To me what is interesting about the story of the first vaccine, is that it was created as a safer alternative to a pre-existing form of inoculation that had severe, sometimes fatal, side effects. Embedded into vaccination’s own conception story are adverse reactions, unethical human experimentation, and as a result widespread vaccine refusal.

And yet, this information is not commonly passed on in stories told about Edward Jenner, the English scientist and physician widely known for inventing the world’s first vaccine against smallpox.

While so many attribute only a positive narrative to Jenner, what’s not often discussed is that his own son became mentally handicapped throughout these repetitious early vaccine experiments.

vacca is latin for cow

We avoid the ethics question altogether (but not when it comes to Wakefield!). We ignore the experiments gone wrong. We conveniently forget that this earliest form of vaccination involved literally taking one person’s bodily tissues, scab and pus and putting it into an open wound in another person’s arm, sometimes an infant, sometimes an infant who was just born–just to see what would happen, with no regard or attention for long-term safety.

The vaccine Jenner would be known for took the pus and scab material from a cow pox sore (vacca is latin for cow), as opposed to an actual smallpox sore or scab from an infected person. Vaccination, therefore, was an attempt at making a safer alternative to variolation, however still risk-filled it was.

Variolation: A Risk-Filled Procedure

For centuries many different cultures practiced ‘variolation’ which was the procedure of taking material and pus from a smallpox sore or pustule from an infected person, and giving it to a person who has never had smallpox. The scab contained variola virus, which was the virus that caused smallpox.

The healthy person would then either inhale the material through their nose, or by scratching the scab tissue material into an incision or scratch on their arm. Sometimes a lancet would be used to make an incision for the smallpox scab.

Variolation resulted in infection, including all the symptoms of smallpox including fever and rash. It was assumed that variolation would result in a milder case of smallpox, but serious side effects did occur, including death.

The procedure was never risk-free. Not only could the patient die from the procedure but the mild form of the disease which the patient contracted could spread, causing an epidemic. Additionally, smallpox variolation also spread other infections such as tuberculosis and syphilis.

Edward Jenner Was Inoculated As a Child

In 1757 as a young boy the age of eight, Edward Jenner was inoculated by variolation. The procedure was elaborate, unpleasant, and some would say cruel. First he was fasted and bled for six weeks:

“He [Edward Jenner] was bled until pale, then purged and fasted repeatedly, until he wasted to a skeleton. He was denied solid food in favor of a vegetable drink that was supposed to sweeten the blood; after the inoculation itself – the least traumatic event of the entire experience – he was removed to an “inoculation stable,” and, according to an early biographer, “haltered up with others in a terrible state of disease, although none died.”

His recovery, amidst the moaning and crying of other inoculated children, took another three weeks, and he was sickly for some time thereafter.”

Without any guarantees of success, this procedure also increased the risk of spreading the disease and making the epidemic worse, as it did in many regions.

1 in 33 Died from Variolation

Victims of variolation could be found at all levels of society; King George III lost two young sons to the procedure as did many others. It was estimated that 3% of those who underwent variolation, died from variolation. That is a rate of 1 in 33, so for every 33 vaccinated people, 1 person will die.

Smallpox was caused by two viruses:

• Variola minor and Variola major. Variola minor caused milder form of smallpox with a fatality rate of < 1%.
• Variola major had a fatality rate of 5-25%.

Both strains of the virus were in circulation, with variola minor being found in the American continents and West Africa. In England, variola minor was the predominant strain after 1904.

However, according to Jenner’s own writing The Three Original Publications on Vaccination Against Smallpox, very mild waves of smallpox circulated in the 1700’s as well, which also sound like variola minor:

There are certainly more forms than one, without considering the common variation between the confluent and distinct, in which the smallpox appears in what is called the natural way. About seven years ago a species of smallpox spread through many of the towns and villages of this part of Gloucestershire: it was of so mild a nature that a fatal instance was scarcely ever Heard of, and consequently so little dreaded by the lower orders of the community that they scrupled not to hold the same intercourse with each other as if no infectious disease had been present among them. I never saw nor heard of an instance of its being confluent.

The most accurate manner, perhaps, in which I can convey an idea of it is by saying that had fifty individuals been taken promiscuously and infected by exposure to this contagion, they would have had as mild and light a disease as if they had been inoculated with variolous matter in the usual way. The harmless manner in which it shewed itself could not arise from any peculiarity either in the season or the weather, for I watched its progress upwards of a year without perceiving any variation in its general appearance. I consider it then as a variety of the smallpox. 

Immunity from variola minor or major is thought to confer immunity to the other, as does cowpox, monkeypox confer lifelong immunity to the variola viruses–if acquired through natural infection.

