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Edward Jenner (17 May 1749 – 26 January 1823) was an Englishphysician andscientist who pioneered the concept ofvaccines and created thesmallpox vaccine, the world's first vaccine.[1][2] The termsvaccine andvaccination are derived fromVariolae vaccinae ('pustules of the cow'), the term devised by Jenner to denotecowpox. He used it in 1798 in the title of hisInquiry into the Variolae vaccinae known as the Cow Pox, in which he described the protective effect of cowpox against smallpox.[3]
Jenner is often called "the father ofimmunology",[4] and his work is said to have saved "more lives than any other man".[5]: 100 [6] In Jenner's time, smallpox killed around 10% of the global population, with the number as high as 20% in towns and cities where infection spread more easily.[6] In 1821, he was appointed physician to KingGeorge IV, and was also made mayor ofBerkeley and justice of the peace. He was a member of theRoyal Society. In the field of zoology, he was among the first modern scholars to describe thebrood parasitism of thecuckoo (Aristotle also noted this behaviour in hisHistory of Animals). In 2002, Jenner was named in theBBC's list of the100 Greatest Britons.
Edward Jenner was born on 17 May 1749[7] inBerkeley, Gloucestershire, England as the eighth of nine children.[8] His father, theReverend Stephen Jenner, was thevicar of Berkeley, so Jenner received a strong basic education.[7]
Jenner's handwritten draft describing the first vaccination is held at theRoyal College of Surgeons in London
When Jenner was young, he went to school inWotton-under-Edge at Katherine Lady Berkeley's School and inCirencester.[7] During this time, Jenner wasinoculated (byvariolation) forsmallpox, which had a lifelong effect upon his general health.[7] At age 13, he was apprenticed for seven years to Daniel Ludlow, asurgeon ofChipping Sodbury, South Gloucestershire, gaining most of the experience needed to become a surgeon himself.[7]
In 1770, at age 21, Jenner became apprenticed in surgery and anatomy under surgeonJohn Hunter and others atSt George's Hospital, London.[9]William Osler records that Hunter gave JennerWilliam Harvey's advice, well known in medical circles (and characteristic of theAge of Enlightenment), "Don't think; try."[10] Hunter remained in correspondence with Jenner overnatural history and proposed him for theRoyal Society. Returning to his native countryside by 1773, Jenner became a successfulfamily doctor and surgeon, practising on dedicated premises at Berkeley. In 1792, "with twenty years' experience of general practice and surgery, Jenner obtained the degree of MD from theUniversity of St Andrews".[2]
Jenner and others formed the Fleece Medical Society or Gloucestershire Medical Society, so called because it met in the parlour of the Fleece Inn,Rodborough, Gloucestershire. Members dined together and read papers on medical subjects. Jenner contributed papers onangina pectoris,ophthalmia, and cardiac valvular disease and commented oncowpox. He also belonged to a similar society which met inAlveston, near Bristol.[11]
Jenner's 1802 testimonial to the efficacy of vaccination, signed by 112 members of thePhysical Society, London
Jenner became a mastermason on 30 December 1802, in Lodge of Faith and Friendship #449. From 1812 to 1813, he served as worshipful master of Royal Berkeley Lodge of Faith and Friendship.[12]
Jenner was elected fellow of theRoyal Society in 1788, following his publication of a careful study of the previously misunderstood life of the nestedcuckoo, a study that combined observation, experiment, and dissection.
Jenner described how the newly hatched cuckoo pushed its host's eggs and fledgling chicks out of the nest (contrary to existing belief that the adult cuckoo did it).[13] Having observed this behaviour, Jenner demonstrated an anatomical adaptation for it – the baby cuckoo has a depression in its back, not present after 12 days of life, that enables it to cup eggs and other chicks. The adult does not remain long enough in the area to perform this task. Jenner's findings were published inPhilosophical Transactions of the Royal Society in 1788.[14][15]
"The singularity of its shape is well adapted to these purposes; for, different from other newly hatched birds, its back from the scapula downwards is very broad, with a considerable depression in the middle. This depression seems formed by nature for the design of giving a more secure lodgement to the egg of the Hedge-sparrow, or its young one, when the young Cuckoo is employed in removing either of them from the nest. When it is about twelve days old, this cavity is quite filled up, and then the back assumes the shape of nestling birds in general."[16] Jenner's nephew assisted in the study. He was born on 30 June 1737.
