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Week 22: Public Health – Liberty vs Compulsion

Lecturer: Gareth Millward

This seminar examines one of the key tensions in public health – how can states get their citizens to engage in “healthy” behaviours without violating their fundamental rights? It does so by looking at the case study of smallpox. While vaccination and public health measures played a key role in eradicating the disease, national and international organisations experienced significant resistance from certain populations.


Discussion/Essay Questions

1. Why did nation states encounter resistance to their vaccination policies in the nineteenth century?
2. Were Western attempts to control and eradicate smallpox in India justified?
3. “Should Childhood Vaccination Be Mandatory?” How can the history of smallpox vaccination inform this debate?


Required Readings

Roberta Bivins, ‘“The People Have No More Love Left for the Commonwealth”: Media, Migration and Identity in the 1961–62 British Smallpox Outbreak’, Immigrants & Minorities 25(3) (2007): 263–89.

Larry Brilliant, WHO smallpox eradication worker in 1970s India speaking to Sanjoy Bhattacharya at the University of York (2009). [Option 10 here: https://www.york.ac.uk/history/research/majorprojects/smallpox-eradication/audio/brilliant/]

Colgrove, James. ‘The McKeown Thesis: A Historical Controversy and Its Enduring Influence’, American Journal of Public Health 92(5) (2002): 725–29.

Frank Fenner et al., Smallpox and Its Eradication (1988), Chapter 6 (pp. 245-276). [Available in full on-line from publisher - http://apps.who.int/iris/handle/10665/39485]

Offit, Paul A. ‘Should Childhood Vaccination Be Mandatory? Yes’. British Medical Journal 344 (2012): e2434.

David M. Salisbury ‘Should Childhood Vaccination Be Mandatory? No’. British Medical Journal 344 (2012): e2435.


Further Readings

David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (1993), esp. pp. 116-158.

Michael Bennett, ‘Jenner’s Ladies: Women and Vaccination against Smallpox in Early Nineteenth-Century Britain’, History 93(312) (2008): 497–513.

P. Bradley, ‘Should Childhood Immunisation Be Compulsory?’ Journal of Medical Ethics 25(4) (1999): 330–34.

Anne Hardy, The Epidemic Streets: Infectious Disease and the Rise of Preventive Medicine, 1856-1900 (1993)

Heidi Larson et al., ‘Understanding Vaccine Hesitancy around Vaccines and Vaccination from a Global Perspective: A Systematic Review of Published Literature, 2007-2012’, Vaccine 32(19) (2014): 2150–59.

Virginia Berridge, Martin Gorsky and Alex Mold. Public Health in History (2011).

James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-century America (2006).

Nadja Durbach, Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907 (2005).

James G. Hanley, ‘The Public’s Reaction to Public Health: Petitions Submitted to Parliament, 1847–1848’, Social History of Medicine 15(3) (2002): 393–411.

Dorothy Porter and Roy Porter, ‘The Politics of Prevention: Anti-Vaccinationism and Public Health in Nineteenth-Century England’, Medical History 32(3) (1988): 231–52.

Bob H. Reinhardt, The End of a Global Pox: America and the Eradication of Smallpox in the Cold War Era (2015).