A Pox Upon Us


By Tom Clavin

“The Overlook” appears every Thursday at tomclavin.substack.com. An overlook is usually a place from which one can see in many if not all directions, including where one has been and where one is going. There is no political or personal agenda at work here other than to tell stories that from time to time will have a particular relevance. If you enjoy the column, please "like" it and let me know what you think by commenting (check out previous issues while you're at it).  Likes, comments, and shares help with author discoverability on Substack.com, and all support is appreciated.And don't forget to hit the ‘Subscribe’ button – it’s free!

Ah! destructive Ignorance, what shall be done to chase thee out of the World!”

Cotton Mather

          It would seem to be okay if some people do not want to receive the Covid-19 vaccine. That leaves more available for everyone else, and those who want it will be inoculated sooner. Once everything has reopened – restaurants, movie theaters, concert halls, offices, etc. – the unvaccinated can stay home or get sick, it is their choice. Other than the unnecessary extra work for healthcare workers, why should the rest of us care?

          But it also seems that is an unscientific outlook. Supposedly, all of society is still at risk if a portion of it is not vaccinated. Maybe one example of the possible consequences of refusing to be protected can be found in an event whose tricentennial is this month.

On April 22, 1721, a British ship arrived in Boston Harbor. On board, one of the sailors had begun to exhibit symptoms of smallpox. He was quickly quarantined, but several more members of the crew soon fell ill with the disease. An outbreak spread quickly through the city. As it worsened, the Puritan minister Cotton Mather reached out to the medical community of Boston, imploring them to use an inoculation method. One physician, Zabdiel Boylston, heeded his call, but most other doctors were hostile to the idea. At the forefront of the anti-inoculation contingency was one of Boston’s only physicians who actually held a medical degree, Dr. William Douglass.

This early resistance proved deadly. From the spring of 1721 until winter 1722, a smallpox epidemic afflicted the city. Out of a population of 11,000, over 6000 cases were reported. However, the 1721 epidemic led to a major milestone in the history of vaccination and smallpox eradication. The finally grudging use of inoculation during this epidemic was one of the first major applications of inoculations in western society, paving the way for Edward Jenner to develop smallpox vaccination by the end of the century.

Cotton Mather is largely credited with introducing inoculation to the colonies and doing a great deal to promote the use of this method as standard for smallpox prevention during the 1721 epidemic. However, he did not invent the practice. Mather is believed to have first learned about inoculation from his West African slave Onesimus. Who he was and how a slave saved Boston is worth exploring.

In 1706, an enslaved West African man was purchased for Mather by his congregation. Mather gave him the name Onesimus, after an enslaved man in the Bible whose name meant “useful.” Mather, who had been a powerful figure in the Salem Witch Trials, believed that owners of slaves had a duty to convert them to Christianity and educate them. But like other white men of his era, he also looked down on what he called the “Devilish rites” of Africans and worried that slaves might openly rebel.

Predictably, Mather didn’t trust Onesimus. He wrote about having to watch him carefully due to what he thought was “thievish” behavior, and recorded in his diary that he was “wicked” and “useless.” But in 1716, Onesimus had told him something he did believe: He knew how to prevent smallpox. Onesimus, who “is a pretty intelligent fellow,” Mather wrote, told him he had had smallpox—and then hadn’t. Onesimus said that he “had undergone an operation, which had given him something of the smallpox and would forever preserve him from it...and whoever had the courage to use it was forever free of the fear of contagion.”

The operation Onesimus referred to consisted of rubbing pus from an infected person into an open wound on the arm. Once the infected material was introduced into the body, the person who underwent the procedure was inoculated against smallpox. It wasn’t quite a vaccination but it did activate the recipient’s immune response and protected against the disease most of the time.

Mather was fascinated. He verified Onesimus’s story with that of other slaves in Boston and learned that the practice had been used in Turkey and China. He became a strong advocate for inoculation—also known as variolation—and spread the word throughout Massachusetts and elsewhere in the hopes it would help prevent smallpox. One of his immediate converts was the physician Boylston. As smallpox began to spread in Boston in April 1721, he inoculated his son and his enslaved workers against the disease. Then he began inoculating other Bostonians. Of the 242 people he personally inoculated, only six died—one in 40, as opposed to one in seven deaths among the population of Boston who didn’t undergo the procedure.

The smallpox epidemic killed 844 people in Boston, almost 15 percent of the population. But it had yielded hope for future epidemics. It also helped set the stage for vaccination. In 1796, Jenner developed an effective vaccine that used cowpox to provoke smallpox immunity. It worked. Eventually, smallpox vaccination became mandatory in Massachusetts.

The debate over the use of inoculation during the 1721 epidemic in Boston bears relevance today. Modern vaccination campaigns, most notably targeting the eradication of polio, continue to face violent opposition in many parts of the world where the disease is still present, particularly in Pakistan, Afghanistan, and Nigeria. Even in the United States, outbreaks among groups of unvaccinated individuals have risen in the past decade, a trend that is often attributed to the spread of misinformation regarding the potential risks, contents, and mechanism of vaccination. We’re seeing that again right now with the Covid-19 vaccination. The story of the 1721 Boston Smallpox epidemic and the controversy that accompanied the introduction of inoculation by Dr. Boylston and Cotton Mather exemplifies how opposition to inoculation and then vaccination has been present for as long as the practices themselves. Today there is the usual cadre of misinformed and uninformed people putting everyone at risk by allowing the coronavirus to remain in our ranks longer than it has to.

By the way: A fun detail is that out of this combination of political conflict and disease in Boston emerged the beginnings of an American free press. In 1721, James Franklin, the older brother of Benjamin Franklin, started a newspaper called The New-England Courant, which would become the first independent newspaper in America. Franklin saw an opportunity in the epidemic and jumped in on the popular side of the debate, which was anti-inoculation. He published the paper without permission from the royal authorities. Ironically, the birth of the free press in America is tied to an entrepreneur who went into business to prey on the fears of the public. Benjamin Franklin made his debut as a writer in the newspaper under the name Silence Dogood.

          Oh, and George Washington, who survived smallpox, became a strong proponent of inoculations. Shameless plug ahead: As Bob Drury and I detail in Valley Forge, having inoculations done went a long way toward saving the Continental Army from extinction during the winter encampment there in 1778.

Tom Clavin is the bestselling author/co-author of 18 books, including, most recently, “Tombstone: The Earp Brothers, Doc Holliday, and the Vendetta Ride From Hell.” The next collaboration with Bob Drury, “Blood and Treasure: Daniel Boone and the Fight for America’s First Frontier,” is being published this month by St. Martin’s Press. Please go to your local bookstore or to Amazon/bn.com to order a copy.