How the History of the Anti-mask and Anti-vaccination Movements Hang Together

Thomas Schlich and Bruno J. Strasser

Robert F. Kennedy Jr. is best known as a vaccination skeptic, but he is also skeptical about using masks for infection control. At the Libertarian National Convention in Washington, DC in May 2024, Kennedy Jr. recalled being asked during the pandemic whether he was scared of dying of COVID-19 since he wasn’t wearing a mask. His answer at the time was: “There’s a lot worse things than dying,” including “living like a slave”. The audience broke into applause.

Such an opinion is not new. A century earlier, during the influenza pandemic, citizen Frank Bobich told a Sacramento police officer that he would rather “be killed or hanged” than cover his face with a mask. Bobich had a mask in his pocket but refused to comply with the city-wide mask mandate. These blusterous statements reveal that for many people masks mean much more than protection against infectious diseases. They are not about health, but freedom. For this reason, the history of masks – and opposition to mask mandates – offers a unique window into the tense relationships between scientific expertise, medical authority, and state power. 

Bruno J Strasser & Thomas Schlich’s new book, The Mask, is out now with Yale University Press

Why would anyone refuse to wear a mask in the midst of a pandemic? In 1918, many people simply found masks uncomfortable, and, on cold days, they fogged up one’s spectacles. For some there were also medical reasons not to wear a mask. Masks were believed to trigger attacks of neuralgia and be altogether unsanitary. Instead of being breathed out, germs would be taken right back when wearing a mask. In November 1918, a resident of Stockton, California, defied the city’s mask ordinance by arguing:
“I am a healthy man now,” but “I know full well if I put one of those things on, I will get sick.” Scientific evidence of the benefit of forcing people to wear masks was rather shaky in 1918.

But the most important reasons for rejecting masks were not medical. They were political and based on an anti-state control sentiment. The history of public opposition against masks mandates is a uniquely American story for a very simple reason: no other country ever imposed masks wearing on such a scale. In 1918, the authorities of a few municipalities in the United States obliged their citizens to put on masks to prevent infections. At first, the measure was relatively well accepted. But over time, more and more people were caught in public places without masks. Sometimes they were arrested and fined like Bobich. In the fall of 1918 San Francisco had a first mask ordinance for a few weeks. In January of the following year, a rebound in the number of influenza cases caused the city authorities to enact a second such ordinance. In reaction, a group of citizens founded an “Anti-Mask-League” on January 17, 1919. The League’s membership included public-spirited citizens, skeptical physicians, but also more zealous critics of modern medicine and state intervention.

Ten days later, the Anti-Mask League held a protest at a public meeting of the Board of Supervisors (San Francisco’s version of a City Council). Several hundred opponents of the masking ordinance turned up. They gave standing ovations to those among the supervisors who were against masks and hissed at those who were in favor. As the representatives departed at the end of the meeting, the protesters shouted, “freedom and liberty”. It was not so much the masks as such that the League opposed. Their protest was directed against the mandate. Forcing a piece of clothing on a citizen’s face was unconstitutional, they argued.

In San Francisco in 1918, a police officer enforced the mask mandate by arresting a citizen who had lowered his mask to smoke a pipe. Courtesy of the California History Room, California State Library, Sacramento, California

Many of the mask critics were civil libertarians who opposed mask mandates because, as they argued, “if the Board of Health can force people to wear masks, then it can force them to submit to inoculation, or any experiment or indignity.”[1] The connection to inoculation – another word for smallpox vaccination – is revealing. It shows that the organized anti-mask movement was a part of a more extensive, politically motivated resistance against state intervention into personal and health matters. The League’s female president, E.D Harrington, had a long track record of commitment to various political causes aiming to increase personal freedoms. She was not the only woman in the League. Women played an important role in the organization, for example, Eily Grosjean who was the Anti-Mask League’s vice-president and who was also president of the Parents’ Rights League of America. Like her, two other leading women of the League were engaged in protesting against what they perceived as an overreach vis-à-vis parents’ rights in the management of children’s health, such as medical tests for children in schools. In accordance with their role in the contemporary anti-vaccination movement these activist women took on the role of defenders of their homes and families against the intrusion of state authorities regarding the use of masks.

