The prehistory of the vaccine wars

Meet Franky Franklin

“In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way,” Benjamin Franklin wrote in his autobiography. By the “common way” Franklin meant contagion during an epidemic. “I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”

Inoculation — the term then used for what we call vaccination — was as controversial in eighteenth century Philadelphia as vaccination is today, for many of the same reasons. The idea of exposing healthy persons to the smallpox virus, even in a weakened or diluted form, seemed so counterintuitive to many as to appear absurd. Nor were they wrong to be fearful. Some of those inoculated did develop full cases of smallpox, and a few died.

Yet many more were saved by the immunity inoculation produced. Advocates of inoculation noted additionally that every immunization reduced the hazard of the spread of smallpox, to the benefit of even the uninoculated.

Some opponents of inoculation, like opponents of vaccination today, cited religious reasons. To inoculate, they said, was to arrogate to humans powers that ought to be reserved to God. He was the one to determine when people should live and die. Some inoculation critics contended that smallpox was a punishment God inflicted on sinful humans. To try to avoid the punishment was blasphemy.

Franklin had been living in Boston when Cotton Mather introduced inoculation there. Mather learned the technique from a West African slave called Onesimus, who had been inoculated before reaching Massachusetts. Mather advocated inoculation for Bostonians to guard against the smallpox epidemics that swept through New England on a regular basis. Some followed his advice. Others resisted. One of the resisters threw a bomb at Mather’s house that failed to kill Mather but revealed the depth of opposition to inoculation.

Franklin sided with Mather and the inoculationists in principle. But his son Francis, called Franky, was often ill as an infant and a young child. And Franklin was preoccupied with his printing business. Between one thing and another, he failed to have Franky inoculated. And Franky died.

For years afterward, when Franklin would see other boys playing who were of the age Franky would then have been, he felt the twinges of the regret he articulated in his autobiography. He never forgave himself for Franky’s death.

Franklin understood the objections to inoculation, but as his advice to parents revealed, he saw that there were risks on both sides. To take no action was to expose one’s child to infection and perhaps death. Some parents might think they were less culpable, in that they had done nothing wrong. But inaction had consequences, as Franklin discovered.

Franklin's counsel applies in other areas of life. Often inaction seems safer than action. Inaction maintains the status quo, while action disrupts it. Sins of omission are generally considered less grievous than sins of commission. If I do nothing, I won't do it wrong.

At the time of Franky’s death, no American law required inoculation. Yet during Franklin's lifetime, conditions arose where inoculation became mandatory. George Washington acquired smallpox in the “common way,” by infection on a visit to Barbados as a young man. He survived, although the illness may have accounted for the fact that he never had children. The immunity Washington received from his bout with smallpox served him and his country well. During the American Revolutionary War, as in most wars before modern medicine, soldiers were at greater risk from infectious disease than from enemy bullets and shells. Smallpox repeatedly visited the camps of Washington's Continental Army. He had no fear of the disease, but he did fear for his soldiers. And he took the action Franklin had not. He ordered the troops inoculated.

Some had fear of the procedure and would have refused if left to their own opinions. But under Washington's discipline and amid the war, the soldiers had no choice.

Washington's action held the army together at Valley Forge when a smallpox epidemic would have scattered it and quite possibly ended the revolution. In the bargain, he saved the lives of many soldiers who would have contracted the disease.

There was a cost, of course. A small number of those inoculated, perhaps one or two percent, died as a result. Perhaps these men would have lived, somehow escaping the wild virus.

There was also the cost to personal liberty. Governments shouldn't lightly order people around. What people put into their bodies is an especially sensitive subject.

But during war, governments do order people around, sending young men — and in recent times young women — into battle, where they might get killed.

Peacetime mandates are harder, as the objections to vaccine mandates during the Covid-19 pandemic showed. Moreover, vaccines can become victims of their own success. When children were dying regularly of measles, a measles vaccine was greeted as a literal life saver. Several decades later, when most Americans have never seen a case of measles and never heard of anyone dying of it, some find it easy to imagine that it's unnecessary. Put otherwise, they focus on the real and imagined risks of the vaccine, giving little or no weight to the risks of the disease itself.

As long as everyone else is getting vaccinated, this is a statistically defensible position. The refusers are protected by the immunity of the herd. But as the number of unvaccinated people grows, the disease returns and with it the much greater risks. What was statistically defensible becomes morally dubious if not indefensible.

Franklin's loss of his son reminded him there are dangers on both sides of every issue. We speak of being safe, but there is no such absolute condition. We are only more safe or less safe. We do well if we let our reason rather than our emotions choose between those alternatives.

Yet reason can be clouded, by circumstance as well as by emotion. If Franklin, a veritable apostle of reason, could fail the test in the case of his own son, what hope have the rest of us of always getting it right?