At the turn of the 20th century, the United States was in the throes of a full-blown smallpox epidemic. During the five-year epidemic from 1899 to 1904, government health officials confirmed 164,283 cases of smallpox, but the actual numbers may have been five times higher.
To slow the spread of the highly infectious and often fatal virus, there has been national pressure for smallpox vaccination. In cities and states with the worst epidemics, vaccination was compulsory and official vaccination certificates were required to go to work, attend public school, take the train, or even go to the theater.
Mandatory vaccination orders angered many Americans who formed anti-vaccination leagues to defend their personal freedoms. In an attempt to dodge public health officials, who went door-to-door (often with a police escort) to enforce vaccination laws, some anti-vaccination activists forged vaccination certificates. Unable to say whether the certificates were legitimate, health officials relied on physical evidence: they demanded to see a vaccination scar.
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Smallpox vaccination was a brutal affair
Following a technique first developed by Edward Jenner in the late 18th century, vaccination against smallpox in 1900 meant scoring the skin of the upper arm with a lancet or knife, then swabbing the wound with a live virus. Vaccine makers in 1900 still got their virus from oozing wounds of cowpox on the undersides of calves.
“The recipient of the vaccine would start to feel pretty sick, usually with a fever and a very sore arm,” says Michael Willrich, professor of history at Brandeis University and author of Pox: an American story. “The vaccination site would become more and more irritated, a scab would form, fall off, and what was left was a small scar about the size of a nickel. And this is how you would know that the vaccination took place.
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False and falsified vaccine certificates
Partly because the vaccination process was so brutal, and partly because anti-vaccination crusaders exaggerated the risk of getting tetanus or syphilis from the vaccine, many people tried to avoid vaccination by any means possible. required. The most common tactic was to buy a fake vaccination certificate.
Even in 1904, an article by The New York Times titled “Vaccination Certificate Fraud” reports “heavy traffic in certificates without sufficient vaccination value from doctors in the East,” perpetrating a “small swindle on the poor, the ignorant and the gullible.”
With all public schools requiring proof of vaccination, the anti-vaccination leagues circulated the names of doctors who would sign a piece of paper saying a child was medically “unfit” for vaccination. If the parents did not want to pay the doctor, they falsified the medical certificate themselves.
The scar as a “ passport ”
In crowded neighborhoods in cities like New York and Boston, where smallpox has spread at lethal speed, health officials have enlisted police to help enforce vaccination orders, sometimes physically restraining uncooperative citizens. . Frustrated by widespread resistance to vaccination, these vaccination teams began to ignore certificates altogether and go straight to the source.
“Because the certificates could be so easily forged, they would insist on seeing the scar from the vaccine,” Willrich says. “Vaccine scars easily served as a certification fitness.”
In 1901, respected physician Dr James Hyde of Rush Medical College in Chicago wrote an editorial urging public health officials to do everything in their power to eradicate smallpox and proposed using the vaccination scar it – even as the only entry ticket or “passport” for citizens. life in America.
“Vaccination must be the seal on the entrance passport of public schools, of the voting booth, of the jury’s lodge, and at every post of duty, privilege, profit or honor in the state gift or of the Nation, ”Hyde wrote.
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The end of smallpox
In schools, factories and government corridors, as well as on immigrant ships arriving at US ports of entry, those who could not produce a “fresh” vaccine scar – signaling inoculation during over the past five years – would be vaccinated on site. .
In 1903, the state of Maine issued an executive order that “no one may enter employment or work in a logging camp who cannot show a good vaccination scar.” That same year, industrialist Henry Clay Frick ordered all employees at his Pittsburgh-area steel plant and their families to show a scar or get vaccinated.
“This order would have affected 300,000 people,” says Willrich. “It’s pretty important for one business.”
As recently as 1921, when Kansas City suffered from a smallpox epidemic, a local newspaper reported that “‘Show a scar’ was officially adopted as the password for lodges and other meetings.”
However, anti-vaccination sentiments never fully dissipated, and some Americans even began to carve their vaccination scars. They did this by painfully exposing a patch of skin to nitric acid to produce the same scab and scar the size of nickel.
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