The beginnings of vaccination

Surprisingly, one year after her disease, her husband got a job as ambassador in the Ottoman Empire. At this time, such a job usually meant a separate life for couples. However, Lady Mary did not think about being left at home with her children. Instead, the whole family joined her husband travelling to Constantinople – the capital of the Ottoman Empire. A very unusual and brave decision at this time. The Ottoman Empire was regarded backwards by the British: Women were segregated, slaves served in households and the empire lacked any development of technology. It was though that this state of underdevelopment was due to “barbaric islam” and their rejection of Christianity. During her travels to Constantinople, Lady Mary developed her own point of view that she keeps in letters: “slaves” were treated the same way as “servants” were treated in the west, women – although segregated – enjoyed a freedom that their western counterparts would envy. 

While in Constantinople, Lady Montagu observed something very paradoxical: old women would make a business in inoculating healthy persons with smallpox to actually protect them from the deadly disease. They did this by scratching scabs from an infected person into the arm of a healthy one. This would lead to the disease with only mild symptoms, instead of the very strong disease if infected air-borne. After this treatment, the “inoculated” person would have life-long immunity to smallpox. Lady Mary was so fascinated by this method that she directly inoculated her son in Constantinople and would then make it her goal to bring this method to England.

Lady Mary had to fight hard to make people believe that this method actually works. At Lady Mary’s time we are still around 150 years before the identification of microorganisms as causative agents for disease. It was known that once you survived smallpox, you would never get the disease again. However, protecting a person from a disease by bringing him the disease seemed to make no sense at all. In England, she let her daughter be inoculated in front of witnesses. A bit later, she advocated for the Newgate experiment, in which 6 prisoners had the choice to be set free from their sentence to death if they agreed to be inoculated and later exposed to the disease. All prisoners survived which lead to huge media attention. A battle between pro- and anti-inoculators was kicked off with an interesting rhetoric that at least in part still seems to persist today. The pro-inoculators used a cool, factual tone and tried to be scientific, whereas anti-inoculators used heated tones and employed scare stories to promote paranoia. When the first people died after the in today’s terms indeed unsafe procedure, words like “murder”, and “depopulation” were employed.

Simultaneously, a similarly fascinating story happened in Boston: when the puritan pastor Cotton Mather asked his slave Onesimus whether he ever contracted smallpox, he simply replied: “yes and no” and went on to explain that in Africa (similarly to the Ottoman Empire) children were protected from smallpox by inoculating them with the disease. Similarly to Lady Montagu, Mather was fascinated by this report, but would need to wait a few years until Boston got hit by a smallpox epidemic to become a witness of the effectiveness of the procedure. Half of the Bostonians got the disease and 15 % died during that epidemic. Simultaneously, a friend of Mather who believed Onesimus, inoculated his son and slaves. Of the 40 people inoculated, only 1 person died. By comparing these numbers, the effectiveness of the method was proven for the first time: If you were a Bostonian at this time, you either did nothing and had a 15 % chance of dying or you went for inoculation with a 2.5 % risk of dying.

Yet, even numbers and the prospect of being more protected from death could not prevent a bitter fight between the pro- and anti-inoculators: In America, the contraction of a disease was perceived as a well-merited punishment by god for the sins committed and only god had the right to take and give life. Protecting people from the disease by an “African rite” seemed like a devilish invention. The events even cumulated in a bomb thrown into Cotton Mather’s home that luckily did not explode. Cotton Mather perceived inoculation as a gift from god, but was simultaneously heavily involved in the Salem witch trials. Onesimus with his answer “yes and no” and his report sticks out as the only rational person in this story.

The discoveries and knowledge of Lady Mary and Onesimus would eventually mix in England. However, a century of hysteric inoculations would follow, where unexperienced European physicians would transform the methodology by adding bleedings or using deep wounds. Of course, this came with unwanted consequences. Also, people inoculated would be contagious to non-inoculated people. Inoculated people not quarantined (which was actually in practice in many other parts of the world) were therefore a threat to non-inoculated people. However, based on the knowledge of inoculation, Edward Jenner would finally in 1796 develop the first vaccine against smallpox which was much safer than inoculation. In 1980, the smallpox was the first disease to officially be declared eradicated in the whole world, freeing humanity from this deadly disease.