Founding fathers fought the British by embracing vaccinations

In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the 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. — Benjamin Franklin’s autobiography, published 1791.

Here’s a modern-day irony. Josh Mandel, who declared he’s running in the U.S. Senate state election in Ohio, shared a misinformation Tweet last month declaring “The Founders would have tarred and feathered Dr. Fauci,” referring to infectious disease expert Dr Anthony S. Fauci, Chief Medical Advisor to President Biden. Au contraire! It is more likely that they would have put Fauci to work vaccinating George Washington’s Continental Army. No kidding. Here’s “the rest of the story.”

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. They often lacked such basics as shoes, even in winter. On the other hand, Washington was facing tens of thousands of British soldiers — the best trained and equipped in the world at the time — In addition to their local Indian allies and European mercenaries.

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 pretty 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. On the way up to Quebec, about 30% of those soldiers became ill with smallpox and died or had to drop out. 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.

During the Siege of Boston, Washington attempted to quarantine sick soldiers and civilians. Civilians with smallpox symptoms were held in the town of Brookline, while military cases were sent to a quarantine hospital. The strategy kind of worked, but not well enough.

However, smallpox was endemic in the British Isles. Consequently, many of them had caught it in their youth and were immune. In addition, the practice of “variolation,” a kind of vaccine that infected the individual with a less-deadly form of the disease, 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 small pox has made such Head in every Quarter that I find it impossible to keep it from spreading thro’ the whole Army in the natural way. I have therefore determined, not only to innoculate all the Troops now here, that have not had it, but shall order Docr. Shippen to innoculate the Recruits as fast as they come in to Philadelphia.

In the 1770’s the principal form of vaccination (“innoculation”) was known as “Variolation,” a disgusting, unpleasant, and fairly dangerous procedure. It involved the lancing of pustules from a smallpox victim followed by insertion of the infected knife or a pus-laden piece of string under the skin of a healthy person. In about two weeks, the patient typically became sick, often very sick, but the illness was less severe than in a naturally acquired infection. Still, the consequences were unpopular among the troops, and the fatality rate was reported to range from 0.5% to as high as 10%.

To complicate matters, the scope of the entire first-of-its-kind mass vaccination of tens of thousands of soldiers had to be conducted in total secrecy. If the British found out that large numbers of American soldiers were laid up in bed with smallpox, that could be the end of the war right there. “I need not mention the necessity of as much secrecy as the nature of the Subject will admit of,” wrote Washington, “it being beyond doubt, that the Enemy will avail themselves of the event as far as they can.” Washington took a big, risky gamble. 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. So does the rather evanescent image of Washington and Fauci sitting there around the camp fire drinking fine colonial whisky and congratulating themselves on yet another successful day vaccinating soldiers. I thank Ohio candidate Josh Mandel for that bit of reverie.

Originally published in Anchorage Press.