England: The Edward Jenner Story
“In May 1796 Sarah Nelmes, the daughter of a farmer in the neighborhood of Berkeley, showed what were indisputably the signs of cowpox on her hands after milking a cow suffering from the disease. Jenner took matter from one of the pustules with his lancet [a double-edged surgical knife with a wide blade used for making small incisions] and transferred it to the arm of an eight-year-old boy named James Phipps, who in due course developed cowpox. Several weeks later he was inoculated with smallpox and failed to respond with even a modified form of the disease. This was the first successful example of what came to be called ‘vaccination’, a word coined by one of Jenner’s friends from the Latin vacca, meaning a cow.” (Williamson, 2007, p. 80)
Edward Jenner was born in the village of Berkeley in 1749, and after he was orphaned at the age of five, he was raised by an older brother. He was first taught about surgery and apothecary during his apprenticeship in the nearby town of Chipping Sodbury, and in 1770 traveled to London to study with the famed surgeon John Hunter. Although he had an opportunity to travel with a group of explorers as the team's naturalist, Jenner was dispositionally uninterested in adventure and instead opted to become a country doctor in his hometown.
At some point during his studies, Jenner observed that people who contracted cowpox never developed the similar yet lethal disease smallpox, and he kept a hypothesis in the back of his mind that the two diseases were somehow related. It would not be until May 1796-- 16 years after he shared his hypothesis with a close friend-- that Jenner finally worked up the courage to test his pet theory. He collected a sample from the hand pustule of a milkmaid recently infected by cowpox and injected the material into a local boy, who in turn had no reaction when he was later variolated with smallpox. Now convinced he was onto something, Jenner tried to publish his finding with the Royal Society, but when they rejected his treatise, he self-published it under the title An Inquiry into the Cause 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.
Perhaps unsurprisingly, some of Jenner's contemporaries were skeptical of his novel medical practice. Doctors reported that vaccinated patients later developed smallpox, which prompted more strenuous guidelines for how to prepare vaccines and precautionary revaccination for children when they reached puberty. Other criticisms were less reasoned. Dr. Benjamin Moseley, for instance, was preoccupied by the "bestial" nature of vaccination and fretted that injecting matter from a cow-borne illness into a human could cause bovine mutations; he pointed to the (potentially fictitious) case of an "ox-faced boy" as proof.
The Royal College of Physicians, Trafalgar Square
Image of the former building of the Royal College of Physicians in Trafalgar Square; the college has since relocated to Regent's Park
In spite of the ferocious opposition of figures like Moseley, most of Jenner's fellow physicians accepted his discovery; by 1800, about 70 "leading lights" signed a testimonial in the Morning Herald in support of vaccination. Lay people also became public advocates for vaccination, with clergymen and high society women personally taking up the lancet to vaccinate their communities: a Lancashire parson claimed to have vaccinated 3,000 people, and Miss Bayley from Hope claimed 2,600 vaccinations. Although this enthusiasm was admirable, it was not always efficacious. Not all amateur vaccinators understood Jenner's rules for when and how to collect samples to perform vaccinations, weakening the immunity granted by the procedure. Over time, standardization corrected these errors, and a National Vaccine Board was formed from the Royal Colleges of Physicians and Surgeons to oversee the collection and administration of vaccination lymph.
Jenner was originally appointed the head of this board, but when his nominated list of subordinates was almost totally blocked, he quit. Indeed, Jenner was never comfortable with the medical establishment. In one private letter, Jenner expressed his contempt for the hoity-toity gatekeepers of the Royal College of Physicians, who refused him membership because he was not fluent in Greek and Latin. He spent most of his later years back in his hometown of Berkeley, serving as its mayor, magistrate, and sometimes local doctor, and died at the age of 73 in 1823.
Frieze of the London School of Hygiene and Tropical Medicine
Edward Jenner's name engraved in the frieze of the London School of Hygiene and Tropical Medicine, as captured by a 2017 photo