WEBVTT - Not Unto Death 0:00:08.245 --> 0:00:13.965 School of humans. Try to picture this a small chapel 0:00:14.005 --> 0:00:24.645 in an English market town October seventeen sixty six. Merchants, tradesmen, shopkeepers, farmers. 0:00:25.165 --> 0:00:27.885 They park their wagons, tie up their horses, and going 0:00:27.965 --> 0:00:33.325 to see what all the commotion is about. The chapel 0:00:33.405 --> 0:00:36.605 is in Ingateston, a common stop on the Essex Great Road, 0:00:37.085 --> 0:00:42.965 which travelers have taken since Roman times. Come in, please 0:00:43.365 --> 0:00:49.245 come in, Nobles and ignobles alike. Enter. All eyes are 0:00:49.285 --> 0:00:54.045 on the fiery reverend. This sickness is not unto death. 0:00:55.565 --> 0:01:02.685 This sickness is not unto death. His name is Robert Holton. 0:01:03.605 --> 0:01:05.845 He's not preaching on the word of God, at least 0:01:05.885 --> 0:01:12.205 not directly. He's evangelizing about a new medical curiosity. This sickness, 0:01:12.285 --> 0:01:18.485 as caused by inoculation, is not unto death. Some in 0:01:18.565 --> 0:01:21.525 the audience believe the product Reverend Holton is selling will 0:01:21.565 --> 0:01:25.245 invite Hell to their village, but he ignores the skeptics 0:01:25.245 --> 0:01:30.765 and rolls on. This sickness, as caused by inoculation is 0:01:30.885 --> 0:01:35.565 not unto death, is not worthy of divine vengeance or 0:01:35.645 --> 0:01:40.405 punishment because it violates no command of God and is 0:01:40.485 --> 0:01:46.125 not included under any sin that he has forbidden the 0:01:46.125 --> 0:01:52.525 practice of inoculation is justifiable. This sickness, as caused by inoculation, 0:01:52.725 --> 0:02:00.445 is not unto death. Reverend Holton's conviction comes with a cost. 0:02:01.125 --> 0:02:03.605 He's getting paid to preach by the founders of a 0:02:03.685 --> 0:02:07.685 fast growing family business, a business that began a few 0:02:07.685 --> 0:02:10.965 decades earlier with the near death of a promising young man. 0:02:14.445 --> 0:02:19.645 The young man's name is Robert Sutton Junior, twenty three 0:02:19.725 --> 0:02:23.085 years old and finished with his apprenticeship, ready to join 0:02:23.165 --> 0:02:29.005 his father, Robert Sutton Senior country surgeons and apothecaries, setters 0:02:29.005 --> 0:02:33.965 of broken bones, dressers of wounds, letters of blood, prescribers 0:02:33.965 --> 0:02:39.405 of medicines. Their patients are lords, farmers, millers, herders, whoever 0:02:39.445 --> 0:02:44.285 can pay. By this time, Robert Junior has learned how 0:02:44.285 --> 0:02:49.245 to heal ills, to remove piles and drain abscesses, set bones, 0:02:49.325 --> 0:02:52.405 and maybe even to amputate limbs. But before he can 0:02:52.445 --> 0:02:56.085 join his father's practice, Robert Junior has to be inoculated 0:02:56.245 --> 0:03:02.605 against smallpox. Inoculation means having someone purposefully cut open your 0:03:02.605 --> 0:03:05.445 skin in a rubbish scab or puss from an infect 0:03:05.685 --> 0:03:09.765 smallpox patient on the exposed wound. In other words, it 0:03:09.805 --> 0:03:15.525 means giving you smallpox, making you sick on purpose. Smallpox 0:03:15.605 --> 0:03:18.165 kills roughly one out of every three people it infects 0:03:18.205 --> 0:03:20.725 at the time, and you're paying someone to give it 0:03:20.765 --> 0:03:26.525 to you. Smallpox inoculation is a sort of ad hoc 0:03:26.605 --> 0:03:30.485 predecessor to vaccination. In a roundabout way, it's the beginning 0:03:30.565 --> 0:03:34.565 of one of humankind's greatest achievements, the ability to protect 0:03:34.685 --> 0:03:38.325 from disease. But it's a young procedure. There are no 0:03:38.405 --> 0:03:42.205 clinical studies and trials, no quality controls and production, no 0:03:42.325 --> 0:03:47.245 regulatory approvals or any other modern safety checks. By the 0:03:47.245 --> 0:03:51.085 time Robert Junior finishes his apprenticeship, innoculation has been performed 0:03:51.085 --> 0:03:53.845 in England and the American colonies for at least thirty years, 0:03:54.165 --> 0:03:57.165 and in Turkey, India, and China for many decades more. 0:03:58.085 --> 0:04:01.125 But in the mid seventeen hundreds, innoculation is