October 20, 2021
Have you met anyone recently who had smallpox? No, you didn’t, thanks to the vaccines that wiped out that disease across the planet. Yet, given the current fracas over Covid vaccines, you’d think they are new, untested medicines. They’re not.
Smallpox was a deadly worldwide disease that killed 30 percent of those it infected. It had been around for thousands of years (scientists have detected it in Egyptian mummies).
When it was brought to North America by European explorers, it killed entire indigenous populations. There is evidence that the Chinese, Africans, and other groups had experimented with curbing smallpox a thousand years ago. The story of the creation of a vaccine that ultimately eradicated this deadly disease involves our own city of Boston.
Smallpox inoculation in America, called variolation, which means putting an active virus into a body, was first done in Boston in 1721 by Dr. Zabdiel Boylston, the result of knowledge gained from an enslaved African named Onesimus. In 1706, Onesimus had become the “property” of the noted Boston minister Cotton Mather, who was the grandson of Rev. Richard Mather, an early minister of the First Church in Dorchester after whom the Mather School is named.
Cotton Mather asked Onesimus about a particular scar he had, and the slave responded that in Africa they treated smallpox by removing pus from a person with an active smallpox sore and putting it into an incision in the bodies of others who did not have smallpox. Mather spoke to other enslaved Africans in Boston, who spoke of this procedure and said that they believed themselves to be immune from smallpox.
Boylston heard of this from Mather, who became an advocate for this process, and during an outbreak of the disease in 1721, the doctor put smallpox pus into an incision in three healthy patients, his 13-year-old son and two enslaved Africans. From that treatment, the three became immune to smallpox. A few hundred others were also inoculated in the same manner. As a result, there were far fewer deaths than in the uninoculated population.
Despite its success and Mather’s advocacy, Boylston’s inoculation method met with tremendous opposition. Other doctors, ministers, and politicians of the day argued that the process interfered with divine Providence while also asserting that enslaved Africans should not be believed. Boylston had many threats on his life, one of which was an effort to hang him. He was arrested and forced to agree to not inoculate others without government permission. Mather himself was also threatened by anti-vaxxer Bostonians.
A few years later, Boylston traveled to London and publicized his work, “Historical Account of the Small-Pox Inoculated in New England,” which prompted English efforts at inoculation. His success also encouraged doctors in many of the American colonies to begin inoculating against the diseases.
In 1776, Abigail Adams inoculated her children against smallpox during an outbreak in Boston. She reported that “a spirit of inoculation” had gripped Boston, and that thousands were taking the treatment.
The first vaccine mandate in American history occurred during the Revolutionary War, when Gen. George Washington ordered mandatory inoculation against smallpox for American troops. This edict followed a losing battle where more than half the American soldiers were stricken with smallpox.
Many historians consider the Revolutionary War to be a battle against two enemies — the British and smallpox. Washington’s mandate was essential in staving off smallpox long enough for his officers and troops to defeat the British.
Vaccination – a treatment that prompts production of antibodies that provides immunity – against smallpox was developed in London when an English physician, Dr. Edward Jenner, noticed that milkmaids who had gotten cowpox (a weakened type of smallpox that infects cows) were somehow protected from smallpox. He took pus from a cowpox sore and tested his thinking by putting it into an incision of a patient who became immune to smallpox.
The word “vaccine” comes from the Latin word for cow because of this connection to cowpox. This allowed for inoculation to occur outside of a smallpox epidemic, and avoided the downside of variation by use of a weakened form of smallpox, which produced immunity without the side effects, including some mortality, which occurred when the actual smallpox pus was put into a healthy person’s body.
Louis Pasteur’s development of a laboratory technique for creating a modern smallpox vaccine led to efforts to eradicate smallpox in North America (elimination declared in 1952) and in Europe (1953). In the 1960s, the World Health Organization intensified its efforts at vaccination for the rest of the world, and in 1980, it declared that the world was free of smallpox.
In previous centuries, smallpox was a major cause of death and illness, often leaving survivors with horrible pockmarks. Despite the evidence that inoculation saved lives, anti-vaxxers continually threatened its advocates with injury and worse. Sound familiar?
The Covid vaccine will soon be authorized for children ages 5-11. It has been tested on thousands of children and will likely be half the adult dose. If you have doubts on whether it’s safe, please consider the following:
There have now been nearly seven billion doses of Covid vaccine given out across the world, more than 400 million in the US alone. No medicine has ever been tested on this number of people. The places with the highest percentage of vaccinated people are the ones with the lowest number of cases, hospitalizations, and deaths.
Our forebears feared catching smallpox and polio, two diseases that were wiped out by vaccines in the face of opposition by anti-vaxxers. This hysteria against vaccination has continued with the Covid pandemic. But there is a bottom line: We will defeat the coronavirus when we achieve universal vaccination.
Against a rising death count soon to surpass 750,000 in the United States alone, let’s apply the knowledge and courage of Onesimus, Dr. Zabdiel Boylston, Abigail Adams, George Washington, Dr. Edward Jenner, and Louis Pasteur to the situation today. Roll up thy sleeve.
Bill Walczak is a Dorchester resident and founding president and former CEO of Codman Square Health Center. His column appears regularly in the Reporter.