How 18th Century Boston Countered Vaccine Hesitancy

Lessons learned from a bygone time

An artist’s satirical depiction of Dr. Edward Jenner administering smallpox vaccines

A deadly pathogen. Life upended. The economy crippled. Schools shuttered. A miracle vaccine developed but widespread mistrust of it. A populace divided. Voices raised. Violence threatened.

The year is not 2021 but 1721. The place is the Massachusetts Bay Colony. Vaccine hesitancy is not new. It is as old as vaccines themselves. The rancor dates back to a crude but effective form of immunization first practiced in Boston exactly three centuries ago. We have been here before, and there are lessons to learn from Boston’s vaccine wars.

Then, as now, the disease came from abroad. On April 22, 1721, a British merchant ship, the HMS Seahorse, docked at Boston Harbor. Within a day, one of the crew-members showed signs of smallpox and was, as was customary, quarantined. Nevertheless, the “speckled monster,” as smallpox was known, gained a foothold in the city, and with devastating result. It killed hundreds of Bostonians, nearly a tenth of the population, targeting the most vulnerable, the very young and the very old.

Then, as now, a six-foot rule was in place, though a very different kind from today’s. Any family with an infected member was told to erect a pole at least six feet in length and attach a red flag with the words “God have mercy on this house.” The town council even restricted the ringing of funeral bells in an attempt — futile it turned out — to prevent full-scale panic. Then, as now, those who had the means to flee to the relative safety of the countryside did so. Then, as now, Harvard suspended classes.

Bostonians felt helpless. No one knew what caused the disease. Clerics claimed it was the wrath of God made manifest. Others blamed “miasmas,” putrid gases escaping from underground. Unsure how to stay safe, some resorted to methods used in previous outbreaks: plugging their noses with tobacco leaves, dangling bags of camphor from their necks, washing patients’ sores with sheep dung. Boston’s ten physicians were equally flummoxed, at least at first.

What happened next is an unlikely tale with unlikely heroes, including a polymath preacher, an African slave and a British noblewoman. It features disinformation campaigns, flame throwing, (figurative…