Research uncovers historical anti-vaccination across Scotland
A Ph.D. student from the University of Dundee has uncovered new evidence showing how vaccine hesitancy—often thought to be a modern phenomenon—can be traced back more than 150 years in Scotland.
Vaccine hesitancy now ranks alongside antimicrobial resistance and climate change in the top 10 global health threats, according to the World Health Organization. A growing 'anti-vaxx' movement has led to a 30% increase in measles cases being reported globally and a number of countries, including the UK, no longer being considered measles-free.
Discredited studies, social media and celebrity skepticism have been blamed for falling take-up rates but the origins of vaccine hesitancy go back more than two centuries, according to Sylvia Valentine, a Ph.D. student within the University's School of Humanities.
The history of the English anti-vaccination movement—dating back to the medical establishment and clergy introduction's opposition to smallpox inoculation in 1721—has been well documented, but until recently it was largely assumed that there was no parallel campaign in Scotland.
"My work builds on that of other researchers and shows how opposition to compulsory vaccination was not confined to England," explained Sylvia. "Compulsory smallpox vaccination took effect in Scotland from 1864, with widespread anti-vaccination sentiment taking hold within a few decades.
"Myriad factors, including nationalism, vegetarianism, religious doctrine and the defense of civil liberties, helped galvanize the movement and bring anti vaccinators from disparate backgrounds together.
"While modern technology enables the ability to connect with a global audience and MMR is the main targets of the movement today, the aims, beliefs and objections of the 21st century anti-vaccinators share many parallels with their Victorian and Edwardian forebears."
The British Government introduced smallpox vaccination in England and Wales in 1840 in an effort to reduce infant mortality rates amongst the working classes and made infant vaccination compulsory from 1853 onwards. Compulsory vaccination in Scotland came into effect 11 years later.
The lobbying efforts of anti-vaccinators, coupled with the scale of non-compliance in England, eventually led to a Royal Commission into Vaccination being established. Its 1896 report failed to recommend repeal but a clause was introduced to enable exemption on the basis of conscience. The law did not extend to Scotland, however, and this differential treatment was met with widespread anger north of the border
"This omission acted as a call to arms for Scottish anti-vaccinators whose efforts had been haphazard up to that point," continued Sylvia. "The Scottish Anti-Vaccination League was formed in early 1896 to coordinate lobbying activities and provide legal advice and support to those prosecuted for non-vaccination."
Sylvia has uncovered reports of speaking tours by leading anti-vaccination campaigners that encouraged Scotsmen to challenge candidates for election to public office about their attitudes to compulsory vaccination. She has also examined newspaper accounts from 1896 onwards and found ample evidence of hustings where potential MPs of all parties were asked for their views on the issues, with local anti-vaccination societies making recommendations about which candidates to support.
People flocked to the cause from all walks of life and many 19th century anti-vaccinators were involved with spiritualist movements or alternative medicine. The fact that smallpox vaccine was made using cowpox lymph also meant that the Scottish Anti-Vaccination League found a ready-made audience amongst animal rights supporters.
"Many anti-vaccinators were vegetarians, supporters of the temperance movement or held non-conformist religious beliefs," continued Sylvia. "The Secretary of the Scottish Anti-Vaccination League was a vegetarian who deemed the use of calf lymph for vaccination unacceptable. It is notable that the Dundee Anti-Vaccination Society held meetings at the Vegetarian Café on the city's High Street in the late 1890s.
"Many people believed that public health measures and sanitary improvements would remove the miasma considered to be the source of disease. More natural methods of treatment for smallpox victims were preferred, particularly the water cure, which was offered at a number of hydropathic establishments across Scotland.
"Parents on both sides of the border strongly objected to being told by the government and local authorities how to raise their children. Many felt it was morally wrong to infect their children with this animal matter which, they sincerely believed, had the potential to cause lasting damage or the death of a beloved child.
"Religion also drove the movement. The Swedenborgian, or New, Church established churches in both England and Scotland, often located in anti-vaccination hot spots. Swedenborgians believed the purity of human blood should never be contaminated by animal matter and one minister, who spoke at a number of anti-vaccination meetings in Scotland, was prosecuted no less than four times for refusing to have his children vaccinated."
On March 26 1888, a Glaswegian joiner called Duncan McCorkindale wrote to the city's Evening Post newspaper to complain that it had not covered a recent court case that led to him being imprisoned.
While most people would welcome a lack of media interest in their brush with the law, McCorkindale wanted to raise awareness of his plight. After refusing to have his child vaccinated against smallpox, then a criminal offense, he had been fined 10 shillings and ordered to pay £1 legal costs. Lacking the means to do so, McCorkindale "had to go to prison, to be treated like a felon—no distinction being made between a respectable citizen and thieves and housebreakers."
McCorkindale explained that the death of one of his older children a few days after being inoculated was his motivation for refusal to comply with the 1863 Scottish Vaccination Act.
A few months before McCorkindale's imprisonment, another skeptical parent, Robert Barr, had been prosecuted for the same offense. Being a man of means, Barr avoided jail by paying the fine that McCorkindale was unable to afford and anti-vaccinators made great play of the fact that the law penalized ordinary working Scots who had no right to plead that vaccination was a matter of conscience.
By 1907, a further Parliamentary Act was required to clarify the legislation regarding conscientious objection. A bill was introduced which ensured the new act also applied in Scotland. Vaccination rates in Scotland plummeted from a high level of compliance of around 95% in the late 1860s to below 40% by 1918. Despite the London-based National Anti-Vaccination League (NAVL) continuing to campaign for total repeal, Scottish anti-vaccinators became less active with equality with the rest of Britain seemingly satisfying most Scots.