Vaccine booster shots for COVID have recently been approved and are being rolled out widely. Wariness about boosters is still evident, however, along with debate over whether vaccinations should be required. All this seems new to us in 2021, but a similar situation played out in the U.S. and globally way back in 1872, when smallpox was raging. Scientific American published an article about the science, fears and debate over “revaccination”—boosters—and the discussion then is eerily parallel to the COVID discourse right now.
The article is reprinted below; it is a fascinating and pretty quick read. The alarming disease was spreading, people were afraid of contagion, the sick were being quarantined, and notably, there was great worry about a variant that could make smallpox much more deadly. Data from Prussia, where law required revaccination every seven years, showed that death by smallpox was rare, compared with higher rates in other parts of the world, so the editors expressed support for revaccination. Scientists were trying to determine how long to wait after initial inoculation before boosters were given. The editors also said that if there were a law requiring vaccination and revaccination, that action could end the scourge, yet they wondered whether such a law could be enforced.
Some of the statements in the 1872 article are spot-on for today. A few are also surprising. We must apologize here, as well: Some of the terminology, and some inferences made, are dated and pejorative.
[The following was published by Scientific American on January 27, 1872. Spelling is retained as in the original.]
The Spread of Small Pox
The accounts which reach us, in reference to the general spread of this alarming disease in both hemispheres, are calculated to frighten the timid, and to arouse the attention of those who, having little personal dread of the complaint, still feel a philanthropic regard for the welfare of mankind. Of all the fearful diseases that scourge the human race, this ranks among those that are justly feared most. The disfigurating scars it leaves, upon many of those who escape death, are a life long sequel to a most disgusting and painful sickness. The fear of contagion banishes the unfortunate sufferer from home and friends, and consigns him to the care of paid nurses hardened by long familiarity with suffering, and thus adds to the distress which at best attends the complaint.
It would be strange did not some exaggeration creep into the statements of the progress of small pox which reach us from every direction, but there is no doubt an unusual prevalence of the disease both in England and America. So far as can be gathered, it is not remarkably malignant in type, and the average of deaths from it is not greater than is common. It cannot, however, be predicted that it will not assume at any time the form of a malignant epidemic, and its continuance gives ground for the fear that it may become so.
In view of these facts, it is pertinent to inquire whether the periodical spread of small pox cannot be prevented. Facts and statistics fortunately enable a definite answer to be given. In Prussia, where the law requires revaccination to be performed every seven years, death by small pox is of very rare occurrence. Watson’s “Practice of Medicine” gives statistics upon this point that will convince any who doubt. Statistics further show that about one half of those who have had the vaccine disease as a result of vaccination, are liable to a modified form of small pox called varioloid, approaching more or less in violence to malIgnant types of the disease. The fact is thus fully established that the protection afforded by successful vaccination varies in time with different cases, and that the liability to varioloid is greatest between the ages of 15 and 25 years.
To insure safety from the disease, it is necessary that revaccination should be practised not only between the ages specified but even before and after the period included in those limits. It is also a matter of fact that a first or second revaccination may fail and a third impart the disease, though the periods between the introductions of the virus be very short. A case of this kind has recently occurred with a student of medicine at Bellevue Hospital, who only succeeded in producing a true vaccine pustule at the third attempt, the time elapsing between each trial being only long enough to determine that the preceding one had failed.
We think there is no fact better established in medical science than that persistent revaccination will practically exterminate small pox. Had we a law compelling vaccination and revaccination, and could its enforcement be insured, we should soon cease to hear of the ravages of a scourge so dreadful. As it is, it is quite doubtful if such a law could be enforced if enacted. The best we can do at present is for the intelligent to protect themselves without law, against the neglect arising from the prejudices of the ignorant; and if, through neglect, the disease is acquired, to treat it in the most rational manner possible. To this end, we throw out some hints for treatment that have been approved by the medical faculty and which may serve as a guide to the patients and nurses.
First, if there has been exposure, there is time for vaccination to be performed, and to develop the vaccine disease before the small pox shall appear, and to modify the latter into the milder type of varioloid. After exposure, the first thing then should be vaccination.
Second, if the disease be acquired, the attendance of a good physician should, if possible, be secured, and the patient encouraged to accept all the necessary treatment. If delirious, he should be carefully watched, to prevent his disfiguring himself by scratching. Itching during the drying up of the pustules is almost completely controlled by a soft ointment of beeswax and sweet oil, with a little tannin, opium, and carbolic acid incorporated, which has, moreover, the advantage of rendering the smell less disagreeable.
The disease is most infectious during the latter stages. It follows that the most thorough cleansing of apartments, clothing, and the disinfection of every contaminated article should follow the death or recovery of a patient.
It has been suggested that glycerin is a far better liquid with which to dissolve the vaccine matter at the time of vaccination, than water, as it does not dry, and therefore allows the more thorough insertion of the virus into the punctures in the skin. There are facilities now for obtaining pure matter taken direct from heifers kept for the purpose. Physicians, therefore, who use impure virus ought to be held to the strictest legal account for malpractice.
Now let every intelligent reader, instead of trembling lest he shall be attacked by small pox, take the only known means of prevention, cease his apprehension, and the disease will be mostly confined to the ignorant and the careless.