Smallpox vaccination


In the 1630s as British colonists began occupying Massachusetts, the Native American population was exposed to several diseases for which they lacked immunity, contributing greatly to the population’s decline. Thomas Morton, one of the founders of present day Quincy, MA wrote,For the natives, they are near all dead of the smallpox, so the Lord hath cleared our title to what we possess.”

Record of innoculations by Zabdiel Boylston (1679–1766)

In 1721, a plague of smallpox hit Boston, infecting half of its estimated 11,000 residents. The infamous Puritan clergyman Cotton Mather learned from his African slave, Onesimus, that he had been inoculated with a small amount of smallpox before he was enslaved, which had given him immunity. Mather convinced Zabdiel Boylston, a Boston doctor, to begin inoculations; the first were Boylston’s young son Thomas, and two slaves.

This practice already existed in the 17th century in Africa and Asia, and probably dates back much longer. The variola virus that causes smallpox multiplies rapidly and overwhelms the immune system after its usual entry through the nasal passages, but exposure through the skin gives the body enough time to mount an adequate defense. British writer and explorer Lady Mary Wortley Montagu had her son inoculated in Turkey, but her advocacy for the procedure upon returning to England was met with disdain by religious and medical professionals as primitive, foreign, Muslim, and unclean.

News of Mather and Boylston’s procedure spread throughout the Boston populace, who “raised an horrid Clamour.” One person threw a bomb through Mather’s window, with a note reading, “Cotton Mather, you dog, dam you–I’ll inoculate you with this, with a Pox to you,” but Mather and Boylston persisted. By the time the epidemic had run its course, 844 people had died, but only 6 of the 242 people who had received the inoculation succumbed

Smallpox vaccination
Administering the smallpox innoculation

During the Black Death, which hit Europe in 1347, officials in the Venetian-controlled port city of Ragusa kept newly arrived sailors in isolation on their ships for 40 days, which became known in Venetian law as a “quarantino,” the origin of quarantining people during epidemics. In Colonial America, each town had a “pest house” (short for pestilence house) where persons afflicted with tuberculosis, diphtheria, cholera, and smallpox were quarantined.

In 1764 a pest house was constructed in Ipswich for quarantining anyone afflicted with smallpox, measuring 24 x 30 feet, and a second pest house was maintained near the town Commons on Scott Hill. One of the most progressive citizens of Ipswich, Dr. John Manning opened a practice in 1760, and in 1771 went to England to finish his medical education. While in London, he became acquainted with Dr. Daniel Sutton’s improved method of treating smallpox, and was himself inoculated in London. He returned home a year later and began inoculating members of his family. The old Puritan town did not take well to this, and initiated an investigation

Voted January 4, 1774 by the Town of Ipswich to determine if Jacob Manning had been inoculated with the smallpox

The Town then voted to confine Dr. Manning to the Pest House:

  • January 21, 1774: The Report of the Committee chosen by the Town this Day to examine the by Laws Respecting the small Pox: “Recommend it to the Town to direct the selectmen to put a guard of two or more Persons in the Pest House to confine Doct. John Manning there, and in case Doct. Mannng should be absent himself from the House without License of the Select men, that a guard be directed forthwith to acquaint the Selectmen. And upon such Information, that the Selectmen be directed to apply to a Justice of the Peace for a warrant to take said Doct. Manning for communicating the Small Pox to two Persons in this Town, and also for trespassing on the Town’s Property, & him forthwith to Commit to the common gaol (*jail). Voted in the affirmative.
Report of the committee to the Selectmen confining Dr. John Manning to the Pest House

Neither understanding nor appreciating the young Dr. Manning’s enlightened initiative, the town instead appointed 34 year old Dr. Samuel Rogers to care for the patients in the Pest House. He was the son of Dr. Samuel Rogers, who held the town office of Register, and grandson of Rev. John Rogers. The young Dr. Rogers at the age of 19 had been an assistant surgeon in 1759 in the battle at Louisburg, Canada. He settled in Gloucester, and became an officer in the company of minutemen. He died in Gloucester at the age of 37.

  • Feb 4th, 1774: “On a motion made & seconded, the vote being Put whether the Town will employ Doctor John Manning as a Physician at the Pest house, it passes in the Negative.” And on February 17:”Voted that the Selectmen, desire Doctor Samuel Rogers to tarry at the Pest House several days longer, until the Sick People there are in a good measure Recovered.”

The issue became divisive in the town as it became increasingly evident that Dr. Manning’s treatments were effective. Yet the mindset of the Selectmen and the Freeholders voting at Town Meeting remained rigid:

  • April 11, 1774 “On a motion made & seconded wither the Town will choose a committee to settle all disputes with Doctor John Manning, and if said Committee cannot agree with said Manning, then the said Committee be empowered to choose a Committee of Persons out of Town to settle said affair, And if said Manning will not comply, then said committee be empowered to prosecute Said Manning in the Law.”

As smallpox inoculations became more widely accepted, Dr. John Manning’s fortunes reversed. In April 1795, the now senior but unabashedly progressive doctor proposed to the town that he would undertake the maintenance of the poor, providing them with food, clothing, “and every kind of attendance in sickness & in health, for a fixed rate, on the condition that the Town would grant him the use of the pest house, purchase Mr. John Harris’s house and land for use as a Poor House, and pay him a set fee per annum. The expense of caring for the Ipswich poor was so controversial that residents in the affluent Hamlet section of town broke away in 1793 to create the town of Hamilton.