still a 0:04:01.205 --> 0:04:05.365 serious risk for each individual patient and for Robert Sutton Junior, 0:04:05.605 --> 0:04:08.605 the soon to be country surgeon, it's not gonna go well. 0:04:13.885 --> 0:04:16.725 Over the past fifty years, we've seen many new diseases 0:04:16.725 --> 0:04:21.925 emerge Ebola, hive swine flu zeka, to name just a few, 0:04:22.765 --> 0:04:28.485 but there haven't been any truly planet wide pandemics until now. Now, 0:04:28.485 --> 0:04:30.925 a virus first scene in China can be in Washington 0:04:31.045 --> 0:04:34.485 in a matter of days, and driven by this pandemic, 0:04:34.925 --> 0:04:38.365 one completely unprecedented in our lifetime, a virus that has 0:04:38.445 --> 0:04:41.525 killed our neighbors, our friends, our families. We have been 0:04:41.565 --> 0:04:44.845 witnesses to a massive international effort to create vaccines and 0:04:44.885 --> 0:04:49.205 get jabs in arms. On this episode of Long Shot, 0:04:49.365 --> 0:04:52.045 We're going to speak to a human guinea pig, one 0:04:52.045 --> 0:04:53.805 of the first people on earth to get a COVID 0:04:53.885 --> 0:04:57.245 nineteen vaccine, and we'll hear more about the predecessors to 0:04:57.245 --> 0:05:02.125 today's vaccine makers, the first big inoculation entrepreneurs who made 0:05:02.125 --> 0:05:05.965 a killing, preventing killing two hundred and fifty years ago. 0:05:07.885 --> 0:05:11.205 We know the ruined the pandemic has brought to lives, relationships, 0:05:11.205 --> 0:05:15.565 and economies on a global scale. Vaccines have instituted a 0:05:15.565 --> 0:05:19.245 real time revival for me and for millions. I want 0:05:19.285 --> 0:05:21.605 to know what went into these vaccines, not just the 0:05:21.645 --> 0:05:25.645 physical ingredients, but the historical ingredients. So I'm tracing the 0:05:25.645 --> 0:05:28.565 story of vaccines to their very beginning and bringing it 0:05:28.605 --> 0:05:32.165 back to today from my Heart Radio and School of Humans. 0:05:32.245 --> 0:05:34.925 I'm Sean Revived and this is long shot, a two 0:05:35.005 --> 0:05:37.605 hundred and fifty year journey to the COVID nineteen vaccines. 0:05:44.125 --> 0:05:47.565 I can't handle needles at all. So when I have 0:05:47.685 --> 0:05:49.765 to get, you know, just a tiny bit of blood 0:05:49.805 --> 0:05:52.565 taken for like, you know, a yearly physical or something, 0:05:52.965 --> 0:05:55.445 I am the person who you know, has to start 0:05:55.485 --> 0:05:58.205 working on my breathing as I wind up having to 0:05:58.245 --> 0:06:00.125 put my head between my knees. Then I have to 0:06:00.205 --> 0:06:04.045 lay down. It's twenty twenty one, so we're speaking over zoom, 0:06:04.085 --> 0:06:07.005 so of course it kind of sus Sorry, can you 0:06:07.165 --> 0:06:09.245 give me just one more minute? I'm sorry, my printer 0:06:09.365 --> 0:06:12.965 was just acting a little funny. No problem, I'm really 0:06:13.045 --> 0:06:16.285 nice to meet you. Can you say your name again? Yeah, 0:06:16.285 --> 0:06:24.925 it's Nicola Pascarelli. Exactly a year earlier, Nicola is led 0:06:24.925 --> 0:06:27.525 into a windowless room with cream walls at the Hope 0:06:27.525 --> 0:06:32.205 Clinic at Emory University in Atlanta. She sits on an 0:06:32.205 --> 0:06:35.765 exam table covered in that paper that crinkles with any movement. 0:06:37.765 --> 0:06:41.565 By this time, Nicola's nurse already knows how nervous she is. 0:06:42.085 --> 0:06:44.885 I get this fear of needles from my dad. He 0:06:44.925 --> 0:06:49.365 once went to a safety class for his work, and 0:06:49.405 --> 0:06:51.765 there was like some I think it was you know 0:06:51.805 --> 0:06:55.605 the importance of wearing safety goggles video and he wound 0:06:55.645 --> 0:06:57.845 up feeling white headed after watching the video, so he 0:06:57.885 --> 0:07:00.085 went off to the bathroom to like compose himself and 0:07:00.085 --> 0:07:02.565 wound up passing out, hitting his head on the toilet, 0:07:02.605 --> 0:07:06.045 and they found him in a pool of blood. That is, 0:07:06.125 --> 0:07:09.885 you know my family line that I come from. Next 0:07:09.885 --> 0:07:11.805 to the table is a wheeled cart that holds one 0:07:11.805 --> 0:07:14.005 of those rubber tubes so