Almost a century later, the cartoon looks strangely contemporary. Not only because vaccine arguments are still with us, but because the artist was already describing them as an information problem.
That sent me looking backwards.
What I found was initially amusing, then increasingly unsettling, with a strong sense of déjà vu.
We have heard this before
In June 1802, only a few years after Edward Jenner introduced vaccination against smallpox, James Gillray published The Cow-Pock, or, the Wonderful Effects of the New Inoculation.
It shows people receiving Jenner's vaccine and subsequently sprouting horns, hooves and miniature cows from their bodies. The Library of Congress dates the print to 12 June 1802.
Gillray was a satirist, so the image should not simply be treated as an anti-vaccination manifesto. What makes it useful is that the fears he was caricaturing were already recognizable.
Vaccination was unnatural. Something foreign was being introduced into the body. Its consequences might be grotesque and uncontrollable.
Another print from roughly the same period goes much further.
A monstrous creature covered in disease is being fed baskets of babies. The children emerge from the other end transformed with horns. Wellcome describes Charles Williams's image as propaganda against vaccination.
The imagery is extreme, but the underlying persuasive structure is not difficult to recognize.
The medical intervention is more frightening than the disease. Children are victims. Doctors are doing something unnatural. Authorities assuring you that it is safe cannot be trusted.
And this was only the beginning.
By the nineteenth century, resistance to vaccination had become organized.
Groups, publications and political movements formed around opposition to vaccination and, particularly, compulsory vaccination. Oxford's history of the idea notes that “anti-vaccinists” were already being described as such in the early 1800s, while organized groups and dedicated magazines appeared by the 1880s.
Opposition was intertwined with arguments about government compulsion as well as arguments about the vaccine itself.
An Anti-Vaccination League leaflet from the 1880s attacked one of the most obvious arguments made by vaccination advocates. Supporters pointed to the disappearance of faces scarred by smallpox as evidence that vaccination worked. The leaflet told readers this was a “curious illusion” and argued that the decline had begun before vaccination.
Now we are moving beyond monsters and frightening pictures.
We are entering competing explanations of evidence.
The same becomes even clearer in Alexander M. Ross's The Anti-Vaccinator, published during Montreal's devastating 1885 smallpox epidemic.
It resembles a newspaper. It contains arguments, statistics, medical claims and the language of reform.
It presents an alternative explanation of disease and public health, one in which sanitation rather than vaccination is the answer and medical authorities themselves are part of the problem.
This is important because misinformation has never depended on looking ridiculous.
Sometimes it looks like research. Sometimes it quotes doctors. Sometimes it contains real statistics.
And sometimes it begins with a legitimate question and builds an unreliable explanation around it.
Other campaigners preferred something much simpler.
An anti-vaccination image reproduced by Oxford and attributed to 1892 shows a woman fleeing with her child from a giant snake labelled VACCINATION. Death stands behind it in the form of a skeleton.
No statistical argument is required. Vaccination is the predator. Mother and child are the victims.
Fear does the rest.
By 1920, Charles M. Higgins could publish an entire illustrated volume titled Horrors of Vaccination Exposed and Illustrated.
Its contents accused vaccination of causing disease and death, attacked health departments, alleged that dangers were being concealed, appealed to personal liberty and surrounded those claims with photographs, statistics, medical references and official-looking documentation.
One image he reproduced came from Harper's Weekly in 1912.
Higgins placed it under a section called “The Slaughter of the Innocents” and used the image of a frightened child being vaccinated to portray the procedure as medical savagery.
He then accused doctors and health departments of concealing deaths caused by vaccination.
Poisoned children.
Profiteering or self-interested experts.
Hidden injuries.
Manipulated statistics.
Government compulsion.
A medical establishment protecting itself.
A courageous minority challenging accepted wisdom.
The technology of misinformation changes much faster than the psychology of misinformation.
So what exactly have we learned?
This is where the historical curiosity turns into a difficult question.
