Chiropractors and Vaccination: A Historical Perspective James B. Campbell, PhD*‡; Jason W. Busse, DC, MSc§; and H. Stephen Injeyan, DC, PhD‡ ABSTRACT. Although there is overwhelming evidence have organized movements whose activities have to show that vaccination is a highly effective method of had a serious negative impact on vaccination pro- controlling infectious diseases, a vocal element of the grams.5 Opponents include some religious organiza- chiropractic profession maintains a strongly antivaccina- tions, citizens’ groups, and practitioners and follow- tion bias. Reasons for this are examined. The basis seems ers of alternative health care systems, including to lie in early chiropractic philosophy, which, eschewing chiropractors.6 both the germ theory of infectious disease and vaccina- tion, considered disease the result of spinal nerve dys- Chiropractic is the third largest regulated health function caused by misplaced (subluxated) vertebrae. Al- care profession in North America (after allopathic though rejected by medical science, this concept is still medicine and dentistry), with ϳ70 000 practicing chi- accepted by a minority of chiropractors. Although more ropractors in the United States, 5000 in Canada, 2500 progressive, evidence-based chiropractors have em- in Australia, 1300 in the United Kingdom, and braced the concept of vaccination, the rejection of it by smaller numbers in ϳ50 other countries.7 The profes- conservative chiropractors continues to have a negative sion is growing rapidly, with over 4000 graduates influence on both public acceptance of vaccination and yearly from 30 educational institutions7 and is ex- acceptance of the chiropractic profession by orthodox pected to reach 100 000 in the United States alone by medicine. Pediatrics 2000;105(4). URL: http://www. 2010.8,9 Approximately one quarter of all North pediatrics.org/cgi/content/full/105/4/e43; chiropractic, chi- 10,11 ropractors, history of chiropractic, spinal manipulation, Americans use chiropractic services. Conse- vaccination. quently, chiropractors are likely to play an increas- ingly influential role in the formulation of societal perceptions of public health issues such as vaccina- ABBREVIATIONS. AMA, American Medical Association; ICA, tion. International Chiropractors Association; ACA, American Chiro- practic Association; CCA, Canadian Chiropractic Association. From its inception in the late 19th century, ele- ments within chiropractic have maintained a strong antivaccination bias.6,12 Because this bias originated lthough public health authorities have re- in early chiropractic history, the present situation is peatedly documented that the benefits of vac- best understood from a historical perspective. cination greatly outweigh the risks both to A 1,2 the individual and to society as a whole, many CHIROPRACTIC HISTORY individuals still choose to reject vaccination for In the late 19th century, Daniel David (D. D.) themselves and/or their children.3–5 In a survey of a Palmer, a magnetic healer practicing in the midwest- subpopulation (subscribers to Mothering magazine) ern United States, made a pivotal discovery.13 One of selected for a high proportion of nonvaccinators his patients, Harvey Lillard, a janitor who had been (43%), Meszaros et al3 identified a number of influ- deaf ever since an accident 17 years earlier, was not ential factors, including perceived dangers of the responding to his magnetic healing techniques. Dur- vaccines and doubts about the reliability of vaccina- ing the course of this treatment, Palmer noticed an tion information. Important sources of public infor- unusually large bump at the back of Lillard’s neck, in mation on vaccination issues include the media, the region of the fourth cervical vertebra.14,15 By his books and pamphlets, public health authorities, and own account: primary health care providers. Additionally, the In- ternet is providing ever-increasing access to a great “An examination showed a vertebra racked from its normal deal of vaccination information, official and unoffi- position. I reasoned that if that vertebra was replaced, the man’s hearing should be restored. With this object in view, a cial, both for and against. Unfortunately, these half-hour’s talk persuaded Mr. Lillard to allow me to replace sources do not always provide reliable information. it. I racked it into position by using the spinous process as a In many parts of the world, vaccination opponents lever and soon the man could hear as before.”15 One might question the physiologic basis for this From the *Department of Medical Genetics and Microbiology, Faculty of cure, particularly because the cochlear nerve does Medicine, University of Toronto; and ‡Divisions of Biological Sciences and §Postgraduate Studies, Canadian