At the 1902 annual meeting of the Massachusetts Association of Boards of Health, the biologist William T. Sedgwick argued that health officers ought to take antivaccinationists seriously by responding respectfully to their criticisms rather than automatically categorizing their opposition as lunacy. Dr. Samuel Holmes Durgin, chairman of the Boston Board of Health, reacted sardonically to his colleague's entreaty. Alluding to his many difficulties with the antivaccinationists, Durgin declared: “I think he has betrayed a more tender and considerate feeling than has been produced within me in the last few months… . I have no sympathy with the men and women who are publishing rash and unfounded charges against vaccination.” In the last months of 1901, Boston's antivaccinationists had publicized illnesses and deaths after vaccination and criticized his management of the epidemic, leading vaccination rates to drop off. As the smallpox epidemic steadily worsened, Durgin had to issue a controversial general vaccination order in a desperate attempt to control the growing epidemic.

Samuel Durgin may have lacked “tender or considerate” feelings for Boston's antivaccinationists, but one more than any other proved especially irritating. From the beginning of the epidemic, Dr. Immanuel Pfeiffer, the “special champion of the opposition to vaccination,” stood out as Boston's leading antivaccinationist. Throughout the fall of 1901, Pfeiffer conducted a one-man crusade against vaccination, Samuel Durgin, and the Boston Board of Health in the pages of his magazine, Our Home Rights, and in every public forum he could find. Focusing his wrath on Durgin, Pfeiffer criticized his management of the isolation hospital and questioned his motives in sending vaccination squads only to poorer sections of the city.

Durgin, the consummate public health professional, resented Pfeiffer's allegations. In many ways, Pfeiffer and Durgin each represented two important strains of reform that had emerged in the late nineteenth century, populism and progressivism. Durgin epitomized the progressive ideal of scientific expertise in government service where trained professionals supposedly brought high standards of scientific objectivity and impartiality to previously partisan appointments. Pfeiffer personified the democratic, populist impulse of the time.