Killing the Speckled Monster: How We Eradicated Smallpox

24:04So there's stories about kids with lesions on their arms getting sent across the sea to like move that vaccine from person to person to like bring the vaccine to America because it was easier to do that than to do it with a cow. Children are smaller than cows. That's true. It's easier to ship them, I found. Yeah. It's a smaller box required. Right. Some of them cooperate better than cows, too. Not all of them. But at least they're smaller. So, you know, you can push them around. But sometimes they would also transmit tuberculosis and not necessarily for the children. But if you were doing this with adults, sometimes you'd transmit syphilis from person to person.

24:40So also not a perfect method. All right. So we moved past just suffering through smallpox and past variolation to minimize the impact into early forms of vaccination. Let's take a break. And when we come back, we'll hear more about the modern approaches to vaccination and the role played by D.A. Henderson in keeping Kelly up at night.

25:09Ready, set, summer with the Honda Summer Event. Make every mile count in an Accord or Accord Hybrid with a standard turbocharged engine or available hybrid powertrain. Honda has all you need to get summer ready with the most fuel-efficient full-line automaker in America. For a limited time, well-qualified buyers can get a 3.99 % APR on a 2026 Accord Hybrid. For more details, visit your Chicagoland Northwest Indiana Honda dealer today. See dealer for financing details. Based on EPA estimate of 2024 large full-line automaker fleet-wide fuel economy. EPA Automotive Trends Report 2025. If your bookshelf and your For You page are equally important to your personality, welcome home.

25:45This is Prose Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives, and anyone who thinks Pride and Prejudice and Love Island deserve the same level of discourse. I'm Eli Rallo, and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. So obsessed. From bestselling authors and your favorite book talk creators to the latest pop culture moments, Nothing is off the table. It's like if you can hide some real messages inside compelling characters, then that is a Trojan horse.

26:22Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro Society on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. See you between the pages. On the new podcast, Solita, We share the messy reality of traveling alone as a woman. I can wait four hours for the next bus or this random dude is offering me a ride on his motorcycle. I chose option B. I'm Julie Pinheiro and I travel by myself because it's a rare space where I can say yes without asking anyone else first.

27:00I'm on a mission to reclaim the word solita, trading the pity for possibility. Every time I tried to be alone, I kept meeting people and they were like, you smiled at us. Not a lot of people smile around here. It's when you're alone that you're most receptive to the world as it is and not the lies you're sold about it. It can be a time where you push your limits, change your mind or wake up to a new version of yourself. So whether you're a solo travel veteran or you're too nervous to book your first trip, I hope you listen to Solita on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

27:56Everyone has a good time and no one gets mad at their publicist for letting them do our show. We've had a lot of great guests like Sarah Sherman. Not that great. Actually, can you help me shape this? How about we flip it on his head? How about we flip the script? What if the surprise woman, who actually you think is the straight man, is actually the one who's acting weird? Adam Scott. This entire time, you've been expecting Adam Sandler to come to visit the show. I would never expect. Let go of that. I have. I would never set expectations for something like that to happen. It seems like you did.

28:33If the universe allows for something like that to happen, I'm open to it. I'm always going to accept. You know, Danny McBride, fine. Yeah. It's all this fragile masculinity exuding. I could smell it walking down the hallway, to be honest with you. I was like, is that weed? Nope. It's fragile masculinity. Ben Stiller, no. Because a lot of times, out of context, people don't get it or even know what a circle is. You know what I mean? They're so stupid. Everyone's so dumb except for you. And fake. Right, fake and also not interested or just like, oh, I've got my life. I don't care about your life.

29:12And a lot of other big shots that wouldn't be where they are without us. Oh, and by the way, Will Ferrell told us personally he loves the show and he wants to be a guest on every episode, but he's just so busy. Listen to Hollywood Handbook on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

29:38Alright, we're back and we're hearing about humanity's struggle and victory against smallpox. The macroscopic beings finally winning out over the microscopic. It's amazing that we can eradicate smallpox, but not rats, right? Rats just seem like they're going to be here forever. Yeah. No, they absolutely are. I would not set your hopes high for eradicating rats. There's a lot of kinds of rats. It's complicated. Yeah. Yeah. And I like rats anyway. So I'm not saying we should. I'm just saying it's amazing how we can actually squash out an entire form of life because we decided it's too dangerous.

