In the early 1900s, the smallpox epidemic had scarred the United States so badly that one needed to prove they were safe to move practically anywhere. The proof wasn’t just required at ports and railway stations, but even to get on with regular life—to go to work, ride the train, attend college, watch a movie or even to grab drinks at a club. And a certificate to show you were inoculated against smallpox wasn’t enough. You were required to present a scar. The scar you wore on your arm was effectively the world’s first vaccine passport.
‘A certificate, a scarred arm or a pitted face’
While the official numbers for smallpox were recorded as 1,64,283 from 1899 to 1904, the real numbers were said to have been five times higher. To battle the deadly outbreak, several states in the country had made the vaccination and presenting certificates mandatory. In 1901, physician Dr James Hyde of the Rush Medical College in Chicago wrote, “Vaccination should be the seal on the passport of entrance to the public schools, to the voters’ booth, to the box of the juryman, and to every position of duty, privilege, profit or honor in the gift of either the State or the Nation.”
Officials began checking for vaccination certificates at ports of entry, including New York’s Ellis Island and San Francisco’s Angel Island or even along the US borders of Canada and Mexico. Travellers had to show one of three things: “A vaccination certificate, a properly scarred arm or a pitted face,” indicating they had survived smallpox, according to an El Paso newspaper in 1910. Some reports suggest that health officials went door-to-door to check if families were vaccinated.
However, it wasn’t that simple. Vaccines weren’t just a prick administered by syringes in those days; they were painful. In 1900, the first-ever vaccination invented by Edward Jenner involved scoring the skin of the upper arm with a lancet and then dabbing the wound with a live virus, which was obtained from cowpox sores. The vaccine recipient would start to develop a fever and a sore arm. The site on the arm would become a blister, and then a scab that would fall off, leaving behind a scar the size of a nickel.
Of course, people tried to scam their way
The vaccine was so excruciating, many people avoided getting it all together. Some anti-vaxxers questioned the effectiveness, while some believed that the vaccine increased the chances of contracting tetanus or syphilis. Many Americans were enraged and believed that the vaccination went against their personal liberties. So, they forged certificates to skip the inoculation. Anti-vaccination leagues circulated names of doctors that signed certificates deeming children medically “unfit” for the vaccination. If parents didn’t wish to spend money on a doctor, they’d just sign the certificate themselves.
The passphrase for public life: “Show a scar”
To avoid being duped by fake certificates, health officials went a step ahead. They demanded seeing the scar. The words, “show a scar” had become the ticket to civil life in America. The approach to vaccination became aggressive. During another smallpox outbreak in Tennessee, in 1882 to 1883, a Memphis newspaper reported, “At Chattanooga, when a doctor and a policeman enter a house together the folks inside know that they have to show a scar, be vaccinated, or answer to the law. There is no-nonsense in that way of stamping out disease and saving life.” And those who could not produce a fresh scar, they would be vaccinated on the spot. Some anti-vaccination crusaders even forged their scars by exposing a part of the arm to nitric acid to produce a scab.
Several employers made smallpox immunity a necessity for employment. Factories, mines, railroads and other industrial workplaces particularly demanded proof of vaccinations. In 1903, Maine’s government decreed that “no person be allowed to enter the employ of, or work in, a lumber camp who can not show a good vaccination scar”. Social gatherings and clubs also required proof of vaccinations. On return to school, students had to present a scar and a certificate by a reputable physician for admission cards.
Is the past a lens into our future? Will vaccinations certificates be the new ticket to enter restaurants, theatres and social events within our city to fight COVID? Only time will tell.