[Editor's Note: Today we are celebrating the anniversary of the discovery of the Smallpox Vaccine. Please enjoy and pass this along.]
When was the last time you lost a loved one to smallpox? When was the last time you heard of anyone dying of smallpox? When was the last time you even heard about anyone sick with it? If you cannot readily answer any of those questions, there’s a reason for that: smallpox is the only disease that has been eradicated by a vaccine. The last natural acquired case was recorded in Somalia in 1977. The worldwide eradication of smallpox was certified by a commission of scientists in December 1979, and subsequently endorsed by the World Health Assembly in 1980. The use of the smallpox vaccine was discontinued in the U.S. in the 1970, way before many of us were born.
The smallpox may be gone, but just like with its “lucky” victims, it has left deep scars on humanity. On the anniversary of the smallpox vaccine, let us take a look at the dreaded disease, the vaccine that ultimately beat it, and the anti-vaccine movement it spawned.
The Disease
Smallpox is credited with being the deadliest disease to ever have befallen human kind; it killed over 500 million people, more than any other disease has, and more than all the wars of the twentieth century combined. When the European settlers brought it over in North America, it decimated the native inhabitants: their population went from 70,000,000 to a little over 600,000. No disease was more destructive than smallpox.
Getting sick with it was not fun either. The disease started with fever, headache, nausea, but these common symptoms would soon morph into something out of a horror movie. Dr. Paul Offit describes the disease in his latest book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, as such:
The face, trunk, and limbs erupted in pus-filled blisters that smelled like rotting flesh - blisters so painful that victims felt like their skin was on fire. Worse: smallpox was highly contagious, spread easily by coughing, sneezing, or even talking. As a consequence smallpox infected almost everyone. Pregnant women suffered miscarriages, young children had stunted growth, many were permanently blinded, and all were left with horribly disfiguring scars. One in three victims died from the disease.
“The smallpox was always present,” wrote a British historian in 1800, “filling the churchyard with corpses, tormenting with constant fears all whom it had not yet stricken, leaving on those whose lives it spared the hideous traces of its powers, turning the babe into a changeling at which the mother shuddered, and making the eyes and cheeks of the betrothed maiden object of horror to the lover.”
It is believed smallpox originated about 3,000 years ago in Egypt or India, and went on to become one of the most devastating diseases mankind has ever faced, decimating populations for centuries. In some cultures custom forbade the naming of a newborn until he/she had caught and survived the disease. It killed Queen Mary II, King Luis I of Spain, Tsar Peter II of Russia, and King Louis XV of France among others.
No effective treatment was ever developed for smallpox. In its deadliest form (variola major) it killed as many as 30% of those infected, and between 65-80% of those it did not kill were left with scars, most prominent in their face. One third of all reported blindness in 18th century Europe was due to smallpox. No one can tell for sure what would have happened if the vaccine had never been invented, but I think it’d be safe to say that many millions of people would have either died or suffered horribly until an alternate solution would have been found.
Thankfully, it turned out that we did not need to experience that alternative scenario. The smallpox vaccine came to humanity’s rescue.
The Vaccine
The smallpox vaccine is both the first vaccine ever invented, and the first one to eradicate the disease it targeted. Its inventor is Edward Jenner, who in 1798 showed that inoculation with cowpox provided protection against smallpox. Jenner was told by a milkmaid that after getting cowpox from milking sick cows, she developed immunity towards smallpox.
On May 14, 1976 Jenner tested the phenomenon: he took fluid from a blister of another milkmaid, and then injected it under the skin of the eight-year old son of a local laborer. The boy developed a small blister which eventually fell off. To test for immunity, Jenner then injected the boy with pus taken from someone with smallpox. The boy survived. The test was a success, and the most successful vaccine of our time was born. Jenner published his finding in 1978; his vaccine spread out rapidly: between 1810 and 1820 the vaccine halved the number of deaths from smallpox.
In the early 1950s, about 50 million cases of smallpox occurred worldwide in a year; by 1967 that number had dropped to 10-15 million cases. At that time, the WHO launched an intensified plan to eradicate the disease, which by then killed 25% of all infected. No effective treatment was ever developed for smallpox, but, thanks to vaccines, by 1980 the disease was eradicated. Millions of lives and untold amounts of suffering and misery have undoubtedly been spared since.