30:12Yeah. So, I mean, we were successful at squashing smallpox, but we've tried. I mean, the amount of money that has gone into trying to squash malaria has been intense, but we have not succeeded. And we were trying at the same time to eradicate malaria as we were trying to eradicate smallpox. But one of the quote unquote nice things about smallpox is that it just infects people. And so that makes it a little bit easier to eradicate. And we were able to create a vaccine that was effective, whereas attempts to eradicate malaria using vaccines haven't been as successful. And I'm queuing up an episode with an expert on why it's so hard to make vaccines for parasites.

30:50But we got lucky that smallpox was easy to control with the vaccine and only impacted people. So we didn't have to also control something like mosquitoes. All right. So then tell us about how we started to make more rapid progress against smallpox. Yeah, so this method of using cows to help vaccinate people and then vaccinating arm to arm was difficult and laborious and it was hard to do mass vaccination. But then we figured out ways to dry the vaccine and then rehydrate it so that you could essentially have a farm with loads of cows. You could collect a bunch of pus, you could dry it out, and then it would be stable for longer periods of time.

31:29And then you could rehydrate it wherever you decided that you needed it. But we're still using essentially cow pus as a vaccine for smallpox. That's right. Yeah. And you said that started in the late 1700s. How long did that go on for? Till we eradicated smallpox. As much as possible, we were using cowpox to vaccinate people instead of smallpox because it was just safer. So early part of last century, early 1900s, we're still using cow pus to fight smallpox. So when I was reading about this in the 1950s, they were talking about how they learned how to freeze dry the viruses for the vaccine. And they were still using cows and they thought it was cowpox that they were using.

32:08But then when they genotyped it later on, it looked like they were using vaccinia, which is another closely related virus. And so maybe that virus got into cows. But we were using stuff collected from cows is the point because it was just less likely to kill people. But it was still a problem for immunocompromised people. There were still some people who had very bad reactions and some who passed away from using this vaccine. So we started out not knowing at all how it worked. And then we developed germ theory while we were still doing this. And then we kept using it even after we had a deeper understanding of like the microbiology of what's going on here.

32:45That's fascinating. Yeah. I mean, we kept using it, but we got better. And, you know, we ended up with better techniques. And at some point, like during the world wars, we had created essentially this like vaccine gun where somebody would come by and it was like hydraulically operated and it would like inject the vaccine and then you could get the next person in. And now you could do a thousand people in an hour. And that really sped things up. But the method that ended up being used to eradicate smallpox was much easier. So they created this cheap, very short needle that was bifurcated. So it's like a fork with only two tines.

33:17And what you do is you would stick it into vaccine that had been freeze dried and then rehydrated. And surface tension would hold the water with the virus particles between the tines. Like a fork. We're talking like a fork, basically. Like a fork, yeah. And then they'd stab you in the arm a bunch of times. And it didn't hurt that much because it didn't need to like go too far in. But they would like get it under your skin by doing that over and over and over again. But they could do it really fast. And then when they were done, they'd put it in another container. And at night they would sterilize those containers and you could use the needles over and over and over again.

33:50And they were cheap. They didn't require a lot of training. You could literally train someone by giving them an orange and being like, practice stabbing this orange. And then they'd be good. So then when you're sitting down to get stabbed and you ask your nurse, have you done this before? She says, oh, I vaccinated lots of oranges, mangoes, apples. I'm super experienced. Yeah. That's right. Any fruit you can think of, I have stabbed. Thank you to all the oranges who suffered so that humans could survive, really. That's right. Taking it for the team. Yeah. So this is really a step forward, not in terms of like virology or microbiology, but in engineering, right?

34:27This is just like, how do we get this vaccine rapidly to a lot of people? I mean, yes and no. So like that jet injector we were talking about, that was an amazing step forward at the time, but it still broke a lot. And you needed to bring replacement equipment with you. And when you're going to really remote places, if you ran out of replacement equipment, you'd be in a lot of trouble. Whereas these bifurcated needles, this was a very simple solution. It was about$5 for a thousand of them. They could be reused a hundred times. You could sterilize them in boiling water. It becomes much easier. And so sometimes it's not about like the most complicated engineering solution.

34:59It's just finding the thing that is cheap and efficient. And in this case, it was a bifurcated needle. But I think that is the best engineering solution, right? Not like over-engineered, but just like how can we use our manufacturing process and deal with the reality situation to solve this problem efficiently, effectively, and cheaply. I think that's great engineering. Yeah. Yeah. Amazing. And they even like would shorten the needle to get the cost down so that they could, you know, use less metal for each one. Okay. So that is how we made and delivered the vaccine that eventually eradicated smallpox.

