Smallpox was a dangerous, scarring and often fatal disease and before the C18th, treatments were painful and hopeless. Then Lady Mary Montagu, wife of the British ambassador to the Ottoman Empire, observed inoculation by variolation. The doctor inserted cells taken from a smallpox pustule, into the skin of a healthy subject; the resulting infection was mostly mild and granted lifelong immunity. Lady Mary’s brother had earlier died of smallpox and she survived the disease in 1715, so she needed to protect her children. But back in London, many British doctors scoffed at the practice as “Oriental folk treatment practised by peasant women”.
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Protesting against a proposed bill that would remove parents’ ability to claim a philosophical exemption to the MMR vaccine, Feb 2019
Yet as the practice of inoculation by variolation successfully spread through UK and the Empire, new opposition emerged. Especially in Boston during a 1721 smallpox epidemic. Local Congregationalist minister Cotton Mather (1663-1728), who’d studied medicine, vigorously advocated inoculations. But some Boston physicians condemned inoculation as an affront to God’s will; only God could determine who might be exposed to smallpox and survive, or die.
Olympia, Washington. Guardian
Yet as the practice of inoculation by variolation successfully spread through UK and the Empire, new opposition emerged. Especially in Boston during a 1721 smallpox epidemic. Local Congregationalist minister Cotton Mather (1663-1728), who’d studied medicine, vigorously advocated inoculations. But some Boston physicians condemned inoculation as an affront to God’s will; only God could determine who might be exposed to smallpox and survive, or die.
Swiss physician Théodore Tronchin (1709–1781) attracted international patients to his clinic. The Duke of Orleans, Louis-Philippe I (1725-85), summoned Tronchin to Paris to treat his children; a tiny amount of the smallpox virus was taken from the pustule of a smallpox patient. Tronchin’s success in saving the royal children sparked excitement about inoculation among Paris’ aristocracy. But his success inevitably led to a campaign of hatred against him, by scientists, clerics and University of Paris scholars.
Edward Jenner (1749-1823) was a doctor practising in his Gloucestershire village where variolation was a part of his duties, using the arm-to-arm system. Then in 1796 Jenner discovered that milkmaids showed no side effects when they were inoculated, yet they still acquired immunity. He knew the maids had caught cowpox from milking diseased cows, and suggested it would be possible to use milder cowpox material for arm-to-arm inoculation. Jenner was successful.
Like Tronchin, Jenner’s ideas were met with immediate public criticism, based on religious, scientific and political protests. Yet in 1802, Jenner’s supporters invited him to join the American Academy of the Arts and Sciences.
Widespread vaccination dramatically reduced mortality rates. Smallpox’s mortality rate in non-inoculated infants reached 80% by the late 1800s; inoculated children had a 0.5–2% mortality rate.
Britain adopted state-sponsored vaccination campaigns: the first Vaccination Act (1853) mandated vaccination of infants. If parents refused, they were prosecuted and fined. When smallpox mortality rates re-rose in the 1860s, the second Vaccination Act (1867) extended the age requirement to 14 years.
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The laws were met with immediate resistance from citizens. The British Anti-Vaccination Leagues arose, anti-vaccination journals sprang up and mass demonstrations started. In Leicester in 1885, c90,000 people marched to protect the parents of unvaccinated children from fines. In response, a royal commission investigated evidence both for and against vaccination. The commission sat for 7 long years, leading to a third Vaccination Act (1907).
In the USA, in 1855, Massachusetts became the first state to require public-school children to be vaccinated. And by the 1890s, most states had adopted compulsory policies. But the Anti-Vaccination Society of America quickly mobilised using pamphlets, court cases and state legislatures, opposing compulsory vaccination laws and protecting civil liberties.
In the landmark Jacobson v Massachusetts (1905), the Supreme Court ruled that the state may be justified in restricting individual liberty, to protect the general public. So penalties could be imposed on parents who refused to vaccinate their children.
Religious American communities continued to demand the right to claim exemption from mandatory vaccination. 45 states allowed moral or philosophical exemptions from mandatory vaccination for enrolment in schools, while 5 states only allowed medical exemptions. Did/do any states allow Distrust Of Science as a reason?
Mandatory vaccination must have worked. There is no evidence of naturally occurring smallpox transmission anywhere in the world today.
Now measles, whose symptoms included high fever, cough, watery nose and eyes, with a rash appearing days later. Complications included pneumonia and encephalitis of the brain. As a highly contagious virus with no direct treatment and a notable mortality rate, measles remained a major public health concern. The first measles vaccine was tested in Oct 1958 in Enders’ Boston lab by Drs Samuel Katz and John Enders when 20 children were given an experimental vaccine. When they discovered that a killed-virus vaccine did not create the desired immunity, they successfully tested a safe, live, attenuated measles vaccine.
In 1971 Merck Pharmaceuticals developed a vaccine that could safely combine measles, mumps and rubella ie MMR. For those parents who could not afford childhood vaccines, public funding programs were quickly established and measles was totally eradicated!
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Edward Jenner (1749-1823) was a doctor practising in his Gloucestershire village where variolation was a part of his duties, using the arm-to-arm system. Then in 1796 Jenner discovered that milkmaids showed no side effects when they were inoculated, yet they still acquired immunity. He knew the maids had caught cowpox from milking diseased cows, and suggested it would be possible to use milder cowpox material for arm-to-arm inoculation. Jenner was successful.
