In early 1902, with smallpox cases cropping up in the hundreds throughout Boston, a health department physician called at a Beacon Hill lodging house. His job seemed simple: the Board of Health had ordered everyone not vaccinated in the last five years to get it done and it sent out squads of doctors, door-to-door, to make sure that each resident complied. The physician even had the backing of a Massachusetts state law that decreed jail time or a fine for those who refused. Yet a reporter who followed this physician on his rounds discovered that the task was anything but simple. The individuals he encountered used all sorts of wily tactics to avoid inspection of their vaccination scars. They blatantly lied or adroitly manipulated the hapless doctor to escape vaccination.

Two female tenants invoked the privilege of gender to avoid exposing their flesh to a strange man's scrutiny. One young woman declared: “Why doctor, you see I’ve got on a tight-fitting sleeve, and I can't roll it up.” Another lady stammered modestly that her vaccination was on her leg and she simply “looked out the window while the physician beat a hasty retreat down the hall.” Other tenants worked as a sort of tag team. One man swore he had been vaccinated four years ago, exclaiming: “and I was sick for two weeks!” But when the doctor tried to look at the man's vaccination scar, a boy distracted him “with questions on all sorts of subjects, much to the relief of the man who had been carrying his scar for at least 15 years.” The ease of their evasions led the reporter to conclude: “enforcement of compulsory vaccination is not as strict as it might be in many cases.”

These people were not antivaccinationists. They did not argue about vaccination or civil liberty—they just seemed wary, seeking instead to misdirect or put off the doctors. Physicians in other states also reported a common distaste for vaccination. Frederick Dillingham, the assistant sanitary superintendent of the New York City Department of Health, observed that when the Girl's High School of Brooklyn ordered its pupils to produce their vaccination certificates or face expulsion, the two thousand students raised “such a storm of excited protest” that it rescinded the order.