35:31And so we're still, again, using the cow sourced one, right? Yeah. That's surprising me. I thought this whole story was going to be like, and then we figured out how to actually build a vaccine against smallpox by like crippling it or one of the typical vaccination strategies. But you're saying we used one disease against another the whole time. Yeah, it's incredible. It's amazing. Wow. That is amazing. Yeah. All right. So tell us about the campaign to eradicate smallpox. Amazingly, it kind of starts with the Soviet Union. So during the Cold War, the Soviet Union kind of like backed away from the international community.

36:02And after Stalin died, thank goodness Stalin died, wish he had died sooner, but he didn't. So anyway. Speaking ill of the dead. Is that what you're doing? He genocided like millions of people. Yes, I am. So anyway, in 1959, the Soviet Union is like stepping back into the World Health Assembly and trying to get involved in the international community again. And they propose, hey, let's eradicate smallpox and we will volunteer to donate freeze dried doses of vaccines, literally millions of them. And this is their way of kind of like getting good with the international community. And the international community, I think the idea at the time was, you know, we probably can't actually eradicate smallpox.

36:46There have been some efforts to eradicate other diseases that had kind of fallen flat on their face. People weren't super optimistic this was going to work. But they were sort of humoring the Soviets because they were happy that they were back. And so while this proposal was accepted, not a lot of momentum happened. Not a lot of people were dedicated to the project. There wasn't a lot of money dedicated, but it was clear the Soviets were on board. So around the mid 1960s, USAID, which I'll note, we tanked. Got doged. Yes, right. So USAID got doged. Doesn't exist anymore, which I think is devastating.

37:22But anyway, so they teamed up with the Center for Disease Control or the CDC in the U.S. And they started trying to eliminate smallpox and measles from 20 countries in West Africa. So they were starting to get the ball rolling and momentum is starting to build. And the World Health Organization, with the U.S.'s input, passes this proposal that, OK, we're going to take eradicating smallpox seriously. And there was a bit of contention here. So there was enough members of the community thinking that this was actually impossible, that when it kind of got pushed by the U.S., D.A. Henderson got put in charge almost as punishment.

37:58So the guy in charge of the World Health Organization thought this was going to fail. And because the Americans had pushed it, he wanted an American leading it so that when it failed, the blame would fall on the Americans. Wow. The politics. The politics. So but tell us, who is D.A. Henderson? Now he's appeared in our story. But what's he been doing this whole time? Yeah. So he's been studying public health. He was working at the CDC on that project where they were trying to eradicate smallpox and measles. And it turns out he's just really great at organizing stuff. He's a really great administrator.

38:34And he is really good at like cutting through the bullshit. And just getting stuff done. And he sort of gets a really good reputation for being a person who makes things happen. And it's fascinating that this is basically the obstacle, right? Like at this point, we have the technology. We even have the engineering to manufacture these things. So they're simple and cheap and robust. It's just a question of like getting all these things to all the arms in the world, right? It's really just a paperwork and organization. Yeah, it's paperwork and organization, but it's also like the cleverness to think through the right system.

39:08So initially the thought was, you know what, if we can vaccinate 80 % of the people in the countries where you're still getting smallpox, we'll get what's called herd immunity. And the idea is that there's enough people who are resistant to the disease that it will run out of people it can infect and it'll fizzle out. But it turned out 80 percent just wasn't high enough. There were still there were enough people being born, especially in places like India, where population density is really high, that this herd immunity at 80 percent wasn't doing the trick. Walk me through the thinking here. So even if you have 20 percent of the population that still is susceptible to smallpox, they're like surrounded by a buffer of people who are immune.

39:48and so the disease just like fizzles out because it can't jump into another host. How do you calculate that 80 % number? Doesn't it depend on like density and interactions and all sorts of stuff? Everything you said is correct. Yeah, they started off thinking 80 % was going to be enough. And then when they actually started observing things out there, they would hit 80 % and the disease still had plenty of people to infect. Plenty of new babies being born and it could still, it's so contagious that that 20 % that were left were enough to keep that disease going. Because if I had to calculate this, like 80 % seems like, I don't know, it's a reasonable figure, but if I had to estimate it, I would have guessed like 99 point something.

40:28Yeah. Because it is an infectious disease, right? And it came from one origin, right? So in principle, one person with it still out there could infect new people. Absolutely. And so that ended up being the reality on the ground was that 80 % was not enough. And there was some discussion about, well, maybe if we kick it up to 90%. And so, you know, part of it, I think, is, well, what number do we think mathematically will work? And then another part of it is, well, what realistically could we accomplish? And another problem they were experiencing was like, so, you know, the Soviets were donating a lot of vaccine, but a lot of the vaccine they were donating was low quality and wasn't working.

