By Forrest Pass

Vaccines work. Yet vaccination opponents have long questioned their effectiveness, in spite of overwhelming evidence. A century-old pamphlet in Library and Archives Canada’s (LAC) collection illustrates how unreliable sources, deliberate misinformation and outrageous conspiracy theories have been used to promote vaccine hesitancy. Reading historical anti-vaccination propaganda with a critical eye can serve as an “inoculation” against misinformation today.

In 1920 as in 2021, epidemic disease was very much on Canadians’ minds. As health authorities and the public worked to contain final flare-ups of the devastating Spanish flu pandemic, they also faced the worrisome resurgence of familiar diseases. In 1919, Ontario experienced a smallpox epidemic, perhaps introduced by returning soldiers or cross-border travellers; by August, the disease had spread westward, appearing among itinerant farm workers in the hops fields of the Fraser Valley, east of Vancouver. To stop the spread, British Columbia’s provincial medical officer of health, Dr. Henry Esson Young, enlisted the help of school boards to vaccinate all schoolchildren, except those exempted for reasons of conscience.

Young faced opposition from what he considered “a very active and clamorous minority.” In April 1920, vaccination opponents formed the People’s Anti-Vaccination and Medical Freedom League of British Columbia. The league’s secretary-treasurer, Ada Muir, argued that mandatory vaccination, even during a public health emergency, was a violation of personal liberty. Its objections dismissed by the provincial government, the league complained to the British Colonial Office and published Muir’s correspondence in a small pamphlet. British authorities forwarded the complaint to Ottawa, as public health was an internal Canadian matter. At the time, the Governor General’s office was a main line of communication between the British and Canadian governments. Thus, a rare—and well-travelled—copy of the pamphlet made its way into the records of the Office of the Governor General of Canada fonds at LAC.

Title page of Correspondence relating to An Appeal to the Imperial Authorities by the People’s Anti-Vaccination and Medical Freedom League of B.C., 1920

Foreshadowing the arguments of present-day vaccination opponents, Muir questioned the purity of the smallpox vaccine and warned of serious side effects. She cited newspaper reports of people who had become sick after vaccination or similar treatments. However, the original sources do not agree with Muir’s interpretations. For example, she blamed medical malpractice for the recent deaths of a Vancouver streetcar driver and his young son, but the story in the Vancouver Daily World made no such accusation: the two had died of diphtheria, a once-common disease now controlled by vaccination.

Obituary for a father and son who died of diphtheria, Vancouver Daily World, June 29, 1920, p. 11 (OCLC 20377751)

In describing the smallpox vaccine’s most frightening alleged side effect, Muir should have looked before she shared, for she relied on the discredited research of a 19-century British doctor, Charles Creighton. Creighton believed that the smallpox vaccine caused syphilis, and pointed to an increase in syphilis deaths after the United Kingdom enacted mandatory vaccination in 1853. However, the two diseases are not related. Thirty years before Muir penned her pamphlet, experts had pointed out that new reporting policies, not vaccinations, explained Creighton’s supposed syphilis “spike”; public health officials had begun to record syphilis as the cause of deaths that they had previously attributed to unknown “other causes.” That this change coincided with mandatory vaccination was just that: a coincidence.

Mistrust of medical experts led Muir to imagine conspiracies worthy of the dark corners of the COVID-era Internet. According to Muir, a secretive guild of evil doctors controlled once-democratic British Columbia and deliberately infected children with terrible diseases to satisfy their perverted curiosity. “The human race,” Muir ranted in the pamphlet, “has degenerated into a mere stockyard for the practice of the licensed medical monopoly.” Doctors, she alleged, were an “alien element” whose loyalty to their own profession overrode community safety.

Unsurprisingly, Muir’s supporting sources for this conspiracy theory were scanty. The best she could do was to quote a “Dr. Lockhart” of “Dorchester St. Hospital, Montreal” who had supposedly admitted in 1902 that doctors swore never to testify against their colleagues in court. A Dr. F.A.L. Lockhart had indeed worked at the Montreal Maternity Hospital on Dorchester Street in 1902, but I have not found a reliable source for Muir’s quotation. I specify “reliable source” because the quotation did appear in two letters to newspapers, first in Winnipeg in 1907 and again in Vancouver some seven years after the pamphlet appeared. In both cases, the writer was Alan Muir, Ada Muir’s husband and fellow vaccination opponent.

The outcome of the 1920 smallpox outbreak directly contradicted Ada Muir’s conclusion that vaccination offered no protection against disease. Dr. Young reported that the vaccination opponents’ misinformation campaign had had “very little effect”: in six months, over 80 percent of British Columbia schoolchildren had been vaccinated. After identifying 576 cases of smallpox in 1920, the province reported only 137 cases in 1921, a decrease of over 75 percent. Muir interpreted the small number of cases in Vancouver as proof that the outbreak was a “scare” and that vaccination was unnecessary. The facts support the opposite conclusion: a swift vaccination campaign had flattened the curve.

The success of this local effort foreshadowed a coordinated global smallpox vaccination campaign after the Second World War. In 1977, the World Health Organization declared smallpox eradicated; this was the first eradication of a disease in human history.

Muir continued her anti-vaccination advocacy into the 1930s, but it became a secondary interest. Astrology was her new passion, and in a 1930 letter to the Vancouver Sun, she argued that a horoscope was as useful a medical tool as a serum or a vaccine. She denied, as Creighton had, that viruses and bacteria cause disease, believing instead that dirt itself was the culprit. It is hard to tell which bias affected which judgment: did Muir’s unusual ideas about health and sickness lead her to question medical expertise, or was she ready to embrace strange new theories because she already mistrusted medical science?

Muir recommends medical astrology, Vancouver Sun, November 27, 1930, p. 6 (OCLC 1081083578)

Errors, sensationalism and discredited theories make the propaganda of Ada Muir and the People’s Anti-Vaccination and Medical Freedom League of B.C. easy to dismiss. Yet today’s slick social media memes and viral videos spread similar anti-vaccination messages. Considering the source, looking for supporting evidence, checking whether others agree, asking the experts, and considering your biases are all useful skills in evaluating medical information, whatever the era.

Forrest Pass is a curator in the Exhibitions team at Library and Archives Canada.