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American History Hotline
The Surprising History of Vaccines in America with Kathryn Olivarius
00:35:05
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- [00:00]
Kathryn Oliverius
This is quite disgusting. I hope Everyone likes to listen to disgusting things. You take a pustule of somebody with smallpox that's pussing, you dry it, you will. You put into a mortar and pestle and basically sort of grind it down and then you snort it, or you put that into your arm, or you put a fresh pus into your arm, basically.
- [00:19]
Bob Crawford
So how did they figure this out?
- [00:22]
Kathryn Oliverius
Trial and error, I suppose.
- [00:27]
Bob Crawford
You've reached American History Hotline. You ask the questions, we get the answers. Leave a message.
- [00:36]
Sophie Cunningham
This is Sophie Cunningham from Show Me Something. Do you know the symptoms of moderate to severe obstructive sleep apnea, or OSA in adults with obesity? They may be happening to you without you knowing. If anyone has ever said you snored loudly, or if you spend your days fighting off excessive tiredness, irritability and concentration issues, it may be due to osa. OSA is a serious condition where your airway partially or completely collapses during sleep, which may cause breathing interruptions and oxygen deprivation. Learn more at don't sleep on osa.com. this information is provided by Lilly a medicine company.
- [01:14]
Danielle Robay
This is Danielle Robay from bookmarked by Reese's Book Club. One thing I love about reading is that books take us to places that feel real. And on TikTok, that feeling is multiplied by millions. And it's where readers fall in love with new worlds, discuss plot twists, and share books that make them laugh, cry, or heal. On TikTok, stories become conversations and conversations turn into community, all in a place that's welcoming and inclusive every day. TikTok's community isn't just celebrating stories, it's shaping them, driving new trends and inspiring readers everywhere.
- [01:48]
Ryan Seacrest
Limu Cable and Doug.
- [01:51]
Doug (Liberty Mutual spokesperson)
Here we have the Limu Emu in its natural habitat, helping people customize their car insurance and save hundreds with Liberty Mutual. Fascinating. It's accompanied by his natural ally, Doug.
- [02:05]
Kathryn Oliverius
Uh, Limu is that guy with the binoculars watching us.
- [02:08]
Doug (Liberty Mutual spokesperson)
Cut the camera. They see us.
- [02:10]
Ryan Seacrest
Only pay for what you need@libertymutual.com Liberty.
- [02:13]
Doug (Liberty Mutual spokesperson)
Liberty Liberty Liberty Savings Fairy Underwritten by.
- [02:16]
Ryan Seacrest
Liberty Mutual Insurance Company and affiliates. Excludes Massachusetts.
- [02:18]
Sophie Cunningham
Okay, only 10 more presents to wrap.
- [02:22]
Danielle Robay
You're almost at the finish line, but first.
- [02:37]
There the last one.
- [02:41]
Enjoy a Coca Cola for a pause that refreshes.
- [02:48]
Ryan Seacrest
Hey, it's Ryan Seacrest for Albertsons and Safeway. The holiday season can be exhausting with all the parties and the end of year celebrations, but don't forget to take care of yourself by stocking up on your favorite nutritional products. Now through December 30th shop in store and online and save on items like Cliff Snack Bars, Luna Bars, Boost Nutritional Energy Drinks, Premier Protein Shakes, Z Bar Variety Packs, Open Nature Powder and Body Fortress Protein powder. Offers end December 30th. Restrictions apply. Offers may vary. Visit albertsons or safeway.com for more details.
- [03:20]
Bob Crawford
Hey there, American History Hotliners. Your host, Bob Crawford here. Happy to be joining you again for another episode of American History Hotline. You're the ones with the questions. I'm a guy trying to get some answers and keep those questions coming. The best way to get us a question is to record a video or a voice memo on your phone and email it to AmericanHistoryHotlinemail.com that's AmericanHistoryHotlinemail.com okay, today's question is about medicine and vaccines. Here to help me answer this question about vaccines is our old friend Catherine Oliverias. She's an associate professor of history at Stanford university specializing in 19th century US history. Kathryn, thanks for joining me today.
- [04:11]
Kathryn Oliverius
Delighted as always.
