The History of Vaccination

Dr Vernon Coleman MB ChB DSc FRSA

Vaccination was first tried in China and India twenty-five centuries ago. It had been discovered that, by putting material from smallpox scabs or pustules into the nose or skin of a healthy individual, a less severe attack of the disease could be produced, which would subsequently provide the patient with protection against the more serious and potentially fatal form. In China, for example, where a proverb cautioned that you should not count your children until they had all contracted smallpox, physicians collected the scales from drying smallpox pustules, ground them to a power and blew them into the nostrils of people who wanted protection. They also tried placing healthy individuals in contact with patients suffering from mild forms of smallpox in the expectation that the healthy people would contract the mild form of the disease and then remain protected.

However, it was not until the beginning of the eighteenth century that this effective form of preventive medicine first became popular in Europe. An Italian, physician, Dr Emanuel Timoni, working in Constantinople in 1714, discovered that the Turks used inoculation to protect their citizens from smallpox, and sent a paper on the subject to the Royal Society in London. Meanwhile Giacomo Pylarini, a Greek doctor working in Smyrna at about the same time, took some thick material from a smallpox pustule and rubbed it into a scratch made with a clean needle on the arm of a healthy volunteer. An account of this experiment was sent to Doctor John Woodward in London, who published the details in the Philosophical Transactions of the Royal Society.

Inoculation became fashionable in Britain and in Europe when Lady Mary Montagu, the wife of the British Ambassador to Turkey, had her daughter publicly inoculated against smallpox.

Unfortunately, this type of inoculation carried risks, and after a few deaths had resulted from the practice, it soon lost popularity in Europe. In American, however, inoculation continued apace. Both Benjamin Franklin and George Washington advocated the method. In the 1740s Dr Kilpatrick in Charleston, who inoculated by making a very shallow, superficial scratch, inoculated between eight hundred and a thousand people in 1743. Only eight of them died.

One man who made a fortune from inoculation was Thomas Dimsdale, a leading British practitioner of the technique, who, in 1786, was invited to go to Russia to inoculate the family of Catherine II. In return, Dimsdale was made a baron, a councillor of state and a major general. He was also given his expenses, a fee of £10,000 and an annuity of £500. Dimsdale may have done well out of this particular family but he did understand the shortcomings of inoculation. When a Society for the Inoculation of the Poor was formed in London, Dimsdale objected on the grounds that, in the overcrowded conditions in which the poor of London lived, inoculation would simply spread smallpox and produce artificial epidemics of the disease. In Dimsdaleís opinion there was no guarantee that individuals who caught the infection from an inoculated patient would not allow the spread of a more dangerous version of the disorder. One doctor reported, for example, that a single inoculated child had infected a total of seventeen people, eight of whom had subsequently died.

1774 also saw a vital breakthrough in the fight against smallpox made by a Dorset farmer called Benjamin Jesty. Frightened by the latest news of a local outbreak of smallpox, Jesty vaccinated his wife and two sons with cowpox (a similar but mild disease contracted by cows) to protect them against the more dangerous disease. Jesty had undoubtedly noticed that girls working on his farm who had contracted cowpox did not seem to get smallpox. Jestyís experiment was, however, ignored by the medical profession for two decades.

The idea was revived by a general practitioner called Edward Jenner. The son of a clergyman, Jenner worked in Gloucestershire, England where it had long been known that dairymaids who developed cowpox did not get smallpox. Jenner slowly collected evidence from his patients and the local people until, in 1796, he was certain enough of his theory to repeat the experiment first tried by Jesty in 1774. With enormous professional courage Jenner inoculated material from a cowpox pustule on the hand of a dairymaid, Sarah Nelmes, into the arm of an eight-year-old, James Phipps. The real test of Jennerís nerve came seven weeks later, when the time had come to inject the boy with material from a genuine smallpox pustule. To Jennerís undoubted relief, the boy remained healthy and Jenner described his work in a booklet which he published himself in 1798.

Within a remarkably short time, news of Jennerís work had spread around the world. In some areas an infected cow would be led from door to door so that material could be scraped off and used to vaccinate the waiting citizens. In France, the Emperor Napoleon ruled in 1805 that all his troops who had not had smallpox should be vaccinated at once.

Getting the material for vaccination to America and other distant parts was not quite as easy as spreading it around Europe. The technique was first introduced in America by Dr Benjamin Waterhouse of Boston, who was Harvardís first Professor of the Theory and Practice of Physics. Waterhouse had been sent a copy of Jennerís booklet by a friend, John Coakley Lettson, who was a leading figure in the Society for Inoculation of the Poor in London.

Waterhouse proceeded to protect the American people and to make his own fortune by vaccinating as many as he could. Later, Thomas Jefferson, the American President, persuaded a deputation of North American Indian chiefs to take supplies of the vaccine back to their people. Mass vaccination programmes were in operation on both sides of the Atlantic within a few years of the publication of Jennerís experiment. And Russian doctors were vaccinating people on their border with China. It had taken only a few years for Jennerís discovery to affect the whole world.

A fuller version of this history of vaccination appears in Vernon Colemanís book The Story of Medicine which is available as a paperback and an eBook on Amazon.

Vernon Colemanís book on vaccination (explaining how vaccination has been dangerously oversold and turned into a hugely profitable but deadly international business) is entitled Anyone Who Tells You Vaccines Are Safe and Effective is Lying. Hereís the Proof and is available as an eBook and a paperback on Amazon.

Copyright Vernon Coleman 2019