History of the Smallpox Vaccination for Kids

If you’re like most children–and, let’s face it, many adults–you probably dread having to go to the doctor for a shot. It’s not fun for anyone, but, as grown-ups have probably reminded you, it’s good for you. Most shots you get are vaccines or medicines that keep you from getting sick with a particular disease or get your body ready to fight that disease if you do get it.

Today, there are hundreds of vaccines that help protect people and animals from all kinds of diseases. But just two hundred years ago, there was only one. It was the very first vaccine, and it protected people against one of the worst diseases known. People would get a high fever, feel tired and achy, and break out in red sores that changed to blisters over time. Many of the people who got it died and many others were left with terrible scars on their skin. 

But the good news? Because of the vaccine, people never get this disease anymore. In fact, no one has come down with it in over 40 years. It’s been eradicated, the only virus ever to be completely wiped out.

The disease is called smallpox.

The story of smallpox and the vaccine that beat it starts much more than 200 hundred years ago. Before the modern vaccine for smallpox was invented, people in China and India had been using a different type of vaccination, which is usually called “inoculation”, against the disease for hundreds of years. 

Warning: it’s kinda gross. 

To inoculate someone, they would take some pus from the sores of a person with smallpox, dry it out, and grind it into a powder. Then, they would use a long tube, like a straw, to blow the powder into a person’s nose. 

It sounds pretty yucky, but it worked! The person who got the powder up their nose often got a little sick with smallpox, but after that, they couldn’t get the disease again for a long time. Their body learned from minor sicknesses how to fight the disease. 

Another early method of inoculating people against smallpox was similar. It also involved taking a bit of the goo from an infected person’s sore, but then they would rub it into a small cut on the healthy person. Just like with the nose route, the person usually got a little sick, but from then on they were protected. Kind of makes me glad we only have to get shots with tiny needles now!

This second method of inoculation spread to the Ottoman Empire, in what is now the country of Turkey, and Africa. It was in the Ottoman Empire that an English noblewoman named Lady Mary Wortley Montagu first came across it. Lady Mary had come down with smallpox in 1715, at the age of 26. It left her with terrible scars on her face and caused her eyelashes to fall out. Her brother had died from it. She knew firsthand just how terrible a disease it was, and dreaded the thought of her own children getting it. 

Two years after recovering from smallpox, Lady Mary was living in the Ottoman Empire, where her husband was an ambassador. There, she witnessed the inoculation procedure and learned how it could save the lives of those who had it. 

Lady Mary immediately asked her doctor, Charles Maitland, to inoculate her five year old son, Edward. Edward, like most people, got a little bit sick but went back to playing happily after a few days. 

When they returned to England, Lady Mary tried to encourage people to get this life-saving procedure, but many were suspicious. The idea of making yourself sick in order to prevent getting more sick later seemed a little crazy, even backward. But in 1721, a terrible outbreak of the disease, as well as some very effective publicity, began to change people’s minds.

In 1721, London began seeing an uptick in smallpox cases. It threatened to become a full-blown outbreak. Lady Mary insisted that Dr. Maitland inoculate her younger daughter, Mary. They invited several other doctors to witness the process, so they could learn from it and tell others if it worked. The inoculation was a success! Soon, Princess Caroline, the future queen of England had her children inoculated. Many others followed the royal example.

In colonial America, an enslaved man known only as Onesimus was responsible for bringing smallpox inoculation to North America. In 1721, a smallpox outbreak was also threatening the city of Boston. Infected people who had arrived by boat in the city were shut up together in a house, with a sign that read “May god have mercy on this house.”  Onesimus had told his master, a minister named Cotton Mather, about inoculation years before. He himself had been inoculated as a child in Africa. His culture was among the many in West Africa that had been practicing it for years. Mather asked other enslaved people about the practice, and many confirmed what Onesimus had told him.

Mather began to promote the idea of smallpox inoculation wherever he could. He saw that many lives could be saved if more people were inoculated. But, many colonists were suspicious of the idea. In the face of the 1721 outbreak though, people began to rethink their positions. Mather teamed up with the one doctor who was willing to help him, Zabdiel Boylston, to inoculate anyone who would let them. They ended up inoculating 242 people. Only a few of these people became very sick, compared with hundreds who became sick and died among the uninoculated. 

Even as more people began to realize that smallpox inoculation saved lives, it was still risky. Those people who thought it was crazy to infect yourself on purpose with a serious disease did have a point.  A very small number of people who got the smallpox inoculation did get very sick and died. Even though that number was FAR, far fewer than the number who died from infection without inoculation, ideally, someone would find a better way. 

A doctor named Edward Jenner would be the one to find that better way.  Jenner was inoculated in 1757, at the age of 8, in Gloucester, England. As a teenager, he began training as a doctor. He was intrigued when he heard a milkmaid say that she would never get smallpox because she had already had cowpox. 

Actually, many people had noticed that milkmaids, who care for and milk cows, rarely caught smallpox, and thought it had something to do with cowpox. Cowpox was a disease similar to smallpox, but that mainly infected cows. Cows usually survived but did get red, oozy sores on their udders, which could infect the person milking them. Luckily, cowpox is very mild in humans. Humans who got it might get a little sick and have a mild rash, but they didn’t die and weren’t left with any scars on their skin. Best of all, cowpox is similar enough to smallpox that once you’ve had it, your body can fight off smallpox as well!

Jenner wondered whether the cowpox virus could be used to inoculate people who weren’t milkmaids against smallpox. He found a milkmaid with cowpox sores on her hands. He took some of the pus from her sores and inoculated a child named James Phipps with it. Unsurprisingly, James, who was the son of Jenner’s gardener, came down with cowpox. When he recovered, Jenner exposed James to smallpox. Remember, many other people at the time had noticed that cowpox seemed to protect people who had it from getting smallpox. Jenner must have been confident because it would have been horrible for James to get sick with smallpox. Fortunately, Jenner–and all the milkmaids–were right. James was immune to smallpox because of the cowpox inoculation! When James grew up, Jenner let him and his family live for free in a cottage he owned. 

Jenner published a detailed description of his experiment with James Phipps and cowpox. He also did more experiments to make sure it really worked. He called his method a “vaccine” because the Latin word for cow is vaca, and of course, he had used a cow disease!  It took a while to catch on, but as more doctors learned about the vaccine, they encouraged their patients to get it, and after a few years it became popular in England and then throughout Europe. 

Jenner himself never became wealthy from his discovery, instead choosing to do whatever he could to make sure as many people as possible got his vaccine. He sent it to any doctor who requested it. He set up a small hut in his yard where he vaccinated poor people for free. One doctor brought the vaccine to America and introduced it to Thomas Jefferson. When Jefferson became president, he set up a national agency to vaccinate people in America.

By the 1950s, almost everyone in Europe and North America was vaccinated for smallpox, and the disease had disappeared from these places. The rest of the world was a different story. In other parts of the world, and especially in poor countries, the disease still ravaged communities and families. The World Health Organization launched a campaign to vaccinate everyone in the whole world. The last smallpox infection was in 1977.  In 1980, the World Health Organization officially declared the world free from smallpox. 

Smallpox is still the only human disease ever to be completely eliminated. It took the work of many doctors, parents, and some very brave children to do it. But now we have vaccines for many other diseases, which help people live longer, healthier lives. Many diseases, like polio, whooping cough, and measles, are rare now thanks to vaccines. Overall, that seems like a good thing. Even if it does require a little prick now and then.