on health authority websites, in an effort to quell concerns, and promote vaccination. Despite vaccination teams visiting schools and homes, some parents signed letters declaring they would not receive vaccines – now, or in the future [9].

India

In an effort to persuade reluctant villagers to have their children vaccinated for polio, the Indian government and UNICEF also use religious leaders to increase vaccine uptake. Islamic leaders give speeches before Friday prayer services, using quotes from the Koran, to encourage their people to accept vaccines. Newspaper columns are prepared and signed off by religious leaders. They also conduct radio question-and-answer sessions to reassure hesitant parents [10].

Vaccine hesitancy in remote areas is hardly surprising. As one religious leader put it: “For decades, the government machinery has not reached out to them; there are no proper roads, no drainage systems, no employment opportunities, no basic facilities – and suddenly a team of health officials arrive there to say we care for your children and therefore we want to vaccinate them [10].

Uganda

In 2016, the Ugandan government announced a new law that would punish non-compliant parents with six months jail time. Anybody found making “public misleading statements about vaccinations could face two years in prison or a fine, under the same law”. A Ugandan baby must have an ‘immunization card’ in order to have their birth registered, and obtain a birth certificate. That immunization card must be shown in order to enrol at school [11].

One religious group in Uganda, known as Njiri Nkalu, are vehemently opposed to vaccines, believing in divine protection, rather than man-made vaccines. In 2016, health workers, along with armed police, forcefully entered their homes and vaccinated some 200 children. Many of the parents and children tried to flee into nearby sugarcane fields, but were rounded up and vaccinated for polio. One member was heard to say: “We don’t see why you bring all these guns to harass us. Our children are protected by God and we don’t need polio vaccines” [12].

At least ten members of the group were detained by police, but later released without charge [13].

The officers also forcefully entered the homes of Tabliq Muslims who had refused vaccines for their children. The District Commissioner, who accompanied the officers, said “Although the operation was a success, there are those who were tipped off and disappeared into the bushes with their children. We shall come back to get them” [12].

Nigeria

In 2003, three states in Northern Nigeria boycotted the oral polio vaccine, due to the alleged discovery of contaminants, including trace amounts of estrogen. The boycott lasted for 15 months [14].

Today, many in the African nation still remain deeply suspicious about the true motive of aggressive vaccination programs. One group is the infamous Boko Haram (which translates to ‘Western education is forbidden’), who came to the world’s attention in 2014, when it was reported they had kidnapped 276 school-girls.

It is too dangerous for vaccinators to go into Boko Haram-held territory during national immunization days, but they do manage to get those who are leaving, or fleeing the area…” At the bus stations, and the state and national border crossings, the lunchbox-toting teams (the polio vaccines are packed into lunchboxes) are there. Peering into cars, lifting the cloaks of women perched on motorbikes to find the babies strapped to their fronts and backs. Squeezing in the little vials of vaccine.

“If they say no, then we tell them they can go back,” said superintendent of immigration, Charles Tashllani, imposing order on Nigeria’s border with Niger in Katsina. Here, late in the evening, the Polio Emergency Operations committee reviews the campaign’s first day, which has seen 3,661 teams immunise 28,882 underfives. The detail is such that eight missing marker pens are on the agenda, as is the sacking of two town announcers who did not inform people about the programme” [15].

But it’s not just extremists who have their doubts. Media reports over the years, reveal that hundreds of parents have been threatened with jail time and prosecution [16].

Pakistan

In 2015, more than 500 parents were arrested by police in Pakistan, for not allowing their children to have the polio vaccine. They could be released on bail, only if they signed an affidavit that they would allow their children to get the vaccine.

A UNICEF team leader in Pakistan explained that “First the workers (try to) convince them, then their supervisors, then senior members of the community”. If all that coercion and intimidation fails, and the parents still resist, then the police are called to arrest them” [17].

Earlier this year, a health worker was murdered, trying to persuade a man to let his children have the oral polio vaccine [18]. This comes amidst reports of an angry mob of parents setting fire to a hospital, after school-children were vaccinated, and 75 students later fell sick. Doctors denied the illness was due to vaccines, and suggested they probably felt sick due to their parent’s anxiety about vaccines [19].

China

In January, 2019, hundreds of parents in Jinhu, China, marched in the streets, demanding an explanation for the expired vaccines given to their children. More than 100 children had suffered fevers, skin rashes, and vomiting – some for months on end – since receiving the vaccines.

“Local authorities eventually found that an entire batch of vaccines was used instead of being destroyed”. Parents claimed the same kinds of reactions had been occurring for at least 10 years, and believe expired and faulty vaccines had been used for years.

