Free smallpox vaccination, as illustrated in a 1905 edition of Petit Journal, France. Photo by DeAgostini/Getty Image
Free smallpox vaccination, as illustrated in a 1905 edition of Petit Journal, France. Photo by DeAgostini/Getty Image

ScienceMay 21, 2019

Vaccination: A brief and sadly necessary history of its life-saving powers

Free smallpox vaccination, as illustrated in a 1905 edition of Petit Journal, France. Photo by DeAgostini/Getty Image
Free smallpox vaccination, as illustrated in a 1905 edition of Petit Journal, France. Photo by DeAgostini/Getty Image

The privilege many 21st-century parents think they have – to choose what illness will befall their children and how they will recover from it – is a relatively new phenomenon, writes historian Ayelet Zoran-Rosen

Vaccines save lives. They have saved millions of lives in the last century, and the best proof of their success is the existence of a growing anti-vaxxers movement. The existence of universal vaccinations created a reality in which people who bring a child into the world can safely assume that their child will grow to adulthood. This reality caused the current generation to collectively forget what it was like to raise kids in pre-vaccination times, when outbreaks of diseases were a recurrent – and dangerous – phenomenon. It is this collective forgetfulness that enables people to believe that vaccines cause more harm than good, because they do not believe that the vaccine-preventable diseases are at all dangerous or because they would prefer that their kids achieve immunity “naturally”.

As a historian, I know that the privilege 21st-century parents think they have – to choose what illness will befall their children and how they will recover from it – is a relatively new phenomenon. Throughout history, and until not too long ago, there were always several diseases that were particularly threatening, and parents were painfully aware of them and were actively looking for ways to spare their kids. One such parent was Lady Mary Montagu. In the years 1716-1717 Lady Mary accompanied her husband, the English ambassador to The Ottoman Empire, and witnessed a procedure called inoculation. This procedure included taking a string from a blister of a smallpox victim, drying it out and then using it to infect another person with attenuated smallpox. The recipient would often get a milder form of smallpox with a significantly lower risk of death.

“The smallpox,” Montagu wrote to a friend in England, “so fatal and so general amongst us, is here entirely harmless by the invention of engrafting … You may believe I am well satisfied of the safety of the experiment” she added “since I intend to try it on my dear little son”. She did have her son inoculated, and upon returning to England she inoculated her daughter as well. While it was much safer than getting real smallpox, inoculation was not without its risks, as there was a 2% chance of dying from smallpox after the inoculation. Some parents were sceptical of the procedure – a famous example is Benjamin Franklin – but many considered the high risk of dying or becoming deformed by the disease and inoculated their children.

By the early decades of the 20th century, humanity enjoyed a much safer and more effective way to prevent smallpox – Edward Jenner’s vaccine, produced from cowpox. Modern medicine has advanced, and a better understanding of infection and hygiene became widespread. But some diseases were still threatening the lives of people, especially of children. One of them was Polio. Summers came to be known as “polio season”, with parents trying to protect their children by avoiding large public gatherings and prohibiting any visit to public swimming pools. And yet, the 1916 epidemic saw the death of 6000 children and adolescents in the US – one out of every four children who became ill. Any sign of illness in summer would raise great fears.

The outbreaks were getting worse – in 1952 there were almost 58,000 cases in America, more than 21,000 of them were left paralyzed and over 3,000 died. During the 1955 epidemic in Boston, “the hysteria in the city was beyond description. Anybody who had a kid that was not feeling well, in the minds of the parents, they had polio until proven otherwise. They used to come running to the hospital to be evaluated … There was a tremendous influx of people,” a paediatrician from Boston’s Children’s Hospital recalls.

Contracting polio meant a long period of hospitalization, often in quarantine or far away from home, and even longer periods in rehabilitation facilities – anything between several weeks to a decade, as people had to learn to use their weakened muscles again in order to walk, swallow or breath. The treatment was painful and expensive. When a vaccine trial was announced in 1954, more than 1.8 million children participated in it. When there were vaccine shortages in 1955, people tried to get it on the black market.

By the 1960s, there were two available vaccines against polio. Parents felt relieved, as other diseases did not seem as terrible as this one. Roald Dahl was not initially worried when his daughter, Olivia, contracted measles in 1962. Everybody had it. “Then one morning,” he recalled “when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. ‘Are you feeling all right?’ I asked her. ‘I feel all sleepy,’ she said. In an hour, she was unconscious. In twelve hours, she was dead.”

Olivia suffered from a complication of measles: measles encephalitis (swelling of the brain). One of every 1,000 people who get measles will develop encephalitis. In 1963, the first measles vaccine was licenced in America.

People’s wish to make an “informed decision” regarding their children’s health is admirable. Their willingness to learn how a vaccine is made or what it contains is commendable. But parents cannot consider themselves “informed” unless they are also aware of what vaccine-preventable diseases are and what it means to live in an unvaccinated society. In a world devoid of vaccines, a child getting severely harmed or even dying of a disease is not a rare occasion that makes it to the news, but an everyday reality and a constant fear for parents.

If the historian can contribute anything to the vaccination debate, it would be to channel the mood and advice of past parents like Benjamin Franklin, who wrote in his autobiography: “in 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it”.

This is the advice of parents like Roald Dahl, who pleaded: “It is not yet generally accepted that measles can be a dangerous illness. Believe me, it is. In my opinion parents who now refuse to have their children immunised are putting the lives of those children at risk.”

Parents today do not fear diseases like past generations did, largely because they do not encounter them any more. Vaccinations have done such a great job in eliminating serious ailments that society started to forget how widespread and dangerous they really were. This collective forgetfulness opens the door for disinformation about diseases and vaccinations, and puts our children at risk.

The Spinoff’s science content is made possible thanks to the support of The MacDiarmid Institute for Advanced Materials and Nanotechnology, a national institute devoted to scientific research.

Mad Chapman, Editor
Aotearoa continues to adapt to a new reality and The Spinoff is right there, sorting fact from fiction to bring you the latest updates and biggest stories. Help us continue this coverage, and so much more, by supporting The Spinoff Members.Madeleine Chapman, EditorJoin Members

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