Distrust Through the Ages: The Deep Roots of the Anti-Vaccine Movement
The World Health Organization (WHO) credits vaccines with having ‘saved more human lives than any other medical intervention in history’ (1). In 2025 their director of the Department of Immunizations, Vaccines and Biologicals called vaccination one of the most powerful public health tools and cited 150 million lives saved over the past fifty years (2). In spite of this a growing number of people are hesitant to or refusing to receive recommended vaccines (3). Enough people, in fact, that in 2019 WHO identified vaccine hesitancy and refusal as one of the organization’s Top 10 global health threats (4).
So, why does this disparity exist? When did people start to question and oppose the vaccination process? And why?
As it turns out resistance to immunization is nothing new. It has existed as long as vaccination has existed (5) and actually predates the creation of the first vaccine. Prior to Edward Jenner’s creation of the Smallpox vaccine in 1796 a procedure called variolation was used to create immunity to Smallpox (6). It was practiced for centuries in the East (China, India, Turkey) and parts of Africa before its introduction to the western world throughout England in the early 1700s (7,8). The introduction was not without controversy.
Historically speaking, anti-variolation arguments can be broken down into four categories. The first was simple: It ran counter to the existing medical beliefs at the time. This was a time before germ theory, where the two main beliefs were the miasma theory (6) and the Hippocratic theory – based on balancing humors (8) and expelling harmful matter (7). This made the idea of purposefully giving a healthy person the disease seemed radical. The second argument against it came from the clergy, who considered illnesses a manifestation of the Will of God (8). Sexism entered into variolization resistance as well, alongside xenophobia, as the practice had been introduced in England by a woman (Lady Mary Wortley Montegu, wife of the British ambassador to the Ottoman Empire, without any medical training, from a Muslim Court, where it was performed, not by physicians, but by Muslim Women (8)!
In the American Colonies of the time similar resistance existed. However, an interesting turn of events occurred in Boston Massachusetts when Puritan Reverend Cotton Mather (the same Rev. Cotton Mather of Salem Witchcraft Trial fame (5)), supported variolation. Despite the belief of the divine origin of illnesses, eventually the local clergy came to support it, along with a single
surgeon, Dr. Zabdiel Boyleston (5,7). The other thirteen Boston surgeons, led by Dr. William Douglas, opposed variolation, not based on medical theory, but a professional issue. Dr. Boyleston was not a surgeon by formal schooling, he had become a doctor through apprenticeships, where Dr. Douglas had been trained through a European university. Douglas believed that medicine should only be practiced by those with a formal education (7). This clash of opinions escalated past verbal threats (7) to acts of physical violence that includ bombs being thrown into Mathers’ and Boyleston’s homes (9).
Enter Dr. Edward Jenner’s 1796 Smallpox vaccine. Seventy-five years had passed since the introduction of variolation to the western world, and the response to the vaccine was just as tumultuous as it had been to variolation. Almost immediately it was rejected by the Royal Society in England, as needing more evidence, and being too ‘revolutionary’. The clergy once more resisted, arguing that since the vaccine mixed human flesh and animal matter it violated God’s Will (the vaccine used cowpox viral matter). For the same reason, a people expressed fears of growing cow-like attributes, such as horns (4). When the British brought the vaccine to India (part of the British Empire) it encountered a deep, well-founded mistrust of anything British in the native population, in addition to a longstanding tradition of variolation by local specialists against whom vaccination competed. Further, Hindus raised religious objections to the vaccine, due to the sacred status of cows in their religion, and whether or not Vaccination was any different than eating beef, a concern that Mahatma Ghandi also later emphasized (8). Beginning in the latter half of the 1800s the question of personal freedom in choosing not to vaccinate came to the forefront, as mandates and laws were passed requiring vaccination (Founded: 1867-Anti-Compulsory Vaccination League in London (4), 1879-Anti Vaccination Society of America, 1882-New England Anti Compulsory Vaccination League, 1885-Anti vaccination League of New York City (10)). In 1905 the argument over personal rights vs public safety reached the United States Supreme Court in the case Jacobson v. Massachusetts (10) with
reports of violence against schools, teachers, and directors in Pennsylvania over school vaccine mandates following (11).