Memorial Chiropractic College, Toronto, not pass through the neck. Nevertheless, this single, Ontario, Canada. possibly apocryphal, observation provided the prac- Received for publication May 21, 1999; accepted Nov 12, 1999. tical basis for Palmer’s future concept of chiropractic, Reprint requests to (J.B.C.) Department of Medical Genetics and Microbi- a name derived from the Greek cheiro (hand) and ology, University of Toronto, Medical Sciences Building, Rm 4388, 1 King’s College Circle, Toronto, Ontario M5S 1A8, Canada. practos (doing by). Over the next few years, he grad- PEDIATRICS (ISSN 0031 4005). Copyright © 2000 by the American Acad- ually refined his theories, concluding by 1902 that emy of Pediatrics. disease (or dis-ease, as he termed it) was primarily http://www.pediatrics.org/cgi/content/full/105/4/Downloaded from www.aappublications.org/newse43 byPEDIATRICS guest on October Vol.2, 2021 105 No. 4 April 2000 1of8 neurological in origin, with 95% of all illnesses re- multiply, propagate, and then because they become so many sulting from pinching of spinal nerve roots by mis- they are classed as a cause.”20 aligned or subluxated16 vertebrae. Reasoning that a Chiropractic opposition to the germ theory contin- healthy body required a properly aligned backbone, ued well into the 20th century. It reached a peak Palmer developed a novel method of spinal adjust- (indicated by numbers of monographs and journal ment to correct these subluxations. publications) in the 1940s,19 at which time the intro- Palmer’s initial theory of chiropractic was more duction of antibiotics (and expansion of vaccination mechanical than spiritual, with the properly adjusted programs) probably contributed to its decline. Nev- body being considered akin to a machine running ertheless, some chiropractors still do not accept that smoothly and without friction.13 As a magnetic microbes can be the cause of disease.19 Whether dis- healer, however, he believed in the concept of vital- ease is caused and cured from within or without the ism, a doctrine that ascribes the functioning of a body still constitutes a very real philosophical dis- living organism to a vital principle distinct from tinction between the orthodox medical and historical physico–chemical and other known and accepted chiropractic approaches to health care. forces. Eventually, this concept became integrated Another tenet of early chiropractic was that drugs within the basic tenets of chiropractic. By using spi- were poisons that interfered with the natural healing nal manipulation therapy for the removal of subluxa- mechanisms of the body. Vaccines were anathema, tions, he believed he was influencing a life force because chiropractic adjustments were considered to within the body which he named “innate intelli- be all that were necessary to correct most disease gence,” the unimpeded presence of which was essen- conditions. B. J. states: tial for good health. When he later equated innate “Vaccine virus, or other poisons which create disease condi- intelligence with a personified part of universal in- tions will not permanently affect the patient when the Chiro- telligence (God), the religious overtones of chiroprac- practor keeps the vertebra in proper position. We have 17 checked the fun of doctors and saved children from being tic became manifest. poisoned, by adjusting the vertebra that the pus poisoning Even as his concepts were developing, Palmer was displacing.”22 founded the first school of chiropractic, the Palmer School and Cure, in Davenport, Iowa in 1897.18 Over Notwithstanding the high anecdotal success rate the next 5 years, ϳ15 students, including several of the Palmer spinal manipulative therapy (or per- haps because of it), the allopathic medical profession medical doctors, graduated from his school with di- of the time vehemently opposed chiropractic.22–26 plomas attesting to their competence to teach and Consequently, and as their numbers grew, chiroprac- practice chiropractic.18 Some took the teaching part tors experienced increasing hostility from physi- literally and quickly started their own schools. Given cians, with serious negative economic and social con- the diversity of their backgrounds and their primi- sequences. By the 1920s, hundreds of American (and tive state of knowledge, it is not surprising that, some Canadian) chiropractors had served jail sen- almost from its origin, chiropractic evolved in sev- tences for practicing their profession.25,26 Morris Fish- eral directions. bein, secretary of the American Medical Association In 1902, Palmer left the school in the hands of his (AMA) and editor of its journal from 1924 to 1949, 20-year-old son, Bartlett Joshua (B. J.), a recent grad- 14,15 was 1 of the most influential of the antichiropractic