VAIOLO e VACCINAZIONE. – Smallpox is an acute, contagious specific disease, characterized by high fever and an eruption of maculopapules that rapidly become vesicles and pustules; crusts then form, leaving scars of varying depth that persist throughout life.
Among the most ancient diseases, knowledge of it in China dating back approximately 1,000 years before the Christian era, for many centuries it spread enormously throughout the world; in Europe the first epidemic, which broke out in France and Italy, also dates from 570 A.D. The disease was fully identified around 1600 and was always greatly feared because of its severe course and the indelible disfigurements it left even in cases of recovery. The severity of smallpox depends on the epidemic constitution and the course with which it manifests itself; indeed, alongside hemorrhagic and fulminant forms with extremely high mortality, there are barely developed forms or epidemics of varioloid that may be considered benign with regard to life.
The present disappearance of smallpox epidemics in civilized countries, particularly in Europe, must be attributed to improved hygienic and prophylactic measures and to the extension of smallpox vaccination. This was the first experience in contagious diseases aimed at inducing immunity against the disease in individuals, and it is due to the English physician Jenner who, after 23 years of study, having established with certainty that local infection with cowpox, although developing without severity, immunizes human beings against human smallpox, inoculated his own son for the first time, in 1789, with lymph from pustules of the pig, thus making him immune to subsequent (1791–92) inoculations of smallpox; on 14 May 1796 he inoculated a child with pus from cowpox (cow-pox) that had developed on the hands of a milkmaid; two months later the child proved to be vaccinated and resistant to inoculation with human smallpox. The vaccination thus invented spread, displacing all the methods previously used, such as “variolization” (inoculation with lymph from the smallpox pustules of individuals suffering from mild forms), the introduction of smallpox scabs into the nostrils, or even the practice of wearing the clothes of smallpox sufferers.
(phot. Alinari)
of them compulsory vaccination has been imposed by law on large sections of the population, thus raising problems of a social and medical-moral nature. For example, in Italy there are compulsory vaccinations in early childhood, at the beginning of school age, or on the occasion of military service; international prophylaxis regulations require vaccination against certain diseases for individuals traveling from one nation to another; certain professions require compulsory preventive vaccinations.
From the medical-moral point of view, one may discuss the State’s right to curtail an individual’s freedom by compelling him to undergo vaccination, and his duty to submit to it or to offer himself for it voluntarily. Some congresses of Catholic physicians have also recently discussed these problems. One may speak of a moral obligation whenever the issue is avoiding the danger of a serious disease threatening the individual himself or society, provided that, according to current medical understanding, there are serious probabilities of beneficial effect and of the absence of serious harm to the individual. This accords with the precept of morality that the individual is obliged to sacrifice part of his own good for that of the community, provided that the danger does not involve his own life or serious impairment of his essential functions.