From Vacca to Vaccination

Alex Johnson - Content Writer

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As soon as you read the word “vaccination” in the title of this article, you might have thought, “Yikes, that’s become a hot-button issue over the past few years.”

Well, you’re right, but vaccination has been a hot button issue a lot longer than that—at least since 1796. Cue Edward Jenner: the English doctor who pioneered vaccination, ultimately leading to the eradication of smallpox: a disease that had plagued humankind and killed untold millions since the Stone Age.

A drawing of Edward Jenner, but also: a drawing of a drawing of a cow.

And he named the process of using cowpox to inoculate patients against smallpox after an unlikely ally: the domestic cow, or vacca, in Latin. Hence the term “vaccine.”

Why name this life-saving process after the cow? Because cows provided Jenner with what would become a life-saving biological fluid.

Milk, right? Nope, and I hope you’re not eating: because it was pus.

But First, A Little Background: Why Was Smallpox Such a Big Deal?

Every day that you and I wake up in the smallpox-free utopia that we currently find ourselves living in (knock on wood), we should be sending flowers to Edward Jenner’s grave—located at the St. Mary the Virgin Churchyard in Gloucestershire, England, if you actually want to take me up on this.1 That’s because, prior to Jenner’s discovery and dissemination of the vaccination for smallpox, the disease absolutely ravaged the peoples of Europe, Asia, and Africa (and, later, the Americas, once Europeans crossed the pond).

We think smallpox appeared alongside humanity’s first agricultural settlements in northeastern Africa around 10,000 BC, and it continued to be a real assh*le right up until the 18th century, when it killed about 400,000 people each year in Europe alone.2

Without getting too gritty, the virus that causes smallpox was extremely infectious and resulted in high fever, rash, and skin lesions. If you got infected, your survival odds were about one in three. 3 Oh, and about one-third of the survivors also went blind. 4

If you were lucky enough to survive an infection, you’d probably bear scars that would last the rest of your life. Hell, they’d even follow you into the afterlife, if you’re into that sort of thing. Take it from Egyptian pharaoh Ramses V. He can’t talk (because he died in 1156 BC) but his mummified head tells a story nevertheless, and that story is: “I probably had smallpox—check out the well-preserved scars all over my face.”

Smallpox epidemics hit everybody, everywhere: rich folks, poor folks; pharaohs, people who weren’t pharaohs; crusaders, crusadees; kings and queens; and, of course, the native peoples of the Americas who had zero natural resistance to the disease, yielding disastrous results. Here’s my point: nobody liked it, everybody hated it, and smallpox approval ratings have always been in the toilet.

The only reason the disease was even called “small pockes” was because the name “great pockes” had already been given to a sexually transmitted disease: syphilis.5 It just goes to show you: even when it comes to disease, sex sells.

Were There Any Troubleshooting Efforts Re: Smallpox, Before Jenner Came Along?

Oh, sure. If you throw enough time, humans, and trial and error at a problem, answers will start to arise. For a long time, folks in Asia, India, and Africa had known that smallpox survivors became immune to the disease. Using this information, a process called “variolation” was devised, and it arrived in Europe in the 18th century.

Here’s an explanation of the variolation process, and I’ll keep it simple since I’m definitely not a doctor: you’d take a little bit of “material” (read: pus, from a pustule) from an infected person, then put it in a person who hadn’t been infected yet, preferably in an extremity. The patient would then sweat it out for a while, and at the end of the ordeal, would hopefully be immune and not dead, and would have a perfectly acceptable level of pock scarring, possibly in a location of their choosing (e.g., not the face).6

So, Jenner already knew about all of that by the time he got to work. But variolation was risky as sh*t, and, at the end of the day, you were still getting smallpox. Which, remember all that crazy dangerous stuff I said about having smallpox in the previous section? It sucked.

OK, So People Already Knew You Could Get Immunity by Just Getting a Little Bit of Smallpox. What’d This Jenner Fella Do?

