by Rob Boddice
Vaccination was born in a time of war. Children, principal vectors of the smallpox virus, became the incubators of immunological hope.
Jenner chases death from Parisian streets as vaccinated children play at the feet of a bankrupt inoculator and his closed premises. Paris, c. 1800. Wellcome Library, London.
Prior to the massive public-awareness campaign spearheaded by Edward Jenner in 1798, distributing both the knowledge and the means of safe protection against smallpox, the smallpox virus itself had been preserved and propagated in the arms of children. It was common medical practice, in fact well into the nineteenth century, to inoculate children with smallpox in the hope that they would escape with a light dose of the disease. Jenner himself had suffered the ordeal at the age of 8. It involved six weeks of preparation – purging, bleeding and starving – in order to ‘sweeten the blood’. The process left the young Jenner ‘emaciated and feeble’. In this weakened state he was given a dose of smallpox and left to endure the disease for two weeks in a Gloucestershire ‘inoculation stable’. The process of recovery took many months, but such was the norm. Inoculation was a rite of passage, a necessary evil, an awful commonplace. Between 2 and 3 per cent of those ‘protected’ in this manner died from the disease. On many occasions the ‘protected’, not sufficiently isolated from their communities, themselves precipitated epidemics. Jenner, before making his famous discovery, would inoculate many children himself, as was his duty as a country surgeon.
Jenner confirmed, with an uncommon meticulousness and experimental rigour, that cowpox – variolae vaccinae – was a benign disease, not contagious, could be cultivated in humans and afforded protection against smallpox. The process took many years and involved many an experiment on children, including on his own. From the first, Jenner wanted to make the knowledge freely available, to broadcast it beyond political obstacles and geographical boundaries. Many thought it would have served him, and England, to make the vaccine a proprietary matter. Patent it, Jenner! Sell it to the well-to-do, the government, the army and the navy! What a fighting force it would be that could evade the most dreaded foe – disease! Here was hope at the end of a lancet.
Risking his status as a patriot, Jenner distributed his vaccine and his knowledge freely. His how-to guide on vaccination was quickly translated into French and Spanish. While England’s medical establishment were busy wringing their hands about the potential demise of a lucrative inoculation business, it was Napoleon’s army that took to the field free of one of the oldest fears. Jenner was a hero in France, the recipient of a Napoleon Medal, correspondent of the Emperor, and negotiator for the release of political prisoners held in France. From Paris to Geneva and Madrid, Jenner was a hero. In France alone, the number of deaths from smallpox went down from 150,000 annually to only 8,500. The children of the French empire had their arms raised for protection; their parents raised theirs in salute. Jenner was the man to whom Napoleon himself could refuse nothing.
Jenner’s discovery went viral thanks to the orders of the Spanish King Charles IV, who sent Francis Xavier Balmis on a vaccination voyage that took in South America, the Asian colonies, Portuguese colonial settlements, and even China. Always, the front line of defence against smallpox was embodied by children, who literally carried the virus, incubating it in their arms, to be harvested and inserted into the arms of others. Military enmity aside, Jenner thought the whole thing a ‘glorious enterprize!’, announcing that he, at least, had ‘made peace with Spain, and quite adore her philanthropic monarch’.
Jenner hoped for freedom from disease and for an end to childhood suffering and parental fear. Those who used his discovery hoped for a healthy population, for a healthy fighting force, and for victory. The bodies of children were at once the sites of all these hopes: demographic, medical and military.