Edward Jenner and vaccination: then and now – Synod Address


First published 16th March 2021

On 14 May 1796, Edward Jenner, whose father was vicar of Berkeley up the road from where I am speaking, tested the hypothesis that pus from cowpox blisters protected milkmaids from smallpox by inoculating James Phipps, an eight-year-old boy who was the son of Jenner's gardener. The pus was scraped from the hands of Sarah Nelmes, who had caught cowpox from a cow called Blossom. Jenner notes all of this in his journals. And Blossom's hide hangs in St George’s Hospital medical school. At the time smallpox killed between 10 and 20 per cent of the population, and scarred most. 

It took until the 1970s for smallpox to be eradicated worldwide, the final vaccinations taking place in Bihar while I was working there (not as a vaccinator). And there is a fascinating backstory around Islamic immunology and the scientific nous of Lady Mary Wortley Montagu, but that is for another day.

And so today some of us on screen will have been volunteers in the Oxford AstraZenica trial or been vaccinated using a product designed at the Jenner institute (where the mother of one of our curates is chief operating officer). And much of our conversation has been around where we fit between the groups and in the timetables of the UK mass vaccination programme (whether AstraZenica, Pfizer or other vaccines).

But back to Jenner and the priorities by which he steered which he would have seen as Christian virtues. And he was deeply loved in his community, not just for his medical skills but also because of his Christian faith and where that faith took him. He's buried in the place of honour, next to the altar on the north side, in Berkley parish church. 

Jenner's motivation was rooted in wonder at the creation which was gifted by God. He had great curiosity about the natural world. He is remembered today as an immunologist, but he was elected to the Royal Society following his study of the life cycle of the cuckoo, describing how the newly fledged cuckoo pushed its host’s eggs and fledglings out of the nest, then describing how the fledgling’s back was adapted to this task, just for the first 12 days of its life. His observation of animals and their interaction was crucial in his thinking about vaccination, observing (and then employing in vaccination) transmission across the animal-human trans-species boundary. He had both extraordinary powers of observation and the ability to combine work across areas which in our day form knowledge stored in separate silos. He worked prior to the creation of those silos and was a cross disciplinary integrationist before universities created that tag. More importantly he worked across social silos. 

Jenner’s interest in immunology was sparked by the story he heard from a milkmaid in his early months apprenticed to a London surgeon. That was after his training as a physician in St Andrews in Scotland. Many would have disregarded the thesis that a milkmaid could know anything about smallpox, certainly not this milkmaid's thesis that she could not get smallpox. An unschooled farmhand, that sort of woman would not generally be attended to. I love the fact that he recorded of the names of the first vaccinated child, the milkmaid and the cow. Here was a person who delighted in all that God had made and knew that it was good in all its detail. 

Jenner was patient and determined in his pursuit of truth. It was in the early 1770s that he was first alerted to the impact of exposure to cowpox on the incidence of smallpox. He published his findings nearly 30 years later, after a huge amount of further work on disease processes, having attended carefully to criticism from peers. The medical establishment spent years deliberating on his findings and it was only after Jenner’s death that the Vaccination Act provided smallpox vaccination free of charge. That long-term pursuit of truth, and faith that there was truth to be revealed, was, in Jenner’s world view, the consequence of a divinely created world and a God who is the source of all truth. 

Jenner attended to the gift of each creature and each person and the particular needs of children (who were most prone to infection) and to those with little wealth. He served a community with both a clear hierarchy and also a clear sense of responsibility, of social bonds which required much of those to whom much was given. He enacted his compassion, his companionship in risk, in including his son in the early cohort of patients and continued to vaccinate in his practice free of charge. 

Many of the virtues Jenner displayed continue to form part of the our nations approach to the coronavirus. The virus is not only available free of charge, it cannot be purchased. Distribution continues to be based on vulnerability to serious disease and mortality, rather than on the basis of vulnerability to infection. 

Alongside all that, through the last two centuries there have been those who are vaccine-hesitant, questioning the claims of scientists, and those who, for their own reasons have stoked those fears. These so-called ‘white knights’ have talked up the vaccine threat, talked down the threat of disease, hinted at conspiracies and other truth claims. Andrew Wakefield was one of these whose, fraudulent 1998 study reported an association between MMR vaccine and autism and led many, particularly expectant mums, to refuse MMR vaccination for their newborns. That work was, I would argue, in Christian moral terms, profoundly wrong. 

There are, of course alongside those doubts, questions about the limits to generosity in our global community. Jenner’s boundary was set by the limit of his Gloucestershire practice. The medics who set up the Oxford Jenner institute in the twentieth century set up their unit because, they were concerned for the welfare and well-being of those across the world. They sent young medics to work and learn in areas with new disease emerging and relatively under-resourced healthcare systems, their focus was global need and a need for an agile response to new diseases. It was those medics who have been the scientists and experimentalists and the communicators who have enabled the creation of a vaccine and the purchase of it which can be used across the globe, at minimal cost. 

Our government, like most wealthy nations, has set a boundary around the nation state, with a ‘UK first’ policy, with the vaccines purchased or ordered hugely more than the doses we need. Understandably, because of the fear of failure of those vaccines, but nevertheless, having a huge impact on our global community. At the current rate, it will take five years to vaccinate every adult on earth just once. 0.02 per cent of the population of Africa had been vaccinated by the end of February, a figure which the leader of the Africa Centres for Disease Control and Prevention called a moral catastrophe (because of the implication that those in Africa are of less value) and self-defeating (because it will allow new variants to emerge). Christian Aid has been trying to persuade government to adjust its policy. 

And Jenner’s tight knit rural Gloucestershire community is far from our great diverse cities and the profound influence of social media. Over recent months as our understanding of vaccine hesitancy has developed, so it has become embedded in some communities. Until the distraction provided by Andrew Wakefield there had been an altruistic consensus, born not least of experience of seeing people dying of diphtheria. Being vaccinated presented a risk, but that risk was part of our obligation to our neighbours to minimise their risk. It was, and is, as Her Majesty the Queen has indicated, our duty to be vaccinated if we can be. But in our generation, with social consensus, even social contract fraying, mass immunisation has become a profound test of that civic duty and of our ability to co-operate.

Which is why the faith communities have been at the forefront of demonstrating their support for vaccination, with vaccination centres in mosques and cathedrals, adherents of faith training as vaccinators or offering as volunteers and faith leaders explaining why their people should be vaccinated. These leaders have often used their family stories of the positive impact of vaccination, and what has become apparent (not least to those of us who have tried to convince the reluctant) is that facts do not convince or convict. This is not because they are seen as wrong, but because facts are seen as irrelevant. A decision to get vaccinated is not dependent, for most of us, on information but on trust. Which is why I chose to speak to this Christian gathering about the Christian virtues of wonder, truth seeking and care for the vulnerable which lie behind vaccination, and the altruism and Christian neighbourliness which continue to be its foundation. So, do continue to build community, do attend to the vaccine hesitant, and, if you are able, contribute to Christian Aid’s ‘thanks be to God’ appeal, in thanksgiving for your own vaccination when it does come. That generosity, that worldview, is something that I think Edward Jenner would have understood and supported.

Right Revd Vivienne Faull, Bishop of Bristol.