OK, first off, that’s Doctor Edward Jenner. He didn’t spend seven years as a surgeon’s apprentice in Chipping Sodbury just so some 21st-century blog writer could bandy his name about without due deference. And I know I already gave it away with “Chipping Sodbury,” but yeah, he was English.

Anyhow, Doc Jenner had already had his own run-in with smallpox, you see. He’d been variolated as a child, and the side effects affected his health for the rest of his life. This sh*t was personal.

Regardless, variolation was the common practice, and Doctor Jenner variolated his own patients in his hometown of Berkeley, Gloucestershire, where he served as the regional practitioner and surgeon.

Berkeley was a rural area and Jenner, despite spending some of his life in the big city, was a rural guy. He had long been fascinated by a bit of country lore, which suggested that local cow-milkers who caught cowpox from their cows somehow gained immunity to the much, much worse smallpox.

Cowpox wasn’t a big deal, even for cows. They’d get some minor pocks on their udders and experience some mild discomfort. Honestly, it sounds like poison ivy is worse. Sometimes milkmaids would catch it on their hands, get some mild pocks as well, feel a bit sh*t for a few days, and then they’d be back to milking those money-making udders.

Doctor Jenner was thus compelled to conduct the most important medical research of his life, and probably all of our lives. He got himself some cowpox pustule fluid from local milkmaid Sarah Nelms, and scratched it into eight-year-old James Phipps.

A sketch of Sarah Nelms’ hand, infected with cowpox.
Steady as a rock, though.

This was back when doctors could get away with a lot of stuff, like telling your gardener, “You, gardener: don’t overwater the bulbs, and also I’m going to do some infectious disease tests on your son. What was his name? Ah, right. James. Very good.” 7

The guinea pig Little James Phipps did exactly what he was supposed to do and got sick with the cowpox he had contracted from Sarah Nelms. This proved that cowpox was communicable between humans. Soon enough he was recovered and ready for the big one. Doctor Jenner performed his routine variolation procedure on the little tyke, introducing the smallpox virus and, lo and behold: no smallpox.8

Publish or Perish

For Doctor Jenner (and probably for his gardener, too) this was incredible news. But science is, like, 10 percent discovery and 90 percent marketing. This discovery wouldn’t do much good if Jenner couldn’t disseminate his findings and get people to adopt the vaccination practice.

So, he wrote a book: 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 The Cow Pox. Seems like more of a synopsis than a title, really, but in this case more was more, because the dude had solved a problem that was over 10,000 years old.9

As Jenner fully described in his very long book title, “Variolae Vaccinae” is the Latin term for “The Cow Pox.” The term “vaccinate” would, for about a hundred years, refer specifically to the process of variolation using cowpox. It wasn’t until 1885 that Louis Pasteur would extend the term’s definition to the broader meaning we infer today.10

Enter: Peer Scrutiny, Big Variolation, and The O.G. Anti-Vaxxers

People and their institutions are often resistant to change. While Jenner’s research was going to be groundbreaking, he hit some roadblocks within the medical community.

Some of it was understandable: Not even medical researchers understood the finer points of infection at the time, and many people didn’t have direct access to cowpox samples. Other doctors wanted to put Jenner’s theory to the test, but they had to send away for some of that precious cowpox material. By the time it reached them, it had often been infected with smallpox as well—since the people who handled the samples also handled smallpox—leading to some not-so-great outcomes and assertions that vaccination wasn’t any safer than variolation.

There were less empathetic characters in the medical community as well: peers who were just haters for competitive or egotistical reasons, as can be the wont of peers. And then you had Big Variolation: the industry surrounding traditional variolation, which stood to lose lots of hot, wet cash if variolation was ditched for a better solution.