However, there appears to be cases in Jenner’s writing where people are infected multiple times, or have infection after being vaccinated:

Elizabeth Wynne, who had the cow-pox in the year 1759, was inoculated with variolous matter, without effect, in the year 1797, and again caught the cow-pox in the year 1798. When I saw her, which was on the eighth day after she received the infection, I found her affected with general lassitude, shiverings, alternating with heat, coldness of the extremities, and a quick and irregular pulse. These symptoms were preceded by a pain in the axilla. On her hand was one large pustulous sore, which resembled that delineated in Plate No. I. (Plate appears in original.)

Variola is from the latin word varius meaning spotted

or varus meaning pimple

Arm-to-arm transmission would continue to be the primary form of inoculation or vaccination until the syringe and needle became more widely available in the late 19th century.

When the smallpox vaccine was analyzed in the 1930s, it was thought that the vaccinia virus that had been used in smallpox vaccines was still related to cowpox, however it was serologically related but different from the cowpox virus.

In the absence of a known natural host, vaccinia has been considered to be a laboratory virus that may have originated from mutational or recombinational events involving cowpox virus, variola viruses or some unknown ancestral Orthopoxvirus.

Smallpox vaccination conferred immunity for three to five years. Revaccination therefore was required, and many people were vaccinated against smallpox many, many times.

In England, and even in the United States, infants were required to be vaccinated by 3 months of age, or face a fine.

Jenner’s Early Vaccine Experiments

In 1789, when Jenner was 40 years old and married only a little more than a year, there was an outbreak in Gloucestershire of swinepox, a disease very similar to cowpox except that it attacked pigs rather than cows.

Jenner decided to try immunizing his ten month old son, Edward, Jr, and two of his neighbor’s servants, by inoculating them with swinepox.

Jenner performed the experiment by making a small scratch on the servants’ and the baby’s arms with a lancet and then infecting the scratch “with matter from a pustule of the baby’s nurse, who had caught the swinepox infection.”

Eight days later baby Edward took sick and developed sores, but then later recovered.

Some months after that his father attempted to deliberately infect him (and the nurse also) with smallpox itself, not just once, but five times, in order to test the efficacy of the immunization.

Two years later, Jenner again challenged his son with smallpox, this time, however, with unhappy results. This time there was a reaction, and a severe one. The inoculation material turned out to be contaminated – a constant danger that later threatened to undermine Jenner’s work altogether.

Young Edward contracted a fever and his arm swelled all the way to the armpit. He eventually recovered, and a year later Jenner inoculated him with smallpox once again.

Unfortunately, however, in the years following these experiments, young Edward “became a sickly child and exhibited signs of mild mental retardation.” The boy died at the age of 21 from tuberculosis.

The Gardener’s Son and the Milkmaid

In 1796, Edward Jenner took the pus from a cowpox blister on milkmaid Sara Nelmes’ hand and placed it in an incision of his gardener’s eight-year-old son, James Phipps, to see if a cowpox infection protected against smallpox.

It’s amazing that retellings of this day, like Smithsonian Magazine’s story here, actually writes that Jenner decided to “extract a small sample of Sarah’s pus and inject it into the arm of a young boy” and “when Jenner stuck Phipps with a second needle, this time sporting a hefty dose of smallpox, Phipps remained healthy.” There were no syringes or needles at this time. They were not invented until the 1860’s!! Like what in the actual?! Do people not do their homework at all? Is there no allegiance to accuracy and everyone just literally writes whatever they want to write, rewriting history completely?

Anyways, it took the boy six weeks to recover from his acute cowpox infection, and then Jenner exposed the boy to smallpox material taken from another boy’s arm, this is essentially variolation. Again, this was all arm-to-arm transmission, there were no needles or syringes, it was done with a lancet, there was no hygiene or ways of sterilizing equipment. Infections were rampant.

When the child didn’t break out in smallpox, Jenner was then able to confirm that viruses offer cross-protection to other viruses that are similar. So by giving someone a cowpox infection, we was able to force or simulate what nature was already providing.

Here is the description in Jenner’s own words:

CASE XVI.–Sarah Nelmes, a dairymaid at a farmer’s near this place, was infected with the cow-pox from her master’s cows in May, 1796. She received the infection on a part of her hand which had been previously in a slight degree injured by a scratch from a thorn. A large pustulous sore and the usual symptoms accompanying the disease were produced in consequence. The pustule was so expressive of the true character of the cow-pox, as it commonly appears upon the hand, that I have given a representation of it in the annexed plate. The two small pustules on the wrists arose also from the application of the virus to some minute abrasions of the cuticle, but the livid tint, if they ever had any, was not conspicuous at the time I saw the patient. The pustule on the forefinger shews the disease in an earlier stage. It did not actually appear on the hand of this young woman, but was taken from that of another, and is annexed for the purpose of representing the malady after it has newly appeared.