Riot police from neighbouring counties were brought in to quench the protests, and authorities banned both regular and social media from reporting on ‘inflammatory’ news about vaccines [20].

It is just one, on a growing list, of vaccine scandals and controversies in China, with many parents declaring they have lost faith in China-made vaccines [21].

PS. All this info, and a whole lot more, can be found in my newly released book, which is available on Amazon.

References:

[1] Larson HJ, Hartigan-Go K, de Figueiredo A, Vaccine confidence plummets in the Philippines following dengue vaccine scare: why it matters to pandemic preparedness, Human Vaccines & Immunotherapeutics, 2018.

[2] Newey S, Trust in vaccines plummet following dengue scandal in Philippines, The Telegraph, 12th October 2018, https://www.telegraph.co.uk/news/0/trust-vaccines-plummet-following-dengue-scandal-philippines/. Accessed March 2019.

[3] DOH: Over 3000 students hospitalized after dengue shot, Rappler, 13th April 2018, https://www.rappler.com/nation/200187-doh-students-hospitalized-dengvaxia. Accessed March 2019.

[4] Tomacruz S, 19 out of 154 kids died of dengue despite Dengvaxia shot, Rappler, 26th September 2018, https://www.rappler.com/nation/212904-doh-report-number-children-dead-dengue-dengvaxia-shot-september-2018. Accessed March 2019.

[5] ABS-CBN News, Failon Ngayon: Dengvaxia, Available on youtube, https://www.youtube.com/watch?v=AQObs3vk3l0 (see at 5:39), Accessed March 2019.

[6] Tomacruz S, Parents still scared of govt’s free vaccines a year after Dengvaxia scare, Rappler, 27th September 2018, https://www.rappler.com/nation/212927-child-vaccination-rate-philippines-as-of-september-2018#cxrecs_s. Accessed March 2019]

[7] Cepeda M, Duque to health workers: ‘Woo’ parents to avail of vaccination programs, Rappler, 21st Febrary 2018, https://www.rappler.com/nation/196551-duque-health-workers-woo-parents-vaccination. Accessed March 2019.

[8] Rujivanarom P, ‘Vaccine Denial’ Behind Measles Deaths in the South, The Nation, Thailand Portal, http://www.nationmultimedia.com/detail/national/30356655. Accessed February, 2019.

[9] Vejpongsa J. Muslim concern about vaccine fuels Thai measles outbreak, AP News, 6th November, 2018.

[10] Pisharoty S. Interview: Muslim clerics to address misconceptions on ongoing measles-rubella vaccine drive, The Wire, 24th April, 2017.

[11] Global Press News Service, Anti-vaccine parents in Uganda face jail time under new law, The Seattle Globalist, 23rd August 2016.

[12] Yolisizira Y. 10 arrested over polio immunization, The Monitor, 3rd June 2016. As of 29th June, this article is still available online, at: https://www.monitor.co.ug/News/National/10-arrested-polio-immunisation/-/688334/3186268/-/view/printVersion/-/11q2sgd/-/%2523.

[13] Uganda 2016 International Religious Freedom Report, https://www.state.gov/documents/organization/268952.pdf Accessed March, 2019. (Note: This document has since been moved or removed from the State Department website, despite both the 2015 and 2017 reports still being available…)

[14] ABC News. Vaccine Boycott Grows in Northern Nigeria, 24th February, 2004.

[15] McVeigh T. Nigeria battles to beat polio and Boko Haram, The Guardian, 7th May 2017.

[16] Hundreds of Nigerian parents refuse polio vaccines, The Star, 2nd August 2011, https://www.thestar.com/news/world/2011/08/02/hundreds_of_nigerian_parents_refuse_polio_vaccines.html. Accessed March 2019.

[17] Saifi S, Botelho G. Over 500 Pakistani parents arrested for children’s failure to get polio vaccine, CNN, 4th March 2015.

[18] Farmer B. Polio worker gunned down in Pakistan trying to persuade family to vaccinate children, The Telegraph, 9th April 2019.

[19] Farooq Khan O. People set hospital afire in Peshawar, Times of India, 23rd April 2019.

[20] Police and parents clash in Jiangsu after 145 children get sick from expired vaccines, Asia News, 11th January 2019, http://www.asianews.it/news-en/Police-and-parents-clash-in-Jiangsu-after-145-children-get-sick-from-expired-vaccines-45954.html. Accessed March 2019.

[21] Leng S, Huang K. As new vaccine scandal grips China, parents say they have lost faith in the system, South China Morning Post, 22nd July, 2018.