41:04And so that was also causing them some problems. And what they ended up deciding was that, like, look, for this disease in particular, hitting some percentage is not going to work. Yeah. So what they did was they'd vaccinate as many people as they could and then they would do contact tracing. So essentially they would wait to hear if someone got infected. And when they got the message that there was an infected person in some city, some village, some herding community, they would go out there. They would lock down that person. They would figure out everybody that person had interacted with. And then who those people would kill them and they would kill them.

41:39No, no. No, they would send them to a farm where they can run and jump all day long. No, no. It was much nicer than they would offer them free vaccines. Oh, OK. Yes. But they've already been infected, right? Well, maybe yes, maybe no. And so, you know, just because you have encountered somebody doesn't necessarily mean you got infected. And then also to try to make sure, like, if those people did get infected, you want to make sure that they don't pass it to other people. And so you not only vaccinate the first group of people who you think contacted the initial infected person you know of, you also vaccinate all of the contacts of those people.

42:15And in this way, you make the most use of your vaccine and you like take the oxygen out of the fire that could have started there. Right. So you're pouring water on all the embers just to make sure they don't spread uncontrolled. Yes, exactly. And one of the things that we kind of lucked out with is, you know, like with a disease like syphilis, there's also a sort of moral judgment that gets passed on the person who gets infected. Smallpox didn't have that kind of moral judgment. And so people were more likely to come forward if they had a case. They would be less likely to hide it. And in some cases and in some countries to try to really encourage people to come forward or to encourage people to rat out other people, we would offer monetary rewards.

42:55Listen to you using the word rat in a negative way. Oh, man. I mean, language, this is where it comes from, Kelly. You're right. You're propagating anti-rat bigotry. Thank you so much for pointing that out. I will work on doing a better job. You need to be a rat ally. I mean, really. I think of myself as a rat ally, as long as they're not in my chicken coop. I didn't like them there. Anyway, but this is a good point where we need to know where the outbreaks are. And we can only know that if people report. So it's important that people are not embarrassed. Yeah. Yeah, that's right. It's important that people aren't embarrassed.

43:28And the other thing that I think is important to learn here is they learned over the course of the work that they were doing and they adjusted the way that they were working, you know? So when you're doing science, so often you start off with one plan. And then when the rubber hits the road, you need to be like, this isn't working. Right. What can we do that's better? Yeah. And so they adjusted. And man, this is an amazing story of people adjusting to so many different conditions. For example? For example. So when the World Health Organization decided that they were going to really try to eradicate this disease, it was still pretty common in about 31 different countries.

44:04And there were a lot of complicated things happening in those countries. So, for example, they had wiped out smallpox in Bangladesh. And then partition happened. And the war broke out between Pakistan and Bangladesh. And when that happened, Bangladeshis crossed the border into India en masse where they picked up smallpox again in refugee camps. And then India went in and kicked out the Pakistanis and the Bangladeshis went back home and they brought smallpox with them. Oh, boy. So the World Health Organization was in there and they were trying to keep people from getting smallpox and trying to contain it as it moved back into a country.

44:42but there were a number of different cases where civil wars or wars of one sort or another would break out. And there were people who were trying to eradicate smallpox who would sort of die through this process, but they were, you know, doing the best they could to figure out, like, how do you vaccinate people when you have all of these refugees moving from one place to another and how do you track things? But amazingly, they did it. And then there were a couple cases where, you know, we talked about how there's not really a stigma around smallpox. There was a stigma around being a nation that still had smallpox in an era where it was being eradicated.

45:15So there was a setback. In 1971, Iran got a case of smallpox, but they didn't want anybody to know because they wanted to commemorate the 2 ,500th anniversary of the Persian Empire. So the Iranian government wanted to have this big celebration, but you don't want people from all over the world descending on your country if you have smallpox. Yeah. And so they were trying to eradicate it with a mass vaccine campaign sort of kept on the down low. But their stocks were of poor quality and it wasn't working. So the World Health Organization eventually got involved. They brought their better freeze dried vaccine and they managed to wipe it out.

45:54But there were all of these cases of like things came up. And, you know, I can just imagine that if I was at the World Health Organization and smallpox broke out and it was because some country's rulers were like trying to make sure I didn't find out about it. Man, at some point you got to be like, how are we ever going to do this? Like, this is never going to happen. I quit. But D.A. Henderson never quit. He just kept going. And it's amazing. And what was he like as a bureaucrat? Was he like a rule follower? Was he like a tyrant? He was not a rule follower. If you read the book that he wrote about eradicating smallpox, it is mostly a story about how he was told to do one thing and he did another.