they tie around your arm 0:07:14.125 --> 0:07:17.925 to help find a vein, and eighteen glass vials ready 0:07:17.965 --> 0:07:21.645 to be filled with Niccola's blood. And I just kept 0:07:21.805 --> 0:07:24.045 counting and being like, eighteen, hold on, count again, it 0:07:24.085 --> 0:07:26.245 can't be eighteen. That's verty too many. Like I don't 0:07:26.245 --> 0:07:29.645 have eighteen vials of blood in me. That's what really 0:07:29.965 --> 0:07:32.205 Like that made me a moozy. Just every time I 0:07:32.205 --> 0:07:34.805 looked over at the table, I was like, oh gosh, 0:07:35.045 --> 0:07:37.005 she's about to be one of the first people in 0:07:37.045 --> 0:07:40.805 the world to get them maderna vaccine. Though it's believed 0:07:40.805 --> 0:07:43.925 the formula is safe, it's still a risky move for Nicola. 0:07:48.365 --> 0:07:50.445 This type of vaccine is made with a strand of 0:07:50.485 --> 0:07:54.845 messenger rabu nucleic acid or mRNA surrounded by a fatty 0:07:54.925 --> 0:07:59.165 lipid nanoparticle bubble. No vaccine of this kind has ever 0:07:59.245 --> 0:08:03.445 been approved by the FDA. Ever, it's brand spanking new, 0:08:04.165 --> 0:08:09.565 and it's about to be injected into her body. Throughout 0:08:09.565 --> 0:08:12.965 the history of vaccines, going back centuries, there have been 0:08:13.005 --> 0:08:16.605 test subjects, guinea pigs, the first people to get the 0:08:16.645 --> 0:08:20.845 first shots. Not all of them have been willing participants, 0:08:20.965 --> 0:08:24.805 like Nicola, who knows exactly what she is getting into. 0:08:27.485 --> 0:08:29.645 Nicola has been chosen because she's young and has a 0:08:29.645 --> 0:08:34.205 clean medical history without any worrisome conditions. She is, as 0:08:34.205 --> 0:08:38.245 her nurse tells me, the healthiest of the healthy. She's 0:08:38.245 --> 0:08:42.165 passed a detailed physical and filled out questionnaires about her health, medications, 0:08:42.165 --> 0:08:46.765 and lifestyle. She's had her temperature and blood pressure checked 0:08:46.845 --> 0:08:50.605 over and over again. She's been assured she can drop 0:08:50.645 --> 0:08:57.525 out of the trial at any time. Despite her needle 0:08:57.565 --> 0:09:00.845 phobia and in all but genetically inherited fear of seeing 0:09:00.925 --> 0:09:09.605 her own blood, She's volunteered for this. You've already started this. 0:09:09.885 --> 0:09:11.725 I'm gonna just ask you straight up, what was your 0:09:11.725 --> 0:09:17.165 motivation for joining the trial? Initially just fear and helplessness 0:09:17.205 --> 0:09:20.325 like I felt like I needed to to do something. 0:09:20.685 --> 0:09:23.445 Um I felt very small and all of a sudden, 0:09:23.485 --> 0:09:26.205 you know, just kind of, you know, I felt. This 0:09:26.245 --> 0:09:28.445 is March twenty twenty, a couple of weeks after the 0:09:28.565 --> 0:09:32.565 entire country has shut down practically overnight. Tom Hanks has 0:09:32.565 --> 0:09:35.965 announced he has COVID. The NBA has canceled all games 0:09:36.005 --> 0:09:39.365 indefinitely after a member of the Utah Jazz tested positive. 0:09:43.765 --> 0:09:47.085 Soon after that, schools are shutting down, offices are closing. 0:09:47.405 --> 0:09:51.205 Ppe is suddenly hard to find. Nobody knows how long 0:09:51.245 --> 0:09:54.725 this is gonna last. Things have just gotten really real 0:09:54.765 --> 0:09:59.725 in the US for everyone, including Nicola. You know, rushed 0:09:59.765 --> 0:10:03.285 to the grocery store like every single other person, and 0:10:03.845 --> 0:10:06.565 you know, the meat sections where empty, and that just 0:10:06.685 --> 0:10:09.325 kind of that was a little eerie to see. I've 0:10:09.365 --> 0:10:12.405 never been in a situation going to a grocery store 0:10:12.445 --> 0:10:15.965 that's always you know, completely stopped to realize, Wow, you know, 0:10:16.085 --> 0:10:19.085 I can't even buy ground beef. I can't buy even 0:10:19.125 --> 0:10:21.565 cuts of beef that I don't want. There's nothing here. 0:10:22.485 --> 0:10:25.445 You know, that was when it really started to sink in. 0:10:25.685 --> 0:10:27.925 But at that point I still thought, this is just 0:10:28.005 --> 0:10:31.245 two weeks. You know, we're being crazy for two weeks 0:10:31.245 --> 0:10:33.005 and then it's going to be over and everything's gonna 0:10:33.005 --> 0:10:35.765 be fine, And all of a sudden, I just felt 0:10:35.765 --> 0:10:39.285 like everything was closed off, and I didn't like that feeling. 