Edward Jenner and the Smallpox Vaccine

Annotated Bibliography

Primary Sources:

Jenner, Edward. ​Further observations on the Variolae Vaccinae or Cow Pox​. n.p.:
Edward Jenner. 1799

One of the patients Jenner experimented on was a boy. The boy had gotten
measles the day before the inoculation, but after the 12th day, the vaccination site
had scabbed and the boy recovered gradually. From experiments like this one,
Jenner has found the same results: every patient who had been inoculated had lost
susceptibility to the disease.

Jenner, Edward. ​An Inquiry Into the Causes and Effects of the Variolae Vaccinae: A
Disease Discovered in Some of the Western Counties of England, Particularly
Gloucestershire, and Known by the Name of the Cow Pox​. n.p.: Edward Jenner.
1798.

The author, Jenner not only gives the reader 23 cases of using the vaccine, but
also gives the reader some drawings of arms from the experiments. Jenner
concludes from the experiments that cowpox protects humans from getting
smallpox. He goes on to say that he will have to continue to study the subject,
being encouraged that it may one day be effective and beneficial to mankind.

Jenner, Edward. ​Vaccination against Smallpox​. Amherst, NY: Prometheus Books, 1996.

At first, Jenner thought a disease horses strongly resembled smallpox, and hence
found it highly probable that it was the source of the disease. Due to carelessness,
the cows also contracted this disease, and from cows, it spread to humans. Though
the symptoms of cowpox were not pleasant, for example, sometimes sores on the
skin; the person who contracted smallpox was immune, or was not able to
contract smallpox. The author, Jenner goes on to give various case studies about
how cow pox inserted into people’s arms were able to protect the person from
contracting smallpox.

Secondary Sources:

Belongia, Edward A, and Allison L Naleway. “Smallpox Vaccine: the Good, the Bad,
and the Ugly.” Clinical medicine & research. Marshfield Clinic Research
Foundation, April 2003.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069029/.
 Smallpox is a not highly transmittable, and higher population densities are have a
higher chance of sustaining the disease. The vaccine provides a high-level of
protection for about five years and a partial protection for about ten years. It is
"good" in terms of humans being able to control the disease, the "bad" refers to
the extra complications some may have after the vaccine is administered, and the
"ugly" refers to the potential that smallpox could be reintroduced.

Children's Hospital. “A Look at Each Vaccine: Smallpox Vaccine.” Children's Hospital

of Philadelphia. The Children's Hospital of Philadelphia, August 22, 2014.
https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/
smallpox-vaccine.

Smallpox, a virus, has probably killed more people in the world than any other
infectious diseases combined: out of every 100 people, 30 die from smallpox. It is
transmitted through coughing, sneezing, talking, or close contact (within about 6
feet). At one point in time, the smallpox vaccine was routinely given to all
children at about one years old, but the routine vaccination of the public has been
discontinued since 1971. The first time someone got the vaccine, they would get
punctured three times, and if the booster shot was given, it would add an
additional 15 punctures. Therefore, many people in their 40's or older may still be
able to see the scar on their arm.

Gillray, James. ​U.S. National Library of Medicine Digital Collections​. June 12, 1802.
U.S. National Library of Medicine Digital Collections​.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101395166-img.

This digital image depicts the mindset of the people who do not support
vaccination. They are fearful of what vaccination might do to a person, which is
shown through the abnormalities of the people, who have presumably gotten
vaccinated. One lady in the center is getting vaccinated, and the process depicted
looks like the doctor is stabbing her arm.

“History of Smallpox.” Centers for Disease Control and Prevention. Centers for Disease
Control and Prevention, August 30, 2016.
https://www.cdc.gov/smallpox/history/history.html.