46:33And that's how you get stuff done, folks. Well, that's how he got this done. And, you know, each different nations would have different bureaucracies that you had to understand or route around. So, for example, there were instances where he had to send mail through an intermediary and he wouldn't get a response back on a timescale that was useful for trying to attack an outbreak. And so even though he was supposed to send the mail through an intermediary, he started sending the mail to the intermediary at the same time as he sent it directly to the other person. And he knew he wasn't supposed to do that.

47:06But there were all sorts of cases where he was like, look, if I don't break this rule, we are not eradicating smallpox. So I'm doing it. And so, yeah, he was he was a bit of a character. Well, sometimes you got to break a few constitutional eggs to make the omelet. Right. And so let's take a break. And when we come back, we'll hear about the last gasps of smallpox eradicating it finally and freeing humans from that suffering.

47:58We'll be right back. Plus, check out our weekly flyer on Menards.com for all the great deals happening now. Save big money at Menards. If your bookshelf and your For You page are equally important to your personality, welcome home. This is Prose Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives, and anyone who thinks Pride and Prejudice and Love Island deserve the same level of discourse. I'm Eli Rallo, and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story.

48:37I'm obsessed. So obsessed. From best-selling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters, then that is a Trojan horse. Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro Society on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. See you between the pages. On the new podcast, Solita, we share the messy reality of traveling alone as a woman.

49:16I can wait four hours for the next bus or this random dude is offering me a ride on his motorcycle. I chose option B. I'm Julie Pinheiro, and I travel by myself because it's a rare space where I can say yes without asking anyone else first. I'm on a mission to reclaim the word solita, trading the pity for possibility. Every time I tried to be alone, I kept meeting people and they were like, you smiled at us. Not a lot of people smile around here. It's when you're alone that you're most receptive to the world as it is and not the lies you're sold about it. It can be a time where you push your limits, change your mind, or wake up to a new version of yourself.

49:57So whether you're a solo travel veteran or you're too nervous to book your first trip, I hope you listen to Solita on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, this is Hayes Davenport. And Sean Clements. We host the podcast Hollywood Handbook on the Big Money Players Network. Our show is extremely accessible to first-time listeners. Each week, we talk to someone in show business, a.k.a. the biz, and try to help them with their careers and see what they have to offer us. Everyone has a good time, and no one gets mad at their publicist for letting them do our show.

50:31We've had a lot of great guests like Sarah Sherman. Not that great. Actually, can you help me shape this? How about we flip it on his head? How about we flip the script? What if the surprise woman, who actually you think is the straight man, is actually the one who's acting weird? Adam Scott. This entire time, you've been expecting Adam Sandler to come to visit the show. I would never expect. Let go of that. I would never set expectations for something like that to happen. It seems like you did. If the universe allows for something like that to happen, I'm open to it. I'm always going to accept.

51:10You know, Danny McBride, fine. Yeah. It's all this fragile masculinity exuding. I could smell it walking down the hallway, to be honest with you. Mm-hmm. I was like, is that weed? Nope. It's fragile masculinity. Mm-hmm. Ben Stiller, no. Because a lot of times, out of context, people don't get it or even know what a circle is. You know what I mean? They're like, oh, it's a state. Everyone's so dumb except for you. And fake. Right, fake and also not interested or just like, oh, I've got my life. I don't care about your life. And a lot of other big shots that wouldn't be where they are without us.

51:46Oh, and by the way, Will Ferrell told us personally he loves the show and he wants to be a guest on every episode, but he's just so busy. Listen to Hollywood Handbook on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

52:09Alright, we're back and we're hearing about the story of smallpox, humanity's victory over the microbe. So we're near the end of this. Tell us, what were the last battles in eradicating smallpox? So towards the end, India still had about 60 percent of the remaining cases. There's a lot of people in India that density and the fact that this country is huge made it really hard to eradicate. And as we mentioned, there was that conflict happening with Pakistan and Bangladesh. There were people crossing borders. It was getting really hard to get this stuff under control. Additionally, there was an issue because there was a small community who had a religious leader that was refusing the vaccine and was refusing the vaccine for the rest of the community as well.