Jenner's understanding of the cuckoo's behaviour was not entirely believed until the artistJemima Blackburn, a keen observer of birdlife, saw a blind nestling pushing out a host's egg. Blackburn's description and illustration were enough to convinceCharles Darwin to revise a later edition ofOn the Origin of Species.[17]
Jenner's interest in zoology played a large role in his first experiment with inoculation. Not only did he have a profound understanding of human anatomy due to his medical training, but he also understood animal biology and its role in human-animal trans-species boundaries in disease transmission. At the time, there was no way of knowing how important this connection would be to the history and discovery of vaccinations. We see this connection now; many present-day vaccinations include animal parts from cows, rabbits, and chicken eggs, which can be attributed to the work of Jenner and his cowpox/smallpox vaccination.[18]
A lecturer's certificate of attendance given to Jenner. He attended many lectures on chemistry, medicine and physics.
Jenner married Catherine Kingscote (who died in 1815 fromtuberculosis) in March 1788. He might have met her while he and other fellows were experimenting withballoons. Jenner's trial balloon descended intoKingscote Park, Gloucestershire, owned by Catherine's father Anthony Kingscote.[19] They had three children together: Edward Robert (1789–1810), Robert Fitzharding (1792–1854) and Catherine (1794–1833).[8]
Jenner earned his MD from theUniversity of St Andrews in 1792.[20] He is credited with advancing the understanding ofangina pectoris.[21] In his correspondence with Heberden, Jenner wrote: "How much the heart must suffer from the coronary arteries not being able to perform their functions".[22]
The initial source of infection was a disease of horses, called "the grease", which was transferred to cattle by farm workers, transformed, and then manifested as cowpox.
Inoculation was already a standard practice in Asian and African medicine but involved serious risks, including the possibility that those inoculated would become contagious and spread the disease to others.[23] In 1721,Lady Mary Wortley Montagu had importedvariolation to Britain after having observed it inConstantinople. WhileJohnnie Notions had great success with his self-devised inoculation[24] (and was reputed not to have lost a single patient),[25] his method's practice was limited to theShetland Islands.Voltaire wrote that at this time 60% of the population caught smallpox and 20% of the population died from it.[26] He also stated that theCircassians used the inoculation from times immemorial, and that the Turks may have borrowed the custom from them.[27] In 1766, Daniel Bernoulli analysed smallpox morbidity andmortality data to demonstrate the efficacy of inoculation.[28]
By 1768, English physicianJohn Fewster had realised that prior infection with cowpox rendered a person immune to smallpox.[29][30] In the years following 1770, at least five investigators in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) successfully tested a cowpox vaccine against smallpox in humans.[31] For example,Dorset farmerBenjamin Jesty[32] successfully vaccinated with cowpox and presumablyinduced immunity in his wife and two children during the 1774 smallpox epidemic, though it was not until Jenner's work that the procedure became widely understood. Jenner may have been aware of Jesty's procedures and success.[33] In 1780,Jacques Antoine Rabaut-Pommier made similar observations in France.[34]
Jenner postulated that thepus in blisters from sufferers ofcowpox (a disease similar to smallpox but much less virulent) protected them from smallpox. On May 14,1796, Jenner tested his hypothesis by inoculatingJames Phipps, the eight-year-old son of Jenner's gardener. He scraped pus from cowpox blisters on the hands of Sarah Nelmes, a milkmaid who had caught cowpox from a cow called Blossom[35] (whose hide now hangs on the wall of theSt. George's Medical School library, now inTooting, London). Phipps was the 17th case described in Jenner's first paper onvaccination.[36]
Jenner inoculated Phipps in both arms that day; this led to a fever and some uneasiness but no full-blown infection. Later, Jenner injected Phipps withvariolous material, the routine method of immunization at that time and again no disease followed. The boy was later challenged with variolous material and again showed no sign of infection. There were no unexpected side effects, and neither Phipps nor any other recipients underwent any future 'breakthrough' cases.
