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A 1901 smallpox epidemic, a charismatic quack, and the rise of anti-vaxx propaganda in Boston were the catalysts for the antivax movement

A 1901 smallpox epidemic, a charismatic quack, and the rise of anti-vaxx propaganda in Boston were the catalysts for the antivax movement

THE SPECKLED MONSTER had returned to Boston.

Dr. Samuel Durgin remembered its last visit well. In 1873, when smallpox ravaged the city and killed more than 1,000 of its inhabitants, he had just been appointed to the Boston Board of Health. Ohne a thorough vaccination campaign, the death toll would have been higher. But it was May 1901, more than a quarter century later, and smallpox was back in full swing.

Durgin had good reason to be concerned. In the months ahead, an estimated 3 people out of every 1,000 in the city of half a million would contract the disease, and nearly 1 in 5 Bostonians who contracted it would die from it. The chances of contracting the disease were even greater for the citys Black residents and immigrant families, many of whom lived in densely packed rooming apartments where the airborne illness spread quickly through coughs and sneezes.

Robert E. Lee and his army surrendered at Appomattox Court House on September 6. Durgin, a 61-year-old Civil War veteran, had been present at the courthouse when he arrived. To combat the spread of smallpox, the health board chairman deployed his forces like a military commander and used his most powerful weapons smallpear vaccines.

Durgin set out to combat the smallpox epidemic with free vaccinations at locations around the city in the fall of 1901. Hunderte of doctors went door-to-door under a state law of 1855 that gave local health boards the power to require people to be inoculated. Anyone who refused could face a 15-day prison sentence or $5 fine, which is roughly $160 today. Durgin was never shy about using heavy-handed tactics. He dispatched virus squads to rooming houses, where police officers tied down occupants so physicians could administer vaccines. One man received his vaccinations, as well as stitches for a head wound left by clerical club.

Even as his all-out campaign began to show results, Durgin believed that some of his fellow Bostonians were traitors to the cause. That antagonism would result in one of the nations earliest vaccine fights.

Dr. Zabdiel Boylston and preacher Cotton Mather, who first learned of the procedure from a West African man named Onesimus whom he enslaved, had resisted smallpox vaccinations since they were first introduced in Boston in 1721. Even with a solid majority of Bostonians in 1901, opposition to the government's policies remained fierce.

Anti-vaccination activists in Boston responded to mandatory vaccinations with a brochure titled Vaccination Is the Curse of Childhood. It falsely claimed that the vaccines caused smallpox rather than preventing it, and maintained that good drainage, good ventilation, pure water, healthy food, as well as pure drinking water, which it claimed was the only effective method to prevent infection. Anti-vaccinationists, as they were often referred to, deemed compulsory vaccination a violation of their civil rights. Parents should write to a Beacon Street address to obtain physician-signed certificates that state children were unfit subjects for vaccination and should be exempt from the state requirement to show proof of vaccination to attend public school, they added.

By January 1902, more than 80% of the city's 586,000 residents had been vaccinated, but that didn't appear to be enough to achieve herd immunity. Durgin grew frustrated by the tens of thousands of unvaccinated Bostonians who allowed the epidemic to persist. The number of cases in Massachusetts had risen from about 100 in 1900 to 773 in 1901, with 97 deaths. The new year posed the threat of even greater uncertainty.

The smallpox epidemic had grown into a epidemic of the unvaccinated, with the vaccinate missing 9 out of every 10 cases in Bostons so-called pesthouses. Durgin told The Boston Post, I have no patience with those who claim vaccination is useless and harmful. I wish the smallpox would come into their ranks, rather than just among innocent people, he said.

Durgin made a surprise decision: He would call their collective bluff with shrewd dare to willingly expose themselves to smallpox.

If there are among the adult and leading members of the antivaccinationists any who would like an opportunity to demonstrate to the people their sincerity in what they profess, he said in The Boston Globe. I will arrange by which that belief may be tested by exposure to smallpox without vaccination.

Durgin stated, I do not believe there is a man or woman among them who will volunteer to suffer from smallpox. He couldnt have imagined that anyone would take him up on his offer. Dr. Immanuel Pfeiffer, on the other hand, wasnt an option for him.