Growth and spread of civilizations, along with exploration, and expanding trade
routes led to the global spread of smallpox. Originally, people tried variolation,
which resulted in still getting the initial symptoms, but fewer people dying from
the variolation than if they had contracted the disease themselves. Fast forwarding
to 1959, the World Health Organization (WHO) came up with a plan to eradicate
smallpox; but it did not have sufficient funds, personnel, nor commitment from
countries to continue with the plan. By the time the plan started again, this time
known as the Intensified Eradication Program, began in 1967 and scientists were
now able to produce higher-quality, freeze-dried vaccines, the disease had already
 been eliminated from North America and Europe. The world was officially
declared to be smallpox-free by the 33rd World Health Assembly on May, 8th,
1980; currently, there are two locations with stocks of the virus officially stored
and handled under WHO supervision.

“History of Smallpox.” Timeline | History of Vaccines. Accessed November 4, 2019.

https://www.historyofvaccines.org/timeline/smallpox.

Smallpox, the only human disease to be eradicated through vaccination, had been
plaguing people throughout history. It was estimated to have been in Europe by
about 300 AD. Scarring similar to smallpox scarring had been found on Ramsey
V's mummy, texts in ancient Sanskrit depict a smallpox-like disease, and the
number of deaths form smallpox during the 20th century, some estimates say, was
over 300 million. This website gives a timeline of the history of smallpox,
including the first known inoculation.

Riedel, Stefan. “Edward Jenner and the History of Smallpox and Vaccination.”
Proceedings (Baylor University. Medical Center). Baylor Health Care System,
January 2005. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/.

Smallpox was believed to appear around 10,000 BC, the time of the first
agricultural settlement in northeastern Africa, and was introduced to Europe
sometime between the 5th and 7th centuries and greatly effected the development
of the Western civilizations. The Arab expansion, the Crusades, and the discovery
of the West Indies all contributed to the spread of smallpox. Inoculation, also
known as variolation, was likely used in China, India, and Africa before it was
introduced to Europe in the 18th century. After many trials, inoculation was
accepted by the public. One of the many inoculated, was Edward Jenner
(inoculated in 1757).

“Smallpox Questions and Answers: The Disease and the Vaccine.” New York State
Department of Health. Revised April 2003.
https://www.health.ny.gov/publications/7004/#targetText=It%20was%20successf
ully%20used%20to,eradicated%20in%20the%20United%20States.

Even though smallpox is considered eradicated, the threat of it being used as a

bioterrorist weapon still stands. Therefore, the United States has taken precautions
such as vaccinating the health care and public health workers, so that they can
effectively protect others from the disease if an outbreak should occur. There is
also enough of the vaccine to be administered in the event of a outbreak. The
disease can be prevented, though there is no known cure. The vaccine is not given
using a hypodermic needle, but using a two-pronged needle that is dipped into the
vaccine solution, which is then used to prick (generally) the upper arm fifteen
times in a few seconds.
“Smallpox: Resistance to Vaccination.” U.S. National Library of Medicine. National
Institutes of Health, July 30, 2013.
https://www.nlm.nih.gov/exhibition/smallpox/sp_resistance.html.

Anti-vaccination societies became more vocal, especially in the late 19th century,
believing that vaccination did more harm than good, that George Bernard Shaw
even considered it a type of dirty witchcraft. People who did not support
vaccinations had various reasons to resist. For some, it was because of the idea
that the government should not force their citizens to undergo any medical
treatment; for others, it was because they thought that vaccination was dangerous.
For another group of people, especially from India, they thought that a
vaccination made from a substance derived from cows were unacceptable. No
matter the reason, many governments found the resistance to vaccination, when it
put other members of a community at risk, to be unacceptable.

“Smallpox Vaccines.” World Health Organization. Accessed November 11, 2019

https://www.who.int/csr/disease/smallpox/vaccines/en/

Smallpox was one of the most deadly diseases known to humans, and the only
one to be eradicated (as of 2016). Before it was considered to be completely
eradicated, global eradication efforts were put into place, and consisted of mass
vaccination campaigns that strived to achieve 80% vaccine coverage in each
country. The bifurcated needle was developed in 1961, and was the main
instrument used in the program for 11 years, from 1966 to 1977. The new needle
used less of the vaccine to vaccinate someone, and made the vaccination simpler
to perform. Currently, there are 31.01 doses of the vaccine in donor countries'
stockpiles.