Jenner's biographerJohn Baron later speculated that it was Jenner's observation of the unblemished complexion of milkmaids that led to his understanding that it was possible to be inoculated against smallpox by being exposed to cowpox, that is he did not build on the work of his predecessors. The milkmaid story is still widely repeated even though it appears to be a myth.[37][38]
Known:
Smallpox is more dangerous than variolation and cowpox less dangerous than variolation.
Hypothesis:
If target is infected with cowpox, then target is immune to smallpox.
Test:
If variolation after infection with cowpox fails to produce a smallpox infection, immunity to smallpox has been achieved.
Consequence:
Immunity to smallpox can be induced much more safely than by variolation.
US physicianDonald Hopkins has written, "Jenner's unique contribution was not that he inoculated a few persons with cowpox, but that he then proved [by subsequent challenges] that they were immune to smallpox. Moreover, he demonstrated that the protective cowpox pus could be effectively inoculated from person to person, not just directly from cattle."[39] Jenner successfully tested his hypothesis on 23 additional subjects.
Jenner continued his research and reported it to theRoyal Society, though the initial paper was not published. After revisions and further investigations, he published his findings on the 23 cases, including his 11-month-old son Robert.[40] Some of his conclusions were correct, some erroneous; modern microbiological and microscopic methods would make his studies easier to reproduce. The medical establishment deliberated at length over his findings before accepting them. Eventually, vaccination was accepted, and in 1840, the British government banned variolation – the use of smallpox to induce immunity – and provided vaccination using cowpox free of charge (seeVaccination Act).
The success of Jenner's discovery soon spread around Europe and was useden masse in the SpanishBalmis Expedition (1803–1806), a three-year-long mission to the Americas, the Philippines, Macao and China led byFrancisco Javier de Balmis with the aim of giving the smallpox vaccine to thousands.[41] The expedition was successful, and Jenner wrote: "I don't imagine the annals of history furnish an example of philanthropy so noble, so extensive as this".[42]Napoleon, who at the time wasat war with Britain, had all his French troops vaccinated, awarded Jenner a medal, and at Jenner's request, released two English prisoners of war, allowing them to return home.[43][44] Napoleon remarked he could not "refuse anything to one of the greatest benefactors of mankind".[43]
Jenner's continuing work on vaccination prevented him from continuing his ordinary medical practice. He was supported by his colleagues and KingGeorge III in petitioningParliament,[45] and was granted £10,000 for his work on vaccination in 1802.[46] In 1807, Jenner was granted another £20,000 after the Royal College of Physicians confirmed the widespread efficacy of vaccination.[2]
The steps taken by Edward Jenner to create vaccination, the first vaccine for smallpox. Jenner did this by inoculating James Phipps with cowpox, a virus similar to smallpox, to create immunity, unlike variolation, which used smallpox to create an immunity to itself.
Edward Jenner advising a farmer to vaccinate his family. Oil painting by an English painter,c. 1910
Jenner's discovery of the link between cowpox pus and smallpox in humans helped him to create the smallpox vaccine.
Jenner performing his first vaccination onJames Phipps, a boy of age 8, on 14 May 1796
James Gillray's 1802 caricature of Jenner vaccinating patients who feared it would make them sprout cowlike appendages.
