The pioneering vaccinators

The Cobb buildings – once home to an isolation hospital

How Dorset played a role in the first ever vaccine

Science feature by Professor Glenn Patrick

2021 is finally here and let us hope that it is an improvement on last year. One of the things that we can look forward to is the mass vaccination programme against COVID-19 – and hopefully this will ensure a gradual return to normality.

If we are successful in eradicating, or at least controlling, the coronavirus, we will forever be in debt to the scientists and companies from around the world who have developed the vaccines.

The university scientists who have developed the Oxford/AstraZeneca vaccine are from The Jenner Institute. This is named after Edward Jenner – the country doctor from Gloucestershire widely considered to be the father of modern vaccination due to his work on the first vaccine for smallpox.

Science is rarely a straight journey with many twists, turns and cul-de-sacs on the road to discovery. This often results in the “forgotten man or woman” whose contributions are lost when the textbooks are written.

Benjamin Jesty, an oil painting by M.W. Sharp 1805 [Credit: Wellcome Library, no. 654136i]
The concept of vaccination has a long history and the role that Jenner played in public vaccination against smallpox is well known. What is perhaps less appreciated is that Dorset was home to an often-forgotten man – by the name of Benjamin Jesty – who also deserves recognition who we will return to later.

Smallpox was a lethal disease in early 18th century Britain killing 30 per cent of the people that it infected. Those who survived were often left disfigured, maimed and sometimes blind. We now know that it was caused by infection with the variola virus and was spread between humans by inhaling respiratory droplets – in a similar way to the coronavirus.

The origins of the virus are still unknown, but it is thought to have emerged thousands of years ago in east Africa and was probably spread by rodents before it jumped to humans.

Until the 19th century, the only way of controlling smallpox transmission was via isolation in either private homes or in pest houses. This led to local authorities establishing isolation hospitals; some specifically for smallpox and others covering a range of infectious diseases such as the plague.

An interesting local insight is that part of the buildings on the Cobb were apparently once used as an isolation hospital to quarantine sailors to prevent them from importing diseases such as typhus, cholera, and the plague. This was an obvious transmission route given that the Black Death entered England through Weymouth in 1348 when a ship docked after sailing from France.

In fact, Lyme Regis Sailing Club occupied the same Cobb building in 1921 and their records show that there was still a clause in their lease requiring vacation of the premises in the event of plague, cholera and smallpox arriving on a vessel from overseas!

Lady Mary Wortley Montagu, an English aristocrat, played an unlikely role in the story of vaccination. In 1715, aged just 26, she contracted smallpox, but survived.

After accompanying her husband – the British Ambassador – to Constantinople she observed that the Turkish women would deliberately infect themselves and their children with material from the sores of smallpox sufferers. This was done by scratching the material under the skin of the arm or inhaling it.

The technique, known as “variolation”, was an early example of inoculation where someone was deliberately infected with smallpox to give them a mild form of the disease – followed by immunity to the more deadly version. It is believed this practice started in China and spread to India and Africa, but was much less well known in Europe.

Lady Montagu inoculated her own children and helped to publicise variolation in Britain, raising awareness that perhaps smallpox could be defeated.

Variolation was a precursor to vaccination. The problem with it was that 1 to 3 per cent of those inoculated died – much better than the 30 per cent of those who contracted smallpox, but still a drawback. There was also the issue that those inoculated were contagious and needed to be isolated to avoid spreading the virus even more!

Amazingly, it was country people who first came up with the idea of vaccination. They observed that milkmaids seemed to be protected from smallpox after contracting the milder cowpox from cows. At that time, this was just folklore, but we now know that this is because cowpox belongs to the same family as the variola viruses which cause smallpox.

Benjamin Jesty was a farmer in Yetminster in north Dorset. He so believed in the local milkmaids’ tales that, during a smallpox outbreak in spring 1774, he vaccinated his wife Elizabeth and two sons, Robert and Benjamin, with cowpox taken from the lesions of an infected cow.

All three of them lived to a good age unaffected by smallpox. His sons were even variolated with smallpox 15 years later and emerged unaffected!

Jesty’s vaccination story spread like wildfire through Dorset. The news did not go down well with the local population and he was treated with superstition and hostility. Unsurprisingly, Jesty did not seek further publicity, which might explain his lack of recognition.

The milkmaid story is often attributed to Edward Jenner. In fact, Jenner did perform his first vaccination in 1796 on an eight-year-old boy called James Phipps using material extracted from a milkmaid – but 22 years after Jesty! He was therefore not the first to test out vaccination in this way and, by then, the use of cowpox was already well known in rural areas.

In 1805, Jesty was eventually invited to the Original Vaccine Pock Institution in London where he allowed his son Robert to again be inoculated with live smallpox to prove that he was still protected after 31 years! As a result of this experiment, proof of the “antivariolous efficacy” of Jesty’s technique was published by the institution in the Edinburgh Medical and Surgical Journal.

It is not clear whether Jenner was aware of Jesty’s work who died in 1816 and is buried in Worth Matravers. To be fair, Jenner systematically and scientifically studied the vaccination of 23 people and had the connections to publish his work. This led to the 1840 Vaccination Act which made variolation illegal, but provided vaccination free of charge.

As we head into 2021, we should be ever grateful to both Jesty and Jenner for pioneering the concept of vaccination – a major milestone for mankind.

After worldwide immunisation, the World Health Organisation declared in 1980 that smallpox had been successfully eradicated. Even today, it is the only human disease for which this can be claimed.

Glenn Patrick is a particle physicist and science communicator who explores the quantum world of sub-atomic particles (including at the Large Hadron Collider) and now lives in Lyme Regis.

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