Life before Vaccines: Growing up in the 1930s and 40s

Margot Smith, Dr.P.H.
Saturday August 31, 2019 - 11:05:00 AM

Medical science has profoundly changed our lives. I am sure that I would not have survived to this old age without antibiotics, advances in epidemiology and surgery.

I was a child in the 1930s. We lived in a flat across the street from my grammar school playground and I had friends in the neighborhood. It was a time when parents simply said “Go out and play” and we did. Our games were hopscotch, kick the can, jacks, tag, jump rope, handball and hide and seek. We cruised on roller skates and bikes, and built club houses out of boxes in vacant lots. We were supposed to come home at twilight, before dark. The milkman, bakery truck and iceman delivered to our doors. We felt safe in our neighborhoods.

But my parents were fearful of epidemics. At school In first through 8th grades, I had classmates who suffered from scarlet fever, mumps, measles, German measles, chicken pox and whooping cough. I had rubella and had to stay in bed for several days in a darkened room; they thought light bad for sick children’s eyes. Several of these diseases required the family to put a quarantine sign on their door; their children missed a lot of school.

As an adult, I knew survivors—men who could not father children because they had mumps as a child, a woman with a flail arm from polio, people with chicken pox scars, those deafened because of measles, a man who spent 3 years in a tuberculosis sanitarium and a woman whose child was retarded because she had German measles during her pregnancy. I have friends who had polio then who now have post-polio syndrome, that is, muscle weakness, fatigue, and pain, for which there is no known cure. They experienced their illnesses before vaccines and antibiotics. 

Understanding Disease 

In the 1930s germ theory was less than 100 years old. Although people from Biblical times knew that diseases were contagious, no one knew exactly how they were spread. In 1854 there was the famous moment when John Snow stopped an epidemic of water-borne cholera in London by removing certain water pump handles. In the 1860s, Louis Pasteur and Robert Koch found that diseases were caused by germs--this led to both a new world of medical exploration and to new fears as to how epidemics originated 

All had heard of Typhoid Mary, the infamous cook in 1900 New York who was a typhoid carrier and infected her employers. She was finally quarantined and incarcerated. The well-known author Helen Keller was blind and deaf because of fever as a child; she was taught to communicate through sign language and later speech by her teacher, Anne Sullivan. A movie, The Miracle Worker, was made in 1960 about her life. 

The First Vaccine 

People long knew that exposure to certain diseases made them immune; one could get certain illnesses only once. This was known about smallpox, which killed about 30% of those catching it and often left facial scars on survivors. In Asia, India and Turkey, it was known that inoculation with smallpox scabs could lead to a mild disease that made one immune. 

In the 1790s, Edward Jenner, a country physician in England noticed that the faces of milkmaids, the young women who milked cows, were rarely scarred with smallpox. He found that their exposure to cowpox, an infection of cows, protected them. This led to the development of cowpox vaccination as smallpox prevention—the word vaccine is derived from the Latin, Variolae vaccinae (smallpox of the cow), 

My childhood vaccination for smallpox left a scar on my upper arm, a rarity now. (Although there is an internet site which shows actresses with vaccination scars.) Now that smallpox has been eradicated, smallpox vaccinations are no longer required. The last U.S. wild smallpox case occurred in 1949 and, after extensive vaccination campaigns, the last case of smallpox in the world occurred in 1977. 

Vaccines for Common Childhood Diseases 

Polio: For my parents, polio was a major fear. In summer, public swimming pools were closed because of polio which thrived in summer months. The consequences of polio were serious: children lost the ability to walk, to breathe, to use a limb. Hospitals had wards full of patients living out their lives in iron lungs. 

Our president, Franklin Roosevelt, was a victim of polio. He found relief from his symptoms with trips to Warm Springs, Arkansas. In 1955, Jonas Salk developed the first polio vaccine. The oral polio vaccine was developed by Albert Sabin and came into commercial use in 1961 

In 1963, I could give my children an oral vaccine in a sugar cube and was grateful that I did not need to fear this dreadful disease. In 1965 there were only 61 cases in the U.S. By 1994, Polio was declared eliminated from the Americas. In 2002, it was eliminated from Europe Today, only Pakistan and Afghanistan continue to have polio cases. 

Diphtheria: In my childhood, I was not aware of anyone having diphtheria. However, my mother was from eastern Europe (Chernowitz, Ukraine), born in 1893 and the youngest of eleven children. She knew only 8 of her sibs as her parents lost 3 sons to diphtheria in one week, years before she was born. At that time, 40% of children who caught diphtheria died. 

Measles: Measles were another real danger for us children. In 1912, U.S. healthcare providers and laboratories were required to notify the health departments of measles cases. In the first ten years of reporting, there were about 6,000 measles-related deaths each year and 48,000 were hospitalized. Complications from measles were difficulty breathing, ear infections and loss of hearing, seizures, hepatitis, eye infections, and neural and heart complications and pneumonia may be fatal. 

Before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. I never caught measles and was glad to vaccinate my children. We feared measles, whooping cough, rubella, mumps and scarlet fever-- they might be fatal, or make us very ill and keep us out of school for weeks. Some parents arranged to expose their children to measles and chickenpox. These diseases were far more dangerous in adults. 

Preventing Childhood Diseases: 

The success of small pox vaccination and the identification of specific germs led to a search for vaccines for other diseases. In my lifetime, these vaccines now protect my children and grandchildren from devastating diseases: 

· 1923 diphtheria 

· 1924 tetanus 

· 1940 pertussis (whooping cough), 

· 1955 poliomyelitis (polio), 

· 1963 measles, 

· 1967 mumps 

· 1969 rubella (German measles) 

· 1994 hepatitis B 

1995 varicella (chickenpox) 

We no longer fear epidemics and deaths from these childhood dangers because vaccination prevents them and we have antibiotics to treat them. Because so many people are vaccinated, these diseases are no longer commonplace. Although not all children are vaccinated, these diseases are under control. Epidemiologists call this the herd effect--protection from infectious diseases that happen when most of a population is immune and protects those who are not immune. I for one am grateful that these deadly illnesses are no longer prevalent. . I look forward to further miracles in the future for my children and grandchildren.