0:10:39.645 --> 0:10:41.805 And so it's like, what can I do to get 0:10:41.845 --> 0:10:44.965 everything to return back to normal as soon as possible? 0:10:46.285 --> 0:10:48.125 What can I do? What can I do to make 0:10:48.165 --> 0:10:53.405 things better? Because I felt just so hopeless. NICOLEA here's 0:10:53.405 --> 0:10:55.645 about the phase one trial on Facebook from a friend 0:10:55.645 --> 0:11:03.165 who works at Emory and signs up. The first phase 0:11:03.205 --> 0:11:05.045 of a clinical drug trial is when the drug, in 0:11:05.045 --> 0:11:08.765 this case, a vaccine, is first given to humans, generally 0:11:08.805 --> 0:11:12.405 after lab studies and testing in animals. Nicola will be 0:11:12.445 --> 0:11:14.325 one of the first forty five or so people in 0:11:14.365 --> 0:11:17.485 the world to get a COVID vaccine. It's kind of 0:11:17.525 --> 0:11:19.325 shocking to think that while most of us in the 0:11:19.445 --> 0:11:22.205 US are just starting to feel the impacts of coronavirus 0:11:22.205 --> 0:11:25.605 on our lives, not only has a vaccine already been created, 0:11:25.725 --> 0:11:28.805 but a clinical trial is already underway. This is eight 0:11:28.845 --> 0:11:31.485 months before the FDA will approve any vaccine for the 0:11:31.525 --> 0:11:35.205 general public. At this time, many experts are still wondering 0:11:35.205 --> 0:11:37.885 if it's even possible to get an effective vaccine produced 0:11:37.885 --> 0:11:42.285 in a year's time, much less three months. For the 0:11:42.325 --> 0:11:45.525 Phase one trial, the researchers at Emery are mostly interested 0:11:45.565 --> 0:11:49.365 in dosage and safety. The vaccine has already been tested 0:11:49.405 --> 0:11:51.685 in mice, but this is the first time they're testing 0:11:51.685 --> 0:11:54.325 it in people. They want to know the amount to 0:11:54.325 --> 0:11:57.405 give an adult so that elicits a strong antibody response 0:11:57.645 --> 0:12:02.205 without causing overly harsh side effects. Nicola is one of 0:12:02.245 --> 0:12:06.125 the participants slated to get the highest dosage to fifty 0:12:06.165 --> 0:12:09.965 micrograms of vaccine. That's only two hundred and fifty millions 0:12:10.005 --> 0:12:12.365 of a gram, but it's ten times higher than the 0:12:12.405 --> 0:12:20.245 lowest dosage group. It's a lot of vaccine. I remember 0:12:20.445 --> 0:12:23.165 the day that I went in for the vaccine. At 0:12:23.205 --> 0:12:25.765 that point, I was all excited. I put on makeup 0:12:26.165 --> 0:12:28.765 and I had, you know, mascara and stuff on, and 0:12:28.805 --> 0:12:31.885 I had my face mask on. And in the time 0:12:31.965 --> 0:12:34.085 that I had to sit there and wait for the 0:12:34.165 --> 0:12:37.285 vaccine to be ready, because they have to defrost it 0:12:37.365 --> 0:12:40.485 and then mix it all up and get it all prepared, 0:12:40.925 --> 0:12:44.085 I got so progressively more nervous about the needle itself 0:12:44.405 --> 0:12:47.325 that I was sweating so badly that my mascara had 0:12:47.325 --> 0:12:49.125 gone all the way down my face. My mask was 0:12:49.165 --> 0:12:52.685 all black on top, my hair got frizzy. That was 0:12:52.765 --> 0:12:56.205 I remember just being so distinctly worried about I have 0:12:56.325 --> 0:12:59.605 volunteered for this trial and what if they give me 0:12:59.645 --> 0:13:01.765 the vaccine and I pass out, Like they're going to 0:13:01.885 --> 0:13:05.325 kick me out of this study. I think maybe I 0:13:05.565 --> 0:13:08.645 once had this like momentary, you know, Okay, I'm in 0:13:08.765 --> 0:13:12.125 phase one, like I am one of fifteen people getting 0:13:12.165 --> 0:13:15.685 the highest dosage that no one else in this country, 0:13:15.885 --> 0:13:18.645 in this world has ever gotten. And I think for 0:13:18.685 --> 0:13:21.805 a moment I thought, oh god, it might crazy, like 0:13:22.125 --> 0:13:24.365 could I die? And then I was like, no, it's fine. 0:13:24.525 --> 0:13:26.765 Modern medicine is great. Like, you know, I think I 0:13:26.805 --> 0:13:29.085 had that one moment and then I didn't let myself. 