The father of vaccination
- Credit: © Thousand Word Media
In the 18th century, an obscure country doctor from Gloucestershire began a scientific trial. Edward Jenner felt convinced his new method of providing immunity to smallpox – by vaccination – was a breakthrough. But could he convince the rest of the medical world? Owen Gower, manager of Dr Jenner’s House museum, tells us more
‘Vaccines bring hope. In 1804, a friend of Edward Jenner recalled a visit to the home of the vaccine pioneer in Berkeley. As he arrived he saw people queuing along the lane and into the garden, and just had to ask Jenner what was going on…’ @owentg
Owen Gower, museum manager at Dr Jenner’s House in Berkeley, has been tweeting. During the current pandemic, the idea of people packing the streets of this small Gloucestershire town – for whatever reason - is but an increasingly distant memory. In 2019, a record 7,000 people visited Dr Jenner’s delightful museum, in his former home squeezed between churchyard and castle; during lockdown, its porticoed front door has had to remain firmly shut.
Yet never has it been more important to tell the story of the self-effacing, large-hearted, brilliant pioneer who was Edward Jenner; whose medical advances have saved countless millions of lives: not only those of ordinary people who queued through the streets to receive a free smallpox vaccine from a relatively unknown country doctor. But of nations the world over. For thanks to Jenner, humankind is now rid of an infectious disease that, in the 18th century alone, was responsible for up to 20 percent of deaths in England’s towns and cities.
In fact, let’s go a step further. Were it not for Jenner’s insights, generosity and persistence, who knows where we would be in the current fight against another fearful infection: COVID-19.
Through articles, tweets and other social media, Owen Gower – for one – is determined we should acknowledge that.
So to get this right: we’re talking the milkmaid chap? The cowpox doctor.
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Owen Gower has heard all that before. ‘And whilst being at the heart of what he did, that denigrates his work to some extent. Because he was a lot more than a chancer who happened to stumble across an interesting idea.’
When Owen arrived in Berkeley seven years ago, he was well-qualified to head up this delightful, fascinating museum with its 5,000 artefacts – from sharp lancets believed to have been owned by Jenner himself, to family books and some of the doctor’s self-published studies. But though well-versed in collection management, Owen’s previous experience had focused on Egyptology and Japanese Samurai. He was determined to immerse himself in Jenner’s story.
And – as he describes to me – what he learned turned an almost mythical character into rounded, altruistic flesh and blood.
Edward Jenner was born in Berkeley in 1749, son of the local vicar. As a child, he attended the 14th-century Katharine Lady Berkeley’s School in nearby Wotton-under-Edge, still educating youngsters today. Aged 14, he was apprenticed to a Chipping Sodbury apothecary, George Hardwicke; seven years later, in 1770, he made his way to London to learn under surgeon John Hunter at St George’s Hospital. Jenner’s career in medicine was set.
And yet his curiosity knew no bounds. An acute observer, he was granted a fellowship from the Royal Society in 1788 for his work on nesting cuckoos. His description of avian parasites hijacking the parenting skills of other birds was greeted with disbelief in many quarters. ‘It wasn’t until it could be photographed a couple of hundred years later that people said,
‘Oh! Jenner was right!’’
So surely Jenner could have stayed in London, setting up a posh clinic for society patients, making a killing (as it were) from the worried well. Why bypass glitz for the life of a local GP?
‘I think he genuinely loved being in Berkeley,’ Owen says. ‘Later in life, he had houses in London; he had a house in Cheltenham. But Berkeley was always where he returned; where he felt truly at home.’
Let’s turn to two important parts of the jigsaw now. The first is the country tradition – of which Jenner was well aware – that those who contracted the common, mild cowpox would never contract smallpox. Primarily a disease of cattle, milkmaids and farmers were prone to catching it via sores on the udders of cows.
‘You would develop a localised infection of cowpox – a few pus-y blisters; a bit of a fever; chills – but you would make a very quick recovery without scarring. As viruses, they’re in the same family but people wouldn’t have known that at the time.’
