"An ounce of prevention is worth a ton of cure," is a popular English proverb. It has also become an important idea in medicine, to avoid major health crises by preventing them. As part of this, vaccinations have been part of health in the state for many years, with very successful results.
One of the earliest examples of mandatory vaccinations dates to the American Revolution. Smallpox had been a disease that had left millions dead and many others disabled or disfigured.
Up until World War I, most wartime deaths were from disease rather than battlefield injuries. Gen. George Washington knew that the health of his troops could determine the success of entire campaigns.
In the winter of 1777, while his troops were in their winter encampment at Morristown, New Jersey, Washington ordered variolation for all troops who had not had smallpox before. Variolation, the grinding up of smallpox scabs to be inhaled by patients to create immunity, began to be practiced in the American colonies in the 1720s.
After the development of the first successful smallpox vaccine by Dr. Edward Jenner in 1796, the United States government began actively considering new measures to provide vaccines for the public and to preserve the health of the people.
In 1798, President John Adams signed a law that gave the government power to order quarantines in the wake of a yellow fever epidemic that left thousands dead across the country. Medicine was still in a primitive state, and doctors were not entirely certain how the disease operated or spread, but the connection between quarantines of those infected and the prevention of the spread of disease was undeniable.
By 1917, smallpox vaccinations were a requirement in Arkansas for school attendance. Though there were a handful of court cases attempting to challenge periodic quarantines and vaccine requirements, these were dismissed by courts in favor of the importance of preventing disease and saving lives.
By 1952, smallpox had been completely eradicated in the United States. It was wiped out in Europe by 1953 and from South America by 1971. As a result, in 1971, the Centers for Disease Control recommended ending mandatory smallpox vaccinations. Some concern existed among some doctors that it was too soon to end the requirements, but only a handful of cases were still being reported in remote corners of the world.
Mandatory vaccinations ended in the US in 1972, and the last recorded case in the world occurred in 1978. Smallpox was declared completely eradicated by 1979.
The distinctive round scars on the upper arms of those who received smallpox vaccines became an emblem of the end of a terrifying era of disease.
By the early 1950s, up to 50,000 children were still being infected by polio each year. Parents would watch in horror as their children would become paralyzed in a matter of days from the disease or even die.
With the first public trials of the new polio vaccine developed by Dr. Jonas Salk, more than 2 million children across the country participated, lining up in schools to get their polio shots. Mass vaccinations were held across the state, and the public response was overwhelmingly positive.
In 1955, with the vaccine a clear success, President Dwight D. Eisenhower, invited Salk to the White House and publicly thanked him for, in his words, "saving the children of America." Many schools enacted vaccine mandates and initiated mass vaccination programs.
By 1963, polio had effectively disappeared in Arkansas with only four cases reported, down from the state's 1949 height of nearly 1,000 cases. Polio was declared completely eradicated in the United States by 1979.
In 1967, the Arkansas state legislature passed a mandatory vaccine law binding on both public and private school students. This law mandated vaccinations for polio, diphtheria, tetanus and measles.
This would be expanded to include mandatory vaccines against rubella (or German measles) by 1973.
The introduction of the measles vaccine in 1963 dramatically reduced the rates of the potentially fatal disease. For example, a measles outbreak in Texarkana in 1970 and 1971 resulted in 639 infections among area children. The epidemic, possibly deadly, raged for weeks. Because of the vaccination campaign afterward, measles was unheard of in Texarkana children by the late 1970s and almost unknown in children statewide.
The combined measles, mumps, and rubella (German measles) vaccine became available by 1971 and quickly became the standard in medicine and was soon part of the required vaccination schedule for students. The result was that those three diseases were all but eliminated in the state within a few years.
The science of vaccinations is beyond dispute. The result of the vaccine mandates instituted over many years was a healthier population and families who did not have to grieve the loss of loved ones to preventable diseases.
Dr. Ken Bridges is a professor of history and geography at South Arkansas Community College in El Dorado and a resident historian for the South Arkansas Historical Preservation Society. Bridges can be reached by email at [email protected] southark.edu.