Jenner was later elected a foreign honorary member of theAmerican Academy of Arts and Sciences in 1802, a member of theAmerican Philosophical Society in 1804,[47] and a foreign member of theRoyal Swedish Academy of Sciences in 1806.[48] In 1803, he became president of the Jennerian Society in London, concerned with promoting vaccination to eradicatesmallpox. The Jennerian ceased operations in 1809. Jenner became a member of the Medical and Chirurgical Society on its founding in 1805 (now theRoyal Society of Medicine) and presented several papers there. In 1808, with government aid, the National Vaccine Establishment was founded, but Jenner felt dishonoured by the men selected to run it and resigned his directorship.[5]: 122–125
Returning to London in 1811, Jenner observed a significant number of cases of smallpox after vaccination. He found that in these cases the severity of the illness was notably diminished by previous vaccination. In 1821, Jenner was appointed physician extraordinary toKing George IV and was also made mayor of Berkeley[2] andmagistrate[5]: 303 (justice of the peace). Jenner continued to investigate natural history, and in 1823, the last year of his life, he presented his "Observations on the Migration of Birds" to the Royal Society.[46]
Jenner was found in a state ofapoplexy on 25 January 1823, with his right side paralysed.[5]: 314 He did not recover and died the next day of an apparent stroke, his second.[5] Jenner was 73 years old. He was buried in the family vault at the Church of St Mary, Berkeley.[51]
Neither fanatic nor lax,[52] Jenner was a Christian who in his personal correspondence showed himself quite spiritual.[5]: 141 Some days before his death, Jenner stated to a friend: "I am not surprised that men are not grateful to me; but I wonder that they are not grateful to God for the good which He has made me the instrument of conveying to my fellow creatures".[5]: 295
Near the Gloucestershire village ofUley, Downham Hill is locally known as "Smallpox Hill" for its possible role in Jenner's studies of the disease.[62]
Built around 1970, The Jenner Health Centre, 201 Stanstead Road, Forest Hill, London, SE23 1HU[71]
Jenner's name is featured on the Frieze of theLondon School of Hygiene & Tropical Medicine. Twenty-three names of public health and tropical medicine pioneers were chosen to feature on the Keppel Street building when it was constructed in 1926.[72]
^"Observations on the Natural History of the Cuckoo". By Mr. Edward Jenner. In a Letter to John Hunter, Esq. F.R.S. Jenner, E Philosophical Transactions of the Royal Society of London (1776–1886). 1788. 78:219–237(Archived Text)
^Sealy Spencer G (2011). "Cuckoo chicks evicting their nest mates: coincidental observations by Edward Jenner in England and Antoine Joseph Lottinger in France".Archives of Natural History.38 (2):220–228.doi:10.3366/anh.2011.0030.
^(Letter to Hunter at the Royal Society, as above)
^The Biographical Dictionary of Scottish Women. 2006.
^Richard B. Fisher,Edward Jenner (Andre Deutsch, 1991) pp. 40–42ISBN978-023398681-4
^"A brief history of the University".University of St Andrews. Retrieved11 February 2018.Through the centuries many great minds have been attracted to St Andrews:...Edward Jenner, pioneer of the smallpox vaccine (MD, 1792)
^Valentin Fuster, Eric J. Topol, Elizabeth G. Nabel (2005). "Atherothrombosis and Coronary Artery Disease". p. 8. Lippincott Williams & WilkinsISBN978-078173583-4
^Dishington A (1999) [1792]. Sinclair SJ (ed.)."United Parishes of Mid and South Yell".The Statistical Account of Scotland Drawn up from the Communications of the Ministers of the Different Parishes.2 (50). University of Edinburgh, University of Glasgow: Edinburgh: William Creech: 571.OCLC1045293275. Archived fromthe original on 29 August 2021. Retrieved10 October 2019 – via The Statistical Accounts of Scotland online service.
^Plett PC (2006). "Peter Plett and other discoverers of cowpox vaccination before Edward Jenner" [Peter Plett and other discoverers of cowpox vaccination before Edward Jenner].Sudhoffs Archiv (in German).90 (2):219–232.PMID17338405.
^abDe Beer GR (May 1952). "The relations between fellows of the Royal Society and French men of science when France and Britain were at war".Notes and Records of the Royal Society of London.9 (2): 297.doi:10.1098/rsnr.1952.0016.S2CID202574537.
^"Top 10 Tokyo". p. 27. Dorling Kindersley Ltd, 2017
^"Monument à Edward Jenner – Boulogne-sur-Mer".e-monumen.net (in French). L'Association pour la sauvegarde et la promotion du patrimoine métallurgique haut-marnais. 5 July 2011. Retrieved13 May 2018.
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