Pox_ An American History - Michael Willrich [135]
New York lawmakers debated a compulsory vaccination bill in 1902. The state had long banned unvaccinated children from the public schools. But beyond that the legislature had not ventured, prompting The New York Times to assert, “compulsory vaccination is a thing utterly unknown in this State.” In February 1902, State Senator James McCabe, a physician from Brooklyn, introduced a bill that would have been one of America’s strongest vaccination laws. It required cities to enforce universal vaccination whenever the health department called for it. Any resident who refused vaccination was subject to a $50 fine and imprisonment for ten days. Companies with more than ten employees were forbidden to hire anyone not vaccinated within the past five years. The New York County Medical Association championed the measure. So did the Times. Remarkably, the New York City Board of Health opposed the bill. The city’s new health commissioner, Dr. Ernst J. Lederle, explained that the legislation would simply hand the city’s antivaccination leagues a tool for recruitment. Compulsion was unnecessary, Lederle insisted. His department had encountered “no serious difficulty . . . in persuading the people to submit to vaccination.” The bill died in the New York Assembly.56
Residents of New York City—at least those who lived in the tenements or read the daily papers—must have found Ernst Lederle’s public position on compulsion baffling. A Ph.D.-bearing chemist, Lederle had taken office in January 1902, appointed by the city’s new reform mayor Seth Low to head up both the board of health (which promulgated health regulations for the city) and the department (which carried them out). High on the list of disgraceful conditions that Low’s administration promised to eradicate was smallpox, which had continued to spread despite the aggressive tactics of Alonzo Blauvelt’s vaccination corps. Nearly 2,000 cases, with 410 deaths, had been reported in the city’s five boroughs in 1901, making this New York’s worst smallpox epidemic since 1881.57
For Lederle, smallpox was the most interesting problem confronting a modern department whose activities covered everything from making vaccine to policing milk dealers to arresting the spitters who spread the city’s deadliest endemic disease, tuberculosis. Smallpox concentrated Lederle’s mind on the larger purpose of his office: to extend the benefits of modern medicine to the city’s “great tenement population—ill-housed, illnourished, bred in the foul air of the slums; above all, ignorant of the laws of cleanliness and right living, and willing to go to any lengths to hide the evidence of disease from the municipal physicians.” Tellingly, Lederle expressed admiration for the work of the U.S. Army Medical Department in Havana, “a striking example of what can be done in a short time.”58
Under Lederle, the health department managed compulsion well enough without a law that would have strengthened the political base of antivaccinationists and given Albany a greater hand in the affairs of local health departments. Lederle publicly denied that coercive legal power was necessary, even as his department routinely exercised just such power in the city’s tight spaces. Lederle added more than 150 new men to the vaccination corps. By the end of his first year in office the department performed a record-breaking 810,000 vaccinations—more than twice as many as in any previous year. The commissioner sent letters to the owners of all the city’s larger factories, offering them the services of a vaccination squad, at any hour of the day or night. His board of health ordered lodging houses to refuse shelter for more than one night to anyone who failed to provide proof of recent vaccination. Discovery of a pimple-faced passenger aboard a trolley in the Bronx in March