How Fashion Helped Defeat 18th-Century Anti-Vaxxers

In the late 1700s, trend-setters helped normalize the distrusted process of inoculation. Today, a similar movement could encourage parents to vaccinate their kids.

Marie Antoinette, Queen of France, Jean-Baptiste Gautier Dagoty, 1775 (Wikimedia)

It was the perfect storm of disease transmission: a tourist destination packed with foreign visitors and unvaccinated local residents during a busy holiday season. I'm not talking about last month at Disneyland—the epicenter of a measles outbreak that's infected more than 50 people in four states and two countries to date—but the Château de Versailles in April 1774, where smallpox struck more than 50 people, including King Louis XV himself.

In 18th-century Europe, smallpox was a scourge feared by kings and commoners alike. It was highly contagious, grossly disfiguring, and often fatal. But it was also preventable. Smallpox inoculation—which by then was the norm across Asia and the Middle East—was introduced in the West by Lady Mary Wortley Montagu. Herself a smallpox survivor, the English ambassadress to Turkey had witnessed the practice in Constantinople, and upon her return to England in 1718 she became its biggest advocate. Initially, London society found the practice shocking, but by the end of the century, inoculation had been adopted throughout most of Europe.

France was one of the last holdouts. Though inoculation was common in northern Europe by the early 1770s, it was still regarded with suspicion in France, and with good reason: Improperly performed, it could result in infection and even death. Before Edward Jenner developed the first vaccine to combat smallpox in 1798, the practice of inoculation involved injecting a small amount of pus from the lesions of a smallpox sufferer under the skin of a healthy patient—just enough to stimulate the production of antibodies without triggering a full-blown case. (Jenner’s vaccine used cowpox, a mild virus that conferred immunity to its deadly relative; the term "vaccine" is derived from the Latin vacca, meaning cow.) While the likes of Voltaire and Diderot championed inoculation, the conservative French medical establishment resisted the new and risky practice. After a 1762 epidemic was blamed on inoculation gone wrong, it was even banned in Paris for five years.

Despite decades of debate, however, it only took one smallpox death to settle the inoculation question in France once and for all. On May 10, 1774, King Louis XV died after a two-week illness—an inexorable, excruciating, and very public demise. We rarely hear about the 10 other courtiers and palace servants who died during the same outbreak. But the new king, Louis XVI, was sufficiently alarmed that he took the controversial step of submitting to inoculation on June 18, 1774. His two younger brothers, the Comte de Provence and the Comte d’Artois, were inoculated at the same time—in other words, the entire line of succession.

The procedures were a success. The milliners of Paris, attuned to current events that could be translated into quick profits, commemorated the momentous event with an allegorical headdress dubbed the pouf à l’inoculation. Perched atop a woman’s powdered and pomaded coiffure, it depicted the serpent of Asclepius, representing medicine; a club, representing conquest; a rising sun, representing the king; and a flowering olive branch, symbolizing the peace and joy resulting from the royal inoculation. In commemorating the royal inoculation, the milliners and their female clients helped to publicize it, and the practice—like the pouf—instantly became all the rage.

Sadly, no image of the pouf à l’inoculation has survived. At the time, fashion magazines weren't published regularly, and trends came and went so fast that they rarely left a visual record. But as late as 1785, a fashion plate depicted a hat trimmed with a white-spotted "ribbon à l’inoculation," undoubtedly referencing the pustules of smallpox. At a time when many people still bore the scars of la petite vérole, it must have been a powerful and poignant fashion statement.

Crucially, the pouf à l’inoculation wasn't an explicit critique of the 18th-century anti-vaxxers, but simply a visible expression of support for inoculation. Instead of picking a fight, it presented inoculation as something normal and harmless. And because the pouf was worn by the fashionable elite of society, it went one step further, making inoculation look not just normal, but also cool.

A sense of normalcy is exactly what’s missing from today’s vaccination debate. Already stressed-out new parents are bombarded with the alarmist, emotional accusations of the anti-vaxxers who claim vaccination can cause autism on one hand, and the strident, jargony denials of the medical establishment on the other. We hear a lot about the risks of vaccinations—or, alternatively, the much more serious risks of foregoing them and losing herd immunity as vaccination rates drop below 92 percent—but little about the vast majority of parents who quietly continue to vaccinate their children according to CDC guidelines, without complications.

This is where fashion could once more play a role. Just as those "I Voted" stickers have a certain election-day cachet and effectively shame those who haven’t voted into getting to the polls, an "I Vaccinated" sticker could start a revolution, or at a least a conversation. Some clinics already give out similar stickers during flu season—not to reward the vaccinated, but to remind the rest of us to get our shots.

And, indeed, fashion is already doing its part in the form of pro-vaxx and anti-vaxx T-shirts. Many of the anti-vaxx versions come pre-loaded with Libertarian subtext. A syringe with the label "Weapon of Mass Destruction" is a popular theme. Or "No Shots, No School, Not True." One breathtakingly insensitive T-shirt reading "No thank you, you can keep the autism" may have inspired this fierce rejoinder declaring "I have Autism, not vaccine damage."

Pro-vaxx T-shirts are harder to find, but are arguably more stylish and sassy. A cute retro design from Spreadshirt recommends: "Love your kids. Have them shot." Curiously, however, most of these shirts—pro and con—are designed for adults, though some (including "I have Autism") can be purchased in kids’ sizes.

In a way, this makes perfect sense; it’s the parents who make the decision to vaccinate or not to vaccinate a child, and then defend that decision in the court of public opinion. But, from a propaganda standpoint, it’s a missed opportunity. Just as it would be safe to assume that the wearer of a pouf à l’inoculation had been inoculated herself and lived to tell the tale, a healthy child will always be a better argument for vaccination than an opinionated parent. Women Thinking’s 2010 “Hug me, I’m vaccinated” T-shirt campaign embraced this positive, non-confrontational approach to vaccine education. But my favorite comes from Tiny Torsos; a portion of the proceeds are donated to Every Child By Two, a nonprofit devoted to eliminating vaccine-preventable diseases.

Me putting a "Fully Vaccinated—You’re Welcome" T-shirt on my two-year-old is unlikely to bring about a breakthrough in public health, though it will undoubtedly raise a few eyebrows at the local playground. (I live in California, where 11 percent of public elementary schools have kindergarten vaccination rates below 92 percent, including the one my older child attends.) But just imagine what would happen if the paparazzi snapped the likes of Blue Ivy Carter, Nori West, or the Jolie-Pitt kids wearing one. Without saying a word, these instantly recognizable, robustly healthy, enviably privileged children could drown out the Jenny McCarthys and Donald Trumps of the world. Suddenly, vaccination would look not just normal, but incredibly cool. And no one would have to die to make it happen.