- [04:13]
Bob Crawford
Okay, Kathryn, here's a question we were hoping you could answer for us. This comes from Henry from Duluth, Minnesota. I was wondering, what was the first vaccine mandate in the United States?
- [04:27]
Kathryn Oliverius
It's a great question. And this was actually the first vaccine mandate was from General George Washington during the American, the American Revolution. So when we think about the history of vaccinations, really the disease that we're thinking about is in the long history is smallpox. So I can guarantee you that nobody listening to this podcast has actually personally experienced smallpox. This is an amazing feat of modern public health. The fact that we have not had to have any experience with this personally and cross fingers that that persists, that the eradication of this, which has happened since the 1980s, persists into the future. So smallpox was this is caused by the variola virus. And this was this had been, it's been with us for about 10,000 years, but it came to North America on ships, European ships, during the colonial period. And we see various outbreaks of smallpox throughout the 18th century. So Boston, for example, has a series of very, very serious outbreaks of smallpox in the early 1700s, 1750s, all the way up into the revolutionary period. And smallpox is honestly one of the most horrifying diseases that's ever existed. You will be infected. You don't necessarily know that you're infected for some time, then you suddenly develop this horrible, this horrible rash across these pustules all over your body. And it's extremely painful. It's sort of hideous to behold. Many, many accounts. We have from John Adams, for example, who inoculated himself. And we'll talk about that in a second. From smallpox. He just wrote these disgusting sort of accounts of what it was like to actually see somebody who had experienced a serious case of smallpox. And this is a really serious disease. So if you were to contract smallpox in the 18th century, if you were in Massachusetts colony, you had about the chances of dying were about 30%. So that's pretty high. Now enter a few different things. So we know that smallpox has existed for a long time. We also known that humans have developed ways to not vaccinate yet, but to seek to control it. So through inoculation or through what was called variolation. So this happened in ancient China. This also happened in the Middle east and certainly happened in West Africa, where basically you take a pustule literally. This is quite disgusting. I hope everyone likes to listen to disgusting things. You take a pustule of somebody with smallpox that's pussing, you dry it, you put into a mortar and pestle and basically sort of grind it down and then you snort it or you put that into your arm or you put a fresh pus into your arm basically too.
- [07:22]
Bob Crawford
So how did they figure this out?
- [07:25]
Kathryn Oliverius
Trial and error, I suppose. This is, this is, this is the idea that basically, and this is one of the most sort of amazing things about the history of medicine, history of public health, is that, you know, we don't, we don't have any one single account of who the person who decided that this was the good idea to do this the first time. This is kind of clearly like it's kind of folk knowledge that exists, that people knew that this was a way that you could defend against, you know, a more serious case of smallpox. And so actually the person who's most credited with this is Lady Mary Montagu. She was the wife of the ambassador to the Ottoman Empire, a British woman. And she developed smallpox, became very scarred herself. She survived, but she decided she brought this knowledge back with her to England when she, when they returned and she decided to inoculate her three year old daughter. So that means basically taking a person who has got a mild case, a mild case of smallpox grinding up this, the, the pustules or else taking pus from there and then cutting your, cutting, you know, cutting yourself and putting that pus into your own, hoping that basically because it's this mild case that you'll develop a mild case. And this also was, this came to the United States, Cotton Mather, who was a very famous Puritan minister, was told how to do this by his enslaved man, an enslaved man from the person he owned from West Africa named Onesimus, who basically told Cotton Mather how to do this. That clearly is suggesting that this has been done in West Africa, where he's from. From. He was a coromantee man. And so we see this, this idea basically, that you can reduce, you know, you can't entirely get rid of the risk, but you can reduce the risk if you introduce a sort of milder, seemingly milder version of this disease. And so we see this is. This comes to Boston. It's controversial at the time because it is safer. It's certainly safer. So if you do this, if you inoculate, you have, you know, the death rate drops from 30% to 1 to 2%. So it's certainly safer. But, you know, 1 to 2% still is significant. And so this is controversial, too.
- [09:23]
Bob Crawford
So didn't Jonathan Edwards, who was a theologian, and I think he was the head of what became Princeton University, he actually died from the vac. From inoculating himself.