Thus began the 20th century. Germ Theory was becoming the dominant medical theory regarding illnesses (12). The bulk of our now well know vaccines were beginning to be created, and smallpox would be eradicated by the end (1). Concerns over vaccine safety and efficacy (4), along with the role of government in healthcare (5) would become key arguments for opponents of vaccination. Unfortunately, some of these concerns were not unfounded, as the Cutter Incident in April of 1955 highlighted (Cutter Laboratories produced vials of the Salk Polio vaccine that contained live poliovirus, not inactivated. Many children were paralyzed (13), and 10 died (4)). Later in the century, in 1976, a slight increase in risk of developing Guillain-Barre was discovered in the swine flu shot, resulting from it being pulled from use. And as recently as 1999 the RotaShield vaccine was found to cause intussusception in infants and was withdrawn from use by its manufacturer (13).
This brings us to the modern antivaccination movement. Some concerns, such as the fear of developing cowlike traits and appendages, have dissipated in the face of modern scientific understanding. And no major world religions oppose vaccination today, choosing instead to encourage their followers to make their own decisions about medicine and immunizations (14). Instead fear over vaccine safety (4, 14) and the cost/benefit ratio of vaccine side effects versus the potential for contracting the actual disease (4) are the dominant concerns.
So, what can be done to close the gap between opponents and supporters of vaccines? In her September 2025 message from the Department of Immunizations, Vaccines and Biologicals at WHO, Director Kate O’Brien encouraged action based on listening to family and public concerns, working with social scientists to understand the dynamics driving vaccine hesitancy, actively countering disinformation at its source, ensuring that those involved in the vaccination process have accurate information, and – most importantly – supporting and restoring public trust (2). Other sources discuss trust: Trust in science, in authority, in public discourse, and in health professionals (5), and make recommendations of further research into vaccine hesitancy and encourage transparent communication, engagement with local opinion leaders, and accessible and culturally sensitive vaccine campaigns (4).
References
1. A brief history of vaccination. Accessed July 5, 2026. https://www.who.int/news room/spotlight/history-of-vaccination/a-brief-history-of-vaccination
2. Message by the director of the department of immunization, vaccines and biologicals at who - september 2025. Accessed July 5, 2026. https://www.who.int/news/item/22-09-2025-message-
by-the-director-of-the-department-of-immunization--vaccines-and-biologicals-at-who--- september-2025
3. Topic: vaccine hesitancy in the u. S. Statista. Accessed July 5, 2026.
us/?srsltid=AfmBOooraMVGMBgqrqmH11eEt9sNNSU7V1QlnJXbuFVdl8TNEScaWGYs
4. Nuwarda R, Ramzan I, Weekes L, Kayser V. Vaccine Hesitancy: Contemporary Issues and Historical Background. Vaccines. 2022;10.
5. Eichman D, Bichianu D. From Cotton Mather to Dr Fauci: Historical Markers of Vaccine Hesitancy. NeoReviews. 2024;25(4). https://doi.org/10.1542/neo.25-4-e187
6. Edward Jenner, frs frcpe. Accessed July 5, 2026. https://historyofvaccines.org/history/edward jenner-frs-frcpe/overview/
7. International H. The global journey of variolation - Hektoen International. September 29, 2020. Accessed July 5, 2026. https://hekint.org/2020/09/29/the-global-journey-of-variolation/
8. Spencer S. Variolation to Vaccine: Smallpo Inoculation Travels East to West and Back Again. Education About Asia. 2022;27(1).
https://www.asianstudies.org/publications/eaa/archives/variolation-to-vaccine-smallpox inoculation-travels-east-to-west-and-back-again/
9. William a. Neal museum | protecting the populace: the history of vaccination regulation in the united states. May 16, 2025. Accessed July 5, 2026.
https://nealmuseum.wvu.edu/learn/2025/05/16/protecting-the-populace-the-history-of vaccination-regulation-in-the-united-states
10. Accessed July 5, 2026. https://historyofvaccines.org/vaccines-101/misconceptions-about vaccines/history-anti-vaccination-movements/
11. Vaccination Stirs Revolt. The new York Times. 1906:1.
https://www.nytimes.com/1906/02/05/archives/vaccination-stirs-revolt-threats-to-burn-schools and-whip-teachers.html
12. Germ Theory. Harvard Library. https://curiosity.lib.harvard.edu/contagion/feature/germ theory
13. CDC. Historical vaccine concerns. Vaccine Safety. August 5, 2024. Accessed July 5, 2026. https://www.cdc.gov/vaccine-safety/historical-concerns/index.html
14. Religion and vaccines. Arizona Partnership for Immunization. Accessed July 5, 2026. https://whyimmunize.org/get-info/family-and-community/religion-and-vaccines/