Last, but certainly not least, were those who opposed the very idea of taking material from the lowly cow and placing it in one of God’s own humans. Which, for me, doesn’t seem to square so much with drinking milk or eating burgers, either—but what’s civic debate without a little cherry-picking, eh?11

In the End, Doctor Jenner Refused To Be Cowed (Sorry)

Despite all the haters, Edward Jenner kept at it. He spent the rest of his life sending cowpox material to folks all over the world, kind of like an Etsy vendor, but one who shipped disease samples instead of armor for cats.

Thanks for the pocks, you most noble of ungulates.

Jenner died in 1823, but his hard work and perseverance paid off. Variolation was outlawed by the Parliament of Great Britain in 1840, and the cowpox vaccine was made mandatory in 1853.

Skip ahead to more recent memory: the World Health Organization began a campaign to completely eradicate smallpox in 1967. Vaccination teams traveled the world, particularly in developing nations, to treat those at highest risk. By 1980, smallpox was officially declared eradicated, and Edward Jenner’s legacy reached its magnificent “Yeah science, bitch!” climax.

Still, the debate over the merits of vaccination continues. Regardless, the entire human collective, whether we appreciate his work or not, owe an incalculable debt of gratitude to Edward Jenner, the small-town doctor who gave us the tools to eradicate the deadliest disease humans have ever known.

Well, mostly eradicated. We still keep a couple of souvenirs in laboratories in the United States and Siberia. But I’m sure that’ll all be fine.12

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Notes & Gossip 📌

  1. Find A Grave. (Accessed March 1, 2018) https://www.findagrave.com/memorial/12952210/edward-jenner
  2. Riedel, Stefan. (2005, January). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
  3. Cunha, J.P. (2017, November 21). Smallpox. Retrieved from https://www.emedicinehealth.com/smallpox/article_em.htm#what_is_smallpox.
  4. Riedel, Stefan. (2005, January). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
  5. Riedel, Stefan. (2005, January). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
  6. Riedel, Stefan. (2005, January). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
  7. Not an actual quote.
  8. The Jenner Institute. (Accessed March 1, 2018). About Edward Jenner. Retrieved from http://www.jenner.ac.uk/edward-jenner
  9. The Jenner Institute. (Accessed March 1, 2018). About Edward Jenner. Retrieved from http://www.jenner.ac.uk/edward-jenner
  10. Markel, Howard. (2015, November 2). The Origin of the Word ‘Vaccine.’ Retrieved from https://www.sciencefriday.com/articles/the-origin-of-the-word-vaccine/
  11. The Jenner Institute. (Accessed March 1, 2018). About Edward Jenner. Retrieved from http://www.jenner.ac.uk/edward-jenner
  12. The Jenner Institute. (Accessed March 1, 2018). About Edward Jenner. Retrieved from http://www.jenner.ac.uk/edward-jenner

Scholarly Shout-outs 🌟

  • BBC. (Accessed March 1, 2018). Edward Jenner (1749 – 1823). Retrieved from http://www.bbc.co.uk/history/historic_figures/jenner_edward.shtml
  • Brought to Life. (Accessed March 1, 2018). Edward Jenner (1749-1823). Retrieved from http://broughttolife.sciencemuseum.org.uk/broughttolife/people/edwardjenner
  • Brought to Life. (Accessed March 1, 2018). Inoculation. Retrieved from http://broughttolife.sciencemuseum.org.uk/broughttolife/techniques/inoculation
  • Cunha, J.P. (2017, November 21). Smallpox. Retrieved from https://www.emedicinehealth.com/smallpox/article_em.htm#what_is_smallpox
  • Find A Grave. (Accessed March 1, 2018) https://www.findagrave.com/memorial/12952210/edward-jenner
  • Markel, Howard. (2015, November 2). The Origin of the Word ‘Vaccine.’ Retrieved from https://www.sciencefriday.com/articles/the-origin-of-the-word-vaccine/
  • Riedel, Stefan. (2005, January). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
  • The Jenner Institute. (Accessed March 1, 2018). About Edward Jenner. Retrieved from http://www.jenner.ac.uk/edward-jenner

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