18th and 19th century Ideas that would eventually coalesce into anti-vaccine activism have existed for longer than vaccines themselves. Some philosophical approaches (e.g.
homeopathy,
vitalism) are incompatible with the microbiological paradigm that explains how the immune system and vaccines work.
Vaccine hesitancy and anti-vaccine activism exist within a broader context that involves cultural tradition, religious belief, approaches to health and disease, and political affiliation.
Religious arguments against inoculation, the earliest arguments against vaccination, were soon advanced. For example, in a 1722 sermon entitled "The Dangerous and Sinful Practice of Inoculation", the English theologian Reverend Edmund Massey argued that diseases are sent by God to punish sin and that any attempt to prevent smallpox via inoculation is a "diabolical operation". It was customary at the time for popular preachers to publish sermons, which reached a wide audience. This was the case with Massey, whose sermon reached North America, where there was early religious opposition, particularly by
John Williams. A greater source of opposition there was
William Douglass, a medical graduate of
Edinburgh University and a
Fellow of the Royal Society, who had settled in Boston. 's 1802
caricature of
Edward Jenner vaccinating patients who feared it would make them sprout cowlike appendages. Vaccination itself was invented by British physician
Edward Jenner, who published his findings on the efficacy of the practice for smallpox in 1798. By 1801, the practice had been widely endorsed in the scientific community and by several world leaders. Philadelphia physician
John Redman Coxe, noting that even then false accounts were circulated of negative effects of vaccination, wrote, "Such are the falsehoods which impede the progress of the brightest discovery which has ever been made! But the contest is in vain! Time has drawn aside the veil which obstructed our knowledge of this invaluable blessing; and in the examples of the Emperor of Constantinople, of the Dowager Empress of Russia, and the King of Spain, we may date the downfall of further opposition." Coxe's expectation of an end to opposition to vaccination proved premature, and through much of the nineteenth century, the principles, practices and impact of vaccination were matters of active scientific debate. The principles behind vaccination were not clearly understood until the end of the nineteenth century. The importance of hygiene in the preparation, storage, and administration of vaccines was not always understood or practiced. Reliable statistics on vaccine efficacy and side effects were difficult to obtain before the 1930s. It set a precedent for the state regulation of physical bodies, and was fiercely resisted. The following year, in 1854, John Gibbs published the first anti-compulsory-vaccination pamphlet,
Our Medical Liberties. By the 1860s, anti-vaccinationism in Britain was active in the working class, labor aristocracy, and lower middle class. It had become associated with alternative medicine and was part of a larger culture of social and political dissent that included both labor unions and religious dissenters. In June 1867, the publication "Human Nature" campaigned in the United Kingdom against "The Vaccination Humbug", reporting that many petitions had been presented to Parliament against Compulsory Vaccination for
smallpox, including from parents who alleged that their children had died through the procedure, and complaining that these petitions had not been made public. The journal reported the formation of the Anti-Compulsory Vaccination League "To overthrow this huge piece of physiological absurdity and medical tyranny", and quoted Richard Gibbs (a cousin of John Gibbs), who ran the Free Hospital at the same address, as stating "I believe we have hundreds of cases here, from being poisoned with vaccination, I deem incurable. One member of a family dating syphilitic symptoms from the time of vaccination, when all the other members of the family have been clear. We strongly advise parents to go to prison, rather than submit to have their helpless offspring inoculated with scrofula, syphilis, and mania". After the death of Richard B. Gibbs in 1871, the Anti-Compulsory Vaccination League "languished" The Anti-Compulsory Vaccination League published the
Occasional Circular which later merged into the
National Anti-Compulsory Vaccination Reporter.
