HCR -- Vaccinations, a History Footnote

By John Ballard

By now everyone knows about the Perry-Bachmann vaccine exhibition.
This excerpt from a piece by Lindsay Beyerstein  in The Nation is therefore more interesting...

If it hadn�t been for mandatory smallpox inoculation, the Republic might never have survived. General George Washington ordered the Continental Army inoculated against smallpox in 1777, the first large scale inoculation of an army in history. Washington was supported in this effort by Dr. Benjamin Rush, a signatory to the Declaration of Independence and the chair of the Continental Congress� Medical Department.

Inoculation was a precursor to vaccination which induced a milder case of smallpox by scratching the skin and rubbing in pus from a smallpox lesion. Cleric and amateur scientist Cotton Mather provided a dramatic proof of concept for inoculation when he inoculated 287 people during a smallpox epidemic in Boston in 1721. Only six of the inoculated individuals died, a much lower death rate than for natural smallpox. Mather gets credit for introducing smallpox inoculation to North America, but he learned about it from Onesimus, a slave who had undergone inoculation in Africa.

Despite the success of his experiment, Mather was widely vilified for mocking the will of God. At the time, many believed that smallpox was a divine punishment for sins and that trying to evade the consequences of sinning by getting inoculated was a sin in itself. That argument sounds ridiculous to modern ears, but that same logic still prevails in some quarters when discussing sexually transmitted diseases.

Someone threw a small bomb through Mather�s window with a note that said, roughly, �Inoculate this, Mather.�

Inoculation was dangerous both for the patient for others because the inoculated person remained contagious. Nearly all colonies passed laws to restrict inoculation. George Washington vehemently disagreed. He inoculated his entire household. If he had his way, inoculation against smallpox would have been mandatory.

�Surely that Impolitic Act, restraining Inoculation in Virginia, can never be continued. If I was a Member of that Assembly, I would rather move for a Law to compell the Masters of Families to inoculate every Child born within a certain limitted time under severe Penalties," George Washington wrote to one his brothers in 1777.

Despite Washington�s confidence in the procedure, the decision to mandate inoculation of the Continental Army was not an easy one. The Continental Congress debated for a year over whether compulsory inoculation of troops was an overreach of central authority. The delegates worried about whether the troops would accept the inoculation.

Benjamin Rush argued persuasively that without mandatory inoculation of troops the Republic might not survive. Washington, who had survived a bout of smallpox as a teenager, argued that the threat of disease was more dreadful than the sword of the enemy. In May of 1776, smallpox killed 1800 out of 7000 American troops in Montreal in just two weeks.

In the spring of 1777, Alexander Hamilton, then Washington's aide-de-camp, wrote up a memo ordering all regimental colonels to divide their men into two groups, those who had already had smallpox or smallpox inoculation, and those who hadn't. The non-inoculated were sent to Philadelphia to be dosed.

The military stakes were high. Most of the British troops were immune to the disease because they'd survived it in childhood or because they'd been inoculated; but most of the colonial troops were susceptible. Despite their celebrated independence of spirit, there is no record that the Continental troops objected to being inoculated.

A number of historians credit Washington�s decisive action on smallpox as a major contributor to the success of the revolution.

Among his many achievements, which included writing the Declaration of Independence, Thomas Jefferson was a pioneer of smallpox prevention. He was a proponent of smallpox inoculation. As a young lawyer he acted on behalf of doctors who were persecuted for performing inoculations, including one physician whose house was burned to the ground by a mob during an anti-inoculation riot.

Dr. Benjamin Waterhouse, a Harvard professor and doctor and who was trying to use Edward Jenner�s cowpox vaccine in America, contacted then-vice president Jefferson. Jenner�s treatment, which he first tested successfully in 1796, was revolutionary because it was a true vaccine, not a milder case of smallpox.

To say Jefferson was enthusiastic about the project would be an understatement. Jefferson invented an insulated vial that allowed Waterhouse to ship samples of cowpox to Virginia where Jefferson tested the vaccine.

Jefferson foresaw the power of Jenner�s vaccine to conquer the smallpox, 175 years before it was eradicated. In 1806, during his second term as president, Jefferson wrote Jenner, "You have erased from the calendar of human afflictions one of its greatest. Yours is the comfortable reflection that mankind can never forget that you have lived.�

The first mandatory smallpox vaccination law was passed in Massachusetts in 1809. Far from being an anomalous usurpation of government power, Perry�s executive order would have been a routine exercise of state power. Mandatory vaccination policies have always been controlled at the state and local level in the United States. A landmark 1905 Supreme Court case established the power of the states to impose mandatory vaccinations.

Michele Bachmann and the Tea Party routinely abuse science and history. The Founding Fathers were inspired by the ideals of the Enlightenment. Unlike many self-proclaimed conservatives today who elevate, they believed in the power of science and reason to improve human life.