The Anti-Vax movement is born
Jenner’s smallpox vaccine was a triumph and well accepted, that is until the British Government decided to require vaccination. That was the moment the organized anti-vaccine movement was born.
In 1853 the British Government passed a compulsory vaccination law. It required all children to be vaccinated, or the parents would face fines and imprisonment. That law however did not clarify how it was going to be enforced, and as a result it wasn’t enforced properly, leading to a reduction in vaccination rates.
Having learned their lesson, the British Government passed a new act in 1967 which clearly defined how the law would be enforced. Parents that did not comply would first be issued a warning by the medical officers. If the warning was ignored the parents would be taken to court where they faced fines and court costs. If they refused to, or could not afford to, pay the fines their assets would be seized and sold at auction. If enough money was not raised that way, one of them would be imprisoned for up to two weeks.
Compulsory vaccination is what gave birth to the anti-vaccine movement. The first anti-vaccine organization, the Anti-Compulsory Vaccination League was founded by Richard Butler Gibbs, his brother George and cousin John. By 1900, over 200 anti-vaccine leagues had been formed by British citizens.
Their rhetoric was fiery and wrapped in language of patriotism and freedom. They likened vaccination to Devil worshipping and human sacrifice; doctors were portrayed as vampires “hovering over pregnant women”. They maintained Jenner’s vaccine contained “the blood entrails and excretions of bats, toads and suckling whelps” and that it transformed a child into “a scrofulous, idiotic ape, a hideous foul-skinned cripple: a diseased burlesque on mankind”. Sound familiar?
Because the smallpox vaccine was derived from cowpox, people were actually afraid they would turn into cows. There were reports of the “ox-faced boy or children who ran about on all fours, bellowed, coughed, and squinted like cows.” This sentiment has been famously captured in a caricature by James Gillray, titled “The Cow-Pock or the Wonderful effects of the New Inoculation” which shows people being turned into cows from his vaccine: they had horns, snouts, or had small cows growing like tumors in their bodies.
Conclusion
Smallpox is gone, and the vaccine that defeated it is no longer being used, unfortunately as all vaccines are bound to, this one had a side effect which we’re still dealing with today: the anti-vaccine movement. Quite literally, so long as we’ve had vaccines, we’ve had anti-vaxers. Their arguments have not changed much: doctors are evil, vaccines are unnatural and dirty, they are made up of toxic materials, they cause asthma, diabetes, autism, or kill infants. What has changed substantially is their ability to reach the masses via Oprah, Larry King Live, Times Square ads, books, the Internet, Playboy bunnies, comedians and doctors who’ve given up on science and the scientific method.
I am worried that our constant exposure to the anti-vax message might have inoculated us against it. It worries me that we might have become so complacent, even within the skeptical movement, that some of us might have become passive consumers of skeptical information, but are unwilling to take the next step and become skeptical activists.
So I urge you all to take a few minutes and do something. Lend a helping hand to those of us fighting the good fight. I urge you to please take a moment to join our mailing list at Vaccine Times. Learn the facts and counter the anti-vax arguments whenever you come across them on the internet.
There are a lot of skeptics out there, but what we need are a lot of active skeptics. After all, smallpox has been eradicated, but polio hasn’t; measles hasn’t, whooping cough hasn’t. Children are still dying from these diseases.
And that is something we all should be scared of.
Sources
Leart Shaka is a NYC based skeptic, who is focusing his skeptical efforts in countering anti-vaccine misinformation. He is the creator, and Editor-In-Chief, of The Vaccine Times, a quarterly pro-health publication, for parents, by parents, and runs the Vaccine Times website and blog. He can be found on Twitter as @Skepdude and @VaccineTimes.
CORRECTIONS: 05/16/11
Some astute readers have pointed out a few errors in the above entry. These are the corrections:
Jenner tested his vaccine on May, 14 1796 not 1976
Jenner published his findings in 1798 not 1978
The British government second compulsory act was passed in 1867 not 1967
The sentence: "When the European settlers brought it over in North America, it decimated the native inhabitants: their population went from 70,000,000 to a little over 600,000." was based on an erroneous source (which has been made aware and is taking steps to correct its own statement), and is incorrect as worded. Correctly worded it should read as such: " When the European settlers brought it over to North and South America, it contributed to the decimation of the native population, which, due to warfare and disease, went from 70,000,000 to a little over 600,000."