More than two centuries separate Gillray's cartoon from today's information environment.
During that time, literacy became widespread. Mass education expanded. Modern medicine developed. Newspapers, radio and television brought scientific information into ordinary homes. Universities expanded enormously.
Then the internet placed a staggering amount of human knowledge within immediate reach of billions of people.
And yet many of the persuasive structures above remain perfectly usable.
If we can look at an anti-vaccination publication from 1885 and immediately recognize arguments circulating online in the twenty-first century, what does that say about our confidence that education can protect people against propaganda?
Perhaps society has learned remarkably little.
And if that is true, what exactly are we trying to accomplish when we teach people about disinformation, manipulation or corrosive propaganda?
Do we explain confirmation bias, emotional manipulation, scapegoating and information laundering, only for the lesson to disappear the moment somebody encounters a story that makes them angry enough?
Does it simply fly past their ears?
There is a strong temptation to look at two centuries of anti-vaccination activism and answer yes.
But that conclusion has a problem.
The anti-vaccine movement survived. Smallpox did not.
A 1923 British poster from Gloucester presents figures from a local smallpox outbreak and urges people who reject vaccination to consider them.
The Science Museum connects it with an epidemic that had been spreading in Gloucester and the surrounding area since 1922.
Contemporary public-health commentary explicitly blamed anti-vaccination propaganda for helping create the conditions in which the outbreak occurred.
Anti-vaccination activism continued after that.
Smallpox did not.
The World Health Organization declared smallpox eradicated in 1980 following a worldwide campaign built around vaccination, surveillance and containment.
It remains the only human infectious disease to have been eradicated globally.
More broadly, WHO estimates that vaccination against fourteen diseases saved at least 154 million lives during the fifty years following the creation of its Expanded Programme on Immunization in 1974.
So we have two historical facts that seem contradictory only if we expect education and public health to produce unanimity.
Anti-vaccine rhetoric survived.
Vaccination succeeded anyway.
And that distinction is important.
The continued existence of an idea does not tell us how persuasive that idea would have been without education, institutions, experience and counterargument.
We notice the people who still believe something.
We rarely notice the people who might have believed it but did not.
Imagine that a persuasive falsehood convinces thirty people out of every hundred in one environment. After sustained education and exposure to counterarguments, it persuades ten.
Years later we discover those ten people passionately repeating exactly the same claims.
We might point at them and say, “Nothing changed.”
But twenty people changed.
Persistence is not the same thing as unchanged effectiveness.
That seems obvious when stated plainly, yet it is remarkably easy to forget when judging whether education against propaganda “works.”
Education can work. Just not like magic.
There is now experimental evidence that people can be taught to recognize manipulation techniques before encountering them in the wild.
The approach is often called psychological inoculation or prebunking.
Instead of waiting until someone has accepted a particular false claim and then attempting to correct it, the intervention teaches the technique behind the manipulation in advance.
A 2022 Science Advances study tested short videos warning people about methods commonly used in misinformation, including emotional language and false dichotomies, and found improved resilience to misinformation.
Even more relevant to our historical example, researchers published three preregistered randomized controlled trials in 2025 involving 2,326 participants and a short game specifically designed around vaccine misinformation.
Participants became better at distinguishing vaccine misinformation from other information, more confident in doing so, and made better decisions about what they would share.
So people can learn.
The less convenient finding is that learning does not produce permanent immunity.
Research published in Nature Communications in 2025 found that the protective effects of misinformation interventions can decay over time and that strengthening memory through later “booster” interventions can help preserve them.
There is something almost too appropriate about discovering this while studying the history of vaccination.
Education against propaganda may need booster shots too.
Small effects are still effects.
A very large experiment published in 2026 makes the point even better.
Researchers tested prebunking videos across twelve EU countries in thirteen surveys involving 19,735 people.
The videos taught viewers to recognize three familiar manipulation techniques: scapegoating, removing information from context and discrediting opponents.
The results were statistically significant across the surveys, improving recognition of manipulation and some sharing decisions.
