Variolation vs. Vaccination

Messy Miracles

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

Grotesque, But Better than Smallpox

Just about anything is better than getting full-blown smallpox.

Variolation — the forerunner of vaccination — resulted in pocks sprouting all over the site, often an upper arm, centering on a particularly nasty cluster that might stretch six inches across. It left a scar the size of a fist.

Smallpox vaccination, on the other hand, sometimes left dimpled scars about the diameter of a quarter. (I used to have one, but it’s disappeared.)

The Terms: Inoculation, Variolation, Vaccination

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 specifically 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.
• Previously, it had been practiced in China, Turkey, and West Africa.
• Throughout The Speckled Monster, I refer to variolation as “inoculation.”
• The term variolation comes from the scientific name of the smallpox virus, variola major, which in turn comes from varius, Latin for “spotted.”
• Variolation is no longer practiced. (Do I need to say that?) It quickly fell out of favor following Edward Jenner’s success with vaccination in 1796. In the wake of smallpox’s eradication, variolation is now impossible. You need live smallpox virus, and thankfully there isn’t any.

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.”
• Edward Jenner began experimenting with vaccination in 1796.
• “Vaccination” has since become a generic term (like “Xerox” or “Kleenex”), and is now often used to indicate inoculation against any disease.
• You CANNOT get smallpox from the smallpox vaccine. It contains no smallpox virus. See the CDC’s Smallpox Vaccine Basics.

The Odds

• Variolation once killed an estimated 1 in 100 patients: good odds, when your only other choice was to suffer through an epidemic that might kill 1 in 3 of its victims.
• The modern smallpox vaccination kills about 1 or 2 in a million people: an almost miraculous improvement. No vaccine, however, is entirely without risk.

All About Smallpox: Next

Talking about risk…