The Untold Stories About Smallpox Vaccines

Authored by Yuhong Dong via The Epoch Times (emphasis ours),

In the rich tapestry of medical science, vaccines stand out as monumental achievements lauded for their role in controlling, and sometimes eradicating, some of humanity’s deadliest diseases. Yet, the story of vaccines is not just a straightforward account of scientific triumph. It is a complex narrative, woven with evolving methodologies, diverse perspectives, and debates over efficacy and safety.

The story of vaccines—particularly the smallpox vaccine—is more than a chapter in medical history; it’s a reflection of the human journey, marked by groundbreaking discoveries, societal impacts, and ongoing learning. Smallpox, once a formidable scourge, was the first disease to be eradicated through vaccination. However, the path to this success was not linear. It was punctuated with challenges and controversies.

In this series, “Revisiting the Historical Vaccines,” we will explore the multifaceted history of vaccines, examine historical data, and seek a nuanced understanding of vaccine efficacy and safety.

This journey begins with the smallpox vaccine—a starting point that opened doors to modern immunization but also raised questions that resonate to this day.

Our critical evaluation is to offer a well-rounded perspective, grounded in scientific data and enriched by historical context. Join us as we delve into the past to understand the present and shape our thoughts for the future of public health and medical science.

(Illustration by The Epoch Times, Shutterstock, Getty Images)

In general, smallpox vaccines can be roughly differentiated into three stages. The first stage began with the invention of the vaccine by Dr. Edward Jenner in 1796. The second stage involved the different versions of smallpox vaccines propagated and used by people during the 18th and 19th centuries. Finally, the third stage includes modern smallpox vaccines used in the late 20th and 21st centuries.

The Most Fearful Disease in History

The story of vaccines begins with a narrative of groundbreaking triumphs in public health. One of the earliest successes was the development of the smallpox vaccine by Dr. Edward Jenner (1749 to 1823) in the late 18th century, a pivotal moment that demonstrated the potential of the vaccine.

Smallpox, caused by the variola virus, was once one of the world’s most feared diseases. Characterized by fever, malaise, telltale pustules on the skin, disfiguring scars, and blindness in many survivors, it has a storied history that intersects with the evolution of human civilization.

According to the World Health Organization (WHO), smallpox has two forms: variola minor, with a 1 percent mortality rate, and the more severe variola major, with a 30 percent mortality rate. About 65 to 80 percent of survivors bear deep, pitted facial scars called “pockmarks.”

(Left) A transparent viral membrane derived from its host cell covers the virus particle. The inside core (red) contains DNA genetic material. The surface of the virus is covered with surface tubules which help the virus attach to a host cell. (Kateryna Kon/Shutterstock) (Right) Smallpox riots in Milwaukee, Wisconsin (1894). (stock illustration/Getty Image)

Edward Jenner’s 1796 Invention

The smallpox vaccine was introduced by Dr. Edward Jenner in 1796. The story of this first vaccine started with a belief among milkmaids that cowpox infection could prevent smallpox.

Inspired by this belief, Dr. Jenner experimented on an 8-year-old boy, James Phipps. Dr. Jenner used material from a dairymaid’s cowpox lesions and scratched it onto James. When James didn’t develop smallpox after exposure, Dr. Jenner concluded that the cowpox vaccination was effective.

The process above shows the steps taken by Dr. Edward Jenner to create the smallpox vaccine, beginning with inoculating James Phipps with cowpox, a virus similar to smallpox, to create immunity. (Illustration by The Epoch Times)

This process was later termed “vaccination,” derived from the Latin word “vaca,” for cow, and “vaccinia,” for cowpox. Dr. Jenner’s 1798 paper claimed lifelong immunity from smallpox through this method.

This single-person study evolved into the modern narrative being told in our textbooks for hundreds of years that “inspired by milkmaids, Dr. Jenner invented the smallpox vaccine consisting of the so-called cowpox virus, conferring cross-protection against smallpox.”

Furthermore, lesser-known details in this story spread for more than 200 years. There are at least two points that are not true about this narrative. 

The first one, unfortunately, is that the story of the milkmaid was a lie invented by John Baron, Dr. Jenner’s friend and first biographer. In his book, “The Life of Edward Jenner MD,” Mr. Baron states that Dr. Jenner himself never claimed to have discovered the value of cowpox, nor did he ever say, despite a huge volume of correspondence, how he first came across the idea. The myths of the milkmaids are just that, myths.

The second point is that the virus contained in Dr. Jenner’s original smallpox vaccine is supposed to be a type of cowpox virus. However, is this true? The answer is relatively obscure. Rather than the cowpox virus, evidence supports that Dr. Jenner might have used the vaccinia or the horsepox virus, which stands as the biggest mystery in Jenner’s vaccine story. 

Different Viruses, Different Diseases

Smallpox results from the variola virus, a DNA virus belonging to the Orthopoxvirus genus. This virus only infects humans. Unique to humans, who are its only known reservoir, it spreads primarily through inhaling respiratory droplets or through direct contact with infected material on mucous membranes. Importantly, it is not transmitted from cows.

Cowpox is caused by the cowpox virus affecting only milking cows. The cowpox virus mainly resides in wild mammals like cattle and cats without causing obvious symptoms. In humans, the infection is usually mild and self-limiting, characterized by fever, aches, and a red blister that evolves into a pus-filled lesion.

Moreover, the horsepox virus further complicated the story, as Dr. Jenner had also used lymph from horsepox lesions to prepare the smallpox vaccine in 1813 and 1817. Horsepox causes pustular lesions in horses and horse handlers.

The cowpox virus, horsepox virus, and smallpox virus are all different viruses. Even so, Dr. Jenner used various sources, including cows and horses, to create vaccine substances. This practice led to the development of multiple vaccine concoctions, often used without a full understanding of their composition.

(Left) Portrait of Edward Jenner, British physician and scientist who pioneered the concept of vaccines by creating the smallpox vaccine, the world’s first-ever vaccine. (mikroman6/Getty Images) (Right) Old engraved illustration of the first vaccination by Dr. Edward Jenner. (mikroman6/Getty Images)

A 2018 paper in The Lancet Infectious Diseases by Clarissa Damaso carefully revisited the complex and obscure history of smallpox vaccines and concluded that the virus strains used by Dr. Jenner remain a mystery (i.e., cowpox, horsepox, or vaccinia viruses).

In 1823 when Dr. Jenner died, there were already three distinct types of smallpox vaccines: cowpox, described as “pure lymph from the calf,” horse grease, described as “the true and genuine life-preserving fluid,” and horse grease variants.

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