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array of measures governing the bodies and behavior of children, as more and more states made school attendance mandatory into the teenage years. By 1902, nearly 16 million Americans—72 percent of all children aged five to eighteen—attended public schools; another 1.2 million went to private schools. The great exception was the South, where most state legislatures had yet to compel school attendance or vaccination. In 1901, only five states had laws on the books requiring universal childhood vaccination in the first year or two of life. But most took measures to keep unvaccinated children from the public schools, especially when smallpox threatened. (Some states, including California and Massachusetts, mandated school vaccination by statute; others, such as New Jersey and Maine, authorized school boards to order vaccination; and in still other states, school boards simply issued orders at their discretion.) Almost everywhere, the requirements applied exclusively to public schools. Parents with the means to send their children to private schools could opt out.43

In an era when American governments took ever greater responsibility for children—through child labor laws, school laws, and new child-welfare institutions such as the juvenile court—the vaccination rules served multiple purposes. As some health officers pointed out, it would have been unconscionable for states to require children to spend half their day in crowded classrooms without protecting them against socially transmitted diseases. The measures, coupled with increasingly routine medical inspections in the public schools, also extended state authority from the school into the home, bringing working-class and immigrant parents into line with new progressive norms of hygiene. When unvaccinated children were excluded from school, their parents could face prosecution under education laws. Some officials even imagined that the requirement made a positive impression on the students—“familiarizing the juvenile mind with respect for authority,” as one put it, “whatever the merits of the medical expedient may be.”44

Compulsory vaccination turned American public schools into theaters of conflict. Parents, pupils, teachers, and sometimes even principals challenged the rules with tactics ranging from civil suits to civil disobedience. Parents decried the measures as a violation of their domestic authority and a threat to their children’s health. Officials in Chicago and New York uncovered what the Times called “an extensive traffic” in phony vaccination certificates. The school strikes that rocked Camden and Rochester after Camden’s tetanus outbreak were not isolated incidents. In Gas City, Indiana, two hundred mothers, holding their unvaccinated children by the hand, marched upon the public schools building on a December morning in 1902. Facing down a contingent of policemen at the schoolhouse doors, they demanded that their “scarless” children be admitted.45

In nearby Bluffton, Indiana, the school board squared off against the health board, refusing to enforce the latter’s vaccination order. In Delaware County, Pennsylvania, a group of female teachers refused to let physicians examine their arms for scars, protesting a policy that compelled them to undergo a risky medical procedure before entering their workplaces. Students caused trouble, too. Visiting Newburg, Ohio, Cleveland health officer Martin Friedrich came upon some children outside their school. The students called out to each other, “Are you vaccinated? Are you vaccinated?” Friedrich understood: the vaccinators were in the schoolhouse. He slowed his pace and listened. “Pretty soon I knew what they were up to,” he recalled. The corner grocery-man had told some of them that they should wash the vaccine from their arms to keep them from getting sore. “They communicated it to each other in a most lively manner, and all hurried as fast as they could to the grocery-store to wash their arms.”46

New York City schoolboys line up to have their vaccination marks inspected by a public health officer in 1913. COURTESY