- [09:36]
Kathryn Oliverius
This is. This is actually not uncommon, right? So that's like. Yes, so this is. This is. This is not that uncommon that you would, you know, in seeking to cure yourself or seeking to protect yourself long term, you actually then kill yourself. And. And for this reason. So a lot of people, you know, very religious people, actually thought that they, you know, at one point, you know, many, many times, Cotton Mather, for example, was physically assaulted on the streets with people saying, you know, this is. You're interrupting God's will. If God wants you to die for smallpox, you should. Of course, you know, this is. This is trying to plead God. You're interfering with, you know, the divine will. People also said, and this is correct, too, which is that, you know, this is. This is a. This is basically an uncontrolled experiment. So you had to combine inoculation with quarantine. So if you inoculate yourself, then you have got to go into quarantine and be apart from other people who are vulnerable. Otherwise you could unwittingly start spreading this infection. And that did happen. So where you see sort of campaigns for variolation, inoculation, this kind of thing, suddenly you see outbreaks of smallpox that happen, that kill many people. So it can get out of control for these reasons. But, you know, fast forward to the revolution, we see smallpox is a problem that afflicts many, many soldiers, many continental soldiers who do have never had exposure to this virus. And again, they're moving, moving around the country. They're sort of stirring this biotic soup. And Washington in particular is very, very nervous about this because smallpox did prove to be a problem during various sieges in Canada with Benedict Arnold.
- [11:11]
With many regiments during this war, you see basically smallpox being so serious that it again, impedes the Continental Army's ability to actually fight and wage war. So, quite controversially, and he did stick to his guns on this, but Washington mandated that the entire Continental army.
- [11:32]
Would be inoculated for smallpox.
- [11:34]
Bob Crawford
So this is a vaccine mandate.
- [11:37]
Kathryn Oliverius
Well, it's not a vaccine yet, but this is an inoc. We call it an inoculation mandate. This is the sort of forerunner to vaccines. Yeah.
- [11:43]
Bob Crawford
And this is the first of its kind.
- [11:45]
Kathryn Oliverius
Yeah, first of its kind. And it was controversial at the time. A lot of people. My goodness, a lot of people were really nervous about this. And also, it was kept secret because Washington rightly said, my goodness, we have to do this really carefully, because if the British find out that we are doing this campaign of sort of mass inoculation, keeping all of these soldiers sort of away from the front in quarantine, being quartered in individuals, private homes, it would leave all manner of cities very vulnerable to attack. So this is a massive undertaking to try to get as many soldiers as possible.
- [12:20]
Inoculated with. From smallpox. But it did eventually pay off in the end. But it was in small. You know, and Washington himself, in fact, there's some speculation about this from historians, but when he was 19, he traveled to the West Indies. He contracted smallpox on this trip and almost died himself. And this is probably actually. Some historians suggest that this is what made him infertile, so that he could never have biological children, in fact, too. So it's one of these interesting things where every single person has this kind of personal experience with this disease. And everyone recognizes, too, that once you become infected with the disease, if you die, you die, but if you survive, you become immune. And this is a really effective. You know, this is going to be one of the most important weapons in the Continental Army's arsenal.
- [13:05]
Bob Crawford
So at one point, though, there was a mandate for smallpox inoculation.
- [13:11]
Kathryn Oliverius
Yeah. So this is in 1777. This is when Washington puts in this mandate saying that all soldiers would have to be inoculated, and you would do it in stages so that, you know, you wouldn't. Basically, you wouldn't be compromising the entire army all at once. And so, you know, this is. This is really effective. Of course, the Americans, we, you know, win the Revolutionary War and soon thereafter, in the 1790s, this is when Jenner's very famous vaccine, vaccine for smallpox, came about. So what we're dealing with before this is this process, variolation or inoculation, a little bit different from vaccination. So with the smallpox vaccination, this is the first of its kind. And so basically what happened is. So Jenner is an Englishman, and he notices that women who are milkmaids, who were contracting cowpox, this much less serious disease, were.
- [14:11]
Quite resistant to smallpox. And so he decides essentially that he sees a connection here and other people had seen this connection in the past and had sort of tried to. Had sort of worked at creating kind of early vaccines, but he was the first to really document this and then make it into a kind of usable technology that could be used for other diseases going forward. So Jenner then decides, basically, he's going to take the pus from a smallpox from a cowpox victim and give it to inoculate somebody, a young boy, who then. And then he then introduced smallpox to them, and they did not contract this disease. So this is the first vaccine which is basically, this is.
