Inoculation In Boston: A Disqualified Innovation In 1979, the World Health Organization announced the eradication of smallpox in the world. The use of vaccines has drastically improved people’s health around the world. Vaccination evolved from inoculation, an old medical practice dating back to China in the fifteenth century. Interestingly, although people in the past did not fully understand viruses, inoculation utilizes the same principle as vaccination by pre- exposing a healthy individual to small amounts of viruses to allow the body to naturally gain immunity to the viruses.
One may ask, if people in the past practiced inoculation, why did diseases, such as smallpox, still spread widely around the world and caused thousands of deaths? First, in his essay “The Inoculation Controversy in Boston: 1721-1722,” John B. Blake’s discusses how Bolyston, a physician, came to adopt inoculation and how people reacted to the adoption. Second, Everett M. Rogers’explains the three properties of innovation in his “Diffusion of Innovations:” compatibility, trialibility, and simplicity.
Even though people in modern society may perceive noculation as an innovation, people at that time did not recognize inoculation as an innovation because it lacked Roger’s three properties of innovation. Rogers argues that an innovation has to be compatible with society’s current values, people’s experience in the past, and their positive expectations of the innovation. People tend to adopt new ideas when it is compatible with their core values; therefore, if an idea does not match up with current values, it may slow down the adaption rate or even cause society to reject the new idea.
Humans depend heavily from their experiences in he past because their experiences shape how they think and act. For example, a positive experience may encourage a person to try again, while a negative experience discourages a person to continue. In addition, expectations for an innovation also influence how we adapt to it. For example, Microsoft introduced the first tablet pc in 2000, which is relatively unknown even until today. However, ten years later Apple introduced the iPad, which soon became one of the most popular tablets.
Although both products were similar, people reacted differently due to their expectations for the innovation. Inoculation lacked compatibility with the society’s values, people’s past experience, and their expectations of the innovation. First, most people were Puritans and were extremely religious. Blake reports, “Some maintained that it was a sin for a healthy person to bring the sickness upon himself, especially since he might otherwise escape it altogether, and that he should in submission to God’s will leave it to Him to determine whether or not he would suffer the disease.
Many of them believed that small pox represented God’s wrath and any attempt to prevent small pox is an act against God’s will. As result, society rejected small pox because it went against their core values. Second, not only were the common people not familiar with inoculation, but the doctors in town also refused to try inoculation on healthy individuals. Despite knowing how to perform the medical practice, doctors back then did not know the existence of viruses; therefore, they failed to see how infecting healthy people could allow them to gain immunity.
Third, people expected inoculation would increase the spreading of the disease rather than to heal it. Under the influence of both religious beliefs and lack of understanding iruses, people rejected inoculation as it was incompatible with them. Next, Rogers claims that innovation must include trialability for society to adopt it. People need to be able to test an innovation and compare it to other existing ideas. Rogers gave the example of lowa farmers adopting hybrid-seed corn. These farmers tried the new seed while still planting other normal ones, which allowed the farmers to see the difference between the seeds.
When society sees an improvement from an innovation, it tends to be more willing to adopt the innovation. Inoculation in Boston was not trialable and was merely tested by Boylston on his son and two slaves. Even though inoculation prevented the three subjects from getting smallpox, the people still rejected small pox. Blake wrote, “… within four days after Bylston’s first experiment it raised an horrid Clamou.. ” First, the test does not show a comparison between successful and failed inoculation; therefore, the people cannot estimate the risk of inoculation.
Second, if inoculation failed, the patient would be infected with smallpox. Since there is no cure to smallpox, the ailure of inoculation meant death of an originally healthy individual. In other words, Bolyston could not fully test inoculation on patients because if it fails, he could not repeat the experiment nor could he gain knowledge from the failure. Although we may argue that Boylston’s tests results proves the effectiveness of inoculation, the people rejected inoculation because it was not trialable. Last but not least, Rogers argues that people would only adopt an innovation if it is easy to operate and understand.
If a product is extremely simple to operate, people learn how to use n innovation quickly and adopt naturally. If a concept is simple, people will realize why it would be in their interest to utilize it. Rogers gave the example of villagers in Los Molinos, since they did not understand germ theory, health workers had a hard time explaining the importance of boiling water. However, boiling water is almost intuitive to many of us because we know the existence of germs and how they affect human health. In other words, if people can realize without effort how an innovation can benefit them, then they will adopt it right away.
The average person in Boston in the Eighteen Century probably did not know the existence of microorganisms. As a matter of fact, people did not discover viruses until Russian botanist, Dmitry Ivanovsk, theorize the existence of viruses in the early Ninteenth Century. One one hand, the average person in Boston did not know that viruses cause small pox. Their understanding of small pox is that it equates to God’s wrath; therefore, it is logical for them to reject inoculation. On the other hand, despite knowing the method of inoculation, doctors do not know why inoculation works.
Without knowing the existence of viruses and the cause of small pox, Boylston naturally cannot explain how inoculation can benefit people. Not only did both the people and Boylston not understand the cause of small pox, but they also didn’t know how inoculation works. The complexity of viruses and inoculation exceeds the knowledge of the people in Boston, and thus made it hard for both factions, for and against, to explain and understand. Inoculation was incompatible to people’s religious beliefs in Boston because they believed that God’s wrath against sinners came in the form as small pox.
Inoculation lacked trialibilty because Boylston did only a few tests which did not provide enough information for backup plans if inoculation failed. Inoculation was extremely complex because the people did not what viruses are nor did they understand how inoculation works. Even though people in modern society may perceive inoculation as an innovation due to it being the predecessor of vaccination, people at that time did not recognize inoculation as an innovation because it lacked Roger’s three properties of innovation: compatibility, trialibility, and simplicity.