KINDRED LINES: Registers of successful vaccinations
Published in Features, Issue 3 (May/June 2020), Volume 28By Fiona Fitzsimons
Above: James Gillray’s The Cow-Pock—or—the Wonderful Effects of the New Inoculation! (1802) caricatures a scene at the Smallpox and Inoculation Hospital, St Pancras, London. (Library of Congress)
Between 1840 and 1853 vaccination acts introduced free, compulsory immunisation against smallpox in England and Wales. Similar laws for Ireland were enacted in 1863. The Compulsory Vaccination (Ireland) Act required parents and guardians to vaccinate every child born after 1 January 1864, with a follow-up appointment within eight days to determine the efficacy of the vaccine. Sick children could be exempted for up to two months, with a doctor’s certificate. The vaccination programme was delivered through the Poor Law Union dispensary districts.
A companion piece of legislation, the Registration of Births and Deaths (Ireland) Act, introduced civil registration and authorised the use of Poor Law Union dispensary districts as registrar’s districts. programme depended on the sharing of information between the local registrar and the dispensary doctor. The registrar was informed of all births in the district, and he gave parents and guardians written notice to immunise and details of where vaccination was available locally. He received vaccine certificates from doctors and used these to compile a register of successful vaccinations, kept alongside the civil register. He could compare the two registers to track non-compliance, of which he would inform the Poor Law guardians.
The doctors administered vaccine injections, prepared vaccination certificates for parents or guardians as proof of compliance, and informed the registrar so that there was a permanent public record. The Poor Law guardians managed the vaccination programme in the localities. They controlled the vaccination districts (Irish dispensaries and, after 1867, English parishes), paid doctors’ fees and prosecuted vaccination defaulters. All fines for non-compliance were paid into the local Poor Rate.
Although the vaccination programme was structured in a broadly similar way, there was a much higher rate of compliance here than in the rest of the UK. At first glance, the Compulsory Vaccination (Ireland) Act seemed to offer a relaxation of the law as it obtained in England and Wales. It pushed out the age at which infants were immunised from three to six months, but it tightened vaccination protocols. It took as its basic administrative unit the Poor Law Union dispensaries. Dispensary districts were a recent innovation, implemented under the 1851 Medical Charities Act. The 1851 reforms distributed them evenly across Ireland, easing community access to public health. England and Wales didn’t have a comparable framework.
An even greater spur to the Irish vaccination programme was that after 1864 the dispensary medical officers were usually also the local registrars and thus had a financial incentive to steer through vaccinations in their districts.
Perhaps because the impetus to vaccinate seemingly came from within the localities and not from the centre, there was very little popular opposition in Ireland to vaccination. Irish law didn’t allow parents to register their conscientious objections and continued to prosecute defaulters, even after 1907, when the English authorities stopped doing so. There is some evidence after 1900 of a rump movement of anti-vaxxers in Ireland. Jutta Kruse makes a strong argument that they were motivated by humanitarian, socialist, non-conformist and political reasons. The political hypothesis is supported by the fact that half of all prison sentences for not vaccinating were handed down between 1916 and 1921.
Although the registers of successful vaccinations were public records, it’s not entirely clear what survives or where to find them. Some registers have unfortunately fallen into the hands of private collectors and are not accessible to researchers. Cork Archives have a register of successful vaccinations for Clonakilty, while Limerick Archives have published on-line a register for the city and county, 1864–1912 (https://www.limerick.ie/discover/explore/historical-resources/limerick-archives/archive-collections/register-cases).
Fiona Fitzsimons is a director of Eneclann, a Trinity campus company, and of findmypast Ireland.
