IDPH 125th

121 YEARS AGO IN PUBLIC HEALTH


In 1881, smallpox was rampant in Illinois. To address the epidemic, the State Board of Health in November ordered that no child be admitted to public schools in Illinois after Jan. 1, 1882, without presenting satisfactory evidence of “proper and successful” vaccination or a history of smallpox and that the reporting of the disease, by physicians to local health officers, be compulsory.

With little more than one month between the order and its effective date, the State Board of Health’s executive secretary, Dr. John H. Rauch, had to move quickly. First, he directed his staff to develop appropriate vaccination certificates for schoolchildren and the necessary reporting forms. Rauch then plunged into the task of informing school officials and teachers from around the state. His efforts were successful: Within 60 days of the order’s effective date, the percentage of schoolchildren vaccinated against smallpox more than doubled – going from 45 percent to 94 percent.

Many adults – particularly employees of large industries, such as the railroad, and state prison inmates – also heeded Rauch’s public health message and received vaccinations. By March, a total of 510,517 children and adults had been vaccinated.

Once the epidemic waned, however, Illinoisans became absorbed in other problems and soon forgot the compulsory vaccination order. The protection afforded by the mass vaccinations done in 1882 began to fade and outbreaks of smallpox again became widespread. By the early 1890s, the situation had become serious and the State Board of Health again moved to enforce the compulsory vaccination of schoolchildren. The earlier success was not to be repeated, but enough schoolchildren were vaccinated to keep the epidemic in check.

A suit in Lawrence County sought to compel a local school board to admit unvaccinated schoolchildren. The matter eventually ended up in the state Supreme Court and, in 1895, the court ruled against the school board, declaring it unconstitutional to require vaccinations to attend public school. The subsequent practice, which was upheld by the courts, required either vaccination or the quarantine of all schoolchildren during the most contagious period after smallpox appeared in a community.


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