Questions About Vaccination on the US Census?

With the recent controversy over the United States Census, I decided to find out if questions about vaccination status had ever been asked on the decennial census. As it turns out, the answer is yes and no, depending on how you look at it. A question about vaccination status was asked in one of the censuses, but you would be surprised at how it was asked and who were the people asked about it.

The United States has carried out a census every ten years since 1790, in compliance with Article I, Section 2 of the Constitution: “The actual Enumeration shall be made within three Years after the first Meeting of the Congress of the United States, and within every subsequent Term of ten Years, in such Manner as they shall by Law direct.” Censuses at the time were not a novel idea. According to the Central Statistics Office of Ireland, censuses had been done for thousands of years by different groups and nation-states:

“Censuses have been taking place for thousands of years all over the world, with the first known census undertaken nearly 6000 years ago by the Babylonians in 3800 BC. There are records to suggest that this census was undertaken every 6 or 7 years and counted the number of people and livestock, as well as quantities of butter, honey, milk, wool and vegetables.

The oldest existing census in the world comes from China during the Han Dynasty. This census was taken in the year 2 A.D. and is considered to be quite accurate. It recorded the population as 59.6 million, the world’s largest population.

The census was a key element of the Roman system of administration and was carried out every five years and provided a register of citizens and their property. The word census originates in fact from ancient Rome, from the Latin word ‘censere’ which means ‘estimate’.”

As you can imagine, different questions were asked in different censuses. The census in 1880 was different in that it is the only census in the United States asking about vaccination status that we could find. (If this is not the case, and you know of a different census that asked about vaccination, please let us know in the comments.) According to the instructions for enumerators (census workers), they were to ask extra questions of Native Americans living in reservations:

“The 1880 Indian schedule made the following inquiries: Name (Indian name, English translation of Indian name, other name habitually used); relationship to head of household; civil condition (single, married, widowed/divorced, whether a chief or war chief); whether Indian of full or mixed blood; whether adopted into the tribe; time in years and fractions person has lived on a reservation; time in years and fractions person has worn ‘‘citizen’s dress’’; language spoken; sex; age; occupation; whether sick or disabled (if so, what is the sickness or disability); whether vaccinated; whether maimed, crippled, bedridden, or otherwise disabled; whether blind, deaf and dumb, idiotic, or insane; whether attending school; literacy; number of livestock owned (horses, cattle, sheep, swine, dogs); whether the household possess a firearm; acreage owned and type of ownership; time cultivating land; whether self-supporting or supported by other entity (self, family, or government) or occupation (hunting, fishing, or ‘‘natural products of the soil,’’ i.e. roots, berries, etc.).”

(My emphasis in bold.)

The only vaccine used in the United States at the time was Jenner’s smallpox vaccine. The rabies vaccine was still being worked on by Pasteur back in France, and the smallpox inoculation had fallen out of favor due to the success of the vaccination with cowpox to prevent smallpox. So it is very likely that the form is asking about the smallpox vaccination.

I searched around in the different databases of census records and found this microfilmed image of a form from the Yakama Reservation within Washington State:

A census form from 1880 showing information from a family within the Yakama Reservation in Washington State. (Click to enlarge.)

As you can see, under question 20, “Has this person been vaccinated?” only the father “Johnny Albert” is listed as having been vaccinated. (He also reports having two firearms, a rifle and a pistol. Can you imagine a question about gun ownership being asked in today’s political environment?) The family also apparently owned 40 acres and a total of ten horses.

Here is another form:

(Click to enlarge)

Here we have two families, “Henry Nelson’s” and “Charlie’s” families. Henry Nelson’s family consists of five individuals, three of whom report being vaccinated. In Charlie’s family, only Charlie is reported to be vaccinated. (Neither family reported owning firearms.) We can only speculate as to why only some members of the family are vaccinated and others are not, but, as we discussed in a previous post, getting the vaccine from Point A to Point B was quite the endeavor.

There are more forms from other reservations, of course. However, I did not find a clear explanation as to why vaccination was only asked of Native Americans. If you look at the 1880 census form for the general population, the questions about health do not include the same question about vaccination that was asked of reservation residents. (No question about firearm ownership, either.)

Census forms, and the questions they contain, have changed with each census, and the coming 2020 census will have an online component to it, making it effortless for everyone to respond, though not everyone will. The census is not a trivial matter since its results will dictate the apportionment of seats in the House of Representatives, the distribution of resources and the understanding of the makeup of the country. Maybe asking about vaccination status will help us understand which communities are at greater risk for outbreaks of vaccine-preventable diseases? Thankfully, there are other ways of answering this question that don’t have to wait until the next census in 2030.

Author: René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

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