Viewed from a late night and a laptop, much of the world's history looks like a quaint diorama with dark edges. A time when people were burned for witchcraft, the forests were full of fairies and there were monsters at the edge of a flat world. We think that humanity has journeyed so far from the places it once was. It is easy to forget that, for the most part, each new age has been more enlightened than the one that came before it and that perhaps that isn't saying much at all. I am glad I was born in the 20th century; I much prefer a fast food nation to one in which an early freeze kills my crops and I starve to death. But I think in some ways the people that came before us knew things that we have forgotten. Their lives were short, and they understood what it meant to be hungry for more of it. They, too, lived in a time of real threats and real fears.
The first known case of the disease was found in the Egyptian mummy of Ramses V, a pharaoh who died in 1157 BCE. He may have been royalty, but the cause of his death was one of the great equalizers of mankind's history. Smallpox reigned for the next 3,000 years. Depending on the outbreak, smallpox killed anywhere from 20 percent to 60 percent of the people it afflicted. In children the death rate was closer to 80 percent. The wealthy died lying on silk sheets, the poor died in cramped rooms, but they all died the same horrible way. Death from smallpox is a painful, ugly, lonely thing. And until well into the 1970s mothers all over the world knew its face.
The first sign is a fever often high enough to produce hallucinations, quickly met by days of throwing up and crippling back pain. At this point, smallpox's characteristic pustules have not yet appeared and the mother sits by her child's bedside and prays against the thing she already knows is happening. By the third day, the fever abates and for a moment, the mother thinks perhaps she was wrong. It was just a bad flu. Everything is all right. The next day her daughter wakes up with the first pustules blooming across her forehead.
She is not all right.
The little girl can infect people standing up to six feet away from her. The other members of the household are quarantined, but only the mother dares to go into her daughter's dark room. In the next 10 days (if her daughter lives through them) her little body will be overtaken by an aggressive rash full of those pustules, hard as marbles and embedded deep within her skin. She will become unrecognizable. In some cases, the pustules are so numerous they fuse together to form a sheet. When this happens the skin begins to separate from the flesh underneath. If the girl is lucky, the disease will not become malignant or hemorrhagic. Both manifestations of the disease are nearly always fatal. If she is lucky, she will not develop a secondary infection, pneumonia or go blind. If she is lucky, she will live through the back breaking pain, the thousands of pustules will scab over and the scabs will fall off. They will leave behind deep pitted scars. If she is lucky, she will emerge disfigured but alive.
If the mother has had the disease, she is immune. If she has not, the odds of her catching it through the care of her child in that darkened room are significant. And yet she will sit by the girl's bedside every day. She will brush the hair out of the little face she no longer recognizes and give her water when she is thirsty. And when it isn't too painful for her baby, she will pick up that hot little body and tell her everything is going to be all right, because sometimes, the things we hope for are all we have as mothers. And then she will wait. Wait to see if the smallpox will take her little girl. Wait to see if her other children will become sick, too. Wait for the moment that she feels a little warm and my, hasn't her back hurt all day?
And because disease is a greedy little bastard it will not keep her waiting for long.
In 1796, a man named Edward Jenner discovered that cowpox, a much less threatening form of disease, immunized against smallpox. His grand invention, the smallpox vaccine, was the answer to thousands of years of prayers said by mothers kneeling by the bed of their sick. The smallpox vaccine had a mortality rate of one in a million. It was used successfully, though at times sporadically, in developed countries. It was not used extensively worldwide. In fact, in the 20th century (you know, that one we left just 14 years ago) smallpox killed over 300 million people.
In 1959, the World Health Organization decided to change that and set about destroying the disease one vaccine at a time. Vaccination clinics were set up in bustling metropolises and places without roads. And mothers -- oh the mothers! -- who had watched sisters, brothers, husbands and babies succumb to the disease drove, walked, biked, begged their way to the clinics. And then they waited in lines that stretched into the night for the opportunity to vaccinate those they loved against something they hated. By 1980, the disease had been completely eradicated from the planet.
We are so far removed from the things that came before us, we do not realize how delicate our current situation is. Won't we always be disease-free? Because we eat organically and well, know better? I mean, isn't that how it works? The names of the things that vaccinations protect my children from are foreign to me. Pertussis, Measles, Polio, Pneumococcal -- to name a few. But just a generation ago these were words used at the dinner table; they represented real things that routinely maimed and killed. My dad had friends stricken with polio, my mom had a complicated bout of mumps and pertussis is now making a new resurgence. (Some of this due to the current vaccine's limited protection over time. The solution for now? More vaccinations.)
How are we letting this happen? Why aren't we in lines stretched into the night, offering our children something that will help give them a better world?
I think that we believe, or would like to believe, that we have conquered the primal world. That we have moved past the point of our history where there are monsters at the edge of the map. And my, wouldn't that be nice? But we have not. We will not. We cannot. And we only seem to realize that when something like Ebola rears its ugly, spewing head. There isn't a vaccination for Ebola right now, but what will we each decide when there is one?
Life is not without hard decisions. Life is not without risk. And I will sit here and freely admit that vaccines are accompanied by risk. There are certainly mild illnesses I would not feel compelled to vaccinate against -- if they come up with a shot for the common cold, I'll probably pass. For me the risk vs. benefit wouldn't measure out. That being said, our current vaccinations are not burdened by the statistics that weighed down the smallpox vaccine. There is no "one in a million death" rate. In fact, there simply is no official or agreed upon unofficial death rate. (Of course, there are anecdotes and conjecture but perhaps those are our modern-day version of haunted forests and evil spirits.)
For most vaccines, the possible complications include fever, irritability, and soreness. The CDC reports that in the weeks following a vaccine a few cases of seizure and brain damage have been reported but that "these [instances] are so rare it is hard to tell if they are caused by the vaccine." With the absence of a proven connection, this is the equivalent of me stating that a few weeks after I ate garlic bread my heart stopped and so garlic bread caused the cardiac arrest. Perhaps. But unlikely.
I understand that for many mothers, "so rare it is hard to tell" is a chance they would rather not take with their children. But the choice we are making is not between complete health and one in a million. The choice we are making is between a world in which polio lives an ocean away and a world in which it lives down the street.
I have friends with children who cannot be vaccinated because of health issues. For them, not vaccinating was the right decision. But they are the exception, not the rule. My children and I (and probably yours and you, too) are the rule. It is time to accept that we live in a real place with real threats. If we would get the Ebola vaccine that exists somewhere in the future, then we need to examine our reasons for not utilizing the vaccines that exist right now.
As mothers we will never be able to completely eradicate disease, sorrow or danger from our children's lives. I know that. But there are some dark rooms we never have to walk into again and it is our duty to make sure it stays that way. It is beyond time to protect our children the best way we can. We owe it to the mothers that came before us and we sure as hell owe it to the sons and daughters we love.
So let's do this thing.