But the effects were small.
That is the interesting part.
The researchers reported effect sizes ranging roughly from 0.08 to 0.38 and explicitly called for further work on repeated and context-specific interventions.
That is much less satisfying than announcing that we have discovered how to immunize democracy against propaganda.
It is probably much closer to reality.
A short educational intervention does not transform somebody into a perfectly rational citizen.
It moves the probability a little.
But society is made of probabilities multiplied by millions of people.
A small improvement in the proportion of people who recognize a manipulation, refuse to share it or hesitate long enough to investigate it can become socially significant even though most individuals barely notice the change.
Perhaps the mistake is expecting an educational intervention to leave behind obvious converts.
The person at the bottom of the rabbit hole may be the wrong audience.
There is another assumption worth questioning.
When we talk about countering propaganda, we often imagine the person who already believes it.
Then we measure success by whether we can change that person's mind.
That may be one of the hardest possible tests.
Once an explanation becomes entangled with identity, community, status, grievance and belonging, another fact sheet is competing against much more than an incorrect factual claim.
The history of vaccine resistance itself warns against treating the problem simply as ignorance.
Opposition has repeatedly involved questions of trust, political compulsion, access, institutional behaviour and social identity alongside claims about medicine. Oxford's historical work on vaccine hesitancy stresses how context dependent these attitudes have been.
Perhaps the educational audience we should worry about most is not the person at the bottom of the rabbit hole.
It is the person standing near the entrance.
Someone encountering their first video explaining that “they don't want you to know this.”
Someone seeing an outrage that perfectly confirms everything they already believe about another political group.
Someone watching a genuine grievance slowly acquire an imaginary conspirator.
Someone being told that the absence of evidence proves how effective the cover-up has been.
Someone about to share something because it feels true.
That person may not need a complete education in information warfare.
They may need one familiar warning bell.
Maybe resistance is enough.
We use enormous language when discussing education against disinformation.
We talk about defeating propaganda, building resilience, protecting democracy and creating informed societies.
There is nothing wrong with ambition, but those phrases can also create an impossible standard.
Propaganda is not going away.
Neither are fear, tribal loyalty, resentment, motivated reasoning or the pleasure of discovering information that confirms what we already suspected.
Two centuries of anti-vaccine rhetoric should cure us of the idea that enough factual information will somehow remove those vulnerabilities from human beings.
But removing them was probably never a realistic goal.
What education can create is friction.
A moment between seeing and sharing.
A suspicion that an emotionally irresistible story may have been designed to feel irresistible.
Recognition that a complicated event has been compressed into one villain.
Awareness that “they don't want you to know” is itself a persuasive technique.
The habit of checking where a statistic actually came from.
The ability to recognise when five apparently independent sources all lead back to the same original claim.
The willingness to ask one more question.
None of these things sound revolutionary.
That may be exactly why they are useful.
Back to the cliff
The strange little cartoon that started all of this is nearly a century old.
Its anti-vaccinationist is still walking.
Misinformation still exists.
Prejudice still makes an effective blindfold.
If our definition of successful education is a society in which nobody again falls for these techniques, then the historical verdict is not encouraging.
But perhaps we have been asking education to accomplish something no education can accomplish.
Human vulnerability is not a lesson that can be permanently taught away.
It has to be managed, challenged and taught again.
Every generation arrives without the previous generation's experience. Every new technology provides old manipulations with another delivery system. Every crisis creates new fear, new uncertainty and new opportunities to exploit both.
The propaganda survived but so did the resistance to it.
That may be the lesson worth taking from two hundred years of vaccine controversy.
We are probably never going to make people immune to manipulation.
But if somebody recognises a technique a little earlier, hesitates a little longer, checks one additional source or chooses not to amplify one persuasive falsehood, education has already changed the outcome.
Perhaps not dramatically and perhaps not permanently.
But across a society, repeated often enough, that small difference may be what resistance actually looks like.
And now, you know.