Anti-Vaccination Society of America In the United States, many states and local school boards established immunization requirements, beginning with a compulsory school vaccination law in
Massachusetts in 1855. and opposed compulsory
smallpox vaccination for smallpox from the final decades of the 19th century through the 1910s. During this period, smallpox vaccination was the only form of vaccination that was widely practiced, and the society published a periodical opposing it, called
Vaccination. A series of American legal cases, beginning in various states and culminating with that of Henning Jacobson of Massachusetts in 1905, upheld the mandating of compulsory smallpox vaccination for the good of the public. The court ruled in
Jacobson v. Massachusetts that "the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good". The London Society focused on lobbying parliamentary support in the 1880s and early 1890s.
The National Anti-Vaccination League The UK movement grew, and as the influence of the London Society overshadowed the Hume-Rotherys and it took the national lead, In 1906,
George Bernard Shaw wrote a supportive letter to the National Anti-Vaccination League, equating methods of vaccination with "rubbing the contents of the dustpan into the wound".
Anti-Vaccination League of America In 1908, the Anti-Vaccination League of America was created by
Charles M. Higgins and industrialist
John Pitcairn Jr., with anti-vaccination campaigns focused on New York and
Pennsylvania. Higgins was the League's chief spokesman and pamphleteer. Historian James Colgrove noted that Higgins "attempted to overturn the New York State's law mandating vaccination of students in public schools". The League dissolved after the death of Higgins in 1929.
20th century Anti-vaccine activism ebbed for much of the twentieth century, but never completely vanished. In the UK, the National Anti-Vaccination League continued to publish new issues of its journal until 1972, New vaccines were developed and used against diseases such as
diphtheria and
whooping cough. In the UK, these were often introduced on a voluntary basis, without arousing the same kind of anti-vaccination response that had accompanied compulsory smallpox vaccination. The idea of an autism link was first suggested in the early 1990s and came to public notice largely as a result of the 1998
Lancet MMR autism fraud, which Dennis K Flaherty at the University of Charleston characterized as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper authored by Wakefield and published in
The Lancet falsely claimed the vaccine was linked to
colitis and
autism spectrum disorders. The paper was retracted by
Lancet in 2010 but is still cited by anti-vaccine activists. The claims in the paper were widely reported, leading to a sharp drop in vaccination rates in the UK and Ireland. Promotion of the claimed link, which continued in anti-vaccination propaganda for the next three decades despite being refuted, was estimated to have led to an increase in the incidence of
measles and
mumps, resulting in deaths and serious permanent injuries. Following the initial claims in 1998, multiple large
epidemiological studies were undertaken. Reviews of the evidence by the
Centers for Disease Control and Prevention, the
American Academy of Pediatrics, the
Institute of Medicine of the
US National Academy of Sciences, the UK
National Health Service, and the
Cochrane Library all found no link between the MMR vaccine and autism. Physicians, medical journals, and editors have described Wakefield's actions as fraudulent and tied them to epidemics and deaths. An investigation by journalist
Brian Deer found that Wakefield, the author of the original research paper linking the vaccine to autism, had multiple undeclared
conflicts of interest, had manipulated evidence, and had broken other ethical codes. After a subsequent 2.5-year investigation, the
General Medical Council ruled that Wakefield had acted "dishonestly and irresponsibly" in doing his research, carrying out unauthorized procedures for which he was not qualified, and acting with "callous disregard" for the children involved. Wakefield was found guilty by the General Medical Council of serious professional misconduct in May 2010, and was struck off the
Medical Register, meaning he could no longer practise as a physician in the UK. The
Lancet paper was partially retracted in 2004 and fully retracted in 2010, when
Lancets editor-in-chief
Richard Horton described it as "utterly false" and said that the journal had been deceived. In January 2011, Deer published a series of reports in the
British Medical Journal, in which a signed editorial stated of the journalist, "It has taken the diligent scepticism of one man, standing outside medicine and science, to show that the paper was in fact an elaborate fraud." A 2011 journal article described the vaccine-autism connection as "the most damaging medical hoax of the last 100 years". In February 2015, Wakefield denied that he bore any responsibility for the
measles epidemic that started at
Disneyland among unvaccinated children that year. He also reaffirmed his discredited belief that "MMR contributes to the current autism epidemic". By that time, at least 166 measles cases had been reported.