The Marblehead smallpox riot The Marblehead smallpox riot, January 1774 - In 1773, the selectmen ordered all houses where the disease had appeared to be closed, and dogs to be killed immediately. The fears of the inhabitants increased when permission was granted to build a smallpox hospital on Cat Island.… Continue reading The Marblehead smallpox riot, January 1774

Revolutionary War

By September 1774 , the issue with Dr. Manning seems to have subsided, and bigger issues were being debated on Sept. 21, 1774: “Voted that the Representatives now chosen be a Committee to meet with the Representatives of other Towns in this Province to form a Provincial Congress. Voted that the Town will choose a Committee to form Instructions to their Representatives.” Despite the growing acceptance of inoculation, a serious smallpox outbreak seized Boston in 1775, and continued to be a scourge throughout the Revolutionary War.

On the day after the battle of Lexington, April 19, 1775, Dr. John Manning drove to Boston to bring his sister, Mrs. McKean, to Ipswich. When near Boston he was stopped by a British soldier who had been wounded, for whom he provided medical attention, for which kindness the officer enabled Dr. Manning to enter the city and depart with his sister. Upon arriving back at his home, Dr. Manning aroused his family to gather medical supplies, and hastened back to Boston to care for all persons wounded in battle.

A smallpox epidemic raged during the British occupation of Boston, and when the British gave up the city in the spring of 1776, the outbreak spread into the countryside, continuing until the summer. In Captain Joseph Hodgkins ‘ letters to his wife Sarah Perkins, alone with their children on East St. in Ipswich, he wrote about an epidemic that was sweeping the camp at Prospect Hill, the American redoubt at the northern end of the siege lines in what is now Somerville:

Camp Prospect Hill, Jan. 7, 1776. I am sorry that I have the occasion to inform you that it is a good deal sickly among us. We buried Willeby Nason last Thursday. John Sweet is very sick in camp, & Josiah Persons of Cape Ann in our Company is just moved to the Hospital. Capt. Parker is a little better. Mr. Harden is sick in Camp. John Holladay died last Thursday night. There was five buried that day. We buried Mr. Nason from the hospital. Capt. William Wade has lost one man. He was buried Friday. We live in our tents yet, but the men are chiefly gone into barracks.”

Jan. Ye 8. Capt. Parker remains very sick. I am in hopes John Sweet is a little better. One of Capt. Dodge’s sergeants is very dangerously sick. It is a good deal sickly among us, and a great many die very sudden, but I hope God will spare for us and remove the Pestilence and the Sword.”

March ye 18, 1776. My Dear, I wrote a letter yesterday morning, and soon after I wrote there appeared a great movement among the Enemy, and we soon found that they had left Bunker Hill & Boston, and all gone on board the shipping & our army took possession of Bunker Hill and also of Boston, but none went to Boston but those that have had the small pox. Brother can inform you of matters better than I can by writing. All I can says is that we must move somewhere very soon, but I would not have you make yourself uneasy about that, for our enemy seems to be a fleeing before us, which seems to give a spring to our spirits.”

After the British left the city in March of 1776, Washington sent in a force of 1,000 smallpox-immune American troops to occupy Boston in order to avoid further spread of the disease. General Washington ordered that no one in his army be inoculated, in order to not be incapacitated and be vulnerable British attack. In February 1777, Washington reversed course and ordered that all troops be inoculated., “Finding the smallpox to be spreading much and fearing that no precaution can prevent it from running through the whole of our army, I have determined that troops shall be inoculated….This expedient may be attended with some inconveniences and some disadvantages, but yet I trust in its consequences will have the most happy effects. For should the disorder infect the army in the natural way and rage with its virulence we should have more to dread from it than from the sword of the enemy.”

English doctor Edward Jenner administering his smallpox vaccine.

The cowpox vaccination

In 1799, Harvard professor Benjamin Waterhouse obtained a strain of the cowpox vaccine that was being used against smallpox by Dr. Edward Jenner of London, who is regarded as the founder of immunology, and successfully inoculated members of his household. After at first refusing requests from other doctors for samples of the vaccine, Waterhouse began providing the material to individual practitioners in return for a quarter of their profits. Dr. John Manning’s son Dr. Thomas Manning of Ipswich broke Waterhouse’s monopoly when he received a sample of “the matter” from his brother in London and began providing it to other practitioners without payment.

In 1801, President Thomas Jefferson declared vaccination with Jenner’s discovery to be one of the nation’s first public health priorities. By the mid-19th century, despite a persistent anti-vaccination movement, Jenner’s vaccine had replaced the earlier practice of inoculation with smallpox scabs, dramatically replacing mortality rates. In 1855 Massachusetts became the first state to require public school children to be vaccinated, and within a few decades, most of the other states followed. Yet, as late as the 1950s an estimated 50 million cases of smallpox were occurring world-wide each year, resulting in millions of fatalities.

A massive global vaccination campaign put an end to Smallpox in 1977, and in December 1979, the WHO certified the global eradication of smallpox, making it the first disease ever eradicated. The only remaining cultures of the virus are in scientific laboratories in the United States and Russia.

Sources and further reading:

Related posts

The Marblehead smallpox riot The Marblehead smallpox riot, January 1774 - In 1773, the selectmen ordered all houses where the disease had appeared to be closed, and dogs to be killed immediately. The fears of the inhabitants increased when permission was granted to build a smallpox hospital on Cat Island.… Continue reading The Marblehead smallpox riot, January 1774

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