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Herd Immunity

Can the social contract be protected from a measles outbreak?
M. Spencer Green/AP Images

In the fall of 1713, measles struck the city of Boston, where Cotton Mather, a Puritan theologian and pastor, lived with his pregnant wife and numerous children. Within a month, his wife, their twin newborn babies, another child, and their maidservant had all died. On November 12, Mather wrote in his journal, “The epidemical Malady began upon this Town, is like to pass thro’ the Countrey. . . . it [might] be a service unto the public, to insert in the News-paper, a brief Direction for the managing of the sick. I will advise with a Physician or two.” On November 21, he wrote, “Lord I am oppressed; undertake for me!” On November 23, he wrote, “My poor Family is now left without any Infant in it, or any under seven Years of Age.”

Eight years later, when an explosive smallpox epidemic threatened Boston’s population of eleven thousand, Mather became an outspoken advocate for a new prophylactic against the virus: inoculation. Dr. William Douglass, one of the few doctors in town with a medical degree, rallied others to oppose Mather, claiming that the method was untested (which was true, at least in the new colony) and that it jeopardized the lives of all those who received it. In young Boston, the fight over inoculation tore at epidemic-addled nerves. In November 1721, a bomb was thrown through Mather’s window. A letter attached to it read, “Cotton Mather, you dog, dam you! I’ll inoculate you with this; with a pox to you.”

Douglass won out, quashing Mather’s plans for a systematic inoculation of the town’s population. Eight hundred and forty-four people died of the virus, accounting for 75 percent of all deaths in Boston that year. The unexploded bomb on Mather’s floorboards disabuses those of us living in 2019 of the impression—generated over the past two years by endless news stories about the current global measles outbreak—that inoculation controversies are a novel feature of our present hyper-mediated, hyper-politicized time.

Measles was considered to be eliminated in the United States in 2000. Still, the virus has regained extraordinary ground—and claimed an increasing number of lives—in recent years. Seven hundred and four cases were reported in the United States in the first four months of 2019, according to the Centers for Disease Control and Prevention. The count reached 1,077 by mid-June, occurring in twenty-eight states. More than six hundred cases have occurred in New York City alone since September of 2018.