- [14:52]
A vaccine that's based on a bovine smallpox. Smallpox virus, this cowpox. And this is actually the origin of the word vaccine. Vaca, cow. So that's where that comes from. So thereafter, this is the first major vaccine in world history, and it saved, you know, three. It's estimated that approximately 300 million people died of smallpox. This is basically the population of the United States today. So this is obviously a huge public health victory in, you know, one of the really key turning points in the history of disease and humanity.
- [15:26]
Bob Crawford
What were the first states to embrace this vaccine?
- [15:31]
Kathryn Oliverius
So all over the place. So actually, this is. This is. This is one of these interesting things too, where not every. This was not necessarily done by the state, was not necessarily involved in a sort of large capacity necessarily. This was often done by individual hospitals or if you were rich, you might pay for it, you might pay a private doctor to do this. But this is not necessarily. This was not the state implementing any kind of vaccine mandate. We don't see that again until much, much, much later, until the 20th century, actually, where we have sort of vaccine mandates coming back into play again. But you have, you know, what we sort of. We're seeing here, too, with the smallpox vaccine. These, I think, quite familiar debates to us about the sort of ethics of public health and the ethics of being against vaccines and what it means to have individual rights versus the public good and getting to that sort of crucial stage of herd immunity. So that, you know, basically that means that enough people in a society, in a community have immunity to this disease that it can't really set in, it can't ever really penetrate. So you don't have epidemics. And that's getting to that threshold is really difficult. But throughout the 19th century, this was controversial. It was controversial back then. It wasn't as controversial as it is perhaps today. But we see these kinds of the seeds of anti vaxxing, this ideology that really take place, that really take hold in the end of the 18th century, 19th century.
- [17:06]
Bob Crawford
So we can say that smallpox was the first vaccine.
- [17:10]
Kathryn Oliverius
Yes, yes.
- [17:11]
Bob Crawford
In the United States. What was the next one to come along?
- [17:15]
Kathryn Oliverius
So what happens? We sort of have like a break for about almost a century at this point then. And then we have a sort of slew of vaccines that come on to the scene, all basically because of Lily Pasteur. And so Louis Pasteur.
- [17:32]
Very famous for pasteurizing milk, pasteurizing, actually wine and beer at the time to basically make things safer to ingest and make them last longer. What ended up happening, he was looking for a cure for rabies and he was looking for a cure for cholera and he was doing experiments. And this actually did happen. It's really quite serendipitous in sort of the magic of the way that scientific discoveries happen, which is that they were working on basically trying to find a cure, isolated cure for chicken cholera, foul cholera in his lab. And he told one of his assistants before he went on holiday, inject this live culture.
- [18:17]
Into these chickens. The assistant forgot to do it, came back a month later after being on holiday and said, oh my goodness. Okay. So he then injected this material into the chickens, the, the cow, excuse me, the chicken cholera. And they noticed that then these chickens did not get sick with cholera. There were something about this virus that had been sitting out for a month, made it less virulent somehow, and it also again then gave immunity. So this is the first live attenuated, what we call a live attenuated virus vaccine. So we have basically here we have Lily Pasteur coming up with.
- [18:55]
With these lab attenuated vaccines for not just chicken cholera, but then for rabies. And then we see other doctors take on.
- [19:05]
Vaccine. Technology is developing. We see a vaccine come in by 1896 for typhoid fever, then for cholera also then for bubonic plague, tuberculosis, a massive killer worldwide, still a massive killer worldwide. We see a vaccine for that diphtheria, tetanus, pertussis or whooping cough. As we're going into the early 20th century. Yellow fever, a big one. And then probably the one that most people, most listeners are sort of familiar with and probably had themselves actually were the polio vaccines that these were by Sabin and Salk. The Salk vaccine, this was basically in sort of polio had been this horrible disease that had, you know, afflicted many, many, many thousands of people, Especially in the late summer, of course, our president FDR developed polio, almost diagnant, but was therefore incapacitated for the rest of his life after contracting polio. So this was a huge, just a huge step forward to have the sort of salt, you know, the vaccine, which was basically still given up until very recently, which is just a few drops of the vaccine on a sugar cube. And this saved generations of children from having to be in iron lungs or from death for many, many centuries.
