With all the uproar about jabs and boosters in recent times, we could be forgiven for thinking that debates about the pros and cons of being vaccinated are very much a 21st century preoccupation. In fact, vaccination in history has always had its supporters and its detractors, and our very own Queen Victoria had some forthright opinions on the matter.

Until the 20th century, ‘vaccination’ really meant vaccination against smallpox, a terrible disease for which there was no cure. Killing a third of those it infected and leaving many others with awful disfiguration and even blindness, smallpox was top of the public health agenda for decades. After Dr Edward Jenner’s discovery of the smallpox vaccine in 1796, the question of whether our ancestors were vaccinated largely came down to the affordability and availability of the vaccine in the area in which they lived. But as the disease claimed more and more victims, particularly in the new industrial cities, there were growing calls for vaccination to be made both free and compulsory.

By the time, Queen Victoria came to the throne in 1837, the debate had reached a high pitch. Whether or not the young queen would decide to set an example to the country and update the smallpox vaccination she had had as a baby was a matter of concern to some of her advisors. Six European monarchs in the not- too-distant past were known to have died of smallpox; nobody wanted Victoria to be the seventh.

Smallpox ‘like wildfire’
On Sunday 20 January 1839, the young queen recorded in her journal that Lord Melbourne, her prime minister at the time, had reminded her between more light-hearted conversations about horses and Shakespeare that her people were getting smallpox ‘like wildfire’. He had gently but persistently asked her to get vaccinated. At this point in her life (not quite 20 years old), headstrong Victoria was set against having the jab on the grounds that she ‘thought it quite useless’. But Melbourne persisted.

You think it’s childish, he continued; now that’s nonsense; I shall see Halford [Sir Henry Halford – her doctor] tomorrow morning; shall I ask him? I said he might &c. He was very kind and earnest about it; and I, very obstinate.”

Melbourne emphasised ‘what a scrape [Victoria] would get us all into’ if she actually contracted smallpox and potentially could not communicate with her ministers. It would appear that Victoria did at this point succumb to Melbourne’s advice.

Soon after this, in 1840, Parliament passed the first Vaccination Act, offering free inoculation to all. It also banned the dangerous practice of ‘variolation’ whereby patients had sometimes been inoculated with material from smallpox pustules on another patient (rather than with material derived from the less nasty cowpox). Take-up of the vaccine was encouraging and reduction of infection noticeable, but because the Act had stopped short of making vaccination mandatory, there were still many concerning outbreaks of the disease across the country. Stricter measures were deemed necessary and in 1853, another Act of Parliament made vaccination compulsory (on penalty of a fine) for infants under three years old. Vaccination certificates were given out by local registrars when a baby’s birth was registered. These had to be returned to the registrar having been signed by a doctor. Further legislation in the late 1860s and early 1870s created new administrative roles specifically to oversee vaccinations, and penalties for non-compliance were raised.

Vaccination backlash
These new, more stringent, rules about vaccination caused a backlash. To start with, the chief reasons that ordinary people objected to vaccination were cosmetic and medical. It was popularly believed that the vaccine itself could cause disfiguration, blindness and even death. A further key concern was that the human lymph (which was used as a diluent in the vaccine) could, in itself, transmit diseases – including hepatitis, syphilis and even the smallpox it was trying to eradicate – from one person to another.

An outbreak of smallpox in Scotland in 1871 prompted a more vigorous vaccination programme and this time Queen Victoria readily obliged by having her vaccination updated. Unfortunately, she took ill soon after receiving the dose in the spring of 1871. As might have been predicted, there was an outcry of sympathy from the growing anti-vaccination movement. A letter from one ‘Looker on’, published in Cosmopolitan on 21 September 1871, referred to the queen having submitted to the ‘filthy operation’ and having been ‘dreadfully punished for her presumption’. The enraged writer even went so far as to say the queen had been ‘poisoned by vaccination’.

