The Class Politics of Vaccination
he belief that public-health measures are not intended for people like us is widely held by people like me. Public health, we assume, is for people with less — less education, less healthy habits, less access to quality health care, less time and money. I’ve heard mothers of my class suggest, for instance, that the standard childhood vaccination schedule groups together multiple shots because poor mothers can’t visit the doctor frequently enough to get the twenty-six recommended shots separately. (No matter that many mothers, myself included, might find so many visits daunting.) That, we seem to be saying of the standard schedule, is for people like them.
When the last nationwide smallpox epidemic began in 1898, some people believed that whites were not susceptible to the disease. It was called “nigger itch” or, where it was associated with immigrants, “Italian itch” or “Mexican bump.” When smallpox broke out in New York City, police officers were sent to help enforce the vaccination of Italian and Irish immigrants in the tenements. And when smallpox arrived in Middlesboro, Kentucky, everyone in the black section of town who resisted immunization was vaccinated at gunpoint. These campaigns did limit the spread of the disease, but most of the risk of vaccination, which at that time could lead to infection with other diseases, was absorbed by the most vulnerable. The poor were forced into the service of the privileged.
Debates over vaccination, then as now, were often cast as debates over the integrity of science, though they could just as easily be understood as conversations about power. The working-class people who resisted England’s 1853 provision of free, mandatory vaccination were concerned, in part, for their own liberty. Faced with fines, imprisonment, and the seizure of their property if they did not vaccinate their infants, they sometimes compared their predicament to slavery. In her history of that antivaccination movement, Nadja Durbach returns often to the idea that the resisters saw their bodies “not as potentially contagious and thus dangerous to the social body, but as highly vulnerable to contamination and violation.” Their bodies were, of course, both vulnerable and contagious. But in a time and place where the bodies of the poor were seen as a source of disease, as dangerous to