Understanding Public Attitudes Towards Vaccination in 1941: Lessons from a Historic Opinion Poll

You’ve probably seen in the news the results of an opinion poll on some subject. Opinion polls are an efficient way for policymakers and others to gauge attitudes, knowledge, and beliefs of the public on subjects of public interest. We get bombarded with poll results around elections, and often hear a poll or two mentioned in a policy discussion. Polling is a science. When done correctly, it reveals information about large groups of people by asking questions of a small sample.

In 1941, the United States looked at the war in Europe and the Japanese military successes in the Pacific with unease. The American military was expanding in anticipation of helping supply the countries resisting the Axis Powers, or being fully involved in the war. (The United States officially entered World War II after the bombing of Pearl Harbor, Hawaii, by Japanese forces.) Once the United States entered the war, soldiers were required to receive vaccinations against typhoid fever, smallpox, and tetanus. Vaccines against influenza and yellow fever would soon follow. But how did the public feel about vaccines, about any vaccine mandates due to the war, and did they know how and where to get vaccinated? To answer these questions in 1942, researchers looked at a survey done in 1941, and extrapolated some conclusions on how the whole country would react to compulsory vaccination to keep the American workforce healthy during the war.

The survey is summarized in a report titled “Attitude of the Nation Toward Immunization Procedures: A Study Based on a Public Opinion Poll Made in 1941.” (You can click here to read the full report as a PDF file.) As the researchers point out, Table 2 of the report shows that a majority of those polled believed in the typhoid, diphtheria, and smallpox vaccines’ ability to prevent disease.

The paper further states that many who did not believe the vaccines prevented disease believed the vaccine had some protective effect: “Of those who had answered "no," about 60 per cent believed that, because of immunization, a person will have milder forms of the diseases-indicating an even wider acceptance of the procedures than indicated in the “yes" and "no" answers. An additional 18 to 20 per cent felt it might be effective or help in some cases. Only 9 per cent took the fatalistic attitude that "if you're going to get it you're going to get it."

The paper states that 85% of those polled saw “no serious drawbacks” to immunization. Two percent saw vaccination as “too expensive or too much trouble.” Persons in charge or children were more likely to want those children protected from those diseases through vaccination. Those same people, however, believed vaccination should be done upon exposure to a disease and/or at when entering school (around age six). The paper noted from these and other findings that few people knew the proper — or medically accepted — timing of vaccinations.

Several “generalizations” were made in the conclusion section of the paper regarding the “the attitudes of the adult white population in the United States”:

“1. In general the public is aware of the value of immunization against and of the serious nature of diphtheria, smallpox, and typhoid fever, and sees no specific drawbacks connected with being inoculated against them.

2. Over 50 per cent of those who are in need of protection say they might be willing to be protected.

3. The public is not well informed concerning when or how often to be immunized. The importance of having children protected against diphtheria and smallpox in infancy needs particular emphasis.

4. Persons responsible for children are generally better informed concerning immunization procedures than adults not responsible for children.

5. In general, the public opinion is sufficiently favorable toward active immunization against smallpox, diphtheria, and typhoid fever that public health officials and private physicians can well urge such procedures as a routine practice.”

Reference

Baumgartner L. (1943). Attitude of the Nation Toward Immunization Procedures: A Study Based on a Public Opinion Poll Made in 1941. American journal of public health and the nation's health, 33(3), 256–260. https://doi.org/10.2105/ajph.33.3.256