For historians of African American public health, the 2008 U.S. presidential election was a landmark event--not only because it produced the nation's first African American commander-in-chief, but also because unprecedented numbers of elderly African Americans received "flu shots" in the process. Considered wary of vaccination due to a long collective history of medical exploitation and neglect, African Americans have long ranked among those U.S. citizens least likely to avail themselves of preventive vaccines, resulting in low vaccination rates among black children, adults, and senior citizens alike. (1) Governmental and private agencies have devoted vast resources to correcting this disparity, encouraging many innovative outreach programs. (2) Among the most striking is "Vote and Vax," the Sickness Prevention Achieved through Regional Collaboration (SPARC) initiative that worked with community groups to bring influenza vaccination to polling places in 2008. Launched in 1996 and expanded in 2006 with support from the Robert Wood Johnson Foundation, "Vote and Vax" provides convenient polling-place vaccination to the elderly, who comprise the largest numbers of both registered U.S. voters and influenza fatalities. (3) Through such outreach, the program melds the civic responsibilities of the franchise with those long associated with vaccination. (4)
Almost a year before the 4 November 2008 election, the Robert Wood Johnson Foundation announced that "Vote and Vax 2008" would offer free influenza vaccination at 250 sites in thirty-five states and Washington, DC, on election day. (5) Some observers, noting that analysts expected Barack Obama's candidacy to increase African American voter participation exponentially, predicted a concomitant spike in the number of black elders consenting to polling-place vaccination. (6) Post-election reports vindicated these forecasts, as analysts concluded that "Vote and Vax" had immunized record numbers of African American senior citizens during the 2008 election. (7) If, as some researchers have argued, racial disparities in willingness to be vaccinated vary according to the characteristics of the vaccination program, then Barack Obama's presidential bid appears to have provided some African Americans with increased incentive for polling-place vaccination. (8)
With "Vote and Vax" pledged to participate in the approaching midterm elections of November 2010, this is an opportune moment to consider the historical antecedents of the 2008 presidential election's marriage of vaccination and African American political concerns. (9) Because effective vaccination campaigns encourage prevention among individuals in order to guard against the spread of disease within the larger population, they have traditionally appealed to civic duty in ways that blend politics and medical science. (10) Nonetheless, much of the press coverage of "Vote and Vax 2008" presupposed that the program's juxtaposition of vaccination and African Americans' national political interests was without precedent. (11) However, reporting of much older provenance, specifically that of the abolitionist and African American press that comprised black print culture in the United States in the four decades preceding the Civil War, presented smallpox vaccination as an integral part of African Americans' understanding of civic and political involvement. Within this antebellum print culture, vaccination featured in free, northern African Americans' efforts to demonstrate that both they and their enslaved brethren in the South were "fit for freedom," that is, possessed of the mental and physical soundness and commitment to civic engagement that qualified them for full citizenship rights. More importantly, this print culture promoted vaccination in order to encourage behaviors consistent with citizenship, including intellectual advancement and civic responsibility, among its African American readership.