It’s World Immunisation Week. To celebrate, let’s look back at the life of Edward Jenner, creator of the first vaccine and the man whose endeavours have singlehandedly saved more lives than the work of any other human being.
Born in 1749 in the Gloucestershire county of England, Jenner had the fortune of being born to a local vicar, who laid the groundwork for the well-rounded basic education that he would receive over the next two decades of his life.
During this time, he was inoculated for smallpox. Like so many who undertook the treatment, Jenner never fully recovered from exposure to the disease, struggling with health issues for the rest of his life.
At the age of 14, he was made an apprentice to Daniel Ludlow, a surgeon from whom, after seven years, he gained the knowledge and experience to become a surgeon himself.
In 1770 he relocated to London. There, he studied under acclaimed Scottish surgeon John Hunter at St George’s Hospital. Perhaps most inspiring of all were three simple words: “Don’t think; try”.
Hunter swiftly recognised Jenner’s abilities and discerning eye. They would remain lifelong friends.
Three years later, Jenner returned home and established himself as the local practitioner. He also co-founded the Gloucestershire Medical Society, where he and other medical professionals met to dine and read papers on medical subjects they produced. Jenner himself wrote about such topics as cardiac valvular disease, angina, ophthalmia (inflammation of the eye resulting in loss of vision), and cowpox.
It was the latter that would be most important to Jenner’s legacy.
In 1721, Lady Mary Wortley Montagu has imported the method of variolation (also known as inoculation) to Britain from Istanbul. The practice – which saw a sample of smallpox introduced to artificial cuts on a subject’s arm in an attempt to prevent future, large-scale contractions of the disease – had been popular in China and the Middle East for hundreds of years.
According to Voltaire, 60% of the British population caught smallpox during their lives, and 20% of the total population died of it.
When variolation was introduced, its positive effects vastly outweighed its positive. 1 in 100 died from the procedure, and chances of reinfection still existed for those who survived. Doctors tried to monopolise the simple procedure by convincing the public that it had to be performed by a professional. To raise the credibility of their claim, doctors began creating deep, almost surgical incisions in which to apply the smallpox sample, and even experimented with bloodletting, causing patients to nearly faint in order to ‘purify’ the blood before undertaking the process.
Still, it was better than the slow, agonising death one-third of the affected faced in the grip of the most frightening disease the world had ever known.
Jenner had heard folk-stories suggesting that farmers were somehow immune to smallpox, and that even if they did contract it, they were not dying.
He soon discerned a link between the stories and cowpox, a disease similar but less virulent then smallpox. When farmers – particularly milkmaids – came into contact with the pus-filled blisters that developed on an infected bovine’s udders, they soon started showing symptoms. Besides a slight wooziness and the painless blisters on their hands, however, they were unaffected by any serious side effects.
Jenner first tested his theory on May 14, 1796. For his subject he selected James Phipps, the healthy eight year-old son of his gardener. Scraping pus from the cowpox blisters on the hands of milkmaid Sarah Nelmes, Jenner inoculated Phipps. Over the next 10 days, the boy suffered a fever and slight restlessness and discomfort, but no full-blown infection, confirming that cowpox could be passed from human to human. Afterwards, he injected variolous material containing smallpox into Phipps, but no disease followed (no doubt to everyone’s relief). His immunity was tested several more times, but the results were the same.
Though Jenner’s methods were not of an expected standard, the results were clear: he had just developed the world’s first vaccine.
Two years and many more experiments on 23 further subjects later, he published a book entitled An Inquiry into the Causes and Effects of the Variolae Vaccinae; a Disease Discovered in some of the Western Counties of England, Particularly Gloucestershire, and Known by the Name of The Cow Pox”.
Donald Hopkins, Vice President and Director of Health Programs at The Carter Center, explains the value of Jenner’s findings: “Jenner’s unique contribution was not that he inoculated a few persons with cowpox, but that he then proved (by subsequent challenges) that they were immune to smallpox. Moreover, he demonstrated that the protective cowpox pus could be effectively inoculated from person to person, not just directly from cattle.”
At the time, however, Jenner’s work was opposed by medical authorities, who refused to publish his initial paper. Many even refuted his claims as a result of the mishandling of cowpox samples in an age when infection was not understood. The same people handling the cowpox were often those carrying out variolation, resulting in the samples becoming tainted. Worse still were those who saw vaccination as a threat to the profits they were making from variolation, and so did everything possible to try and ensure Jenner failed.
They were unsuccessful. In 1802, he was granted £10,000 by Parliament (just a little over $1.25 million AUD by today’s standard) for his work, and a further £20,000 in 1807 from the Royal College of Physicians, who confirmed vaccination’s efficiency.
His continued work force him to give up his medical practice. He was the president of the Jennerian Society in 1803, a group focused on promoting the efficacy of vaccination, and presented a number of papers as a member of the Medical and Chirurgical Society in 1805. Jenner has also been elected as a foreign member of the American Academy of Arts and Sciences, and the Royal Swedish Academy of Sciences.
Napoleon minted a special medal which he awarded to Jenner in 1804. The Empress of Russia gifted him a ring, while the North American Indian Chiefs offered a string and belt of Wampum beads, as well as a certificate of gratitude.
By 1821, Jenner was made physician extraordinary to King George IV, justice of the peace, and mayor of his hometown, Berkeley.
He died in January 1823 of an apparent stroke. He was 73.
In creating vaccination, Jenner had also created anti-vaccinationists. Mostly religious, they refused to be treated with something that derived from a ‘lowlier creature’.
Days before his death, he reflected to a friend “”I am not surprised that men are not grateful to me; but I wonder that they are not grateful to God for the good which he has made me the instrument of conveying to my fellow creatures”.
In 1840, variolation was forbidden by Parliament. Vaccination with cowpox was made compulsory in 1853. ‘Anti-vaxxers’ protested, but their cries went unnoticed in the face of common good.
Today, statues of Jenner stand everywhere from London to Tokyo, but it is the following statistics that stand as the most important testament to his work:
- Only one in around one million people now die each year due to the smallpox vaccination. That’s a mortality rate 1000 times less than in the days of variolation.
- By 1967, most of the developed world was free of smallpox, but trouble areas still existed in South America, Africa, and India. The World Health Organisation (WHO) responded by sending teams of vaccinators to even the most remote communities around the world.
- In 1980, the WHO formally declared “Smallpox is dead!“
It has been estimated that the work Jenner started has resulted in the saving of more human lives than the work of any other person.
The last remaining specimens of smallpox are held in laboratories in Siberia and the USA. These labs have higher security measures than nuclear missile silos.
When the research these samples are used for run their course, they will be destroyed, and smallpox will be known as the first major infection disease wiped from the face of the Earth.
And, for that, we only have one person to thank.