Researching Smallpox Vaccination during the COVID-19 Pandemic

Allyson Poska, University of Mary Washington

I began the project out of which my JWH article “An Operation More Appropriate for Women”: The Gendering of Smallpox Vaccination in the Spanish Empire” grew before COVID-19 even existed, thinking that the extension of the smallpox vaccine with its global reach would provide insights into race and gender tensions in the waning years of the Spanish Empire. While that is still the focus of my research, with the advent of the pandemic and the subsequent roll out of public health measures, including vaccines, to counter the virus, I have found myself increasingly engaged with the current debates over those measures. Although I am always attentive to the differences between the world that I study and the world in which I live, the reactions to the COVID-19 vaccine have given me useful insight into  how public health measures have dredged up many of the same concerns over women’s bodies and government intervention that hindered the extension of first inoculation and then vaccination against smallpox more than two hundred years ago.   

As a women’s historian, I have been struck by the repeated concerns expressed by parents and young women about the effects of the COVID-19 vaccine on menstruation and fertility, topics that were not typically in the forefront of media coverage. For instance, listening to a call-in show on public radio during my short drive to work, a caller asked whether the vaccine affected girls’ menstrual cycles and whether parents should wait to have their daughters vaccinated until after their periods began.  The interviewee had to quickly refute the misinformation that prompted the question.  Recently, the Washington Post opinion section pointed to a recent study of more than 18,000 people that found that ten percent believed that the vaccine made it more difficult for women to become pregnant  Immediately, I was drawn back to the eighteenth century, when doctors were concerned that, based on humoral theory, inoculating girls who did not have regular periods could provoke a dangerous expulsion of fluid that might kill them.  In fact, opponents of inoculation spread the story of a French girl who supposedly died from inoculation because she had only had one period prior to inoculation. Later in the century, as physicians promoted vaccination, they were constantly having to reassure people that the vaccine had no effect on girl’s periods and that there was no need to schedule the procedure around them. Both then and now, young women’s bodies became a flashpoint in the cultural clash over disease prevention. 

Many of us have been shocked at the virulence of parental reactions to public health measures aimed at children, from masks to proposed vaccine mandates and to quarantine and isolation protocols. Across the US, parents have even threatened violence against school board members, principals, and other officials who promoted and/or attempted to enforce these measures.  Here again, the resonance with the past has been undeniable. While working in the archive in Mexico City, I came across reports from the smallpox epidemic of 1790-91 that Indigenous mothers supposedly hid their children wrapped in rugs in the rafters of their homes and in holes in the back yards when local authorities went door to door checking to see who was infected. In one village, a group of mothers stormed the hut outside of town where infected children were being isolated and attacked the guards in an attempt to “extract” their children from the quarantine hut. For me, the lesson was clear – COVID protocols were only the most recent manifestation of the conflict between parents and authorities over who should exercise  authority over children’s health.

Listening to the ongoing debate over vaccine mandates has also exposed interesting parallels with governmental attempts to spread the first vaccine. Although an array of vaccines are required for both children and adults in the United States and many governmental authorities indicated that they supported vaccine mandates, most politicians have been hesitant to require COVID-19 vaccination and instead have promoted a rhetoric focused on personal responsibility to encourage people to get the vaccine. The same was true at the beginning of the nineteenth century.  Despite the fact that smallpox vaccination could save thousands of lives, Spanish imperial authorities refused to make it compulsory. Instead, they urged political and medical authorities to use “kind words and persuasion” to convince parents and rejected any attempt to compel them to submit their children to vaccination.

The decision not to require vaccination forced Spanish authorities to invest both money and energy to encourage people to come to the sites where the smallpox vaccine was being administered and to ease their anxieties while they waited to undergo the procedure.  In city after city across Spanish America, local officials put on fantastic spectacles that included fireworks, bands, and orchestras meant to create a festival atmosphere around vaccination. Without knowing the historical precedent, local health officials have intuitively employed the same tactic with COVID-19 vaccinations.  Among others, The New York Times reported that authorities in Mexico City hired dancers and Lucha Libre wrestlers, gave yoga lessons, and presented live operatic performances to calm the fears of the city’s elderly as they waited to receive the jab. In Virginia, members of the Richmond Philharmonic played while people got vaccinated at the Richmond Raceway Complex Without compulsory vaccination, it fell to local authorities to create scenarios in which people would be willing to receive the vaccine.   

Researching vaccination during the COVID-19 pandemic has provided me with an unusual opportunity. In the archives, I work to uncover the perspectives of ordinary people and to understand who would submit to vaccination and who would not.  Today’s conversations have given me surprising insight into the social and medical debates of the past and my knowledge of history informs my understanding of the present. Although the disease and the historical context are different, I am able to monitor to the concerns about public health measures in a way that would not have been possible before March 2020.