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vaccinators. The answer was an unblinking No. Citing “a principle as old as English law, that ‘the King can do no wrong,’” the court refused to allow a resident of Rome, who had submitted to vaccination “under protest,” to sue the government for using “vaccine matter which was bad, poisonous and injurious, and from which blood poisoning resulted.” To allow such a case to proceed, the court warned, “would be to paralyze the arm of the municipal government, and either render it incapable of acting for the public weal, or would render such action so dangerous that the possible evil consequences to it, resulting from the multiplicity of suits, might be as great as the smallpox itself.” The arm of the state was protected; the arm of the citizen was not.7

Supporters of compulsory vaccination defended the policy in a quasi-scientific rhetoric of risk assessment. From the expert point of view, lay concerns about vaccine safety were steeped in ignorance and fear, which should have evaporated in the face of hard statistical evidence. Officials assured the public that vaccines were safer than ever: “the preparation of glycerinized vaccine lymph has now been brought to such perfection that there should be no fear of untoward results in its use,” Surgeon General Walter Wyman said three years before Camden. Even if untoward results did arise, the social benefits of vaccination outweighed the costs. As the Cleveland Medical Journal put it, “Better [by] far two score and ten sore arms than a city devastated by a plague that it is within our power to avert.”8

The vaccine crisis of 1901–2 revealed that cost-benefit analysis was not the only way Americans thought about risk. When the Times observed that Camden parents reasonably concluded that vaccination had become more dangerous than smallpox, turning the public health argument on its head, the paper made a rare concession to vaccination critics. As the Times said, the incidents were “furnishing the anti-vaccinationists with the only good argument they have ever had.” But most worried parents would not have called themselves “anti-vaccinationists.” And much more was involved in the rising popular resistance to vaccination in 1901 than a cool-headed consideration of quantifiable facts.9

Perceptions of risk—the intuitive judgments that people make about the hazards of their world—can be stubbornly resistant to the evidence of experts. This is because risk perceptions are mediated by experience, by culture, and by relations of power. Certain factors tend to elevate the sense of risk that a person associates with a specific thing or activity, even in the face of countervailing statistical data. A mysterious phenomenon whose workings defy the comprehension of laypeople causes more dread than a commonplace hazard. A hazard whose adverse effects may be delayed, rather than immediate, heightens perceived risk. Significantly, perceived risk tends to spike when the hazard is not voluntarily undertaken. This is especially true when the social benefits claimed for a potentially hazardous activity are not readily apparent to those ordered to undertake it.10

All of which helps to explain why in the fall of 1901 popular perceptions diverged so radically from the official line on vaccine safety. A century after the introduction of Jennerian vaccination, vaccines remained mysterious entities—even to the companies that made them and the physicians who used them. Many American communities had experienced neither a small-pox epidemic nor a general vaccination in over fifteen years, increasing both the public’s sense of complacency about the disease and its unfamiliarity with the prophylactic. By force of law, local health boards and school boards ordered citizens to assume the risks of vaccination. Many did, some eagerly, some grudgingly, some only with a billy club against their back. Then the St. Louis and Camden tragedies shocked the nation. Public confidence in the vaccine supply, already shaky, plummeted. Opposition to compulsory vaccination, already strong, surged. Ultimately, these events pierced