My dissertation explores the historical context of controversy about vaccination behind Jacobson v. Massachusetts (1905), a landmark U.S. Supreme Court decision upholding state police power to compel vaccination.; Despite enthusiastic support for vaccination among leading physicians and public health officers, the persistence of smallpox epidemics during the nineteenth century indicates that Americans did not vaccinate sufficiently. Data from Massachusetts show that many people viewed vaccination with suspicion and only reluctantly accepted it as a necessary evil forced upon them by their employers or the law. Parents waited until their children reached school age and rarely sought second vaccinations for them at adolescence. Even during epidemics, a significant portion of the population avoided vaccination.; Many Americans feared vaccination for good reasons. It induced mild to severe discomfort and occasionally led to severe, even fatal infections. Lymph came from a variety of sources, with no assurance as to either quality or safety. Bovine lymph, adopted in the 1870s to obviate the possibility of syphilis transmission through vaccination, was easily contaminated with disease-causing organisms if producers and distributors got careless.; Controversy over vaccination created public anxiety during the 1901-02 smallpox epidemic in Boston and Cambridge that formed the context for Jacobson. Although most residents submitted to vaccination, many did so grudgingly and enough avoided it to force both cities to order compulsory vaccination for everyone. A few individuals defied the order and antivaccinationists organized to support their resistance and oppose the law. Neither anti-scientific nor anti-government cranks, these antivaccinationists, like their nineteenth-century predecessors, pointed out inconsistencies in the medical science behind vaccination and questioned evidence used to promote it. They believed vaccination too dangerous to compel upon the unwilling. Even though they lost their case, their arguments dampened public acceptance of vaccination so much that few states passed similar compulsory vaccination laws in the wake of Jacobson.
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