A detailed examination of the political forces and events that shaped
smallpox vaccination policy in England, Wales, Ireland, and Scotland
during the nineteenth century.
The introduction of public vaccination was among the greatest of public
health triumphs. By the end of the nineteenth century, legislation
framed and implemented by medical experts in Britain's government
brought smallpox under control for the first time.
The Politics of Vaccination: Practice and Policy in England, Wales,
Ireland, and Scotland, 1800-1874, by historian Deborah Brunton, reveals
the conflict that accompanied this success, and highlights how power
differentials among government officials, medical experts, and general
practitioners influenced vaccination policy across Great Britain.
Brunton challenges the assumption that expert supervision was crucial,
showing instead that local organization was pivotal to successful public
vaccination.
Throughout Britain, ordinary practitioners -- eager to enhance their
professional status -- demanded the right to shape and supervise public
vaccination. But their achievement depended on wider political
considerations, and varied from country to country. In England and
Wales, for instance, practitioners were defeated by a new band of
medical experts who had established apower base within government. In
Scotland, medical professionals contrived to keep most vaccination
within the private sector, but local enthusiasm ensured very high levels
of participation. Public vaccination was most successfulin Ireland,
where practitioners had limited influence over dispensary provision and
smallpox was nearly eradicated, if briefly, in the 1860s.
In The Politics of Vaccination, Brunton demonstrates that public
vaccination was not simply a medical matter: it was a divisive political
issue, with outcomes strongly influenced by competing partisan
interests.
Deborah Brunton is senior lecturer in History of Medicine at the Open
University.