0:13:29.405 --> 0:13:32.205 I just remember thinking, do not pass out, Do not 0:13:32.245 --> 0:13:37.045 pass out. The Maderna Phase one trial is a big deal. 0:13:37.725 --> 0:13:40.405 The first humans are getting shots of a vaccine meant 0:13:40.405 --> 0:13:43.645 to protect them against the novel coronavirus. Though by this 0:13:43.685 --> 0:13:46.125 point there are more than a hundred coronavirus vaccines in 0:13:46.125 --> 0:13:50.845 the works, Madernos is the furthest along even with billions 0:13:50.845 --> 0:13:52.965 of dollars at stake in the race for a vaccine, 0:13:53.005 --> 0:13:55.205 it seems like a minor miracle to already be jabbing 0:13:55.205 --> 0:13:58.925 it in humans. Historically, vaccine development has taken years, if 0:13:58.965 --> 0:14:03.125 not decades, to get to phase one, and before clinical 0:14:03.125 --> 0:14:07.445 trials were even practice in any real signific sense, inoculation 0:14:07.565 --> 0:14:11.485 was more about improvisation. It was more art than science. 0:14:12.765 --> 0:14:22.805 That is until the Sutton family came along. It's seventeen 0:14:22.885 --> 0:14:26.925 fifty four in Suffolk, England, and a disease called smallpox 0:14:27.005 --> 0:14:29.445 is a recurring terror in the lives of the English 0:14:29.445 --> 0:14:33.285 and people around the world. It's been that way as 0:14:33.285 --> 0:14:36.925 long as anyone can remember. One hundred miles away in London, 0:14:37.445 --> 0:14:40.125 just about everyone gets smallpox at some point in their lives. 0:14:42.565 --> 0:14:46.045 A lot of people die, succumbing to the fevered delirium 0:14:46.085 --> 0:14:51.085 and hemorrhaging. It's an ugly and tortuous disease. The morepox 0:14:51.165 --> 0:14:54.685 you get, the worse off you are. Five hundred is 0:14:54.725 --> 0:14:59.405 considered a lucky break. Sometimes they number in a thousands, 0:14:59.405 --> 0:15:03.285 completely consuming the skin. Swelling can be so severe that 0:15:03.285 --> 0:15:08.725 patients can't see or swallow. An eighteenth century writer describes 0:15:08.845 --> 0:15:16.685 smallpox patients as creatures flayed. Still, most people who get 0:15:16.725 --> 0:15:21.365 smallpox live, though forever scarred, they're also protected for the 0:15:21.405 --> 0:15:25.045 rest of their lives. A bit like lightning. In one sense, 0:15:25.285 --> 0:15:30.365 smallpox does not strike the same person twice. Wealthy families 0:15:30.365 --> 0:15:34.445 seeking caretakers for their children examine the skin of potential employees. 0:15:35.325 --> 0:15:37.445 It's too risky to hire someone who has never had 0:15:37.485 --> 0:15:42.605 the pox. In a way, it's reverse discrimination. Show your scars, 0:15:43.285 --> 0:15:50.645 get the job. For hundreds of years, smallpox kills and 0:15:50.845 --> 0:15:54.765 kills and kills in England. When Elizabeth the First dies 0:15:54.805 --> 0:15:57.845 in sixteen oh three, the Stewarts take over the royal family. 0:15:58.845 --> 0:16:02.125 Over sixty years time, they lose three potential rulers to 0:16:02.165 --> 0:16:05.805 the pox. In sixteen ninety four, Queen Mary the Second 0:16:05.845 --> 0:16:08.765 dies of smallpox. The future of the Empire is altered 0:16:08.805 --> 0:16:12.325 over and over by the disease. Smallpox does not care 0:16:12.325 --> 0:16:14.405 how much gold you have. It is a part of 0:16:14.445 --> 0:16:18.365 life for all rich and poor, urban and rule. Every 0:16:18.365 --> 0:16:20.925 once in a while, a smallpox plague comes to town. 0:16:21.645 --> 0:16:26.885 It's the way it is. But around the time that 0:16:27.005 --> 0:16:30.845 Robert Sutton Senior is ten years old, inoculation comes to England, 0:16:31.645 --> 0:16:33.845 and by the time his own son, Robert Junior is 0:16:33.885 --> 0:16:36.725 ready to be a country surgeon himself. Inoculation is a 0:16:36.765 --> 0:16:40.805 somewhat normal, if still hotly debated, totally unregulated, and frankly 0:16:40.885 --> 0:16:45.765 wild practice. Inoculators travel around and making incisions in people's 0:16:45.845 --> 0:16:50.285 arms and rubbing in live smallpox virus pus really collected 0:16:50.285 --> 0:16:57.525 from the pox of infected patients. The idea is that 0:16:57.565 --> 0:16:59.365 if you infect a person with a small amount of 0:16:59.445 --> 0:17:03.045 smallpox on purpose, they will get a little sick, not 0:17:03.205 --> 0:17:07.485 very sick, not die covered in hideous pustules that scar 0:17:07.645 --> 0:17:11.245 them for life. They will not only recover, but be 0:17:11.285 --> 0:17:14.685 protected from further smallpox bouts and live unafraid of the disease. 