CASE XVII.–The more accurately to observe the progress of the infection I selected a healthy boy, about eight years old, for the purpose of inoculation for the cow-pox. The matter was taken from a sore on the hand of a dairymaid [Footnote: From the sore on the hand of Sarah Nelmes. See the preceding case.], who was infected by her master’s cows, and it was inserted, on the 14th of May, 1796, into the arm of the boy by means of two superficial incisions, barely penetrating the cutis, each about half an inch long.

On the seventh day he complained of uneasiness in the axilla, and on the ninth he became a little chilly, lost his appetite, and had a slight headache. During the whole of this day he was perceptibly indisposed, and spent the night with some degree of restlessness, but on the day following he was perfectly well.

The appearance of the incisions in their progress to a state of maturation were much the same as when produced in a similar manner by variolous matter. The only difference which I perceived was in the state of the limpid fluid arising from the action of the virus, which assumed rather a darker hue, and in that of the efflorescence spreading round the incisions, which had more of an erysipelatous look than we commonly perceive when variolous matter has been made use of in the same manner; but the whole died away (leaving on the inoculated parts scabs and subsequent eschars) without giving me or my patient the least trouble.

In order to ascertain whether the boy, after feeling so slight an affection of the system from the cow–pox virus, was secure from the contagion of the smallpox, he was inoculated the 1st of July following with variolous matter, immediately taken from a pustule. Several slight punctures and incisions were made on both his arms, and the matter was carefully inserted, but no disease followed. The same appearances were observable on the arms as we commonly see when a patient has had variolous matter applied, after having either the cow–pox or smallpox. Several months afterwards he was again inoculated with variolous matter, but no sensible effect was produced on the constitution.

But not everyone had a good experience…

On March 16, 1798, five-year-old John Baker was inoculated with horse pox:

He became ill on the sixth day with symptoms similar to those excited by cow–pox matter. …The boy was rendered unfit for inoculation from having felt the effects of a contagious fever in a workhouse soon after this experiment was made….The boy, unfortunately, died of a fever at a parish workhouse before I had an opportunity of observing what effects would have been produced by the matter of smallpox.

A woman in the eighth month of pregnancy was inoculated, but sensed no further fetal movement from the 23rd day after vaccination. Twelve days later she delivered a death infant, whose skin was covered with pox-like blisters. At the time, these deaths were attributed to vaccination.

Another account goes:

CASE XX – From William Summers the disease was transferred to William Pead, a boy of eight years old, who was inoculated March 28th. On the sixth day he complained of pain in the axilla, and on the seventh was affected with the common symptoms of a patient sickening with the smallpox from inoculation, which did not terminate till the third day after the seizure. So perfect was the similarity to the variolous fever that I was induced to examine the skin, conceiving there might have been some eruptions, but none appeared. The efflorescent blush around the part punctured in the boy’s arm was so truly characteristic of that which appears on variolous inoculation that I have given a representation of it. The drawing was made when the pustule was beginning to die away and the areola retiring from the centre.

Experiments on a Newborn:

Wishing to see the effects of the disease on an infant newly born, my nephew, Mr. Henry Jenner, at my request, inserted the vaccine virus into the arm of a child about twenty hours old. His report to me is that the child went through the disease without apparent illness, yet that it was found effectually to resist the action of variolous matter with which it was subsequently inoculated.

Experiments on a Child With Active Measles:

I have had an opportunity of trying the effects of the cow-pox matter on a boy, who, the day preceding its insertion, sickened with the measles. The eruption of the measles, attended with cough, a little pain in the chest; and the usual symptoms accompanying the disease, appeared on the third day and spread all over him. The disease went through its course without any deviation from its usual habits; and, notwithstanding this, the cow-pox virus excited its common appearances, both on the arm and on the constitution, without any febrile interruption; on the sixth day there was a vesicle.

8th: Pain in the axilla, chilly, and affected with headache.

9th: Nearly well.

12th: The pustule spread to the size of a large split-pea, but without any surrounding efflorescence. It soon afterwards scabbed, and the boy recovered his general health rapidly. But it should be observed that before it scabbed the efflorescence which had suffered a temporary suspension advanced in the usual manner.

Here we see a deflation from the ordinary habits of the smallpox, as it has been observed that the presence of the measles suspends the action of the variolous matter.

These writings are from Jenner’s publications, trying to clear the air on smallpox vaccination, because at this time there were already adversaries.

Final Thoughts

There are countless more stories, but to me what is important is the realization that this invention, at its core, was an approach of preventing disease by causing disease. And with every medical intervention or experiment, there may be adverse reactions, unintended consequences, and what is often called “non-specific effects” of vaccination, like the research of Peter Aaby.

Now, this is ever more relevant with the emerging vaccines against sars-covid 2. We may be observing many more non specific effects of vaccination. And we should keep asking questions, like “Do vaccinated children have higher rates of allergic disorders, or neuro developmental disorders? Do fully vaccinated children have higher rates of cancer? What are the differences, what are we not looking at, what is the piece of the story that we don’t know….?

Time will tell such things.