Pox_ An American History - Michael Willrich [121]
For Camden, the new era arrived too late. The tetanus outbreak of November and December 1901 had sharpened public fears of that mysterious product of the stable and the laboratory called vaccine. So many parents revolted against vaccination that school officials delayed reopening the schools after Christmas break. Many residents continued through the winter to tell their doctors that they viewed vaccination as an unacceptable health risk for them and their children. They preferred to take their chances with smallpox, rather than risk exposing their loved ones to tetanus.
No more postvaccination tetanus deaths occurred in Camden after Bessie Rosevelt’s death in December. But the toll from smallpox rose. By March 1902, smallpox had struck 165 people in the city, killing 15. Few among the dead in Camden had ever been vaccinated—none of them within the past three years. By the time the epidemic wound down that spring, smallpox had indeed proved more fatal there than vaccination.99
SIX
THE POLITICS OF TIGHT SPACES
In the rear room above Caballo’s saloon in East Harlem, behind the door with the big brass padlock, three children lay sleeping one cold February night in 1901. They slept under the bed, on a piece of cloth. Molina Caballo, the eldest, was four. Huddled beside her were her baby sister, Rose, and eighteen-month-old Antoinette Alvena. Some boxes of clothing stood by the bed, like a low wall, blocking the view from the doorway.1
Out on the street two hundred and fifty men awaited the order to move. Their breath formed a bank of fog against the winter night. Half of them were doctors—vaccinators and inspectors from the New York City Department of Health. The rest were uniformed patrolmen from the East 104th Street Police Station. It was 9:30, the hour chosen by Dr. Alonzo Blauvelt to ensure that the working people of Italian Harlem would be at home in their beds. The forty-seven-year-old chief inspector of the department’s Division of Contagious Diseases had forsaken the warmth of his own bed to lead this raid in person. The vaccination corps aimed to inspect every room, yard, and body between Second Avenue and the East River, moving north from 106th Street to 115th Street. On an ordinary street map, the area didn’t look like much: a few blocks on a vast city grid. But to the Department of Health, this stretch of five- and six-story tenements, where as many as five large families crowded onto every floor, marked a trouble spot in the medical geography of Manhattan, one of the island’s most thickly populated and disease-ridden Italian “colonies.”2
Ten weeks had passed since the Thanksgiving smallpox outbreak on All Nations Block, over on the West Side. In that time, the department had reported nearly two hundred cases—not quite enough to strike terror into a city of three and a half million people, but more than enough to cause the circulation of library books to plummet, the city’s regional trade to shrink, affluent families on the Upper West Side to cast out their servants, and the health department to hire seventy-five extra vaccinators. The department’s smallpox strategy, as Blauvelt had recently explained it to The New York Times, involved isolation of all infected persons, surveillance of their family members and known contacts, and vaccination of “suspicious neighborhoods.”3
City health officials often reminded the public that the Empire State had no compulsory vaccination law. But their actions said otherwise. The department’s strategy for containing smallpox ensured that the full power of public health policing would be felt chiefly in the city’s tight spaces—the crowded places where the wage earners lived,