Vaccinations have been controversial since the late 1700s, when Benjamin Jesty and Edward Jenner first created a vaccine against smallpox. Two issues are central: the dangers of infectious diseases (measles, polio, diphtheria) vs. the danger of the vaccines themselves (which can cause real harm, if only to--relatively speaking--a very few), and public health concerns vs. private freedom.

The latter issue is of particular note as vaccination is the one area of public health on which federal and local governments take a fairly firm stand--proof of vaccinations, for example, is required for entrance to most public schools. Concerns about informed consent arise as well--if parents are made aware of small percentage of children who may die or be damaged by vaccines, how many will forego vaccination? Many do make this choice, for health, religious, or other reasons.

The debate about vaccinations has become more heated of late, perhaps (ironically) because widespread mandatory vaccination has eliminated once-terrifying diseases from both the lives and the memories of younger generations in the industrialized world. Rivera's sketch does not call to mind these conflicts, except, perhaps, in reminding us that infants and very young children--too young to do cost-benefit analysis or give informed consent--are the primary recipients of vaccines.

Rivera's baby, standing tall, seems to have a power all his own, calling to mind (my mind, at least) earlier images of the infant Jesus. Of course, Jesus as Christ sacrificed His single life for the lives of many, so perhaps the idea of personal good vs. common good is not entirely absent from Rivera's seemingly benign image of one of medicine's greatest advances.