Millions of New Yorkers were immunized against smallpox within a few weeks in April 1947. The stimulus for this mass immunization was the importation of smallpox by a businessman who had acquired the disease during his travels. While we are in the middle of a massive influenza immunization campaign, it is useful to review the 1947 accomplishment as a model for public health planning and mobilization.
Early in March 1947, an American arrived in New York City by bus from Mexico City. He was ill upon arrival, and died in hospital within a few days. The cause of death was listed as bronchitis. Eleven days later a 22 month old baby and a 25 year old man were admitted to the same hospital with symptoms of smallpox. Laboratory tests revealed that these two individuals, as well as the businessman from Mexico, were positive for smallpox.
As a result of the smallpox diagnosis, all the hospital employees, as well as anyone who might have had contact with the patients outside the hospital, were immunized with smallpox vaccine.
The New York City Health Commissioner also recommended immunization of all New Yorkers who had not received smallpox vaccine since early childhood. Vaccine was supplied free of charge to clinics set up all over the city, and to private physicians. When a second person died from the disease on April 13, the Mayor asked all 7.8 million New Yorkers to be vaccinated. At this announcement, the city shifted into crisis mode, with contributions by police, fire, health departments, and hospitals. The campaign slogan was “Be sure, be safe, get vaccinated!”
It is interesting to note that vaccine side effects were barely considered during this crisis. The Health Commissioner assured the public that “Vaccination is painless. The skin is not even broken by the needle. Sometimes a soreness develops in the armpit. If the arm becomes very sore, apply an icebag”. The contrast with the amount of information provided today is considerable.
It is estimated that 5-6 million people were immunized by the end of April. The outbreak seemed to have been halted by the practice of ring vaccination, in which anyone who had contact with infected individuals were immunized.
The fact that the public health establishment of 1947 was able to quickly and effectively respond to an infection crisis should provide confidence in managing the current influenza immunization program or one against a novel infection of the future. But even though science and medicine have significantly improved since 1947, we still have a limited set of responses to frightening outbreaks: vaccination, quarantine, and anti-infective drugs.
Sepkowitz KA (2004). The 1947 smallpox vaccination campaign in New York City, revisited. Emerging infectious diseases, 10 (5), 960-1 PMID: 15216846