Smallpox arrived in Boston in 1721, carried by passengers on a ship from the Caribbean. It was the second coming of the epidemic to American soil—the first had landed more than one hundred years earlier. This outbreak was more severe, though, and by the time it had run its course, half of the ten thousand residents of Boston had fallen ill, and more than a thousand had died. Cotton Mather, the fiery, brilliant, and unpleasantly self-righteous preacher, had heard about vaccination several years earlier from an African slave. He then read about the practice in a British scientific journal and became convinced it could provide the answer to the plague that threatened the city (and the entire New World). Mather attempted to interest the town’s residents in what he acknowledged was the genuinely risky “Practice of conveying and suffering the Small-pox by Inoculation,” a practice “never used . . . in our Nation.”
There were few takers. Instead, the majority of the population was awed by the ability of smallpox to wipe out entire nations and wondered whether it was not simply a judgment from God, rather than a disease one could defeat with medicine. Most people condemned inoculation. Perhaps the answer was to turn inward, to pray more fervently. Mather screamed from the pulpit (joined by several others, including his father, Increase Mather—they came to be known as the Inoculation Ministers). They faced opposition from the nation’s first powerful newspaper, known at the time as the New England Courant (eventually to become the Hartford Courant ), which was published by Benjamin Franklin’s brother James—and not just from him. “Cotton Mather, you dog, damn you! I’ll inoculate you with this; with a pox to you,” said a note that was attached to a bomb lobbed into Mather’s house. All because he argued for the adoption of the most important public health measure in the history of colonial America.
Ben Franklin himself opposed the idea of the inoculation—called variolation, in which healthy people would have pus from the scabs of smallpox victims rubbed onto their skin. This usually produced a much milder form of smallpox, although a small percentage of the people vaccinated in this way died as a result. When the final tally was made, however, the salutary effects of vaccinations were impossible to deny. Of the 240 people inoculated during the epidemic in Boston, six died, one in forty. Among the rest of the population the mortality rate was one in six. Even those made sick by the vaccine tended to become less seriously ill than those who acquired the infection in the usual way.
Years later, Franklin’s son died of smallpox, after which he became an ardent supporter of vaccination. He even made a special appeal to parents who might be afraid of the consequences. “In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way,” he wrote in his autobiography. “I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.” George Washington initially hesitated to vaccinate his Continental Army troops during a smallpox outbreak, writing that “should We inoculate generally, the Enemy, knowing it, will certainly take Advantage of our Situation.” By 1777, however, he ordered mandatory vaccination for every soldier.
Vaccines work primarily by stimulating the immune system to produce a defensive response; there is a small risk that the response won’t be good enough and the vaccine will cause the disease it has been designed to prevent. Unless you compare those risks with the alternative—that is, of not having the vaccine at all—there is no way to properly judge any
There were few takers. Instead, the majority of the population was awed by the ability of smallpox to wipe out entire nations and wondered whether it was not simply a judgment from God, rather than a disease one could defeat with medicine. Most people condemned inoculation. Perhaps the answer was to turn inward, to pray more fervently. Mather screamed from the pulpit (joined by several others, including his father, Increase Mather—they came to be known as the Inoculation Ministers). They faced opposition from the nation’s first powerful newspaper, known at the time as the New England Courant (eventually to become the Hartford Courant ), which was published by Benjamin Franklin’s brother James—and not just from him. “Cotton Mather, you dog, damn you! I’ll inoculate you with this; with a pox to you,” said a note that was attached to a bomb lobbed into Mather’s house. All because he argued for the adoption of the most important public health measure in the history of colonial America.
Ben Franklin himself opposed the idea of the inoculation—called variolation, in which healthy people would have pus from the scabs of smallpox victims rubbed onto their skin. This usually produced a much milder form of smallpox, although a small percentage of the people vaccinated in this way died as a result. When the final tally was made, however, the salutary effects of vaccinations were impossible to deny. Of the 240 people inoculated during the epidemic in Boston, six died, one in forty. Among the rest of the population the mortality rate was one in six. Even those made sick by the vaccine tended to become less seriously ill than those who acquired the infection in the usual way.
Years later, Franklin’s son died of smallpox, after which he became an ardent supporter of vaccination. He even made a special appeal to parents who might be afraid of the consequences. “In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way,” he wrote in his autobiography. “I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.” George Washington initially hesitated to vaccinate his Continental Army troops during a smallpox outbreak, writing that “should We inoculate generally, the Enemy, knowing it, will certainly take Advantage of our Situation.” By 1777, however, he ordered mandatory vaccination for every soldier.
Vaccines work primarily by stimulating the immune system to produce a defensive response; there is a small risk that the response won’t be good enough and the vaccine will cause the disease it has been designed to prevent. Unless you compare those risks with the alternative—that is, of not having the vaccine at all—there is no way to properly judge any
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