The citys stodgiest anti-vaccination voice had a healthy ego. Pfeiffers practice was advertised in newspapers as having a natural healing power and innate magnetism, making him the most wonderful man in the world. He bragged of his ability to treat chronic diseases considered incurable by regular physicians by the simple application of hands at his offices at the Hotel Pelham at Tremont and Boylston streets. A shameless self-promoter with a luxurious beard and lush head of hair, he praised his capacity to help general doctors diagnose chronic illnesses by laying on his hands.

A Danish immigrant, Pfeiffer believed proper diet, exercise, and hygiene were the only effective means of preventing disease. He claimed no drugs nor prayer did a sick man any good. He was also a strong advocate of hypnosis, which stated in the minds quasi-monopoly over all organ functions. His mental ability to digest, he added, allowed him to endure a 21-day fast and survive on an occasional sip of water.

Our Home Rights, his 48-page monthly magazine, was as diverse as the editor himself. It featured advertisements from magnetic healers and psychics, as well as regular columns on astrology and womens rights, and on the evils of saloons and eating meat, along with the United States tax code, among other things. Pfeiffer saved his strongest opinions by railing against the smallpox vaccine, even though he backed down. He described compulsory vaccinations as a civil liberties violation and stated that smallpox was not as contagious or debilitating as health officials claimed.

The pages of Our Home Rights reeked of misinformation about the vaccine. Not only did Pfeiffer claim that it did not offer any protection, but he also stated that vaccination was more dangerous than smallpox itself, which drew attention to poor hygiene and intemperate habits. He claimed that cow milkers' syphilitic hands were the origin of the vaccine material and that doctors were only vaccineing patients to enrich themselves. He told wistful tales of Bostonans who suffered serious illness after receiving the vaccination, including a 2-year-old who died from septic abscesses on her shoulder and oblivious young store worker whose arm had to be amputated.

When Durgin gave his dare to the anti-vaccinationists, the world-renowned agitator seized. Pfeiffer had received a smallpox vaccination as an infant more than 60 years earlier, but it had long since lost its effectiveness and offered little protection. Still, he approached the Board of Health chairman to ask for permission to inspect the smallpox hospital on Gallops Island in Boston Harbor, so a diagnosis could be made faster.

Durgin didn't need much help to make a one-time exception to the island hospital's requirement that every visitor be immunized. Durgin told Pfeiffer that despite not knowing you were recently vaccinated, I promise to keep my promise.

On January 23, 1902, the quarantine steamer Vigilant cut its way through the icy chop as it carried Pfeiffer 6 miles out into Boston Harbor to Gallops Island. More than 100 smallpox sufferers bundled up from chills, sweated from fevers and sought any relief from the oozing red spots that surrounded their skin, eyelids undined, and mouths inside the hospital. As he visited the hospital, the unvaccinated doctor came into close contact with the infected patients, even stopping to inhale the breath of the sickest among them.

After returning to the city, Pfeiffer boarded a crowded elevated train and attended supper at Tremont Temple, where he boastes of holding in friends faces ox-infected handkerchief which I used freely while in contact with the smallpouch cases. Durgin, on the other hand, was also mistaken for Durbin. While acting with the brazen disregard of someone who believes himself immune to the contagious disease, Pfeiffer believed it was Durgins, not him, who had just fallen into a trap.

Dr. Durgin is either a fool or knave, wrote Pfeiffer shortly after his hospital visit in Our Home Rights. He has criminally remunerated me for allowing me to do what I did, and if he does not believe in vaccination, a criminal liability in enforcing the Compulsory Vaccination Act.

Durgin, on the other hand, had placed Pfeiffer under daily surveillance by Board of Health officers. 11 days after Pfeiffers island visit and right at the end of the incubation period for smallpox -- the spotlight-seeking doctor vanished.

Prior to becoming a super-spreader, Health officials launched remanhunts to track down Pfeiffer. While the doctors office staff insisted that he was in Philadelphia or maybe it was New York a witness in spotting him sneaking into oblivion in an apartment building in Charlestown pointed out that the physician was located in New Jersey. Investigators determined that an ill Pfeiffer had visited a doctor on the night of Thursday, February 6, then hired sled to transport him to his familys sprawling Colonial farmhouse in Bedford.

When public health officials invaded the 60-acre farm, Pfeiffers son tried to keep them at bay. The authorities, however, escorted Pfeiffer down the stairs and found him covered in smallpox pustules and too ill to say more than a few words. The doctor had become the patient. The next day, a newspaper headline read: Pfeiffer Has Smallpox. An Anti-Vaccinationist May Not Live.

