One could easily argue that the most significant public health development in history was the invention of the smallpox vaccine in 1796 by Edward Jenner. In 1700, life expectancy was about 35. They did not die of overeating or lack of exercise. Many went hungry and they did physical work finding and growing food to survive. They were not fat and they were fit. Viral and bacterial diseases killed most people They did not live long enough to have strokes, heart attacks, or cancer. Many died in childhood. One reason was smallpox—one of the deadliest diseases known to humans.
“Over thousands of years, smallpox killed hundreds of millions of people. The rich, the poor, the young, the old. It was a disease that didn’t discriminate, killing at least 1 in 3 people infected, often more in the most severe forms of disease.” When Europeans brought smallpox to the Americas, whole villages of Native Americans were wiped out. They had no natural immunity.
Have you ever run into anyone who has had smallpox? Have you ever had it. Of course not! It is the only human disease that has disappeared. “One of the deadliest diseases known to humans, smallpox remains the only human disease to have been eradicated. Many believe this achievement to be the most significant milestone in global public health.”
Smallpox was a terrible way to die. This viral illness caused high fever, nausea, mouth sores, vomiting, and then followed by pustules covering the whole body. If you survived, they left scars. Death often came within 2 weeks. Survivors could be left blind and unable to have children.
Smallpox has been around for at least 3000 years. It has been documented to be present in Egyptian mummies. There has been a form of vaccination for the disease in Africa and parts of Asia long for over 2000 years. The ancients found that removing a small amount of pus from the smallpox blisters and inoculating it in the skin of healthy people led to a milder illness with a much lower death rate. This was long before we had any idea that a virus causes the disease. Europeans began to use the technique in 1721. The final refinement came when Edward Jenner discovered you could use coxpox for the inoculation which caused even less severe disease but still enough protection that we have eliminated smallpox as a threat to human life.
Have you ever had polio in your community? I never heard of a case anywhere close to me in all the decades I was a primary care doctor. I never heard of it in my state. That is because the polio vaccine has virtually eliminated the polio virus and it is highly effective. When I was a child we all got the polio and smallpox vaccines. I remember going to the city hall to get it. Polio was a horrible, highly contagious viral illness. This is one of the most cruel of all diseases. It mainly affected children under the age of five and it produced paralysis in many Americans. The paralysis might impact an arm or a leg and it could be permanent. If it hit the breathing muscles, it was fatal. Our president, Franklin Roosevelt, was paralyzed in both legs by this illness. Polio cases around the world have dropped by 99% since 1988. Polio has been eliminated from all but two countries. We could eliminate polio like we eliminated smallpox. As long as a single child remains infected, your children and grandchildren at risk of becoming paralyzed or dying from this disease. A failure to eliminate polio means a global epidemic could still occur. Dr. Jonas Salk became a national hero when he invented a highly effective polio vaccine 70 years ago.
Influenza or the flu can be a very deadly illness. From 1918 to 1919, the Spanish Flu pandemic killed 20–50 million people worldwide. It killed one out of 67 young men in the American armed forces. The flu killed more people than all combat operations in WWI. It was devastating. By 1945, there was an effective vaccine for influenza. The flu vaccine reduces your risk of death from influenza by about a third.
How about yellow fever? I have never heard of a case in the United States during my lifetime, but epidemics of yellow fever killed many Americans in the 18th and 19th centuries. In that infection, people die because the disease destroys the liver and causes them to become yellow. This illness came in waves from other countries and port cities were the primary targets. The disease occasionally spread up the Mississippi River system. Savannah, New Orleans, Mobile, and Charleston were repeated targets; Yellow fever epidemics caused terror, and economic disruption. One yellow fever epidemic literally decimated Philadelphia, killing one out of ten inhabitants of that city. Yellow fever and malaria killed 20,000 workers during the French attempt to build the Panama Canal causing them to abandon the project. Mosquito control measures and an effective vaccine eliminated this disease fro the US.
These are not just stories. The impact of these epidemics on communities was awful. Consider this quote from New Zealand. “More than a third of influenza victims in Auckland were buried at Waikumete Cemetery. In the third week of November, a team of about 35 men were digging graves almost non-stop on the western boundary of Waikumete Cemetery. The Railways Department provided two special trains daily from 13-20 November to transport bodies to Waikumete. Despite popular belief that epidemic victims were buried in unmarked mass graves, most bodies were buried separately.” The picture at the beginning of the article comes from a marker in this cemetery.
In 17th century New England, 40% of children died before reaching adulthood, many of them from contagious viruses. Now it is very unusual to die as a child from a virus, but that progress is threatened. I hear people talk about vaccines for viruses like they were talking about Santa Clause. “I don’t believe in vaccines.” What??? Vaccines are not a matter of belief. They are a matter of scientific fact. They are a matter of knowledge. There may be more effective vaccines and less effective vaccines, but vaccines are one of the monumental advances in scientific medical achievement. Our lifespans have doubled over the last couple of hundred years and highly effective vaccines are an important part of the story.
Pre-Covid, most thinking adults would agree with your conclusion and most trusted public health. That has changed. Government vastly oversold the efficacy and side effects of the Covid vaccine and down played adverse cases. Being personally tied to healthy athletes debilitated from adverse events post vaccination I’ll say that public health trust and trust in vaccines has been lost for many. It will take time and better data to regain public trust.
This is highly debatable - even around smallpox. An excellent analysis (I have read various) is from A Midwestern Country Doctor. Then, we need to look at the current plandemic. Further, for children, unvaccinated children do better, in terms of health evaluation, on every score - vaccinated children have 4-5 times the autism rate, way higher attention deficit, allergies, etc, etc. The polio vaccines - yes. Almost ll other childhood vaccines, a resounding no. My sense is you have much to explore in this area.