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History Of The Government's Role In Preventing Health Emergencies


An outbreak of measles has infected more than 750 people in nearly 25 U.S. states. For a long time, the government has played a role in fighting epidemics, like one that terrified the country in 1949.


UNIDENTIFIED REPORTER: This year, the enemy, poliomyelitis, struck with such impact and fury that it shook the entire nation. It spread its crippling tentacles from ocean to ocean and border to border.

KING: In 1952 alone, almost 60,000 children were infected with polio and more than 3,000 of them died. And then in 1955, a vaccine became available and kids around the country lined up to get the shots.

Epidemics, immunizations and the controversy over them is what we're talking about this week in our Ask Cokie segment. Good morning, Cokie.

COKIE ROBERTS, BYLINE: Good morning, Noel.

KING: Here's our first question.

ANNA KRAMER: This is Anna Kramer from Boulder, Colo. Has the government always responded to health emergencies? If not, when and how did government leaders decide that the government should play a role in dealing with health emergencies?

ROBERTS: Well, actually, it's a long history, starting at the beginning of the republic when quarantine stations were set up in port cities to keep diseases from coming into the country on ships. But most of the responses in early years were left to state and local governments until, first, a massive yellow fever outbreak, then a cholera epidemic in the late 19th century spurred Congress to pass legislation providing for a greater federal role. And polio really brought that home, Noel. It was terrible. I was a kid during that epidemic, and the fear was just everywhere. Swimming pools were closed, theaters were closed. We were terrified.

KING: Did you line up to get the vaccine like so many kids did?

ROBERTS: Oh, sure, of course.

KING: We had a listener call in and ask whether the government is generally effective in these kind of efforts.

MICHAEL WALSTON: This is Michael Walston from San Antonio, Texas. How well coordinated was the government response to the HIV epidemic from the top down?

ROBERTS: It was awful. At first, no one knew what this new disease was. And then as it spread among gay men, there was a very negative response, particularly from some religious groups. They said that the victims of AIDS were responsible for their disease, and they were stigmatized. Meanwhile, the number of deaths every year climbed into the thousands.

And then in 1986, the surgeon general - a very conservative person - C. Everett Koop sent out this very frank report, and the government became active in fighting the disease. And then he sent brochures to every American household. Some found them shockingly graphic in explaining how AIDS was transmitted and how to guard against it. And federal dollars then poured into AIDS research. And then, of course, the lifesaving antiretroviral drugs were discovered and that was government scientists at work.

KING: We had one last question.

SETH WILHELM: This is Seth Wilhelm in Dayton, Ohio. Have legally mandated vaccinations ever faced high-profile legal challenges?

ROBERTS: Sure, they have, and there have been a couple of landmark Supreme Court cases - one in 1905 where a Massachusetts man objected to having to take the smallpox vaccine, and one in 1922 that upheld the right of a Texas school district to keep unvaccinated students out of school.

But, you know, some states, Noel, have been requiring vaccinations for schoolchildren for a very long time. Massachusetts started in 1855, and the federal government has been encouraging vaccinations even longer than that. The National Vaccine Agency was established in 1813, and it provided the smallpox vaccine to any citizen who wanted it. But what we see happening in history is a pattern here. There's a response after a terrible epidemic and then a relaxation as the memory fades.

KING: That is commentator Cokie Roberts. You can ask Cokie your questions about how politics and government work by tweeting us with the hashtag #AskCokie. Thank you so much, Cokie.

ROBERTS: Always good to talk to you. Transcript provided by NPR, Copyright NPR.