Paul Offit disagreed, saying that the outbreak was "directly related to Dr. Wakefield's theory". Wakefield and other anti-vaccine activists were active in the American-Somali community in Minnesota, where a drop in vaccination rates was followed by the largest measles outbreak in the state in nearly 30 years in 2017. The anti-vaccination movement was historically apolitical, but in the 2010s and 2020s, the movement in the United States has increasingly targeted conservatives.
2019 and 2025 measles outbreaks Vaccine hesitancy led to declining rates of vaccination for measles, culminating in the
2019–2020 measles outbreaks. The most significant of these, in proportion to the national population, was the
2019 Samoa measles outbreak. In July 2018, two 12-month-old children died in Samoa after receiving incorrectly prepared MMR vaccinations. These two deaths were picked up by anti-vaccine groups and used to incite fear towards vaccination on social media, causing the government to suspend its measles vaccination programme for ten months, despite advice from the WHO. The incident caused many Samoan residents to lose trust in the healthcare system.
UNICEF and the
World Health Organization estimate that the measles vaccination rate in Samoa fell from 74% in 2017 to 34% in 2018, similar to some of the poorest countries in Africa. In August 2019, an infected passenger on one of the more than 8,000 annual flights between New Zealand and Samoa probably brought the disease from
Auckland to
Upolu. Over three percent of the population were infected. The cause of the outbreak was attributed to decreased vaccination rates, from 74% in 2017 to 31–34% in 2018, even though nearby islands had rates near 99%. After the outbreak, anti-vaxxers employed racist tropes and misinformation to credit the scores of measles deaths to poverty and poor nutrition or even to the vaccine itself, but this has been discounted by the international emergency medical support that arrived in November and December.
COVID-19 pandemic activism During the
COVID-19 pandemic, anti-vaccine activists undertook various efforts to hinder people who wanted to receive the vaccines, with such activities occurring in countries including Australia, Israel, the United Kingdom, and the United States. These included attempts to physically blockade vaccination sites, and making false reservations for vaccination appointments to clog up vaccination booking systems. Protests were also organized by the activists to raise awareness for their cause. In some instances, anti-vaccine rhetoric has been traced to
state-sponsored internet troll activities designed to create social dissension. Worldwide, foreign disinformation campaigns have been associated with declining vaccination rates in target countries. Anti-vaccine activism online, both before and during the pandemic, has been linked to extreme levels of falsehoods, rumors, hoaxes, and conspiracy theories. In another 2023 incident, college basketball player
Bronny James experienced cardiac arrest at the
Galen Center at the
University of Southern California, leading to assertions that this was a result of receiving a
COVID-19 vaccine; it was later revealed that the episode had been caused by a
congenital heart defect. Also, anti-vaccine activists believed
Foo Fighters drummer
Taylor Hawkins died in 2022 from the COVID-19 vaccine, while in actuality it was a drug overdose. In December 2023,
The New York Times published a detailed investigation of the distortion and misrepresentation of the circumstances surrounding the death of 24-year-old George Watts Jr. by
Robert F. Kennedy Jr. and other anti-vaccine activists. Some unvaccinated persons opposed to COVID-19 vaccination began referring to themselves in social media groups as "purebloods", a term historically connoting racial purity. Prominent biomedical researcher
Peter Hotez asserted that he and other American scientists who publicly defend vaccines have been attacked on social media, harassed with threatening emails, intimidated, and confronted physically by opponents of vaccination. He further attributes the increase in aggressiveness of the anti-vaccination movement to the influence of the extreme wing of the Republican Party. Hotez estimates that roughly 200,000 preventable deaths from COVID-19, mainly among Republicans, occurred in the US because of refusal to be vaccinated. A 2023 study published in the
Journal of the American Medical Association found "evidence of higher excess mortality for Republican voters compared with Democratic voters in Florida and Ohio after, but not before, COVID-19 vaccines were available to all adults in the US". ==Strategies and tactics==