Vaccine controversies have occurred since almost 80 years before the terms vaccine and vaccination were introduced, and continue to this day. Opponents question the effectiveness, safety, and necessity of recommended vaccines. They also argue that mandatory vaccinations violate individual rights to medical decisions and religious principles. These arguments have reduced vaccination rates in certain communities, resulting in outbreaks and deaths from preventable childhood diseases.
Evidence surrounding vaccination shows that prevented suffering and death from infectious diseases outweigh any adverse effects. Immunization programs depend on public confidence to be effective. Safety concerns often follow a pattern: a potential adverse effect is hypothesized; a premature announcement is made; the initial study is not reproduced; and finally, it takes several years for the vaccine to regain public confidence. A modern and notable example involved Andrew Wakefield's discredited claims of MMR vaccines causing autism.
Public reaction has contributed to a significant increase in preventable diseases, notably measles. In 2011 the vaccine-autism connection was described as "perhaps, the most damaging medical hoax of the last 100 years".
Early attempts to prevent smallpox involved deliberate inoculation of the disease in hopes that a mild result would confer immunity. Originally called inoculation, this technique was later called variolation to avoid confusion with cowpox inoculation (vaccination) when that was introduced by Edward Jenner. Although variolation had a long history in China and India, it was first used in North America and England in 1721. Reverend Cotton Mather introduced variolation to Boston, Massachusetts, during the 1721 smallpox epidemic. Despite strong opposition in the community, Mather convinced Dr. Zabdiel Boylston to try it. Boylston first experimented on his 6-year-old son, his slave, and his slave's son; each subject contracted the disease and was sick for several days, until the sickness vanished and they were "no longer gravely ill". Boylston went on to variolate thousands of Massachusetts residents, and many places were named for him in gratitude as a result. Lady Mary Wortley Montagu introduced variolation to England. She had seen it used in Turkey and, in 1718, had her son successfully variolated in Constantinople under the supervision of Dr. Charles Maitland. When she returned to England in 1721, she had her daughter variolated by Maitland. This aroused considerable interest, and Sir Hans Sloane organized the variolation of some inmates in Newgate Prison. These were successful, and after a further short trial in 1722, two daughters of Caroline of Ansbach Princess of Wales were variolated without mishap. With this royal approval, the procedure became common when smallpox epidemics threatened.