52:50So we talked earlier about like, you know, what what do you do in this case? Like, so at this point, almost all the countries in the world had smallpox eliminated. They were closing in on being able to eradicate this disease, which has killed millions of people, millions of people in our history. For thousands of years. For thousands of years. And so the question is, do you respect this religious leader's desire to not get the vaccine when it has been documented that smallpox cases are popping up in this community and are then spreading to surrounding regions? And so this is not something that will burn out on its own.

53:24This has been causing problems that are spreading. And what they end up deciding they need to do is they essentially pin the religious leader down and vaccinate him. Wow. Against his will. And once he's vaccinated, he says something to the effect of, all right, well, I guess that was God's will. Everybody else should get vaccinated, too. That's a good but classy way to handle it. Yeah, I guess. And so but yeah, so there were some very difficult ethical questions. I think in general, what they would try to do is they would in every country where they started a program for eradication, they would try to find local medical people and get them on board and have talked to them about how the vaccine worked and help them talk to the community so that people could have their questions answered.

54:10And this could be done in the most like ethical, not like pushy way possible. But at the end there, I don't think there were a lot of cases where people were pinned down and vaccinated. But at the end there, they were like, look, we are closing all the loops. Yeah. Well, it's a fascinating question and a real puzzle for policymakers, right, how to deal with these things. And there are arguments for it on both sides, right? It's clearly a balance between public good and individual freedom, right? And it's not clear where to draw that line. And it's different in every case. And I'm not a philosopher or an ethicist.

54:43You know, imagine somebody is like walking around shooting guns out in random directions in public areas. You'd be like, yeah, that's not allowed. That's clearly over the line. You could make the argument that, you know, walking around spreading a disease is similar to that. And so I'm not making that argument. I don't want to be authoritarian about lockdowns, whatever. I know this is a really touchy subject. Yeah. But I just want to highlight that there's never an easy answer here for public health officials. You know, so many times during COVID, I would hear people complaining about how things were being managed.

55:12And my response every time was, I am so glad I'm not in charge right now. Me too. I would hate to make these decisions because, you know, lives are on the line. Every decision that you make has a downside no matter what you do. And even if you do nothing, then you're sort of still on the hook for a bunch of deaths. And the scientific understanding is evolving, right? Like we don't understand how does this spread? What works? What doesn't work? And as we were saying earlier, you need clear policies, right? You can't always convey like, hey, everybody go read these papers. Let's discuss. You know, somebody's got to make a decision.

55:44Like, do we close schools or not? Those are hard decisions to make. And science informs them. But in the end, it's a political decision, right? How do you balance this versus that? This risk versus that risk? Science doesn't make the decisions. It just informs them. And sometimes science is wrong, right? It's never fully settled. And it's always in flux. So, wow, it's hard to be a public health official. Oh, my gosh. Yeah, so hard. And it's so important that we are spending this time when there isn't a major pandemic killing a bunch of people, that we try to spend that time helping the public to understand science and trying to build trust that we then get to benefit from when something like that happens.

56:24But anyway. So tell us about the victory, right? So people worked in India. They pinned down this religious leader to stamp out those last embers. Was that the end of smallpox? I believe the last case in 1975 was a homeless person on a railway platform that they found and they treated and quarantined and it didn't get passed. And then Ethiopia was the last country to have smallpox. That was a little complicated because there were a lot of nomadic herders. So it was hard to get in touch with each herd to make sure there hadn't been any cases of smallpox. So we had a period where no smallpox cases were reported.

57:00We thought we had eradicated it. We waited for an additional two years where people were hired to like go around the world looking for cases and like go into communities trying to find it. And after two years of looking hard for smallpox and not finding it, we declared in 1980 that smallpox had been eradicated. Amazing. Yay. But this wouldn't be an episode run by Kelly if there wasn't something scary at the end. So one of the difficult things about smallpox is that it looks like chickenpox and monkeypox. And so when you're trying to figure out if you've eradicated it or not, if a pox case pops up, you want to send a sample of that virus to a lab to confirm, hey, this is definitely chickenpox, not, for example, smallpox popping back up again.

57:49And so during this eradication procedure, it was regularly the case that samples of the pox were sent to labs in the Soviet Union and the United States. And they split the caseload because it was a lot of work verifying what virus was which. But at the end of this process, a lab in the United States and a lab in the Soviet Union had lots of different virus samples in their freezers. Oh, I see. So at the end of this process, the virus had been eradicated in the wild. It had been eradicated in human bodies, but it was still existing in labs. And Kelly, at three in the morning, as a new mom, were you worried about this escaping from labs and infecting your children?