Like Tronchin, Jenner’s ideas were met with immediate public criticism, based on religious, scientific and political protests. Yet in 1802, Jenner’s supporters invited him to join the American Academy of the Arts and Sciences.
Widespread vaccination dramatically reduced mortality rates. Smallpox’s mortality rate in non-inoculated infants reached 80% by the late 1800s; inoculated children had a 0.5–2% mortality rate.
Britain adopted state-sponsored vaccination campaigns: the first Vaccination Act (1853) mandated vaccination of infants. If parents refused, they were prosecuted and fined. When smallpox mortality rates re-rose in the 1860s, the second Vaccination Act (1867) extended the age requirement to 14 years.
Andrew Wakefield was struck off in the UK, but feted in the USA
flanked by supporters ahead of an appearance before the GMC.
Guardian, 2007
In the USA, in 1855, Massachusetts became the first state to require public-school children to be vaccinated. And by the 1890s, most states had adopted compulsory policies. But the Anti-Vaccination Society of America quickly mobilised using pamphlets, court cases and state legislatures, opposing compulsory vaccination laws and protecting civil liberties.
In the landmark Jacobson v Massachusetts (1905), the Supreme Court ruled that the state may be justified in restricting individual liberty, to protect the general public. So penalties could be imposed on parents who refused to vaccinate their children.
Religious American communities continued to demand the right to claim exemption from mandatory vaccination. 45 states allowed moral or philosophical exemptions from mandatory vaccination for enrolment in schools, while 5 states only allowed medical exemptions. Did/do any states allow Distrust Of Science as a reason?
Mandatory vaccination must have worked. There is no evidence of naturally occurring smallpox transmission anywhere in the world today.
Now measles, whose symptoms included high fever, cough, watery nose and eyes, with a rash appearing days later. Complications included pneumonia and encephalitis of the brain. As a highly contagious virus with no direct treatment and a notable mortality rate, measles remained a major public health concern. The first measles vaccine was tested in Oct 1958 in Enders’ Boston lab by Drs Samuel Katz and John Enders when 20 children were given an experimental vaccine. When they discovered that a killed-virus vaccine did not create the desired immunity, they successfully tested a safe, live, attenuated measles vaccine.
In 1971 Merck Pharmaceuticals developed a vaccine that could safely combine measles, mumps and rubella ie MMR. For those parents who could not afford childhood vaccines, public funding programs were quickly established and measles was totally eradicated!
Smallpox patient with the characteristic late-stage confluent maculopapular scarring,
Italy, 1965. Wiki Anti-vaxxer resistance to vaccination had long emerged on both sides of the Atlantic. Even in 1998, a British doctor Andrew Wakefield published a paper in The Lancet reporting that the Measles-Mumps-Rubella vaccine was linked to 12 cases of autism. So Dr Wakefield called for the suspension of MMR-linked vaccines! The paper was entirely fraudulent and fraught with conflicts of interest, but the link with autism is still believed.
To protect mass immunity, the Infectious Diseases Society of America requires a 95% anti-measles vaccination rate. At that level, the efficacy of vaccination as a public health tool is irrefutable, against many highly infectious diseases.
So why is measles suddenly resurging? The BBC reported that in 2018 there were 9.8 million cases of measles and 142,000 deaths, the worst-affected countries being D.R Congo, Liberia, Madagascar, Somalia and Ukraine. In Aug 2019 alone, the US Centres for Disease Control reported 1,215 cases of measles across 30 states, 75% of them in New York state. And around the world, WHO reported 364,808 new cases by July 2019 - a 150% increase in cases.
In Feb-March 2019, a measles outbreak hit the Philippines with 31,056 measles cases including 415 deaths. 83% of all deaths were children under 5. Measles appeared in the Pacific island of Samoa in Sept 2019 and by Nov, the Government had declared a state of emergency; schools were closed and vaccinations mandated. In Samoa, where the national immunisation rate had fallen to a low of 30%, 72 precious children died from measles in late 2019!
See Origins for photos, medical texts and critical cartoons.
Dr Joe
To protect mass immunity, the Infectious Diseases Society of America requires a 95% anti-measles vaccination rate. At that level, the efficacy of vaccination as a public health tool is irrefutable, against many highly infectious diseases.
So why is measles suddenly resurging? The BBC reported that in 2018 there were 9.8 million cases of measles and 142,000 deaths, the worst-affected countries being D.R Congo, Liberia, Madagascar, Somalia and Ukraine. In Aug 2019 alone, the US Centres for Disease Control reported 1,215 cases of measles across 30 states, 75% of them in New York state. And around the world, WHO reported 364,808 new cases by July 2019 - a 150% increase in cases.
In Feb-March 2019, a measles outbreak hit the Philippines with 31,056 measles cases including 415 deaths. 83% of all deaths were children under 5. Measles appeared in the Pacific island of Samoa in Sept 2019 and by Nov, the Government had declared a state of emergency; schools were closed and vaccinations mandated. In Samoa, where the national immunisation rate had fallen to a low of 30%, 72 precious children died from measles in late 2019!
See Origins for photos, medical texts and critical cartoons.
Dr Joe