Comments on: Smallpox in 1700’s Boston, Compared with Today’s Swine Flu

By: AnnR

AnnR — Sun, 23 Aug 2009 23:10:05 +0000

I saw the John Adams movie on HBO and they dramatized Abagail’s inoculation of the children.

The doctor brought around a poor soul in the back of a wagon. He had lots of juicy pustules and the doctor extracted some of that to do the children. Quite a ways from the clean little glass vile they use today.

By: Shadowcatdancing

Shadowcatdancing — Sun, 23 Aug 2009 19:35:00 +0000

If you want a first hand account of smallpox innoculation in colonial Boston read the letters of John and Abagail Adams. Some of the earliest letters between them are from the time before they were married when John went into the city to be innoculated and wrote to Abagail about the experience. Later while John was off serving in Congress during the war Abagail took all of the children into Boston to be innoculated and wrote to John about it.

By: drcharles

drcharles — Sun, 23 Aug 2009 18:48:49 +0000

An interesting question:
Was getting the smallpox inoculation a rational choice for a Bostonian in 1763?

They could have known that in 1722, during the last major smallpox breakout, 50% of the population contracted smallpox and 1 in 6 died, the rest were scarred to varying degrees. Cumulative risk of dying from smallpox –> 1/2 x 1/6 = 1/12 chance of dying

In 1722, Dr. Boylston observed that of the 300 people he inoculated, only 6 died (see above). But if you got the inoculation you had a 100% infection rate as you noted.
Cumulative risk of dying from inoculation –> 1/1 x 6/300 = 1/50 chance of dying.

Rationally, you would chose a 1/50 chance of dying over a 1/12, although I still understand the fear of 1/12 dying. In modern times, with seemingly unproven vaccine fears, a similar accounting of relative risks seems like a good idea.

By: drcharles

drcharles — Sun, 23 Aug 2009 18:29:39 +0000

Not sure how I’m being unduly harsh… except for noting that “fear” was present then, and is still present now in terms of much safer immunization.

I would have been quite scared getting the inoculation back in that day, even though it seems there was some good accumulated evidence by 1763 that it was worth the risk. Shows you the quantum leaps that have been made in surveillance, record-keeping, and clinical trials.

No thanks on the HIV inoculation… that’s really not analogous, and adds a certain “edge” to your comment that’s surprising.

By: Greg P

Greg P — Sun, 23 Aug 2009 18:12:36 +0000

I think you’re being unduly harsh on the resistance to inoculation. Let’s face it, this was anecdotal treatment, where you had to have some “leap of faith” to trust someone that if they gave you smallpox (ie, 100% infection rate), you might be saved from dying.

This is quite, quite different from the eventual smallpox vaccination we all went through years ago, with a simple cutaneous inoculation using cowpox virus.

What if someone proposed inoculating you with HIV?