0:17:16.365 --> 0:17:21.285 What's craziest of all is it usually works to protect 0:17:21.285 --> 0:17:24.325 yourself from a lot of virus, give yourself a little 0:17:24.365 --> 0:17:32.285 of it. That's inoculation. Robert Junior knows that he can't 0:17:32.285 --> 0:17:34.925 be a country surgeon without being protected from a smallpox. 0:17:35.245 --> 0:17:37.725 He will eventually come into contact with an infected patient, 0:17:38.725 --> 0:17:41.325 but innoculation is not the Sutton's business, so they hire 0:17:41.325 --> 0:17:45.165 a neighbor and innoculator. Robert Junior's arm is cut open 0:17:45.165 --> 0:17:47.245 and a bit of a smallpox matter rubbed into it, 0:17:48.045 --> 0:17:52.085 but the procedure goes wrong. Maybe the cut gets infected. 0:17:52.605 --> 0:17:55.445 Maybe the innoculator infects him with too much virus, giving 0:17:55.485 --> 0:17:59.645 Robert Junior a full blown smallpox. Robert Junior nearly dies. 0:18:00.525 --> 0:18:08.325 His father is devastated. Robert the elder witnesses the failure 0:18:08.325 --> 0:18:12.005 of his son's inoculation and sees opportunity. He knows that 0:18:12.085 --> 0:18:15.925 some innoculations work perfectly. The patient gets a mild sickness 0:18:16.085 --> 0:18:19.525 a few pustules near the wound, and recovers. But some 0:18:19.645 --> 0:18:22.845 go badly, as it did with Robert the Younger, and 0:18:22.965 --> 0:18:26.645 the patient gets very sick. Precisely what innoculation is supposed 0:18:26.645 --> 0:18:32.325 to prevent. Robert Senior thinks over the many inoculation methods. 0:18:32.845 --> 0:18:35.845 Deep cuts through the entire thickness of the skin, shallow 0:18:35.845 --> 0:18:39.085 cuts that barely draw blood, insertions of thread dipped in 0:18:39.125 --> 0:18:42.765 smallpox matter, rubbing of a scab from a smallpox infected patient. 0:18:44.405 --> 0:18:48.005 He settles on a minimalist approach, an older method that 0:18:48.085 --> 0:18:52.485 is somehow lost favor. He takes a small surgical knife, 0:18:53.005 --> 0:18:55.965 dips it in smallpox matter, holds it at a slight 0:18:56.005 --> 0:18:58.205 angle to the arm of his patient, and sticks it 0:18:58.285 --> 0:19:01.485 only a millimeter into the skin, just deep enough to 0:19:01.565 --> 0:19:04.405 draw the smallest amount of blood and get smallpox into 0:19:04.445 --> 0:19:14.725 the body. It works. Robert Sutton Junior turns his discovery 0:19:14.765 --> 0:19:18.885 into an enterprise. He opens it innoculation house and advertises 0:19:18.885 --> 0:19:23.805 his services in the local newspaper. Gentlemen and Ladies, he writes, 0:19:24.405 --> 0:19:28.645 will be prepared, innoculated, boarded, and nursed. Fish and wine 0:19:28.645 --> 0:19:31.765 are included for only seven guineas. Farmers get Tea and 0:19:31.885 --> 0:19:35.085 Mutton with their innoculation for five guineas. And for the 0:19:35.165 --> 0:19:38.605 benefit of the meaner sort, the poor folks, the price 0:19:38.725 --> 0:19:41.125 is just three guineas, including a month's boarding for the 0:19:41.165 --> 0:19:44.405 recovery period. If you can board yourself while recovering, it's 0:19:44.445 --> 0:19:46.645 just half a guinea. For the pleasure of the knife. 0:19:51.645 --> 0:19:55.325 Word travels fast. Six months later, Robert Senior opens a 0:19:55.365 --> 0:19:58.885 second inoculation house, and in another six months a third. 