- [20:21]
Bob Crawford
Yeah, let's talk about vaccines in school children. So when did this idea of vaccinating young children or even vaccine mandates in schools.
- [20:34]
Come in vogue?
- [20:36]
Kathryn Oliverius
This has been around for many, many years, certainly since the early 20th century. This idea that if you have a vaccine for a what is now, you know, for these incredibly contagious, very dangerous, very fatal childhood ailments like measles or mumps or rubella, these kinds of diseases, that actually this should be something that all children should have from a young age. And this is, by the way, drastically reduced child, infant mortality across the board. So this is, you know, we are talking just a massive drop in the number of children that die from what are today now highly curable or highly sort of preventable infectious diseases like measles, for example. And so there's no one moment when these sort of schools, for example, would adopt requirements for vaccine mandates for children. And happens in patchworks. And it, of course, doesn't happen. There's always been exceptions in the American system that are either basically granted by the state, religious exceptions to getting a vaccine or else otherwise personal exceptions that you can sort of apply for that apply to have your kid not be vaccinated. But we're talking about really from the 1930s, 1940s, 1950s, and the idea of also vaccinating children. Parents would line their children up for the Salk vaccine for a polio vaccine, because this is such a terrifying disease that would just. It would cause so much pain and angst in appearance that people were adamant that they wanted to get their child vaccinated as quickly as possible to prevent such a terrible thing.
- [22:19]
Bob Crawford
So there was less vaccine hesitation in the 1930s and 40s.
- [22:24]
Kathryn Oliverius
Yes, it existed and it most certainly existed. But I think the sort of, the, perhaps the real moment for vaccine hesitation this came with the mmr, this came with measles and this now highly discredited paper that linked measles, the measles vaccine with autism. And this has now since been discredited many, many, many times over in various large scale academic, in many large scale studies. And there is no connection. I mean, there are risks associated with vaccinations certainly, most certainly nothing is totally perfect or totally 100% safe. But fundamentally it's about balancing risk with reward, which is the risk is contracting disease. And also the reward is not just saving your child or yourself potentially from a disease that has killed millions of people in the past. That people, you know, if you lived 200 years ago, mothers and fathers would have killed for a vaccine for, you know, measles if they, you know, if they had had access to it. Because, and I've seen many, many letters to this effect of parents who are just, you know, watching their child die, you know, from the 1840s, from New Orleans or from New York. It's just, it's, it's, you know, this, this is a universal and sort of timeless experience of not wanting your children to have pain. So, you know, this is, there's, you know, there are risks associated with vaccines certainly in some people do have adverse reactions, but the disease is worse, just the disease is worse. And so that's really sort of back to hesitancy. And of course this took off during COVID especially fueled by social media and by everyone being a sort of armchair physician themselves, becoming a self styled expert.
- [24:06]
Danielle Robay
This is Danielle Roubais from bookmarked by Reese's Book Club. There's magic in books. The way one story can make you laugh, another can make you cry, and the right one can stay with you long after the last page on TikTok. That magic doesn't stop when you turn the last page. It multiplies. Readers are swapping their favorite genres, highlighting lines that feel personal and sparking conversations that travel across the globe. One person's review can put a forgotten classic back on the bestseller list. One reader's reaction to a plot twist can connect with millions who felt the exact same way. And one recommendation can grow into you joining a fandom you never knew existed. This isn't just talking books. It's the book community on TikTok, where stories live on long after the last chapter, where discovery never ends and where your next favorite book is always just a scroll away.
- [24:57]
Sophie Cunningham
This is Sophie Cunningham from Show Me Something. Do you know the symptoms of moderate to severe obstructive sleep apnea, or OSA in adults with obesity? They may be happening to you without you knowing. If anyone has ever said you snored loudly, or if you spend your days fighting off excessive tiredness, irritability and concentration issues, it may be due to osa. OSA is a serious condition where your airway partially or completely collapses during sleep, which may cause breathing interruptions and oxygen deprivation. Learn more at don'tsleep on OSA.com this information is provided by Lilly, A medicine.