58:33Not initially. But as I said, in 2014, they found some smallpox vials that were in a lab in the U.S. that were just in some stinking closet where somebody had, like, forgotten them there. And at this point, we probably don't have immunity anymore. None of us. And so if it got out, it could spread quickly. And it does get out of labs sometimes. It does. Are there documented cases of that? Yeah. So in 1978, there was a woman who was working in a lab above a UK lab that studied smallpox. And smallpox must have gotten into the ventilation system and ended up in her lab. And she got smallpox and died.

59:12Oh, gosh. And so we know that sometimes it does get out. And I think after that, the UK was like, you know what, we'll just destroy all of our stores. But the scientific community has decided to not get rid of all of our samples. And there's a complicated reason why. So in 1972, a bunch of countries agreed, look, we're not going to try to make biological weapons anymore. And so nations were supposed to stop doing that kind of research. But the Soviet Union kept doing it. And in particular, they kept doing research on how you could weaponize smallpox. And there's some reason to believe that they thought the U.S.

59:49was doing it too. And so they had to do it to keep up. But the U.S. wasn't doing it. Or at least if the U.S. was doing it, that has not become public. And so the Soviet Union continued to do it. And so around the time when there was discussions about like, OK, all the labs that still have smallpox, we should destroy it. This news came out that the Soviet Union had been using it for biological weapons. And now the U.S. didn't want to eradicate theirs because what if a biological weapon made from smallpox does get released? If you have smallpox in your lab, then you've got a starting point for doing research to figure out how you can maybe make more vaccines or how you can address this.

1:00:30And so it ended up being determined that the U.S. didn't want to eradicate theirs and then the Soviet Union didn't want to eradicate theirs. And then when the Soviet Union fell apart, scientists who had access to the vaccines ended up all over the place. And there was some concern that a lot of the scientists during the fall of the Soviet Union didn't have enough money to feed their families. So are they selling it to nations that might like to have smallpox to make their own biological weapons? And so it is still the case that we have these samples in our freezers and hopefully they never get out.

1:01:06I mean, they're under many layers of security, but they're kept for a variety of reasons. the bio-warfare stuff we talked about. Also, you know, maybe if monkeypox jumps to humans in a way where it's even more transmissible than it has been in the past, maybe understanding smallpox could help us with that. And so there's a bunch of different science-related reasons that we've come up with. But the point is, smallpox still exists on this planet, and that keeps Kelly up at night. So why don't we just keep vaccinating people? Like, yeah, we eradicated it, but it sure would be nice to be immune. What's the cost of vaccination?

1:01:40Yeah. So difficulties with vaccination is another reason why some people argue that we need to keep smallpox around. So the current vaccine that we have using that cowpox is dangerous for people who are immunocompromised. So, for example, people with HIV AIDS could die if they got this vaccine. And so there are folks who argue like, look, we need to keep smallpox around because we might be able to, as you mentioned earlier in the show, maybe we could genetically modify smallpox so that we could create a vaccine that makes people immune to smallpox without killing people who are immunocompromised.

1:02:17And so because we don't have a perfect vaccine, maybe you want to keep smallpox around in case you need to do more vaccine research in the future. To more clearly address your question, you asked, why don't we just vaccinate everybody? So one, you'd have to always vaccinate everybody for a disease that isn't in circulation right now. That would be incredibly expensive. And this vaccine is not without risks. And so if you vaccinated everybody, there would be a subset of the population who would die from this vaccine every year, which seems unnecessary at a time when this disease is not spreading in the United States or in the world.

1:02:52Yeah. Yeah. So there really are risks there. You don't just want to vaccinate people. Yeah. Just for the heck of it. Although, man, in 2014, if you had told me I could vaccinate my daughter for smallpox, I might have. I might have gone for it because I was a little crazy in the middle of the night. I was talking to a friend who's in the military, and I think he said that he did get vaccinated for smallpox. And so I think there are some people working in some government job where if you are not immunocompromised, you might still get the vaccine on the off chance that you would be the kind of person who would encounter a bioweapon on the front line.

1:03:25But this conversation I had was like over a decade ago. So maybe we don't do that anymore. All right. Well, it's amazing what humanity can do when they come together and get organized and decide that we all have the same goal. We're going to make the sacrifices and use the resources necessary to achieve that goal. It's incredible. It is incredible. And so, you know, when I was rereading D.A. Henderson's book, and I also reread Scourge by Jonathan Tucker, and while I was rereading these stories. I love your pronunciation of that word, scourge. How do you say it? Scourge. Scourge. Oh, no. Is it like prions where I'm saying it wrong?

