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The long and messy history of vaccine cards

Even in our 21st-century pandemic, we’re clutching a familiar paper artifact.

A form that affirmed the health of travelers in 17th-century Italy.
A form that affirmed the health of travelers in 17th-century Italy.Wellcome Collection/CC by 4.0

My first vaccination at the Hynes Convention Center happened startlingly quickly, and I was grateful for 15 minutes in the recovery area to sit with my vaccine card and my thoughts. I am a historian, and I use documents like this to piece together the forgotten past and to tie individuals to the momentous events of history.

I often reflect on which objects from the past survive into the present — the censored books, the broken lenses, the literal shackles of chattel slavery — and on how their meaning evolves with time.

My vaccine card, carefully filled out in black pen by the Navy sailor from Alabama who administered my vaccine, is a historical object replete with meanings. I will hold on to it among my treasured mementos: a valet slip from the hotel on my wedding night; an envelope of hair from my child’s first haircut; a broken pin I remember my mom wearing when I was a child.

Like those ephemera, most of these cards will surely have disappeared in a century or two, regardless of their importance to us today.

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I wonder if the 17th-century Italians I study felt similarly attached to the printed health forms that they carried with them, certifying that they were free of plague and could cross local borders. Did the paper pass they carried evoke for them the strange combination of nostalgia, opportunity, and responsibility that this document signifies for me? I doubt it. Tracking and managing plague outbreaks was a normal if terrifying part of life in late-Renaissance Europe, and these early modern health passes were part of the regular bureaucracy of business, just like the censor who inspected books for heresy as they arrived at the city custom house. We should be careful not to project our emotions too readily onto items from the past.

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Over the past year, though, I have been repeatedly struck by the ways that aspects of this pandemic have made the distant past seem unnaturally close. The material reality of vaccine cards seems to elide the distance between past and present.

In early 19th-century New England, a three-by-five-inch vaccine card documented the successful inoculation of 12 children against smallpox. It commemorated these children’s survival as a sign of the efficacy of inoculations, which, to the issuers, was “a blessing as great as it is singular in its kind.”

A card documenting the inoculation of 12 children in Milton in 1809.
A card documenting the inoculation of 12 children in Milton in 1809.National Museum of American History, Smithsonian Institution

Over the past few months, my friends have shared their experiences of lining up at athletic facilities from Fenway Park to the Oakland Coliseum, which were temporarily repurposed into mass vaccination sites. Another set of historical vaccine cards reminds me of the more sinister transformation of the Tanforan Racetrack in San Bruno, Calif., into a relocation center for thousands of Japanese Americans during World War II. Their processing and confinement at the track included vaccinations for typhoid and smallpox, which had the potential to run rampant in the close quarters of internment camps. While vaccination in general is essential for public health, in the context of internment these vaccine cards primarily document oppression by the state, not liberation from disease.

A card documenting the vaccination of an 8-year-old Japanese American boy processed at the Tanforan Racetrack in 1942.
A card documenting the vaccination of an 8-year-old Japanese American boy processed at the Tanforan Racetrack in 1942.National Museum of American History, Smithsonian Institution

When New York City children lined up to receive their diphtheria vaccines in the 1920s, they clutched their vaccine cards in their right hands while exposing their left arms to the school nurse. Like them, when I return for my second dose, I’ll be holding tight to my vaccine card — a memento of my own mortality, of the many lives lost since this coronavirus began its rampage, and of the long and troubled history of disease control. It’s a portal to the past and, I hope, a ticket to a better future.

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Hannah Marcus is assistant professor of the history of science at Harvard University and author of “Forbidden Knowledge: Medicine, Science, and Censorship in Early Modern Italy.”