Science  /  Antecedent

The U.S. Has Had 'Vaccine Passports' Before—And They Worked

History shows that the benefits of such a system can extend far beyond the venues into which such a passport would grant admission .

... U.S. border with Canada or Mexico, officials expected border-crossers to prove their immunity. As an El Paso newspaper put it in 1910, travelers needed to show one of three things: “A vaccination certificate, a properly scarred arm, or a pitted face” indicating that they had survived smallpox.

... U.S. border with Canada or Mexico, officials expected border-crossers to prove their immunity. As an El Paso newspaper put it in 1910, travelers needed to show one of three things: “A vaccination certificate, a properly scarred arm, or a pitted face” indicating that they had survived smallpox.

Today, as Americans have begun to look ahead to life after the COVID-19 pandemic, some have argued that a printed or electronic certification of a person’s vaccination status, often referred to as a vaccine passport, would allow a safe return to communal life. A few major sports arenas have already announced that they will only allow fans to attend games with proof of vaccination. Many are also speculating that proof of vaccination will be necessary for international travel this summer. Detractors claim that requiring such documentation infringes on individual liberties. Some even suggest that these passports could be the beginning of a slippery slope toward “1940s Nazi Germany” or a surveillance state. Florida Governor Ron De Santis has announced a blanket ban on all vaccine passports, calling it “unacceptable for either the government or the private sector” to require vaccination in order for citizens to be “able to participate in normal society.”

But this would not be American history’s first example of a vaccine passport—and in fact, Americans’ long campaign against smallpox shows that the benefits of such a system can extend far beyond the venues into which such a passport would grant admission.

Introduced to the western world in the 18th century, the smallpox vaccine was the first of its kind. It was administered not with a syringe but by scratching pustular material on a person’s arm. Typically, the vaccinated area would form a blister, scab over, and leave behind a distinctive scar. Because of its unique appearance, Americans treated the smallpox scar as a documentation of vaccination, or a sort of early vaccine passport. Toward the end of the Civil War, a smallpox outbreak in Tennessee led Union Brigadier General Ralph Pomeroy Buckland to order that physicians inspect everyone in Memphis and vaccinate “all found without well marked scars.”

By the late 19th century, American public health professionals pushed for an even more aggressive approach to vaccination. During another smallpox outbreak in Tennessee, in 1882 to 1883, for example, a Memphis newspaper reported, “At Chattanooga, when a doctor and a policeman enter a house together the folks inside know that they have to show a scar, be vaccinated, or answer to the law. There is no nonsense in that way of stamping out disease and saving life.”

During a series of smallpox outbreaks across the United States from 1898 through 1903, many states authorized compulsory vaccination, while other leaders sought to use the power of public and private institutions to pressure reluctant Americans to accept the vaccine. A Chicago physician wrote in 1901 that “Vaccination should be the seal on the passport of entrance to the public schools, to the voters’ booth, to the box of the juryman, and to every position of duty, privilege, profit or honor in the gift of either the State or the Nation.”

Employers across the country acted to make smallpox immunity a condition of employment. Factories, mines, railroads and other industrial workplaces with tight quarters were particularly forceful in demanding proof of vaccination. In 1903, Maine’s government decreed that “no person be allowed to ...