Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907.

Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907. By Nadja Durbach (Durham: Duke University Press, 2005. 296 pp. $22.95PB).

I have recently been exposed to quite a number of explanations about how vaccines contribute to asthma, allergies, and auto-immune problems and that's just the list of "a"s. If I were to go through the full alphabet of diseases that vaccinations allegedly caused, one would wonder why we are still alive as a species since vaccines are so dangerous. Having read Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907, I am struck by the consistency of attitudes over time despite the lack of historical awareness amongst the speakers. For this bizarre sense of consonance alone, I am grateful to Nadja Durbach.

Durbach's history of anti-vaccination in Britain begins with a brief discussion of the development of inoculation and vaccination. According the Durbach, vaccination was the medicine of the physician and Parliament while "alternative medicine was physic for the people." (p. 31) The Compulsory Vaccination Act (1853) forced the physician's style of medicine on the people's bodies by mandating vaccination, creating public vaccinators, and linking vaccination with the Poor Law. The legislation also spawned the Anti-Vaccination League which remained organized until it won concessions from the British government in the early twentieth century. It is this organization that forms the centerpost of Durbach's book. Durbach wants to rescue its members and their beliefs from obscurity and demonstrate the ways that one of the great progress narratives--the eradication of smallpox--conflicts with another great progress narrative--the triumph of individual liberty.

In one sense, Durbach has set herself a hard course: the eradication of small pox has been one of medicine's successes and anti-vaccinators have been looked at as cranks and crackpots. In another sense, Durbach's course is made easier by the vaccination's very success. Now that smallpox no longer endangers the public health, it is far easier to see anti-vaccinators as bravely taking on the state. By making anti-vaccinators into heroes, Durbach has created a book that I both admire and fear.

Durbach's book is admirable because she so clearly demonstrates the importance of the anti-vaccination movement. While many have run across anti-vaccination rhetoric, few could have taken it up as a topic of a book and few would have done so compellingly. Durbach is a strong historian who puts together a well-written, well-argued story that rests on compelling evidence. She makes use of many types of analysis from a close examination of the class issues around organizing, to the medical models used in vaccination versus anti-vaccination, to the cultural associations with bloodletting. In doing so, Durbach tries to capture the movement from all angles.

While that movement might have been headed by middle-class "vegetarians, homoeopaths, Matteists" (p. 42), the majority of members were working-class parents who withstood real penalties for their refusal to comply with state-mandated vaccination. As Durbach explains, vaccination not only became allied with the much hated Poor Law reforms but was also viewed by workers as an incursion into the integrity of the body in ways that could compromise health. Parents refused to vaccinate their babies because they thought it might kill them. For parents who refused to vaccinate, punishment included heavy fines and prison sentences--neither of which workers could afford. If workers did not have enough money to pay the fines, the state authorized the auction of their belongings. Opposing vaccination could literally beggar a family. With that in mind, to oppose vaccination was to risk the very family that workers were trying to save.

Anti-vaccination activists forced the state to show its coercive powers and used the strategies of rallies, parades, and public speeches. They also made courtrooms and auctions into dramas of the people versus the state, particularly at the public sales of anti-vaccinator's belongings. The organization of the anti-vaccination movement allowed workers to push back against the state successfully. As a result the state developed the status of conscientious objector for anti-vaccinators that later applied to anti-war objectors. While the Anti-Vaccination League lived on, it lost its solid working-class base and thus no longer carried great influence.

As Durbach makes clear, the anti-vaccination movement had a much wider sense of public health than the vaccinators, one that embraced clean air, sanitary measures, and most importantly living wages. Living wages would allow for good food, good accommodations, isolation if necessary, and sanitation certainly. It is this sense of a broad obligation that separates today's anti-vaccination movements from earlier ones. Early anti-vaccinators pitted an expansive sense of public health that might well have insisted on even greater incursions into the public realm than the state was willing to take. In contrast, current anti-vaccinators believe in individual choice alone is more important than the public good.

And this is why I fear her book. Durbach has the admirable goal of telling a story of a fringe group that took on the state and won; however, it is also the story of fighting vaccination, and Durbach refuses to acknowledge any legitimate public health interests in forced vaccination. Currently, further polio vaccinations could mean the end of polio as a living disease, but fear of vaccination and loss of will have allowed polio to have a resurgence in Africa and India. Whooping cough was on the wane in America until distrust of the vaccine encouraged middle-class families to avoid vaccination; now the disease threatens the elderly, infants, and the infirm. If it is social history's self-appointed task to rescue the diversity of voices from the past, that does not mean we have to glamorize everything people have said.

Each time I listen to very good reasons not to vaccinate, and each time people decry their responsibility for the spread of whooping cough and rubella, and each time I read about the history of the anti-vaccination movement, I wonder whether some signposting might be just a bit necessary--brave and foolish people inside; consort with at your own risk.

Lisa Z. Sigel

DePaul University