U.S. National Library of Medicine Digital Collections​. ​U.S. National Library of Medicine
Digital Collections.​ Accessed January 30, 2020.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101419674-img.

This digital image is of Edward Jenner, the man who invented the first smallpox
vaccine by inoculating people with cowpox instead of smallpox. The image
depicts him in clothes of the time period, and with a straight expression, or even
with a “don’t question me” kind of expression. He was drawn using the halftone
technique.

U.S. National Library of Medicine Digital Collections​. ​U.S. National Library of Medicine
Digital Collections.​ Accessed February 1, 2020.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101434084-img.

This digital image depicts a man with a “discrete” case of smallpox. The image
shows only the man’s head, with all the pustules from the smallpox. At the bottom
 of the image, it reads, “DISCRETE SMALL-POX” and the image itself has a
pinkish-purpleish gradient: lightest in the middle, increasingly getting darker
towards the outside corners.

U.S. National Library of Medicine Digital Collections​. 1963. ​U.S. National Library of
Medicine Digital Collections​.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101446969-img.

This digital image was published in 1963 and depicts a woman with sunglasses
getting vaccinated with the smallpox vaccine. The man touching her arm
(presumably the one giving her the vaccine) has a hat that looks like it was from
the armed forces. There are many other people behind them as well, who look like
they are either giving or receiving the vaccine.

U.S. National Library of Medicine Digital Collections​. January 13, 1883. ​U.S.National
Library of Medicine Digital Collections​.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101435879-img.

This digital image depicts an infant being vaccinated in a doctor’s office. There
are two more moms with infants waiting in line for their infants to also be
vaccinated. The infant being vaccinated looks like she is screaming (presumably
with pain). The image was published in 1883.

U.S. National Library of Medicine Digital Collections​. 1857. ​U.S. National Library of
Medicine Digital Collections​. Accessed January 30, 2020.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101435896-img.

This digital image is of a symbolic parade. Its topic is about the evils of
inoculation, and has a lot of German on it. When translated by Google Translate,
it translated to something like, “The wrong degree of vaccination and its
repercussions on science...” The image also depicts a skeleton riding in a carriage
carrying a scythe (which is what the Grim Reaper, also known as Death). The
visual imagery depicted shows that the artist had a bias that was not in favor of
vaccination.

U.S. National Library of Medicine Digital Collections​. 1898. ​U.S. National Library of
Medicine Digital Collections​.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101436201-img.

This digital image depicts a person’s arm with pustules on the 8th day after
getting vaccinated. There are a total of five pustules on the arm, and they look
pretty deep, at least deeper than a regular scar from a minor scrape. The sleeve
looks like it is rolled up and tied up.
U.S. National Library of Medicine Digital Collections​. ​U.S. National Library of Medicine
Digital Collections.​ Accessed February 9, 2020.
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101457103-img.

This image depicts a cuckoo bird from its profile view. The bird is standing on a
green plane, which is presumably grass, and the image has words on the viewer’s
right hand side. The bird itself is not in color, but only drawn out.

U.S. National Library of Medicine Digital Collections​. 2010. ​U.S. National Library of
Medicine Digital Collections.​
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101596464-img.

This digital image depicts a person’s arm and hand that has cowpox lesions on it.
The image of the arm with the cowpox lesion is from ​Edward Jenner's ​Inquiry
into the causes and effects of the variolae vaccinae​, and the image is facing p. 32.

“Vaccine Basics.” Centers for Disease Control and Prevention. Centers for Disease
Control and Prevention, July 12, 2017.
https://www.cdc.gov/smallpox/vaccine-basics/index.html.

The smallpox vaccine has been effectively preventing smallpox infections in 95%
of the people who have gotten the vaccine, proving that it is effective. It has been
able to lessen infection or even prevent it a few days after when given to a person
who had been exposed to the virus. The vaccine does not actually contain
smallpox, and hence, is not able to give you the disease. The protection from
smallpox lasts about three to five years, and after that, you would need to get a
booster shot if long-term protection is needed.