The anti-mask movement was in fact very much modelled on the anti-vaccination movement. Historically, anti-vaccination was a worldwide phenomenon in the late 19th and early 20th centuries. It was often combined with anti-vivisection, vegetarianism, and other physical and social purity movements, as well as with feminist objectives. The United States had a long tradition of both anti-vaccine movements and mandatory vaccination, the latter going back to 1809 when Massachusetts was the first state to make smallpox vaccination compulsory.[2] This was followed by various such laws in the different states, which provoked different forms of resistance. By the 1890s, anti-vaccination societies had organized themselves to fight against compulsory vaccination laws. But in 1905, in the case Jacobson v. Massachusetts, the US Supreme court confirmed the right of states to enforce vaccination laws. When the influenza pandemic broke out in 1918, states like California or Massachusetts had smallpox vaccination laws. It was thus not a radical step for municipalities such as San Francisco or Boston to pass mask mandates.

Opposition against compulsory vaccination – and masks – was part of a profound skepticism about the growing reach of the government into the spheres of education, family life, personal belief, and bodily autonomy. It was rooted in American libertarian radicalism, a radical democratic ideology – a “populism of the body”, as historian Robert Johnston has named it.[3] Part of it was the so-called “Medical Liberty” movement. Medical Liberty activists fought against all forms state intervention in matters of hygiene and health through compulsory measures –examinations, inspections, medication, vaccination.[4] Often this kind of criticism was targeted at what was probably the most powerful argument in favor of state intervention at the time: germ theory, the idea that specific bacteria, viruses or fungi cause specific diseases. The prominent New York City anti-vaccination critic Harry B. Anderson, for example, spoke of “Bacteriophobia and Health Board Folly” when he criticized the interdiction of spitting on the city sidewalks.[5] Anderson authored a book, published in 1920, that was evocatively titled State Medicine: A Menace to Democracy.

Anti-vaccine activists typically rejected the science that was used to justify targeted public health measures, as they were typical for the “New Public Health” of that period, and that went beyond traditional epidemic control to include vaccination and other population-wide medical interventions. Activists endorsed alternative approaches: for them, health could be achieved through proper personal hygiene, diet, exercise, rest, and a positive mental attitude, but also good living conditions. Compulsory measures, medical libertarians argued, were palliative makeshifts designed to hide the effects of capitalism, which was the true root of all the health evils. It was poverty, substandard housing, the lack of clean water and healthy food that made people sick.

What contributed to making these public debates possible was the fact that the effectiveness of public health measures such as mandatory smallpox vaccination or mask wearing was still a matter of dispute among physicians and scientists. A century later, the evidence in favor of vaccination for diseases such as smallpox is scientifically undisputed (even if Robert Kennedy Jr’s still seems to have his doubts). The evidence in favor of population-wide mask mandates, on the other hand, was much less certain when the Covid-19 pandemic broke out in 2019. This opened a space for a vocal opposition against mask mandates connecting, once again, public health interventions to an infringement of individual liberties. This opposition also found allies among those who were already critical of any kind of scientific evidence, echoing old anti-vaccine view that an elite of scientists and doctors were monopolizing authority over medical matters, hijacking the American government for their own monopolistic commercial interests and violating the fundamentally American values of freedom of speech and enterprise.

It’s a claim that reflected a fundamental tension at the heart of American society in the Progressive Era and remains unresolved today. What is at stake is the place of technical expertise in modern societies, as well as the balance of personal liberty versus solidarity, social conformity versus individualism. Both, the anti-vaccine and the anti-mask movements opposed the subordination of individual freedom to community welfare. These questions are still at the root of today’s ideological and political divides as they manifest themselves in the rhetorics of public figures like Robert F. Kennedy Jr.

Thomas Schlich, MD, is a James McGill Professor in the History of Medicine at McGill University, Montreal, head of the Department of Social Studies of Medicine. His research interests include the history of modern medicine, science, and technology, specifically the origins of modern surgery, 1800-1914.

Bruno J. Strasser, a historian, is a full professor at the University of Geneva and an affiliate of the History of Medicine at Yale University. In addition to exploring masks, he is currently working on the history of disposable medical devices in the 20th century

[1] Alfred W. Crosby, America’s Forgotten Epidemic: The Influenza of 1918. 2^nd ed (Cambridge: Cambridge University Press, 2003), 109.

[2] James Colgrove, State of Immunity. The Politics of Vaccination in Twentieth-Century America (Berkeley, Los Angeles, London: University of California Press, 2006), 9.

[3] Robert Johnston, The Radical Middle Class: Populist Democracy and the Question of Capitalism in Progressive Era Portland, Oregon (Princeton: Princeton University Press, 2003), 178.

[4] Steven Petrina, “Medical Liberty: Drugless Healers Confront Allopathic Doctors, 1910-1931”, Journal of Medical Humanities 29 (2008), 205-230.

[5] H.B. Anderson, State Medicine: A Menace to Democracy (New York, N.Y.: Citizens Medical Reference Bureau, 1920), 49-50.