In her middle years, Victoria maintained an interest in the problem of smallpox and was particularly concerned about how the public were to be convinced that vaccination was a good thing. On Sunday 5 March 1871, she spoke to William Forster (the Whig statesman who had recently campaigned so successfully for universal elementary education) and described how he had spoken ‘of the smallpox being so fearful and the people in many cases so unreasonable about vaccination’. To Victoria’s consternation, Forster also advised that it was difficult ‘to find Hospitals for [all the smallpox] cases’.

Royal vaccinations
Now Victoria began to take her responsibilities as role model more seriously; the royal family continued to be regularly jabbed and allowed that fact to be reported in the press. On 10 January 1877, for instance, the Birmingham Mail reported that, ‘Yesterday afternoon, at the Request of her Majesty, a number of members of the Royal Household were vaccinated at Windsor Castle by Doctor Fairbank, the Queen’s surgeon.’ These vaccinations went ahead despite the fact that the queen was aware that they could have unpleasant side effects. In her journal for Tuesday 1 May 1883, she wrote that, ‘the little wee Baby [probably her granddaughter Princess Alice, daughter of her son Prince Leopold, born February 25 1883] is always brought in at breakfast & luncheon time. Poor little thing, it has a most terrible leg from vaccination.’

But the example of the royal family did not quell public fears about vaccination. Throughout the 1880s and 1890s, the numbers of people suffering from smallpox actually fell, the result of a combination of public health initiatives of which vaccination was only one. Perversely, protests against being inoculated grew. Now the arguments against were less to do with the perceived medical dangers of vaccination and more to do with social liberty. Many people simply did not want to be told by government what to put into the bodies of their children. On 23 March 1885, there was a large and unruly anti-vaccination demonstration in Leicester in which between 40,000 and 200,000 (estimates varied) people marched, including many who had either been imprisoned or fined for failing to pay fines for having refused to be vaccinated.

As a result of such vociferous protests in the press and in the streets, the government was eventually forced to relax the laws governing vaccination. In 1889 a Royal Commission into Vaccination made several recommendations including the abolition of cumulative penalties for refusal to vaccinate and the use of safer vaccines. In 1896, the Anti-Vaccination League (founded by William Tebb) set out further to persuade the government to reduce penalties for refusal to vaccinate.

The last years of Victoria’s life were coloured by the ups and downs of this nationwide debate on vaccination. Thankfully, however, she lived to witness a legislative turning point which pacified some of the critics. The Vaccination Act of 1898 removed cumulative penalties for refusal to vaccinate. And, crucially, members of the public were now granted the right to refuse vaccination by applying for a ‘Certificate of Conscientious Objection’. The new rules allowed a loophole for – and for a time satisfied – those people who absolutely objected to the idea of vaccination and paved the way for even laxer laws in the decades after Victoria’s death.

Though elderly and infirm by the end of the 19th century, Victoria’s interest in the subject of vaccination had not waned. On Sunday 7 August 1898, she wrote in her journal that the previous day, she had talked to the prime minister, Lord Salisbury ‘over the vexed & difficulty question of vaccination’. She did not agree with the so-called ‘Conscience Clause’, believing that vaccination should remain compulsory. But she did conclude that the new bill was ‘in many ways good’. On vaccination, as on so many other matters during her long and scientifically challenging reign, Victoria had proved herself open minded, wise and sensitive to the needs and concerns of her subjects. {

Further reading

• Brunton, Deborah. The Politics of Vaccination: Practice and Policy in England, Wales, Ireland, and Scotland, 1800–1874: Rochester Studies in Medical History, 2008
• Gibson, Jeremy & Rogers, Colin. Poor Law Union Records [England & Wales]: Federation of Family History Societies, 1997/2000 (Contains lists of surviving vaccination records and their whereabouts)
• Williamson, Stanley. The Vaccination Controversy: The Rise, Reign and Fall of Compulsory Vaccination for Smallpox: Liverpool University Press, 2007