- [25:35]
Kathryn Oliverius
Company.
- [25:38]
Doug (Liberty Mutual spokesperson)
And Doug Here we have the Limu Emu in its natural habitat, helping people customize their car insurance and save hundreds with Liberty Mutual.
- [25:49]
Fascinating. It's accompanied by his natural ally, Doug.
- [25:53]
Kathryn Oliverius
Limu is that guy with the binoculars watching us.
- [25:56]
Doug (Liberty Mutual spokesperson)
Cut the camera. They see us.
- [25:58]
Ryan Seacrest
Only pay for what you need@libertymutual.com Liberty.
- [26:00]
Doug (Liberty Mutual spokesperson)
Liberty Liberty Liberty Savings Fairy underwritten by.
- [26:04]
Ryan Seacrest
Liberty Mutual Insurance Company Affiliates excludes Massachusetts. Hey, it's Ryan Seacrest for Albertsons and Safeway. The holiday season can be exhausting with all the parties and the end of year celebrations. But don't forget to take care of yourself by stocking up on your favorite nutritional products. Now through December 30, shop in store and online and save on items like Cliff Snack Bars, Luna Bars, Boost Nutritional Energy Drinks, Premier Protein Shakes, Z Bar Variety Packs, Open Nature Powder and Body Fortress Protein powder offers end December 30th. Restrictions apply. Offers may vary. Visit albertsons or safeway.com for more details.
- [26:37]
Sophie Cunningham
Okay, only 10 more presents to wrap.
- [26:40]
Danielle Robay
You're almost at the finish line, but first.
- [26:56]
There the last one.
- [27:00]
Enjoy a Coca Cola for a pause that refreshes.
- [27:13]
Bob Crawford
This is American History Hotline. I'm your host, Bob Crawford. Today my guest is Katherine Oliverius. She's an associate professor of history at Stanford university specializing in 19th century US history. We're talking about repeating history over and over again and never seeming to learn any lessons when it comes to vaccines. Your first book, Necropolis Disease, Power and Capitalism in the Cotton Kingdom isn't so much about vaccines, but it's about a way to inoculate yourself from yellow fever.
- [27:50]
Kathryn Oliverius
Yes. And so again, the vaccine for yellow fever, it won't come about until 1937. And I deal with the 19th century. So we're dealing with a century before. And this is a mosquito borne illness, yellow fever. That was during the 19th century, probably the most terrifying disease in the Atlantic world. This is a disease, you know, you get bitten by a mosquito within a few days. And they did not know that it was spread by mosquitoes. But within a few days or a few hours, you develop these symptoms of nausea. You have back pain, eventually you sort of. You develop jaundice as your organs start to fail. And then the sort of telltale symptom happens, which is black vomit, where you regurgitate up this sort of partly coagulated blood that looks a lot like coffee grounds. And then patients would lapse into a coma and die. Very, very painful way to die. In many ways, the sort of most similar.
- [28:43]
Sort of similar symptomatically disease that most people would be familiar with today would be Ebola. Of course, yellow fever still exists. So there's no cure, there's no inoculation, there's no vaccination for this disease. People did not understand how it was spread or why some people developed only very mild cases while other people died. But they did understand that if you survived a case of yellow fever, you would become immune for life. You have a very thorough, very durable immunity, and your chances by the way of acquiring this immunity are not good. If you became sick with yellow fever in the 19th century, you had basically a 50, 50 chance of survival. So that's really. That's extraordinarily high. High chance of dying. Very, very high. But again, if you survived, you became immune for life. And so my first book, Necropolis, was all about people basically seeking out this immunity. It was so valuable, so important to the sort of social and economic structure of the cotton kingdom, where if you wanted to be, basically, if you wanted to be a successful person, you had to demonstrate somehow that you were immune to yellow fever, because otherwise people wouldn't invest in you, you couldn't get a job, you can get credit because you were just considered to be too risky. So my whole book is basically about how this desire to chase this disease, to acquire this very valuable immunity to it, how this permeated the entire sort of ethos of the cotton kingdom.
