Vaccinating Britain SOCIAL HISTORIES OF MEDICINE Series editors: David Cantor and Keir Waddington Social Histories of Medicine is concerned with all aspects of health, illness and medicine, from prehistory to the present, in every part of the world. The series covers the circumstances that promote health or illness, the ways in which people experience and explain such conditions, and what, practically, they do about them. Practitioners of all approaches to health and healing come within its scope, as do their ideas, beliefs, and practices, and the social, economic and cultural contexts in which they operate. Methodologically, the series welcomes relevant studies in social, economic, cultural, and intellectual history, as well as approaches derived from other disciplines in the arts, sciences, social sciences and humanities. The series is a collaboration between Manchester University Press and the Society for the Social History of Medicine. Previously published The metamorphosis of autism: A history of child development in Britain Bonnie Evans Payment and philanthropy in British healthcare, 1918–48 George Campbell Gosling The politics of vaccination: A global history Edited by Christine Holmberg, Stuart Blume and Paul Greenough Leprosy and colonialism: Suriname under Dutch rule, 1750–1950 Stephen Snelders Medical misadventure in an age of professionalization, 1780–1890 Alannah Tomkins Conserving health in early modern culture: Bodies and environments in Italy and England Edited by Sandra Cavallo and Tessa Storey Migrant architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s–1980s) Julian M. Simpson Mediterranean quarantines, 1750–1914: Space, identity and power Edited by John Chircop and Francisco Javier Martínez Sickness, medical welfare and the English poor, 1750–1834 Steven King Medical societies and scientific culture in nineteenth-century Belgium Joris Vandendriessche Managing diabetes, managing medicine: Chronic disease and clinical bureaucracy in post-war Britain Martin D. Moore Vaccinating Britain Mass vaccination and the public since the Second World War Gareth Millward Manchester University Press Copyright © Gareth Millward 2019 The right of Gareth Millward to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. This electronic version has been made freely available under a Creative Commons (CC-BY- NC-ND) licence, thanks to the support of the Wellcome Trust, which permits non-commercial use, distribution and reproduction provided the author(s) and Manchester University Press are fully cited and no modifications or adaptations are made. Details of the licence can be viewed at https://creativecommons.org/licenses/by-nc-nd/4.0/ Published by Manchester University Press Altrincham Street, Manchester M1 7JA www.manchesteruniversitypress.co.uk British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library ISBN 978 1 5261 2675 7 hardback ISBN 978 1 5261 2676 4 open access First published 2019 The publisher has no responsibility for the persistence or accuracy of URLs for any external or third-party internet websites referred to in this book, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Typeset by Toppan Best-set Premedia Limited Contents List of figures and tables page vi Acknowledgements vii Abbreviations x Introduction 1 Part I The development and evolution of the vaccination programme 29 1 Diphtheria 31 2 Smallpox 72 3 Poliomyelitis 114 Part II Vaccination crises 147 4 Pertussis 149 5 MMR 180 Conclusion 220 Select bibliography 236 Index 272 Figures and tables Figures 1.1 England and Wales: diphtheria deaths, 1931–48 page 40 3.1 Poliomyelitis notifications, 1939–69 118 4.1 Pertussis notifications, England and Wales, 1940–2005 154 5.1 Percentage of children receiving first dose of MMR before 24 months in London, rest of England and Scotland, 1999–2000, 2015–16 182 5.2 Mentions of MMR in major daily newspapers, 1996–2016 190 5.3 Notifications of measles in England and Wales, 1940–2015 203 Tables 1.1 Family background and immunisation 51 1.2 Diphtheria notifications and deaths in England and Wales, 1938–60 59 2.1 Importations of smallpox into England and Wales, 1936–70 76–7 2.2 Select vaccination rates as at 31 December 1964 79 Acknowledgements The research for this book was possible thanks to the generous funding of the Wellcome Trust. It forms part of the Wellcome Investigator Award ‘Placing the Public in Public Health: Public Health in Britain, 1948–2010’ (grant number WT-100586-Z-12-Z). The work was com- pleted at the Centre for History in Public Health at the London School of Hygiene and Tropical Medicine. I am grateful to the staff at The National Archives, Coventry History Centre at the Herbert Museum and the various digital curators and platform providers for providing access to the material which forms