Embracing Vaccinations

Founding Fathers Fight the British by Embracing Vaccinations

Contributed by Lawrence D. Weiss


The Continental Army was formed by the Second Continental Congress after the outbreak of the Revolutionary War.  General George Washington was the commander-in-chief of the army throughout the war, and he had his hands full. His recruits were typically poorly trained, fed, and equipped. On the other hand, Washington was facing tens of thousands of British soldiers -- the best trained and equipped in the world at the time.

But Washington faced an even more dangerous enemy...disease. Among the Continental regulars in the American Revolution, 90 percent of deaths were caused by disease. Variola, the smallpox virus, was the most feared of them all. It’s ugly. According to the Mayo Clinic,

“Following the incubation period, a sudden onset of flu-like signs and symptoms occurs... A few days later, flat, red spots appear first on your face, hands and forearms, and later on your trunk. Within a day or two, many of these lesions turn into small blisters filled with clear fluid, which then turns into pus. Scabs begin to form eight to nine days later and eventually fall off, leaving deep, pitted scars. Lesions also develop in the mucous membranes of your nose and mouth and quickly turn into sores that break open.”

Ick! Moreover, smallpox is extremely contagious. It can put a victim completely out of action for about a month, and in 20-30% of the cases it was fatal. Easy to see how, if left unchecked, it could defeat an entire army. In fact, it did. A smallpox epidemic struck Continental army troops that invaded Canada in 1775-1776.  Ultimately about 50% of the troops became infected. Their fighting capability was wiped out, and the Americans had to retreat. Smallpox was a decisive factor that helped destroy the campaign to bring Canada into the revolution.

Both Benedict Arnold and Benjamin Franklin, after reviewing the devastation wreaked by smallpox in the Canadian campaign, expressed fears that the virus would be the army's ultimate defeat.  Washington didn’t need convincing. He had caught it as a teenager, suffered greatly, and was knocked out for a month. He knew all about it from personal experience.

Smallpox was endemic in the British Isles. Consequently, many of the British soldiers had caught it in their youth and were immune. In addition, the practice of “variolation,” a kind of vaccine, was widespread throughout Europe. As a result, most British troops were immune to smallpox, giving them an enormous advantage against the much more vulnerable colonists. To make matters worse, there was an active anti-vax sentiment in the colonies which briefly led to the Continental Congress to issue a proclamation in 1776 prohibiting Surgeons of the Army to inoculate.

Pushing past the inoculation prohibition, on February 5, 1777, Washington wrote John Hancock, president of the Second Continental Congress,

“The smallpox has made such Head in every Quarter that I find it impossible to keep it from spreading through’ the whole Army in the natural way. I have therefore determined, not only to inoculate all the Troops now here, that have not had it, but shall order Docr. Shippen to inoculate the Recruits as fast as they come into Philadelphia.” 

According to the Library of Congress, here’s how it played out...

“Weighing the risks, on February 5th of 1777, Washington finally committed to the unpopular policy of mass inoculation by writing to inform Congress of his plan. Throughout February, Washington, with no precedent for the operation he was about to undertake, covertly communicated to his commanding officers’ orders to oversee mass inoculations of their troops in the model of [earlier pilot vaccinations of soldiers at] Morristown and Philadelphia. At least eleven hospitals had been constructed by the year's end.

“Variola raged throughout the war... Yet the isolated infections that sprung up among Continental regulars during the southern campaign failed to incapacitate a single regiment. With few surgeons, fewer medical supplies, and no experience, Washington conducted the first mass inoculation of an army at the height of a war that immeasurably transformed the international system. Defeating the British was impressive, but simultaneously taking on Variola was a risky stroke of genius.”  --- John W. Kluge Center, Library of Congress

Now I have to get used to thinking about George Washington as my latest public health hero. Gives me a warm and fuzzy feeling inside.