Variolation vs. Vaccination

Posted by on Feb 8, 2014

Variolation (left) vs. Vaccination (right)

The 12th and 13th Days
Chromolithograph (1896) after a painting by George Kirtland
Wellcome Library, London


Inoculation is the practice of introducing a small amount of viral matter into the body (usually through the skin) in order to prime the immune system to recognize and destroy that virus. It is a preventative measure, not a cure.

  • Inoculations essentially make the body a tiny bit sick (usually locally), in order to guard against major future infections.


Variolation (pronounced vuh-RYE-oh-lay-shun) is inoculation against smallpox using live smallpox virus, variola major.

  • This is the procedure brought to the attention of Western science by Lady Mary Wortley Montagu and Zabdiel Boylston in 1721. They referred to it as “inoculation” or “engrafting.”
  • Previously, it had been practiced in China, Turkey, and West Africa.
  • Throughout The Speckled Monster, I refer to variolation as “inoculation.”
  • The name variola comes from varius, Latin for “spotted.”


Vaccination, in its original and most precise usage, means inoculation against smallpox using the related, but far less dangerous vaccinia (or cowpox) virus.

  • The name vaccinia comes from vacca, Latin for “cow.”
  • “Vaccination” has since become a generic term (like “Xerox,” “Kleenex,” and “Levi’s”), and is now often used to indicate inoculation against any disease.
  • You CANNOT get smallpox from the vaccine. It contains no smallpox virus.


The Odds

  • Variolation kills an estimated 1 in 100 patients: good odds, if your only other choice is to suffer through an epidemic killing up to 1 in 3 of its victims.
  • The modern smallpox vaccination kills about 1 or 2 in a million people: an almost miraculous improvement.


Further Reading

  • Biss, Eula. On Immunity: An Inoculation. Minneapolis, Minnesota: Graywolf Press, 2014.

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