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By Root 418 0

Camden case was reported on December 4. Three days later Bessie Rosevelt, age seven, the daughter of a local horse dealer, died at her home on Ferry Avenue. No two of the new cases had been vaccinated by the same physician. The Tribune awkwardly noted that Bessie’s was the “fourteenth case since the epidemic [of tetanus] made its appearance, and despite the fact that it has been found that the disease does not come from vaccination lymph, all of the victims have been vaccinated.” A headline in the Omaha World-Herald suggested that for much of the public, the story was more straightforward: “Poisoned Vaccine Still Proving Fatal at Camden, N.J.”62

If the mere assertion of expert opinion could not restore public confidence in vaccine, at the height of the most extensive U.S. epidemic of small-pox in recent memory, then what could? The Times warned that this was “not a momentary sensation.” St. Louis and Camden had done “incalculable injury” to medical progress, while the profession whose “pride and business interest” were most closely tied to that cause stood idly by. In the coming months, the American medical profession would be anything but idle. The New York County Medical Society resolved to investigate the “entire subject” and to determine “the steps that should be taken to guard against the possibility of a repetition of such deplorable disasters.” Other societies followed suit, as one local and state organization after another called for investigations of the vaccine industry and debated the need for government control. Physicians stepped away from both the biologics makers and the public health boards, seriously considered their own interests, and worked to restore public confidence in vaccination.63

Physicians knew better than anyone that even under the best of circumstances vaccination carried health risks. The same late nineteenth-century developments in bacteriology that had made U.S. military medicine a much safer and more ambitious enterprise had introduced a heightened concern for aseptic practices in routine medical procedures, including vaccination. As Arthur Van Harlingen, a Philadelphia doctor, noted approvingly in 1902, “few men will now come to the delicate infant with the odor of stable and animal on the unwashed hands, or will moisten their instruments with their own saliva.” And still physicians knew that introducing animal vaccine into the human system could produce unpredictable results, especially if the patient did not have the constitution for it, or if the vaccine itself was impure.64

American doctors had been concerned about vaccine quality since the first wave of the turn-of-the-century smallpox epidemics spread across the southern states in 1898 and 1899. But the doctors had kept their worries mostly to themselves, maintaining a solid (if occasionally splintery) defense of vaccine before the public. Their own medical society minutes and journals told a different story. Physicians and health officials—including a few federal officials such as C. P. Wertenbaker of the U.S. Marine-Hospital Service—complained that contaminated tubes and points were producing sore arms and open rebellions. At a meeting of the North Carolina Medical Society, local physicians swapped stories about “the violent results” caused by the vaccines they were receiving from northern manufacturers. “The popular prejudice against vaccination is not wholly without justification,” one doctor confessed. He recalled many “very sore arms” and lamented the suffering of his “own little daughter [who] was for three days violently ill” after he vaccinated her. As the epidemics spread north, the stories were much the same. From Omaha, Dr. F. T. Campbell wrote of the “vile vaccine” found on the shelves of grocery stores. “[A]nd so the ‘sores’ ran wild with contiguous and constitutional infection. From such cases came complaints that vaccination was ‘worse than smallpox.’” By the time tetanus broke out in Camden, American physicians had good reason to wonder what was really in those skinny tubes and points they carried around in