Edward Jenner

Edward Jenner (17 May 1749 – 26 January 1823) was an English physician, immunologist, and zoologist who developed the world's first vaccine. His work on smallpox, was a major step forward in combating what was arguably the most deadly disease in human history. In a 2002 poll, he was ranked the 78^th greatest Briton of all time.[1]

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Early life

Edward Jenner was born in Berkeley, Gloucestershire. He received a basic primary education before beginning an apprenticeship with a surgeon at the age of 14. In his early 20s he began another apprenticeship at St George's, University of London to continue his study of surgery and general human anatomy.[2] In 1772 he earned his M.D from the University of St Andrews and went on to become a successful general practitioner and surgeon. He later became a member of the Royal Society in 1788 where he published groundbreaking new research on the behavior of the cuckoo bird and its life history strategy.[3]

Smallpox

Smallpox's origins are unclear. It appears to have first arisen in ancient Egypt (1570–1085 BCE) before spreading to India and later Europe. Since then, it repeatedly ravaged different parts of the world in devastating outbreaks.[4] During the 20^th century as many as 300 million people were killed by it. After 1492, when first introduced to the New World, it contributed to the deaths of about 54 million people.[note 1] In medieval Europe, China and India, it killed hundreds of thousands of people every year, leaving many of its survivors blind, scarred, or both.[5][6][7]

Variolation

Before the vaccine there was variolation, which seems to date back to around the year 1000 CE in China, although precise references to smallpox immunization don't appear until a few hundred years later.[8][9] Variolation was a practice in which people were intentionally exposed to a mild form of the disease. Scabs were taken from someone with smallpox and powdered into dust and then inhaled through the nose of uninfected people. Occasionally, more direct contact was made by rubbing the powdered scabs or even pustule fluids into a shallow cut. Overtime the practice spread West across Eurasia into Africa and eventually Europe. Those inoculated had lower rates of death than the untreated but there were some serious deficiencies. People who were treated often still carried a live virus, meaning they became a potential walking biohazard who could infect others if not quarantined for a time.[10] The actual effectiveness, though very good compared to those not immunized, was not as high as vaccination, with some dying anyway.[11] Variolation also suffered from another defect, it did not always prevent a second attack with the immunity sometimes wearing off. Finally, variolation performed by cutting could lead to infections, however minor, and was sometimes more dangerous because of misdiagnosis.

Jenner's contribution

Cartoon satirizing early anti-vaccination concern.

Jenner had actually been variolated in his youth before going on to study medicine himself. The practice was first introduced to Europe in the early 18^th century where it was met with skepticism but was eventually practiced. By 1768, English physician John Fewster had discovered that people who had been struck with cowpox were immune to smallpox. Noting the common observation that milkmaids were generally immune to smallpox, Jenner theorized that the pus in the blisters that milkmaids received from cowpox immunized them to smallpox. Jenner hypothesized that exposure to cowpox would protect people from smallpox.[12][13]

In 1796, Jenner tested his hypothesis by inoculating one James Phipps, the eight-year son of his gardener. He acquired pus from cowpox blisters on the hands of a milkmaid who had caught cowpox from a cow named Blossom. Phipps was the 17^th case described in Jenner's first paper on vaccination. Jenner inoculated Phipps in both arms that day, resulting in a fever and some uneasiness, but no full-blown infection. Later, he injected Phipps with variolous material, the routine method of immunization at that time. No disease followed. The boy was later challenged with variolous material and again showed no sign of infection.[14] Jenner went on to successfully test his hypothesis on 23 additional subjects.

Jenner continued his research and reported it to the Royal Society, which did not publish the initial paper. After revisions and further investigations, he published his findings on the 23 cases, including his own infant son Robert. Eventually, vaccination was accepted, and in 1840, the British government fully banned variolation and began providing vaccination using cowpox free of charge.[15]

The success of his discovery soon spread around Europe after some initial hesitancy.

Later Life and Legacy

“”I avail myself of this occasion of rendering you a portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility.

—Thomas Jefferson[16]

Jenner continued to pursue and encourage research and experimentation to study and improve his vaccine for the remainder of his life. He died at age 73 due to a complications from internal bleeding and eventually a stroke. His keen use of the scientific method; observation, experimentation, inquisitiveness, cross-disciplinary learning, served as a major breakthrough in modern medicine. In many ways he represents the best of the Enlightenment and Scientific Revolution, helping pave the way for later scientists like Louis Pasteur while simultaneously helping untold numbers of people by making breakthroughs in applied science. Smallpox was officially declared to have been fully eradicated in 1980, Jenner helped take some of the earliest steps toward making that happen.

Further Reading

• Early Efforts at Control : Variolation, Vaccination, and Isolation and Quarantine

Notes

1. Smallpox was one of the most notorious diseases in ravaging the populations of the New World. It was not, however, the only one. American Indians had no immunity to any Old World diseases including bubonic plague, measles, and yellow fever.

References

1. https://web.archive.org/web/20030401083737/http://www.bbc.co.uk/history/programmes/greatbritons/list.shtml
2. "Edward Jenner — Jenner Institute". www.jenner.ac.uk.
3. https://www.encyclopedia.com/people/medicine/medicine-biographies/edward-jenner
4. "History of Smallpox | Smallpox | CDC". www.cdc.gov. 15 February 2019. Retrieved 6 January 2020.
5. Riedel, S. (2005, January). Edward Jenner and the history of smallpox and vaccination. In Baylor University Medical Center Proceedings (Vol. 18, No. 1, pp. 21-25). Taylor & Francis.
6. Koch, A., Brierley, C., Maslin, M. M., & Lewis, S. L. (2019). Earth system impacts of the European arrival and Great Dying in the Americas after 1492. Quaternary Science Reviews, 207, 13-36.
7. Microbe hunters, then and now. Medi-Ed Press. 1996. p. 23.
8. Williams, Gareth (2010). Angel of Death. Basingstoke: Palgrave Macmillan.
9. Needham, Joseph. (2000). Science and Civilization in China: Volume 6, Biology and Biological Technology, Part 6, Medicine. Cambridge: Cambridge University Press. Page 134.
10. Smallpox: Variolation www.nlm.nih.gov.
11. "Variolation vs. Vaccination." 2014. http://jenniferleecarrell.com/variolation-vs-vaccination/
12. L. Thurston and G. Williams (2015) "An examination of John Fewster's role in the discovery of smallpox vaccination," Journal of the Royal College of Physicians of Edinburgh, 45 : 173–179.
13. "Edward Jenner | English surgeon". Encyclopedia Britannica.
14. "Edward Jenner | History of Vaccines". www.historyofvaccines.org.
15. Wolfe, R. M., & Sharp, L. K. (2002). Anti-vaccinationists past and present. Bmj, 325(7361), 430-432.
16. http://www.let.rug.nl/usa/presidents/thomas-jefferson/letters-of-thomas-jefferson/jefl172.php