0:19:59.685 --> 0:20:02.805 Soon he's got agents in sixteen towns convincing folks to 0:20:02.805 --> 0:20:09.005 get inoculated. Robert Sutton Senior's other son, Daniel, is an 0:20:09.005 --> 0:20:12.205 even better business man than his dad. He cuts the 0:20:12.245 --> 0:20:16.165 time required for innoculation preparation, allows patients to spend time 0:20:16.205 --> 0:20:19.885 outdoors after the procedure, rather than his father's preferred method 0:20:19.925 --> 0:20:24.885 of indoor confinement, and he lowers the price. Then Daniel 0:20:24.965 --> 0:20:27.205 uses one of the most effective mediums of his day, 0:20:27.925 --> 0:20:31.285 the pulpit, and hires that fiery Reverend Holton from a 0:20:31.325 --> 0:20:36.445 local church to help market the great Satonian system, which 0:20:36.485 --> 0:20:39.365 brings us back to that passionate sermon in October seventeen 0:20:39.445 --> 0:20:45.245 sixty six, held in Daniel Sutton's private chapel. This sickness, 0:20:45.325 --> 0:20:50.165 as caused by inoculation, is not unto death, the ravages 0:20:50.285 --> 0:20:55.685 of the smallpox. It's spreading. Infection and fatality strike with terra. 0:20:56.765 --> 0:21:00.845 No one is secure for infection rides on the wings 0:21:00.925 --> 0:21:04.845 of the wind, and the air is incorporated with malignant vapor. 0:21:06.205 --> 0:21:10.725 The danger the fatality of the smallpox, when received by 0:21:10.845 --> 0:21:16.325 natural infection, clearly evinces the efficacy and safety of inoculation. 0:21:17.245 --> 0:21:26.565 What does inoculation mean more than self preservation? The fire 0:21:26.605 --> 0:21:30.485 and brimstone delivery works on the back of the preacher's words. 0:21:30.685 --> 0:21:34.965 The Suttons become the standard bearers for inoculation. They franchise 0:21:35.045 --> 0:21:38.605 the Setonian system. Anyone who pays one hundred pounds can 0:21:38.645 --> 0:21:42.725 inoculate under their name. Their services spread around England and 0:21:42.765 --> 0:21:47.565 as far as France. Canada and the American colonies. The 0:21:47.685 --> 0:21:52.205 method works. Very few of the thousands of people inoculated die, 0:21:52.645 --> 0:21:55.165 compared to the thirty percent of smallpox patients who end 0:21:55.205 --> 0:21:59.285 up in the grave. It's also so easy that anyone 0:21:59.365 --> 0:22:01.325 can do it. You don't need to be a doctor, 0:22:01.365 --> 0:22:03.925 even by the standards of doctors back in the eighteenth century. 0:22:04.645 --> 0:22:07.165 All you need is a night smallpox matter from an 0:22:07.205 --> 0:22:12.005 infective patient and an arm to jab it into The 0:22:12.045 --> 0:22:15.445 Suttons are not the first inoculators, far from it, but 0:22:15.525 --> 0:22:17.685 they may be the first to turn it into big business, 0:22:17.925 --> 0:22:26.685 to draw mass competition for arms to inject. The Setonian 0:22:26.765 --> 0:22:31.725 system of innoculation becomes so popular that copycats are inevitable inoculators, 0:22:31.765 --> 0:22:35.045 selling the Sutton name and method without sharing the profit. 0:22:36.085 --> 0:22:38.885 One of their rivals is a doctor named Thomas Dimsdale, 0:22:39.525 --> 0:22:42.885 who learns of the Setonian method of inoculation, sees that 0:22:42.925 --> 0:22:46.045 it works better than his own method, and embraces it himself, 0:22:46.605 --> 0:22:50.685 albeit without paying a fee to the Suttons. Dimmesdale is 0:22:50.685 --> 0:22:53.885 older than the upstart Daniel Sutton, his Uppercruss family, his 0:22:53.965 --> 0:22:57.285 own land in Essex. For centuries. He's got a reputation 0:22:57.325 --> 0:23:00.245 as an inoculator and physician. He even writes a book 0:23:00.285 --> 0:23:03.765 on his co opted innoculation method. The book spreads his 0:23:03.805 --> 0:23:07.125 reputation throughout Europe, lending him in the court of Russian 0:23:07.165 --> 0:23:11.565 Empress Catherine the Great. Dimmesdale earns fame and fortune on 0:23:11.605 --> 0:23:14.685 the back of the country bred Sutton family, whose contributions 0:23:14.685 --> 0:23:16.645 are all but forgotten. By the end of the century. 