Smallpox Vaccination

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Smallpox Vaccination

The Scourge . Smallpox was a deadly fact of life in early America, just as it had been in Europe for centuries. It came to the United States among the first settlers—and every ship that visited from Europe or the West Indies had the potential for starting another epidemic. Little was known about the disease, and nothing could be done about it except to fast and pray: smallpox was God’s punishment.

Early Immunization . One fact about smallpox was understood: people who contracted the disease and survived were thereafter immune to it. A crude method of inoculation had developed (possibly in India or Africa) but was rarely used in Europe: inject a healthy person with the smallpox matter taken from the sore of a person suffering a mild case, producing another mild case and lifetime immunity. But, as can be easily imagined, the idea of exposing a healthy person to smallpox was not widely accepted. Typical of the religious objection was a 1722 sermon titled “A Sermon Against the Dangerous and Sinful Practice of Inoculation.” Only God, it warned, could inflict disease.

Mather and Boylston. After learning that his African slave had been immunized, Cotton Mather (himself a minister as well as a physician) tried to popularize the concept in colonial America in the early 1700s. He encouraged the experiments of Boston physician Zabdiel Boylston, who had learned of Turkish inoculations in 1721. These experiments were risky: Boylston’s angry neighbors threatened to charge him with murder if any of his patients, including his own six-year-old son, died. Some Americans, including Thomas Jefferson, had been immunized by this “direct” method. However, it was still considered dangerous by many physicians, and with good reason: it was quite possible to cause the disease rather than prevent it. Benjamin Franklin believed the risk was worth taking. “In 1736 I lost one of my Sons a fine boy 4 Years old, by the Small Pox,” he wrote in his autobiography. “I long regretted bitterly & still regret that I had not given it to him by Inoculation.” Boylston’s work had saved many lives, but a safer method would be required.

Jenner’s Experiments. Beginning in the 1760s, an English country doctor named Edward Jenner had observed that English milkmaids who had contracted cow-pox disease seemed to be immune to smallpox. Speculating that smallpox and the milder cowpox were related, Jenner experimented with “vaccination” using cowpox (vaccine is from vacca, the Latin word for cow) and proved in 1796 that it was effective against smallpox. But the medical establishment was not convinced. Britain’s prestigious Royal Society rejected his findings the following year. Still, he wrote a report, An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease … Known by the Name of the Cow Pox (1778), which was to have far-reaching consequences.

Vaccination in America . When Dr. Benjamin Water-house of the Harvard Medical School read Jenner’s report, he began his own experiments. He injected his four children and a young servant boy with cowpox vaccine. They became mildly ill, as expected. He then exposed them to smallpox. When they did not contract the disease, Waterhouse had proved that Jenner’s method was effective. Dr. Waterhouse wrote his own report on vaccination, A Prospect of Exterminating the Smallpox (1800), which he sent along with some vaccine, to President Thomas Jefferson. The president, a great promoter of practical science, helped popularize Jenner’s method by vaccinating his entire family. Recognizing the devastating effect that smallpox continued to have on Native Americans, Jefferson instructed Lewis and Clark to teach the Indians how to protect themselves against the disease.

More to Prove . But Waterhouse’s work was not finished. With the popularization of Jenner’s method, many people tried doing it themselves—often using impure cowpox matter. In 1802 an English sailor who had recently arrived in Boston convinced people that he had cowpox and began selling the virus from his pustules. He actually had smallpox, and a serious epidemic resulted. It took a special investigation by the Boston Board of Health to conclude that “the cow-pox is a complete security against the small-pox.” As cowpox vaccine became more readily available and more doctors accepted Jenner and Waterhouse’s work, there was a significant decrease in the number of deaths from smallpox.

A LETTER TO DR. EDWARD JENNER

Monticello, May 14, 1806

Sir,

I have received a copy of the evidence at large respecting the discovery of the vaccine inoculation which you have been pleased to send me, and for which I return you my thanks. Having been among the early converts, in this part of the globe, to its efficiency, I avail myself of this occasion of rendering you a portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility. Harvey’s discovery of the circulation of the blood was a beautiful addition to our knowledge of the animal economy, but on a review of the practice of medicine before and since that epoch, I do not see any great amelioration which has been derived from that discovery. You have erased from the calendar of human afflictions one of its greatest. Yours is the comfortable reflection that mankind can never forget that you have lived. Future nations will know by history only that the loathsome smallpox has existed and by you has been extirpated.

Accept my fervent wishes for your health and happiness and assurances of the greatest respect and consideration

Thomas Jefferson

Source: Merrill D. Peterson, Thomas Jefferson and the New Nation: A Biography (New York & Oxford: Oxford University Press, 1970).