From Camelot to COVID

There is an amusing scene in the film “Casablanca” when Rick Blaine says he came to Casablanca “for the waters.” When told there are no waters there, he replies, “I was misinformed.”

It looks like, this year, two of the three presidential candidates will be competing for who can misinform the most voters.

I thought about this a couple of weeks ago when, by the windmill in Sag Harbor, several people had set up a table to promote the delusional interests of Robert F. Kennedy Jr. The table has not reappeared since, but a poster remains at the foot of the Lance Corporal Jordan Haerter Bridge.

RFK Jr.’s biggest issue, thus far, has been false claims about vaccinations, which have been extensively documented. He has long pushed the debunked claim that there is a link between childhood vaccinations and autism.

Among other things, he has also misstated the contents of vaccines, falsely claimed there is convincing evidence that the 1918 influenza pandemic and HIV both originated with vaccine research, and repeatedly touted misinformation about COVID-19 vaccines, such as a wave of “suspicious” deaths among seniors who had been vaccinated.

And, yet, there are otherwise intelligent people who support him. It’s the name recognition, even more powerful than Ralph Nader in 2000.

What if the smallpox vaccine had been rejected? Polio? There are countless examples of vaccines that have eradicated or sharply reduced the mortality rates of severe diseases.

Do some people have bad, even fatal, reactions to vaccines? Yes. Did some people contract or even die of COVID after being vaccinated? Yes. However, at the height of its prevaccine rampage, COVID was killing an average of 3,223 a day in the United States. In 2023, there were approximately 70,000 deaths, or 198 per day.

Good thing RFK Jr. was not around on April 22, 1721, when a British ship arrived in Boston Harbor. On board, one of the sailors had begun to exhibit symptoms of a terrifying disease. He was quickly quarantined, but several more members of the crew soon fell ill.

A smallpox outbreak spread quickly through the city. As it worsened, the Puritan minister Cotton Mather reached out to the medical community of Boston, imploring them to use an inoculation method. One physician, Zabdiel Boylston, heeded his call, but most other doctors were hostile to the idea.

This early resistance proved deadly. From that spring until winter, an epidemic afflicted the city. Out of a population of 11,000, over 6,000 cases were reported.

However, the 1721 epidemic led to a major milestone in the history of vaccination and smallpox eradication. The finally grudging use of inoculation paved the way for Edward Jenner to develop a smallpox vaccination by the end of the century. Mather is largely credited with introducing inoculation to the Colonies and doing a great deal to promote the use of this method during the 1721 epidemic.

He first learned about inoculation from his West African slave Onesimus, who, in 1706, had been purchased for Mather by his congregation. Onesimus was named after an enslaved man in the Bible whose name meant “useful.” Mather, who had been a powerful figure in the Salem Witch Trials, also looked down on what he called the “Devilish rites” of Africans. He didn’t trust Onesimus.

But in 1716, the slave had confided that he knew how to prevent smallpox. Onesimus, who “is a pretty intelligent fellow,” Mather wrote, said that he “had undergone an operation, which had given him something of the smallpox and would forever preserve him from it … and whoever had the courage to use it was forever free of the fear of contagion.”

The “operation” Onesimus referred to consisted of rubbing pus from an infected person into an open wound on the arm. Once the infected material was introduced into the body, the person was inoculated against smallpox by activating the recipient’s immune response and protecting against the disease most of the time.

Mather was fascinated. He verified Onesimus’s story with that of other slaves in Boston and learned that the practice had also been used in Turkey and China.

He became a strong advocate for “variolation” and spread the word throughout Massachusetts and elsewhere, in the hopes that it would help prevent smallpox.

One of his immediate converts was the physician Boylston. As smallpox began to spread in Boston in April 1721, he inoculated his son and his enslaved workers against the disease. Then he began inoculating other Bostonians. Of the 242 people Boylston personally inoculated, only six died — one in 40, as opposed to one in seven deaths among the population of Boston who didn’t undergo the procedure.

The smallpox epidemic killed 844 people in Boston, almost 15 percent of the population. But it had yielded hope for future epidemics.

In 1796, Jenner developed an effective vaccine that used cowpox to provoke smallpox immunity. Eventually, smallpox vaccination became mandatory in Massachusetts.

The debate over the use of inoculation during the 1721 epidemic in Boston bears relevance today. Modern vaccination campaigns, most notably targeting the eradication of polio, continue to face violent opposition in many parts of the world where the disease is still present, particularly in Pakistan, Afghanistan and Nigeria.

Even in the United States, outbreaks among groups of unvaccinated individuals have risen in the past decade — a trend that is often attributed to the spread of misinformation by people like RFK Jr. regarding the potential risks, contents and mechanism of vaccination. We saw it again with the COVID-19 vaccination.

The story of the 1721 Boston smallpox epidemic and the controversy that accompanied the introduction of inoculation exemplifies how opposition to inoculation and then vaccination has been present for as long as the practices themselves.

An ironic detail is that out of this combination of political conflict and disease in Boston emerged the beginnings of an American free press.

In 1721, James Franklin started a newspaper called The New-England Courant. (His younger brother Benjamin made his debut as a writer in the newspaper under the name Silence Dogood.) James Franklin saw an opportunity in the epidemic and jumped in on the popular side of the debate, which was anti-inoculation. He published the paper without permission from the royal authorities, making it the first independent newspaper in America.

So the birth of the free press is tied to an entrepreneur who went into business to prey on the fears of the public.

Sounds familiar.