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From the beginning of early vaccination attempts in the 19th century, resistance to vaccinations began, particularly in England and the United States. Early protests against Edward Jenner were voiced soon after he began his vaccination attempts of smallpox. Objections ranged from reasons involving sanitary conditions of the injection, religious reasons against vaccinating, with some seeing it as unclean having come from an animal, scientific or at least pseudo-scientific reasons against vaccinating, and political objections. In the early 19th century, personal liberty was increasingly cited as a reason for those who opposed being vaccinated. In fact, with the English Vaccination Act of 1853 ordered requiring vaccinations for young children, the personal liberty argument became far more pronounced. Interestingly, anti-vaccination movements often emerged as being relatively strong in specific regions. In the United Kingdom, the town of Leicester emerged in the mid-19th century as a hotbed of anti-vaccination rallies. As vaccination laws came into effect in the United States, similar reactions against vaccinations emerged, with personal liberty increasingly cited as the main reason why someone objected to vaccinations. In the United States, the Anti-Vaccination Society of America became established in 1879 after William Tebb, a leading British anti-vaccination activist, visitedthe United States. By the late 19th century, vaccination laws in California, Illinois, and Wisconsin were all challenged in courts. A landmark U.S. Supreme Court case in 1905 ruled that states did have the right to instigate required vaccination campaigns, limiting state-level anti-vaccination movements (Figure 1).<ref>For more on early anti-vaccination movements, see: Merino, N. (Ed.), 2015. <i>Vaccines, At issue</i>. Greenhaven Press/ Gale Cengage Learning, Farmington Hills, Mich. </ref>

By 1962 in the United States, new laws forced the Food and Drug Administration to have stringent guidelines as to formally approving drugs and vaccines, leading to today's formal testing phases. Nevertheless, in the 20th century anti-vaccination movements became more sophisticated as they began to try to use scientific reasons as to why vaccinations should not be forced. Some cases of deaths or strong allergic reactions were sometimes used as supporting evidence. In the 1970s, Gordon Stewart, an outspoken physician, supported the anti-vaccination movement by writing several case reports that attempted to link neurological disorders to vaccinations again diphtheria, pertussis, and tetanus. In the United States, media attention and documentaries have helped to fuel the debate. A well-known documentary, <i>DPT: Vaccination Roulette</i>, was aired in 1981 and attempted to discredit diphtheria, pertussis, and tetanus using arguments given by Stewart. In the 1990s, the anti-vaccination movement also began to criticize the measles, mumps, and rubella vaccines, with British doctor Andrew Wakefield arguing that there was a possible relationship between bowel disease, autism, and the vaccines for these diseases. In the 2000s, anti-vaccination campaigns have also focused on compounds used to preserve vaccines, such as Thimerosal which contains small amounts of mercury. Some have argued that these cause harm; however, similar to Stewart's and Wakefield's arguments, no proof has emerged from the scientific literature supporting that these substances cause direct harm. However, some individuals could be allergic to compounds within vaccines, which could explain some observed negative reactions.<ref>For more on the anti-vaccine movement in the 20th century and later, see: Davidson, T., 2017. <i>Vaccines: history, science, and issues, The story of a drug</i>. Greenwood, an Imprint of ABC-CLIO, LLC, Santa Barbara, California. </ref>