0:23:17.645 --> 0:23:19.725 He's named a baron of the Russian Empire and is 0:23:19.725 --> 0:23:23.045 spoken about all over London. The wealthy want to be 0:23:23.045 --> 0:23:26.525 inoculated using the Setonian method, but Dimmesdale offers the comfort 0:23:26.525 --> 0:23:30.245 of being a peer of his upper class patients. Two 0:23:30.325 --> 0:23:34.725 businesses selling the same life saving innoculation, Dimmesdale's and the Suttons, 0:23:35.565 --> 0:23:38.645 with many other innoculators on their tails, a battle to 0:23:38.725 --> 0:23:41.885 jab the most arms, make the most money, and protect 0:23:41.925 --> 0:23:49.365 the most lives. It sounds familiar. What inestimable advantages do 0:23:49.485 --> 0:23:54.325 the public reap from innoculation? Tis most certainly a happy discovery, 0:23:54.685 --> 0:23:58.205 a blessing of the most weighty concern to this kingdom, 0:23:58.365 --> 0:24:04.205 whose strength, happiness, and fecundity consist principally in the number 0:24:04.365 --> 0:24:09.165 of its inhabitants. The promoting of the practice of innoculation 0:24:09.445 --> 0:24:14.765 is therefore consistent with our best policy, and should be 0:24:14.925 --> 0:24:20.685 encouraged as much as possible. All all are saved by innoculation, 0:24:21.445 --> 0:24:25.445 but thousands, through neglect of it, are every year cut 0:24:25.565 --> 0:24:29.605 off in the prime of youth and manhood. Let any 0:24:29.645 --> 0:24:34.045 man seriously reflect what an immense loss this must naturally 0:24:34.085 --> 0:24:43.765 be to the nation. Despite the aristocratic competition, the Suttons 0:24:43.805 --> 0:24:48.805 become rich. In seventeen sixty five alone, Daniel Sutton inoculates 0:24:48.885 --> 0:24:51.965 more than four thousand people and earns the equivalent of 0:24:52.005 --> 0:24:55.725 more than a million dollars today. A couple of years later, 0:24:55.845 --> 0:24:59.485 the Suttons inoculate fifty five thousand people. They travel the 0:24:59.485 --> 0:25:05.365 English countryside inoculating entire towns. It was explosive. There were 0:25:05.525 --> 0:25:09.325 religious all over the country that adopted the Setonian system. 0:25:09.965 --> 0:25:15.685 By seventeen sixty seven he had fifty partners. Somebody in Virginia, 0:25:15.765 --> 0:25:19.045 there was somebody else in Canada. They were scattered all 0:25:19.045 --> 0:25:24.485 over the country and they advertised themselves as practicing the 0:25:24.525 --> 0:25:30.285 Setonian method. That's Arthur Boylston, an American pathologist. He went 0:25:30.325 --> 0:25:32.365 to Harvard Med School in the sixties and then came 0:25:32.405 --> 0:25:33.925 to the UK for what was supposed to be a 0:25:33.965 --> 0:25:37.405 three year grand period back in nineteen seventy two, and 0:25:37.525 --> 0:25:41.245 I married my boss's secretary and I'm still here. For 0:25:41.285 --> 0:25:43.925 a few decades, he was a professor in London and Leeds. 0:25:44.845 --> 0:25:47.605 Now he's mostly retired, though he's a senior teaching fellow 0:25:47.645 --> 0:25:50.685 in the Department of Pathology at Oxford University, and I'm 0:25:50.685 --> 0:25:54.285 a governor of the Oxford University Hospitals. The rest of 0:25:54.325 --> 0:26:00.485 the time, putter in the garden. You have become British. Okay, very, 0:26:01.045 --> 0:26:06.885 it's been a long time. Twenty five years ago, Arthur 0:26:06.925 --> 0:26:10.325 Boylston fell down in innoculation rabbit hole and he began 0:26:10.405 --> 0:26:14.085 scouring archives for records of the first inoculators, not just 0:26:14.125 --> 0:26:17.205 in North America, but also in England. Once I've discovered 0:26:17.445 --> 0:26:21.965 what inoculation was, I wanted to see how it had developed, 0:26:22.365 --> 0:26:26.285 because it's been almost completely forgotten even in the history 0:26:26.285 --> 0:26:29.405 of medicine. He ended up writing a book about innoculation 0:26:29.485 --> 0:26:33.845 called Defying Providence. Boyleston's research helped resurface the story of 0:26:33.845 --> 0:26:37.805 the Sutton's as innoculation pioneers, and he became convinced that 0:26:37.845 --> 0:26:40.245 in the story of vaccines and of the history of 0:26:40.285 --> 0:26:44.365 the United States. The innoculators have been overlooked. More I 0:26:44.485 --> 0:26:47.805 looked into anoculation, the more interesting. In God, it's the 0:26:47.845 --> 0:26:52.245 reason the United States exists, it's the reason Canada isn't 0:26:52.365 --> 0:26:55.245 part of the United States. We'll get into those claims 0:26:55.325 --> 0:26:59.405 in later episodes, and then ultimately the most interesting thing 0:26:59.445 --> 0:27:02.925 I think for most people is finding how Jenner really 0:27:03.005 --> 0:27:07.525 learned about Copas Boylston is talking about Edward Jenner, a 0:27:07.685 --> 0:27:10.765