1:04:00No, one of us is. All right. Well, 50-50 chance. We'll let the internet tell us. OK, sounds good. But while I was reading those stories, I was getting pretty depressed. So I was uplifted by the fact that our species came together and cooperated across nations to eradicate this disease that had killed millions of us for thousands of years. But on the other hand, U.S. aid is not around anymore. and the World Health Organization, the United States has pulled out of that. And I don't want to pretend that the World Health Organization is without problems because D.A. Henderson complains about the bureaucracy in that organization over and over and over again.

1:04:36But he was still able to coordinate this effort that brought all the nations of the world together and brought all of our resources together. And the strength of this organization with this particular person in charge was able to eradicate this disease. And, you know, I'm worried that we, you know, instead of fixing institutions that have problems in the United States, we're just pulling out of them. And I worry that the next time we need to coordinate, we are going to be in a less good position to do that. And so anyway, I was on the one hand, very proud of our species for eradicating smallpox and a bit scared for our ability to do something like that again in the future.

1:05:14Well, as scientists, the best we can do is to help people understand how this works. What's going on? What do we know? What do we not know? What are the risks? What are the benefits? And we hope that that helps people be informed when they make their decisions, policymakers and individuals. Yep. Yep. But to end on a high note, you know, I do think it's worth sitting and thinking how lucky we are that most of us don't have to worry about tuberculosis or smallpox. We can be vaccinated for measles and for polio. There's so many things that would have occupied so much time and worry for parents or, you know, anyone, for people living in the past that, you know, we can forget about today.

1:05:52So many people have never thought about smallpox for more than five seconds. And what – blessing isn't the word I'm looking for. What's the word I'm looking for? What a luxury that is? What a – What a mitzvah that is. What a mitzvah that is. And so anyway, we are very lucky to live in the time we live in. Yeah. And also it's a testament to what humans can accomplish, right? We have changed the nature of life on Earth. We've removed a big source of suffering and misery. Yeah. And that tells me that we can do more. We can improve lives. Science really does help us improve the quality of our life.

1:06:27Yay, science. Yay, science. Let's end on that. So thank you to D.A. Henderson for coordinating that massive international project to improve all of our lives. and thank you all for joining us on this historical tour of a human victory.

1:06:46Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio. We would love to hear from you. We really would. We want to know what questions you have about this extraordinary universe. We want to know your thoughts on recent shows, suggestions for future shows. If you contact us, we will get back to you. We really mean it. We answer every message. Email us at questions at danielandkelly.org. Or you can find us on social media. We have accounts on X, Instagram, Blue Sky, and on all of those platforms, you can find us at D &K Universe. Don't be shy. Write to us. Aging is real. And so are the benefits of adding Vital Proteins Collagen Peptides to your daily routine.

1:07:29New Vital Proteins Collagen Sparkling Water. Your daily glow-up now in three fresh flavors. strawberry blossom lemon lime and blood orange improved skin health in as little as 30 days thanks to collagen peptides cheers to that or go with our classic collagen peptides so you can stay vital stay you visit vitalproteins.com to learn more and where to buy these statements have not been evaluated by the food and drug administration this product is not intended to diagnose treat or prevent any disease if your bookshelf and your for you page are equally important to your personality welcome home pro society is a weekly podcast that's part book club part group chat for anyone who thinks Pride and Prejudice and Love Island deserve the same level of discourse.

1:08:08Each week, we're connecting the dots between books, the internet, and pop culture with your favorite writers, book talk creators, and plenty of overthought opinions. I'm obsessed. I'm obsessed. Listen to Pro Society on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. On the new podcast, Solita, we share the messy reality of traveling alone as a woman. I can wait four hours for the next bus or this random dude is offering me a ride on his motorcycle. I chose option B. I'm Julie Pinheiro and I travel by myself because it's a rare space where I can say yes without asking anyone else first.

1:08:45I'm on a mission to reclaim the word Solita, trading the pity for possibility. Listen to Solita on the iHeartRadio app, Apple Podcasts or wherever you get your podcasts.

1:09:00I'm Hoda Kotb, host of the podcast Joy 101 with Hoda Kotb. You know, I'm always searching for inspiration and useful tools to maximize joy. Like when my friend Henry Winkler offered advice to aspiring actors and really anybody hoping to stand out. You're not hired just to fill time and space. You're hired to fill the space with you. Listen to Joy 101 with Hoda Kotb on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. This is an iHeart Podcast. Guaranteed human.