Tucson Opinion: It all started with smallpox

Having spent the last year sheltering against COVID-19 and waiting my turn for vaccination, I was reminded of our legacy from the past with vaccines and vaccination. In the beginning, both words had very specific meanings tied to a very specific disease, a very specific virus: smallpox. The word and the process were originally coined by Edward Jenner in 1798 when he discovered a prophylactic against smallpox.

For thousands of years smallpox, a highly contagious and often deadly Old World disease ravaged the people of half the earth. If it did not kill them, it left them horribly scarred. It was known in Europe as well as in the Far and Near East. As a scourge and a known killer, it was studied by the ancients and physicians of past centuries. They were concerned with diagnosis and more importantly, prognosis. The first physician to differentiate between smallpox and measles, which may seem similar at the outset, was the Persian physician, Rhazes (850-923 AD).

Unlike some diseases that remained impervious to human intervention, smallpox yielded to human prevention. Over many centuries, it was observed that people who survived smallpox seemed to be immune to future infections.

Probably from this came the idea of deliberately infecting people with smallpox — a mild case was hoped for but not ensured. Inoculation or variolation (as it was called in the West after the Latin term for smallpox, variola) was practiced in the East for many centuries before it made its way to Europe in the early 18th century. This procedure involved using the pus from a smallpox pustule, creating a small wound, incision, or scratch, usually on the arm, and introducing the pus into the wound. Inoculation was practiced (mostly by the upper classes) but not in a systematic, widespread way, and smallpox persisted.

In the late 18th and early 19th centuries, Edward Jenner (1749-1823), an English physician, discovered that a related, but more benign, disease called cowpox conveyed immunity against smallpox. After some years of experimentation to confirm his findings, he published his seminal discovery in 1798 and 1801 titled: An inquiry into the causes and effects of the variolæ vaccinæ, a disease discovered in some of the western counties of England, particularly Gloucestershire, and known by the name of the cow pox (London: 1798). To distinguish inoculation with smallpox from his use of cowpox, he coined the term “vaccination,” named after the Latin term “vaccinus” (relating to cows).

Thanks to Jenner’s research, his vaccine and vaccination, smallpox virus was finally eradicated from the earth through a worldwide effort by the Global Commission for the Certification of Smallpox Eradication. Starting in 1967, the World Health Organization’s commission began the campaign; they declared victory on May 8, 1980. (Two supplies of smallpox were preserved: one in the United States and one in Russia. As far as we know those are guarded and safe.) But before eradication, millions of people in the New World (Native Americans) and the Pacific Islands were wiped out as Europeans spread smallpox among them. Smallpox was eradicated because virtually everyone on the planet had been vaccinated.

Now we use the term vaccine to refer to any medicine that conveys immunity against certain deadly and debilitating diseases. We’ve made many advances in the efficacy and delivery of vaccines, and it behooves all of us to prevent the spread of disease by getting vaccinated against a variety of diseases that flourish amongst us with varying degrees of severity.

Viruses survive by mutating, and COVID-19 is a highly contagious shape-shifter with a potentially long tail of subsequent consequences for those who gamble with the health of themselves and the community by declining to get vaccinated. An infected person may experience a mild case while spreading the disease to more susceptible members of the community, maybe with a deadly result. Eradicate COVID.