the core of this research. Special thanks are also due to the Wellcome Library for granting permis- sion to reproduce Figure 1.1 from its digitised collection of London Pulse Medical Officer of Health reports. At Manchester University Press, I particularly want to thank Tom Dark for his encouragement and swift replies to garbled emails and Keir Waddington, editor of the Social History of Medicine Series, for his feedback, help and thorough comments. I owe a huge debt to Alex Mold, the principal investigator on the Well- come award, my boss and mentor over the three years of my Research Fellowship at the School. She has made sure that I have stayed on course with the research, made my writing more readable and helped guide my career. If this book is useful to anyone it is because of her; and if not, the fault lies with me, the author. I must also thank Martin Moore and Harriet Palfreyman, who have read through countless drafts of this manuscript and offered constructive advice and criticism throughout. They have challenged my assertions and clarified my thinking. I have come to learn that no amount of praise is ever good enough for them. Daisy Payling, Peder Clark and Hannah Elizabeth, my colleagues on viii Acknowledgements ‘Placing the Public’ have been excellent co-workers, sounding boards and friends over the years. All have helped me to ask new questions of my material, especially Hannah and the work we have done together on the history of emotion within the 1950s polio vaccination programme. I joined the Centre for History in Public Health as a PhD student in 2009. It has been an uncommonly supportive environment in which to work and study. I must pay particular thanks to my PhD supervisor, Martin Gorsky, who has continued to be a mentor; and the outgoing head of the centre, Virginia Berridge. Ingrid James has been a superb administrator, without whom I am sure I could not have got through the past eight years. Christopher Sirrs and Tim Crocker-Bruque have given useful notes on drafts of work related to this project, for which I am grateful. Thanks too to Stuart Anderson, Hayley Brown, Angela Grainger, Anne Hardy, John Manton, Susanne McGregor, Jane Seymour, Ros Stanwell-Smith, Sue Taylor, Jenny Walke, Mateusz Zatonski and all members past and present for making the Centre a vibrant place to do research. Claire Frankland, Victoria Cranna, Dolly Padalia and Lisa Heiler were incredibly supportive in the organisation of an exhibition at the School in 2015 which sparked a number of ideas and allowed me to make a number of contacts. So too were Tracy Chantler and Pauline Paterson with a series of symposiums. I am grateful for the time, resources and encouragement of Heidi Larson at the School and Jo Yarwood at Public Health England, whose wealth of experience made the writing of the later chapters much easier and more rewarding. I must also thank Ian Milligan and Niels Brügger for encouraging my work on the Internet Archive and commissioning a book chapter from me which fed directly into the research in Chapter 5. Jane Winters, Richard Deswarte and Peter Webster must also take credit. As I now move on to a new project with the Wellcome Trust, I must also make special mention of Mathew Thomson and Roberta Bivins at the University of Warwick for their encouragement, reading of draft material and spon- soring my application for a post which started in September 2017. It took a lot of stress out of the final months of submitting and revising the manuscript, as did the support of my new colleagues Jenny Crane, Jane Hand, Natalie Jones and Jack Saunders. I am grateful to the editors and anonymous reviewers at Social History of Medicine and Contemporary British History for accepting Acknowledgements ix my articles on polio and pertussis vaccination controversies. These helped to formulate the arguments in chapters 3 and 4 of this volume. Thanks also to the attendees and organisers of the Modern British Studies conferences in Birmingham (2015 and 2017), the Society for the Social History of Medicine conference in Kent (2016), the Euro- pean Association for the History of Medicine and Health conferences in Cologne (2015) and Budapest (2017), the Voluntary Action History Society seminar series and the University of Birmingham’s medical history seminar series. Baptiste Baylac-Paouly was gracious enough to invite me to speak at the Société française d'histoire des sciences et des techniques conference in Strasbourg in 2017. The feedback on papers given at these has helped enormously. Finally, I must thank my family. Mom, Dad and Aidan have always encouraged me to pursue this career; and without my wife, Emma, I would not even have been able to start down this path, let alone con- tinue on it. But I must dedicate this book to my uncle Bruce.