And then there’s inoculation, which involved deliberately infecting people with mild smallpox to provoke what we would now call immunity. The practice originated in Asia, Africa and parts of the Middle East, popularised in Britain when the well-placed Lady Mary Wortley Montagu – living in Constantinople as wife of the ambassador – asked local medics to inoculate her children in 1718.
‘Jenner himself had been inoculated as a child and it’s said he had a really horrible time... they would purge you; starve you; bleed you beforehand.’
‘When she came back to the UK, she convinced powerful friends in Court – including the Princess of Wales – they ought to try it on their children,’ Owen explains.
(You probably don’t want to know about methods; but they included grinding up scabs of victims and inhaling. If preferred, pus could be scratched into your skin.) It wasn’t fool-proof; but while the mortality rate of catching uncontrolled smallpox could be up to 30 percent, inoculation was in the region of 1-5 percent.
‘Jenner himself had been inoculated as a child and it’s said he had a really horrible time. Western medicine added pre-treatments to make it more ‘effective’. So they would purge you; starve you; bleed you beforehand.’
In 1796 Jenner decided to try and apply some scientific rigour to the smallpox fight. He began by talking to farmers and milkmaids: collecting anecdotal evidence from those who believed that, after catching cowpox, they had been exposed to smallpox without contracting it.
But he knew he needed more than the circumstantial.
‘What he had to do was put it to the test; what we would think of as a clinical trial.’
Enter James Phipps, eight-year-old son of Jenner’s gardener, whom Jenner deliberately infected with pus from cowpox blisters ‘donated’ by local milkmaid Sarah Nelmes. Jenner watched carefully as James became mildly unwell – fever, localised swelling – but made a quick recovery with no scarring. Then came the biggie: Jenner had to infect him deliberately with smallpox. This he tried several times.
James remained well.
To those concerned – as was I initially – that this could be seen as coercion: a master/servant relationship; a poor, vulnerable labourer; then maybe think again. What Mr Phipps senior thought, we don’t know. But there are several crucial elements here, as Owen details.
Firstly, Jenner knew James’s medical history. The lad had had neither cowpox nor smallpox. The second is that inoculation – a generally desired conferral of immunity – was beyond the reach of the ordinary worker. And thirdly, Jenner was no chancer; he was a scientist through and through, and this experiment was clearly thought out and controlled.
‘The crucial part is that Jenner made detailed notes. He tried it out. He had a test. He repeated it.
‘In that series of experiments, Jenner had taken the first steps to proving that you could transfer cowpox from human to human. And that you could also then be protected against smallpox.’
‘... I went and stood in the Temple of Vaccinia and thought: Wow! Edward Jenner did something amazing here.’
In the happy ever after, Jenner would at this point be being lifted aloft and feted.
Of course, he wasn’t.
This was an upstart country doctor with a Gloucestershire accent. The Royal Society was sceptical, to say the least. Jenner’s own published findings in 1798 were well received by the public: ‘By almost everyone except for the medical profession,’ Owen says. ‘That really says something about the way smallpox hung over people’s lives.
‘But when he went to London to try and persuade society medics to take it up, he was broadly ridiculed and ignored.’
It took until 1807 for the Royal College of Physicians to come out in favour; and until 1841 for the government to ban the old method of inoculation.
Jenner was more impatient than his fellow medics to save lives. He had a thatched summerhouse built in his garden – dubbed the Temple of Vaccinia – where he treated poor families and gave vaccines without charge.
And, thus, back to the queues along his lane. Back to the tweet that started this tribute.
What a story! I say to Owen Gower.
And how horribly ironic; how very ironic that museums such as his, underfunded as they currently are, tell a tale of history, hope and inspiration that can influence, inform and provide relevant education today.
Inspiration, especially, Owen Gower says.
‘As a museum, we see first-hand the impact that history has on children. The number of people who have come up to me and said, ‘I was inspired to undertake a career in science after a visit to Dr Jenner’s House. I’m now a pathologist. I’m now an immunologist. And it’s because I went and stood in the Temple of Vaccinia and thought: Wow! Edward Jenner did something amazing here.’