Retro Baltimore

There was a time when Baltimoreans could be jailed for refusing vaccination

As Baltimoreans scramble to chase down COVID-19 vaccine appointments, it’s worth looking back on vaccination campaigns of previous eras.

More than 100 years ago, Baltimore health officials went door to door vaccinating city residents for smallpox. Those who refused to get “scraped,” or inoculated, could face fines, or even jail time.


In 1899, The Sun depicted the efforts of then-Health Commissioner C. Hampson Jones to inoculate 600 people in three hours. Two teams of doctors targeted densely populated Black communities and neighborhoods with high immigrant populations.

The pushes for vaccinations were early, if flawed, efforts to reach out to vulnerable groups. Though the city embarked on such initiatives for the public good, the methods and attitudes they used also show how pandemics have fueled racism and other forms of prejudice.


Today, local governments have struggled to ensure equitable distribution of COVID vaccines by race. As of February, white Marylanders had received more than four times as many doses of the coronavirus vaccine as Black residents, although that gap has narrowed some in recent weeks.

In their zeal to administer smallpox vaccines to at-risk groups, 19th century doctors apparently did little to allay people’s fears of the shots. After starting near Pratt Street, they worked their way “vaccinating everyone in sight who could not prove he had recently undergone a similar operation,” according to the 1899 article.

Back then, people proved they had been vaccinated not by the paper cards issued at mass vaccination sites, but by the scars on their arms. To administer the shot, doctors scraped a small spot on the patient’s arm with a surgical blade, a process that left a visible mark at the injection site.

The doctors traveled along Albemarle Street, which was home to a large Russian Jewish population, where up to 10 people might have lived in a house. In numerous cases, no one in the house spoke English and officials struggled to explain the purpose of their visit. Should someone refuse the shot, health officials called the police, who held the person down until they were vaccinated. Doctors placed a guard at the rear door of a house to ensure no one inside could escape. In Black neighborhoods, people who resisted the vaccine were threatened with being locked up.

In 1913, Baltimore health officials again picked up the vaccination crusade, examining people’s arms throughout the city and inoculating those who lacked “good marks,” according to a Sun article that year. Failure to get vaccinated could result in a $10 fine, going to jail, or both.

The Sun archives show that several people were fined through the years. At least one person was arrested. In 1899, a Miss Laura Watkins was taken into custody after refusing to let a doctor examine her arm.

Such mass vaccination projects also gave rise to groups like Maryland’s Anti-Vaccination League, which met in Baltimore and opposed mandatory inoculations. It was part of a national movement that was the precursor to today’s “anti-vaxxers.”

Doctors and the reporters who covered such work often demonstrated racist attitudes. The author of The Sun article in 1899 used racist and xenophobic language to describe those communities, for example, referring to “the unvaccinated foreign element” and “a very squalid lot of colored people.”


In an August 1901 speech to his staff urging vaccinations before children returned to the classroom, James Bosley, then the city’s health commissioner, racialized the threat of smallpox, claiming that an influx of unvaccinated Black people from the South would infect the rest of the population.

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“We are surrounded by cities where a large number of cases of smallpox now exist and we are constantly threatened with the disease by the arrival of colored people from the South,” he said.

Smallpox outbreaks ravaged free Black populations of the South after the Civil War, killing about 60,000 people. The book “Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction” describes how racist white observers blamed the epidemic on the lifestyles of freed men and women, rather than the federal government’s failure or even refusal to provide help.

While racism characterized so much of American discourse around smallpox, few seemed to remember that a Black man helped bring inoculations to the New World.

Onesimus was born in West Africa in the 1600s. In his home country, he was inoculated for smallpox through an ancient process called variolation. A precursor to modern vaccinations, variolation involved injecting a small amount of infected material in a healthy person. It killed a few people, but saved countless others.

As an adult, Onesimus was kidnapped and brought to the colonies as a slave. He shared his knowledge of variolation with his slaver: a Boston minister named Cotton Mather, who embraced the technique amid a deadly smallpox epidemic in 1721.


Mather’s advocacy of variolation was hotly controversial in Boston. Someone even threw a bomb through his window.

The issue of compulsory vaccination continued to be a controversial one for years in the U.S. In 1905, the U.S. Supreme Court upheld states’ rights to make inoculations mandatory.