My father never believed in vaccination. Consequently, none of his three sons were inoculated against childhood diseases and all survived those illnesses they contracted (in my case scarlet fever, against which there was no vaccine). Reading Nadja Durbach's book "Bodily Matters", which examines the Victorian anti-vaccination campaign, I now understand where some of his attitudes originated.
The book's qualitative research is marred only by Durbach's interpretation of history within the parameters of Michel Foucault's theory of biopolitics and socialist inspired notions of class and gender. Thus, while she provides excellent narrative, her conclusions under-estimate alternative explanations to those she prefers. Her main claim is that in Victorian times, "Parliament consistently introduced, local authorities enforced and the judicial system upheld legislation that focused on bodily issues..... (and) the British state became intimately involved in bodily matters as never before."
Durbach sees this trend as a matter of social and political control but tends to downplay the public health concerns underlying the decision to prevent the spread of contagious diseases which were more prevalent amongst the working classes. During the eighteenth century smallpox killed, on average, 40,000 Europeans each year and it was against this backdrop, ideas of universal progress and the rise of professional science (including medicine) that compulsion was introduced in 1853. The political nature of legislation is self evident but the rationale was not State control over the body but the principle of the common good.
Much of the thrust for compulsory vaccination came from the Utilitarian ideas of Jeremy Bentham that society should be conducted on the principle of "the greatest happiness of the greatest number". Bentham described rights as nonsense, absolute rights as nonsense on stilts and sought to make morals and politics exact sciences. When his acolyte, Edwin Chadwick, introduced public health reforms along utilitarian lines it raised fundamental questions about social values as a whole. Within two decades Chadwick was forced from public office by a combination of his own obduracy and widespread resentment of the utilitarian principle.
The Contagious Diseases Acts of the 1860's were introduced because of the incidence of venereal disease in the armed forces. Those favouring the Acts were convinced that regulation would reduce the disease for the benefit of the community, not just the armed forces. That the Acts discriminated against prostitutes while imposing no restriction on their clients was an example of misguided thinking, not the purposeful action of the bourgeoisie to control the working classes. Opposition to the Acts - as with opposition to compulsory vaccination - was based on the long established British tradition of liberty and dissent.
The introduction of compulsory vaccination followed a pattern in British politics which is familiar even today. The policy was introduced on a voluntary basis and enforced by unpaid servants of the State. When, predictably, it failed, compulsion was introduced without reference outside the decision making elite. When that provoked outrage the issue was referred to wider enquiry and consultation and legislation changed to obviate the most obvious excesses of practical application. This pattern is not confined to Victorian Britain it refers to most social legislation passed in the twentieth century.
Durbach reads too much into "gendered rhetoric that appealed to Victorian ideas of masculinity and feminity." Public discourse, whether populist or Parliamentary, is couched in language which is relevant to its audience, particularly in Britain which rejected Marxist theories in favour of political pragmatism. Durbach is at her weakest when trying to identify the anti-vaccination campaign in class terms and her suggestion that, "resistance to compulsory vaccination was clearly part of a much broader working-class political culture that critiqued the repressive policies of the Victorian state" lacks empirical conviction.
In 1896 a Royal Commission recommended the introduction of a conscience clause which formed part of the 1898 Vaccination Act. In typical British fashion it closed the door after the horse had bolted. Compulsion had met with widespread opposition by half the population and many of those who were supposed to enforce it. Similarly, in typical British fashion, some magistrates refused to grant certificates of exemption under the 1898 Act. Reform was completed with the Vaccination Act of 1907.
Durbach's outstanding narrative is undiminished by her representation of a "radical" perspective, exploring "the intersection of identities such as gender, race, class and sexuality with an eye to their political implications and complications". In fairness, she explained in correspondence her intention was to include such identities not to promote one particular reading. However, recent controversies over the MMR vaccine suggest the inclusive "radical" approach is self defeating. In all societies perception is reality and reality has a complexity which social theorists miss largely because of commitment to fashionable ideologies.
Times change and my children and grandchildren, unlike myself, were vaccinated against childhood diseases - all on a voluntary basis. This splendid book is worth every one of five stars awarded and will be added to my library.
on 14 July 2015
Excellent book, but I despair at some of the comments. After clean water vaccination is the greatest saver of lives we have in our health armoury. Anyone who fails to vaccinate their children is guilty of child abuse in my eyes. Those who are non-vaccinators enjoy the herd immunity provided by those willing to share a miniscule risk for the common good, and are free loaders. Their stance shows a woeful lack of understanding of the diseases being guarded against, a poor appreciation of risk management and disappointing citizenship.