3 - Compulsory Vaccination and Divisions among Practitioners

Summary

The 1853 Vaccination Act, which introduced compulsory vaccination to England and Wales, is often seen as the most important single piece of legislation in the control of smallpox in Britain. Both Anthony Wohl and Dorothy Porter stress the wider significance of the act in introducing the general population to state medicine and in heralding other compulsory health measures. Historians and demographers suggest that the 1853 act produced a significant, long-term increase in infant vaccination and point to it as a milestone in the decline of smallpox mortality. However, close examination of the 1853 Vaccination Act shows that although it was radical in subjecting the population to compulsory vaccination, it was less significant than these studies have suggested. The measure did not alter the provision of vaccination, maintaining the system set up in 1840. The new system of recording vaccination was cobbled together from existing agencies and actors—public vaccinators, poor law guardians, and registrars of births, marriages, and deaths. In its operation, the act was a damp squib, producing little increase in overall levels of vaccination. As parents realized that the machinery of compulsion was wholly ineffective, the initial rush to have children vaccinated evaporated.

However the passage of the 1853 act reveals a good deal about the views of medical practitioners on public vaccination and state medicine. The bill reopened the tension between parliament—which wanted accountable administration—and a large body of medical practitioners who wanted a role in running public health.