Annie Baker | University of Kentucky
Smallpox, which was eradicated long ago, is one of the oldest recorded major diseases in human history. While it’s now only a story in the backs of our minds, in our history texts, historically it had a case fatality rate of 30%. Compare this with the bubonic plague, which before the introduction of antibiotics killed 50% of infected individuals. A disease that was once nearly as prominent a death threat as what caused the black plague was once a continual presence in our world. With that knowledge, it’s not that surprising that what we now call vaccination was originally created for smallpox.
It’s suspected that around the fifteenth century, the Chinese figured out that if you scraped someone’s skin and then rubbed powdered smallpox scabs or pus from smallpox pustules into the wound, the person could develop a mild case of smallpox which they were more likely to live through than naturally-acquired smallpox. It could also be done by blowing the scab powder into the individual’s nostrils. This process came to be called variolation (variola being a word for smallpox) or inoculation in Western countries. After sickness after inoculation, as after a natural smallpox infection, one was immune to it.
This was controversial, but many people still did it, deciding to hedge their bets against avoiding natural infection and instead allowing themselves and their children to be purposefully infected. Statistically, you had a higher chance of not dying of smallpox than facing the world and the disease uninoculated. In the 1700s it spread to Europe and from there to the Americas.
In the 1770s, several different people independently realized that inoculation with cowpox worked just as well against further smallpox infection as variolation did, with the added benefit of cowpox being a milder disease than smallpox. In 1796, the doctor Edward Jenner decided to approach this idea scientifically, showed that it worked, and called the process vaccination (vaccinia being a word for cowpox). Later on in the late 1800s, French chemist Louis Pasteur would popularize the word vaccination to refer to inoculation against any disease (old-style variolation was by then out of favor).
The advent of the smallpox vaccine nearly rid the Western world of the disease but it was still endemic (that is, continually present in the population at some low level) in parts of Asia and Africa. Beginning in 1960 and running until 1980, the World Health Organization (WHO) ran the smallpox eradication program (SEP). In 1972, the smallpox was gone from the United States and routine vaccination of our population ceased because there was literally no need to. The last known natural case was recorded in 1977 in Somalia, and after thorough checking and waiting for any further cases to develop, the disease was declared eradicated from the Earth in 1980.
It is only in our heavily vaccinated world, free of the scourge of smallpox, that we have the opportunity to even dare to think of not vaccinating. The uneducated masses of the past, rather than fearing science as witchcraft, embraced it—it meant their children wouldn’t die. People were once vaccinated almost without exception. Now you can apply for waivers. This is not a matter of politics—this is a matter of history and knowing and understanding it. Generations removed from smallpox and other deadly diseases, our world has forgotten the demons of the past.