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At the beginning of the 20th century, infectious diseases were widely prevalent in the United States and exacted an enormous toll on the population. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died.1 In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died.2,3
In 1900, few effective treatment and preventive measures existed to prevent infectious diseases. Although the first vaccine against smallpox was developed in 1796, >100 years later its use had not been widespread enough to fully control the disease.4 Four other vaccines—against rabies, typhoid, cholera, and plague—had been developed late in the 19th century but were not used widely by 1900.
Impact of Vaccines Universally Recommended for Children—United States, 1900-1998. JAMA. 1999;281(16):1482–1483. doi:https://doi.org/10.1001/jama.281.16.1482-JWR0428-2-1
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