Vaccination Overview

Edward Jenner 

Queen Mary 11, 1662-1694.
Died of smallpox.

 The first documented use of vaccination against smallpox occurred in China around 1000 A.D. when smallpox sores were opened to remove pus, or the dried scabs were ground into a powder, and the resulting material was either scratched into the skin surface or blown into patients’ nostrils. This procedure became known as ‘variolation’, covered by the more modern term, inoculation. Emperor K’ang Hsi, who had survived smallpox as a child, had his children inoculated by variolation in the late 1600s. Queen Elizabeth 1 caught it on October 10^th 1562 and survived but her Lady in Waiting, Lady Mary Sydney, survived but her intense scarring caused her retirement from the Court as did the blight on the former legendary beauty of Lady Katherine Howard in 1619. Queen Mary died of the disease in 1694. In 1721 Lady Mary Wortley Montague, wife of the British Ambassador to Constantinople, decided to have her five year old daughter treated by variolation, having had both sons similarly treated successfully in 1717. The several English physicians who witnessed the treatment, were impressed by the mildness of the subsequent illness and this success stimulated further interest. King George 1 had his grandchildren ‘variolated’ but first, six prisoners in Newgate Prison supposedly volunteered to be guinea pigs in exchange for reprieves and eleven charity schoolchildren received the treatment successfully, after which two Royal children followed suit.

Jenner in action. 1802 cartoon by James Gillray.
Wellcome Institute Library, London.

In 1774, farmer Benjamin Jesty of Yetminster in Dorset, took matter from a cowpox lesion and rubbed it into scratches made with a darning needle in the arms of his wife and two sons. None caught smallpox in spite of living in an area of a smallpox epidemic at the time.

Approximately 10% of all deaths in Britain at this time came from smallpox hence the decision by Edward Jenner in 1796 to attempt to find a cure after noticing repeatedly that milkmaids who contracted cowpox always seemed to avoid later infections of smallpox. Edward Jenner, house pupil of the famous surgeon, John Hunter, at St George’s Hospital, London, had been inspired by his tutor as to the importance of experimentation and after studying cowpox for 20 years, made his first human experiment. On May 14, 1796, he took lymph from a cowpox pustule on the wrist of dairymaid, Sarah Nelmes, and inserted it into two superficial incisions in the arm of a boy, James Phipps. Jenner checked the boy’s condition and symptoms daily, recording the following:

'On Day 7, he complained of 'uneasiness' in the 

Jenner with his gardener's son, James Phipps
May 1796.

 axilla; on Day 9, he became a little chilly, lost his appetite and had a slight headache. On the following day, he was perfectly well. The appearance of the incisions were similar to that produced by variolous matter. On July 1, the boy was inoculated with matter taken immediately before from a smallpox pustule. Several punctures and slight incisions were made in both his arms and the matter was well rubbed into them but no disease followed.'

Jenner continued his experimentations successfully and a few years later published his classic 75 page paper entitled, ‘ An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease Discovered in Some of the Western Counties of England, particularly Gloucestershire, and Known by the Name of Cowpox.’ Although translated into the major European languages, his paper had a mixed reception . However, by the end of 1801, over 100,000 vaccinations had been performed in England with other European countries slowly following. Opposition continued however into the nineteenth and early twentieth centuries though approximately half of English children were vaccinated between 1870-73. In 1870 an epidemic [blamed, of course, on French refugees] killed over 44,000, a quarter of which total was in London and this greatly increased demand for infant vaccination. In 1871, 93% of children born in England and Wales were vaccinated, with special officers appointed to ensure no one was missed. Predictably the element of compulsion aroused opposition so that around 30% of children avoided vaccination by 1897.

1808 cartoon by Isaac Cruikshank showing
Jenner and 2 colleagues seeing off anti-vaxxers.
[Online, the handwritten remarks can be read!]

And the story continues to the present day with, anti-vaxxers growing in number in the 21^st century! The last known case of smallpox occurred in 1978.

I am indebted to Wye Historical Society [Kent] newsletter both for the idea of, and chiefly the information on, vaccination. My blood pressure needed a break from Trump and it is always a salutary lesson to learn of human creativity and the predictable emotional resistance to life-saving progress.