Health officials deployed three guards outside the farmhouse, quarantined Pfeiffers entire family, and, except for the doctor, vaccination them against their initial wishes. Even the farms cows and chickens were forced to socially distance themselves from humans for five weeks.

Pfeiffer's actions were condemned by the public and medical press. The Boston Herald called him the victim of his own folly and professional vanity, while the Philadelphia Medical Journal called his illness poetic justice. Even anti-vaccinationists jumped to the defense. Pfeiffer was a first class idiot in doing what he did, said one.

The doctors Bedford neighbors didnt have a much higher opinion of him either, since his daughters had continued to attend school and, for two days, neighbors had purchased milk from Pfeiffer's farm while the smallpox patient was secretly in their midst. Bedford considered suing the City of Boston for allowing the disease to be introduced into their town at one time. Sympathy for him is entirely lacking in the community, and the epithets applied to him are neither mild nor elegant, according to the Globe, "one of the least suggestive being that he is an old chump. "

As Boston health officials identified and disinfected every place Pfeiffer may have visited while contagious and inoculated anyone he may possess been exposed to the disease, the citys vaccination efforts received a new boost. Karen L. Walloch's 2015 book The Antivaccine Heresy argues that Samuel Durgin would not have received better publicity for the value of vaccination if he'd written it himself.

130 Board of Health doctors retreated to the dense North and West ends of Boston and vaccinated an additional 12,000 people the day after Pfeiffers death made headlines. The Boston Post reported they received with but little objection and that Dr. Pfeiffers case has really assisted their cause. The Board of Health officials dismissed any holdouts by asking, Did you read about the man who wouldnt get vaccinated and who is now dying of smallpox?

Durgin received his share of criticism for putting public health at risk, but he did not regret his decision. I do think it was right and for the greatest number of people, he said, no doubt because if questioned, a public health lesson had been learned from the anti-vaccinationists. Pfeiffer would surprise him once again, though.

PFEIFFER SURVIVED his bout of smallpox, as did his crusade. After five weeks of quarantine, the doctor emerged and declared himself as strongly opposed as ever to vaccination. In fact, he continued to question the importance of vaccines, since none of the other family members isolating alongside him contracted smallpox before they were vaccinated. When he returned to our Home Rights, a neighbor who became sick after they ran to get their shots based on what had happened to him.

Pfeiffer also claimed that his own case was not too serious, which he baldly presented as proof that public health officials overestimated the diseases severity. I laughed and told jokes and played games most of the time, and the small-pox epidemic, as awful as it is, never caused me pain for one minute, he boasted. He claimed that he contracted smallpox because a lack of sleep and not because of being unvaccinated.

Pfeiffers misinformation campaign would have immediate consequences. Henning Jacobson, a Harvard Board of Health member who was all over the papers, was spotted by Cambridge Board officials walking into his house around the time he was in the newspapers. When the pastor refused to be inoculated, he was fined $5. Jacobson sued the state in a case that made it to the US Supreme Court. In a landmark 1905 decision, the court upheld compulsory vaccination for the public good.

Durgins vaccination efforts ultimately paid off, though he and other frustrated health officials lamented that anti-vaccination activists had shortened the duration of smallpox treatment. In 1903, after 1,596 infections and 270 deaths, the disease finally vanished from the city. The citys last case was diagnosed in 1932. In 1980, the deadly strain of smallpox was finally eradicated thanks to a worldwide vaccination campaign.

Anti-vaccination propaganda, on the other hand, was here to stay. Anti-vaccination groups opposed a state mandate in 1926 that required vaccination for private school students. The Massachusetts Board of Health had warned about the holding power of their dangerous message years earlier, at the end of the Pfeiffer scandal. The board reported in 1903 that Boston was practically a hot-bed of the anti-vaccine heresy. While the vaccine house is built on a rock and is unlikely to collapse, the loud storm has dragged many of our people into ill-preparedness or opposition to vaccination.

Christopher Klein is the author of When the Irish Invaded Canada: The Incredible True Story of the Civil War Veterans Who Fought for Irelands Freedom. Follow him on Twitter @historyauthor to learn more about him. Send comments to magazine@globe.com.

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