- [30:12]
Bob Crawford
And what I thought was really fascinating about your research was how some cities got better than others.
- [30:22]
At instituting public health measures.
- [30:24]
Kathryn Oliverius
Yes.
- [30:25]
Bob Crawford
Talk about those who were successful again versus those who are not.
- [30:30]
Kathryn Oliverius
Yeah. So this is so the 19th century in many ways. We can sort of consider this to be the kind of the genesis moment for the states seeking to, you know, the state, the nation or individual states seeking to try to control or at the very least, ameliorate disease for citizens. So you'll see, for example, in cities like New York or Philadelphia, where you Know, yellow fever actually was occasionally a problem in these cities. It can go all the way up to temperate zones, though it's most associated with tropical or subtropical climates. But it can go, you know, so we have periodic outbreaks of yellow fever, but also of cholera in the 1830s and 1840s and 50s. We also have smallpox outbreaks, things like this. And so we have basically doctors and public health specialists thinking, okay, so what are our options? We don't really understand how these diseases are spread. Some of them are quite obviously contagious. And by contagious, what they meant was spread by human to human contact. So me touching you, for example, and giving you smallpox or giving you syphilis. Some diseases they also said were miasmatic. Basically the kind of organic result of dirty city living. So basically, you know, of organic matter under the sun, baking and creating these foul vapors. They thought that literally this bad smell was the cause of disease. So they don't really know a lot about how epidemiology of these diseases are working in New York. But they say, okay, what we're going to do is we're going to experiment because it's better than having, you know, trying and failing is better than not trying at all. And so where New Orleans, essentially the political culture was, we can't prevent yellow fever. We're going to throw our hands up. We're never going to institute quarantines because they're unpopular, because they stymie business, because they, you know, it means that rich people can't get richer, essentially. And businessmen always hate quarantines. No matter where you are, they always hate them. So New Orleans, they never do them. But New York has many quarantine stations, in fact, not just for yellow fever, but again, for smallpox or for plague. So if you, you know, if you're a ship coming into port, you would have a health inspector come on board and determine if there was any infectious disease on board. And then they would maybe quarantine the entire ship if there was. Or they would take it to a quarantine station and let the people. Basically, the people would be in isolation for 20, 40 days, depending on the illness. So you see.
- [33:01]
States and cities seeking to institute these quarantines and build more robust infrastructure to actually handle quarantines. You also, in addition to this, have cities that are taking a more active role in building hospitals that are funded by the state, not just by private institutions. Or as was pretty typical, the church, whether it be sort of the Methodist or the Protestant church or the Catholic church, at this time. And you also have cities that are now engaged in data collection, seeing it as their responsibility essentially, to say, what is the incidence of this disease? How often are people dying from a thing? Where are they dying? Who is dying? Can we collect the kind of vital data so that we can draw out some patterns that we can use for future epidemics to try to prevent disease? And so you see this. Again, it's not perfect.
- [33:50]
Again, when you don't know that germs exist, how can you really prevent against germs? And people are drinking dirty water constantly. If you live in a city, you are living essentially in close proximity to people and animals and dirt and filth. Every street was essentially just a sewer. So you're in constant proximity. This is the kind of situation we're dealing with in urban life at this time. But we see some concerted efforts in certain places with politicians and specialists taking sometimes unpopular decisions to try to protect the public's health.
- [34:24]
Bob Crawford
And so just like public health, measures like quarantines provoke a backlash. It's always been that vaccines throughout American history have provoked backlashes as well.
- [34:39]
Sophie Cunningham
Yeah.
- [34:39]
Kathryn Oliverius
And I think that they've certainly produced a backlash. I think that what we're seeing, we've seen a sort of the. The volume dialed up in the last five years with COVID with COVID 19 and MRNA vaccines in general, where we see this kind of vaccine hesitancy co mingle with a sort of larger distrust with the state, with a kind of politics that saw state interventions during COVID as uneven or, in retrospect, overbearing and things like this. So you see this. We've seen a sort of a massive increase in hesitancy.
- [35:17]
Bob Crawford
I hate to interrupt you, Catherine, but it seems also that there is a suspicion against expertise. Right. People are suspicious of expertise.
