With the Coronavirus disease spreading around the world at an alarming rate, it was interesting to read a timely booklet from the collection of the Welsh physician and psychiatrist, Sir Robert Armstrong-Jones. The items in the collection are divided according to subject and include around twenty pamphlets relating to pandemics.
The general view today is that a vaccine will be the most effective method to stop the spread of Covid-19. However, it is evident from reading this booklet entitled For and against Vaccination that there was disagreement over how best to reduce the spread of smallpox over a hundred years ago. It features a series of letters sent to the Dublin press between General Arthur Phelps, of the Anti-Vaccination League, and Percy Kirkpatrick, a renowned Irish physician and President of the Dublin Sanitary Alliance. Phelps and Kirkpatrick argue for and against vaccination throughout, using statistics of cases and deaths, including those from the French-German war of 1870-71.
But the debate wasn’t that straightforward. Phelps believed that cleanliness was the key to combating smallpox, not a vaccination. Here are his words:
Sanitation is the only remedy for smallpox, typhus, and other dirty diseases. Trying to make someone immune to disease A (smallpox) by infection with disease B (cowpox) is as absurd as it would be for a man to hang violent pictures at his children’s school with the idea of stopping them from lying.
Phelps was discussing Edward Jenner‘s invention of vaccinating against smallpox by giving an injection that includes a cowpox virus. Of course, we know today that injecting someone with a less severe strain of the virus enables the body’s immune system to produce antibodies that will protect the person from the more serious strain of the disease. This is how a vaccine against flu is made and it is hoped that research of this kind will lead to the development of a vaccine against Covid-19.
Professor Minkowski, the Chief Physician of Augusta Hospital, Cologne is quoted in the booklet as saying that the German immunity was due to compulsory vaccination and re-vaccination. He did not believe that staying apart and social exclusion were as important factors. He added that without compulsory child vaccination and adult re-vaccination this would have failed completely.
Dr Brandhomme, who was a Health Hazard Officer for the city of Frankfurt, said the following:
I believe that vaccination and re-vaccination protect people best. Without these it would be impossible to keep the epidemic under control.
Fitzpatrick and Phelps did not have mathematical models to help them as governments do today, but it is clear that they studied statistics to try to find patterns that suggest the effect vaccination would have on the population. Phelps commented on the statistics in the photo below showing the breakdown of the numbers of smallpox cases and deaths in the German Empire in 1908: The most favoured were the vaccinated too late, of whom only 4.76 % died. If all the 434 had been in this happy category, the total deaths would have been not 65, but about 20! Nevertheless, Kirkpatrick believes that the table proves his point that vaccination works. By merging groups I and II (those that were not vaccinated and those that were only vaccinated once) we have a total of 55 deaths from smallpox and 291 cases of the disease. In group III (those that were vaccinated twice) we have 10 deaths and 143 cases.
Today there is no doubt that vaccination against smallpox has been successful and there have been no cases anywhere since 1977. It is interesting to note that a vaccine against Covid-19 developed by the University of Oxford and Imperial College London has begun trial stages during the last fortnight. We eagerly await the results in the hope of finding another vaccine to help mankind.
This post is also available in: Welsh