Section 1.1: A Century-Old Epidemic

In the early 1920s, the United States faced a significant diphtheria outbreak, with more than 200,000 children affected. Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, has become a rarity today, thanks to the introduction of effective antibiotics. In 2019, only two cases were documented in the U.S. due to the widespread availability of a safe and effective vaccine. The introduction of the diphtheria vaccine in the 1920s dramatically reduced the incidence of this disease.

While researching the history of diphtheria, I stumbled upon a compelling article published in the New England Journal of Medicine on September 15, 1921. Dr. Samuel B. Woodward expressed his thoughts on vaccination legislation. As I read his words, I found myself resonating with his observations—not solely because of the historical context but due to their relevance to today’s climate.

Dr. Woodward articulated a struggle familiar to us in contemporary times:

“But there are, here in Massachusetts, as well as in other parts of the country, a number of misguided individuals who, oblivious of the facts in the case, regardless of the history of epidemics, unconvinced and unconvincible by argument and blind to the best interests of themselves and their children, project, year after year, into the legislature, a bill to repeal the compulsory public school vaccination act, occasionally advocating in addition, the passage of other bills which, if enacted into law, would entirely prevent the use of smallpox vaccine throughout the Commonwealth.”

Even in 2022, similar anti-vaccine bills resurface annually in state legislatures. Fortunately, most of these proposals stall in committee and never reach a vote. Some do, only to be rejected by the discerning judgment of lawmakers. A few may even pass, only to face vetoes from thoughtful executives. Alarmingly, a handful might actually be enacted.

Section 1.2: The Persistence of Misinformation

Dr. Woodward elaborated on the challenges faced by advocates of vaccination:

“I am loath to assume that among the objectors to a procedure recognized and accepted by all civilized peoples, there are any who are influenced by other motives than those I have mentioned, but so much apparently manufactured evidence and so many erroneous statements of actual fact came to my attention during the three years I, as Chairman of the Committee on State and National Legislation of the Massachusetts Medical Society, was on the firing line, that it was often difficult to avoid an attack upon motives, instead of confining oneself to the legitimate task of making clear to legislators the value of vaccination per se. Nevertheless and notwithstanding, I am fully convinced that real fear of results, combined with an equally real ignorance of what smallpox means (for few, if any, of these people ever saw a case), warps the judgment of the majority, causes them to accept unconfirmed statements, and is the compelling force which yearly drives them forward in their efforts (so far, thank Heaven, ineffectual) to break down our vaccination laws.”

Here, Dr. Woodward captures a truth that resonates today: the overwhelming influence of misinformation. Numerous false claims about vaccines circulate widely, particularly during the recent debates surrounding COVID-19. Claims that these vaccines alter DNA, induce magnetism, or cause death are unfounded.

A particularly striking anecdote from Dr. Woodward's experience was this:

“An experience of some fourteen years with legislators and legislative committees, while serving on one of the unpaid boards of that State, had, I thought, prepared me for almost anything, but when the leader of the antivaccinationists in the House, in response to the inquiry, “Now, do you mean to tell me you do not believe in vaccination?” answered, “Sure, I do. I am vaccinated, my wife is vaccinated, and all my children are vaccinated. How often ought one to be vaccinated to be protected?” I almost fell down the steps of the State House, on which we were standing. “For goodness sake,” said I, “if you feel that way, why in the name of all that is wonderful, do you act as you do about this legislation?” “Why,” said he, as seriously as if there were nothing unusual or peculiar about it, “I have, down in Spring Brook, a lot of constituents who do not wish school vaccination and I cannot get elected unless I agree to oppose it.” What effect would argument or statistics have on a fellow like that, ready to barter the health of the community for his own petty ambition?”

This scenario remains common in today's political landscape, where some politicians openly declare their own vaccination status but simultaneously propagate anti-vaccine rhetoric. Often, this contradiction arises from pressure exerted by specific groups within their voter base, even if these groups are in the minority.