- [35:27]
Kathryn Oliverius
Yeah. And so I'm sure that most people have probably come into contact with this at some point. But it's the criticism lodged at the COVID 19 vaccinations, fairly or unfairly, I suppose, or that it happened so quickly, it came out so quickly, and that's sort of fair. So most of the time, with all these vaccines that we're talking about from the past, smallpox, polio, influenza, these are all vaccines that took many, many years to develop. And so I think people rightly said, how can we roll out this vaccine so quickly within 2020 in some cases, how are we doing this? And, well, I mean, actually, what ends up happening is that during the pandemic, a lot of the sort of, you know, the existence of this massive public health crisis around the world meant that a lot of red tape was cut so that you could sort of move things through faster. And also one of the sort of most amazing things is that we had the kind of MRNA vaccines. These are not. We're familiar with coronaviruses. We know what these are. And so we had the kind of superstructure for creating this particular vaccine already.
- [36:35]
Before COVID 19.
- [36:38]
Came to American shores. So we basically had the kind of software for this and we could kind of plug and play with the, you know, with this particular virus, COVID 19. So it happened quickly, but it's been, you know, hugely effective. And, you know, today public health specialists argue that, you know, basically with the rollout of the. With the rollout of the vaccine Moderna or Pfizer, Johnson and Johnson, that saved approximately 3 million American lives. That's a large number of people. And so it's, you know, it's easy to recall the hardship of social isolation and being sick and the problems with the economy and schools and things like this. But also, we did save a lot of lives during COVID 19. And it's interesting that how we think about how our perspective changes as we move sort of further away from this, but that the vaccine was. This is a huge triumph that saved not just American lives, but people around the world.
- [37:31]
Bob Crawford
Of course, yeah, I know you specialize in United States history, as do we, but do other countries and governments struggle with opposition to vaccine mandates, or is this a uniquely American thing?
- [37:43]
Kathryn Oliverius
Oh, certainly other countries most certainly do as well. I would say that there's sort of a. There's a particularly American kind of flair right now. That is, it speaks, you know, the Internet speaks with an American accent. And what we're seeing, you know, the sort of discourse on. Discourse on vaccines very much is always sort of put through the lens of the American. The particular American situation. But I grew up in the UK and vaccinations are not. Were not uncontroversial. They were less controversial. And I remember just as a kid, you know, being put into the nurse's office and said, like, you know, give your arm and have a BCG vaccine. And I don't think my parents ever signed any kind of like, you know, gave any authorization for this, but, you know, this was what you did. And so. And I. And I don't recall. There's. There, there is pushback that has been amplified by the Internet, where people who actually have quite fringe views have been able to find community quite easily. But you can't let the people who shout loud on the Internet, control what it is that you do. And vaccines are safe, they are reliable. And my goodness, I don't want to have measles. I don't want my daughter to have measles. And these are diseases that there's a certain kind of amount. As a historian of disease and, and death in this way, you know, I think if I were to talk to a mom, and I see this again in letters and diaries from the 1840s and 50s of parents who are watching their child die from what is today an easily controllable disease. And I think it's, you know, this sort of the height of historical arrogance in some sense to say that we know better. You know, we are. I feel so much community with that woman actually, too. And, you know, she would kill for vaccine if she possibly could have known what that was.
- [39:31]
Bob Crawford
Well said, Catherine. I've been talking with Kathryn Oliverius. She's an associate professor of history at Stanford University. Check out her latest book, Necropolis Disease, Power and Capitalism in the Cotton Kingdom. Katherine, thank you for helping us answer this question today.
- [39:51]
Kathryn Oliverius
It's been my pleasure. Thank you.
- [39:56]
Bob Crawford
You've been listening to American History Hotline, a production of iHeart podcasts and Scratch Track Productions. The show's executive producer is James Morrison. Our executive producers from iHeart are Jordan Runtal and Jason English. Original music composed by me, Bob Crawford. Please keep in touch. Our email is americanhistoryhotlinemail.com if you like the show, please tell your friends and leave us a review in Apple Podcasts. I'm your host, Bob Crawford. Feel free to hit me up on social media to ask a history question or to let me know what you think of the show. You can find me at bobcrawford Bass, thanks so much for listening. See you next week.
- [40:49]
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