Old vaccine technology wasn’t safer—it was smallpox scabs
RFK Jr.’s nostalgia for ‘traditional’ vaccines isn’t progress, it's deadly disinformation.
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We used to immunize people by blowing powdered smallpox scabs up their noses. Today, RFK Jr. wants us to pretend that was the ‘gold standard’ of vaccine technology.
RFK Jr., Marty Makary, and other MAHA allies are eroding trust in biomedical science technology development. On August 5, RFK Jr (now running HHS) cut $500 million dollars in Federal funding for mRNA vaccine research.
Half a billion dollars. Gone.
RFK Jr’s HHS cut 22 research projects funded through BARDA (Biomedical Advanced Research and Development Authority) — the organization that develops medical countermeasures for chemical, biological, and radiation-related accidents, biological and chemical weapons attacks, and emerging infectious diseases.
I’ve worked with colleagues running BARDA-funded projects. It’s critical biomedical research—the lifeline for next generation flu vaccines, cancer vaccines, rapid pandemic response platforms (diagnostics and therapeutics). Cutting BARDA mRNA projects erases our ability to respond to the next pandemic (which is an inevitability), to develop more targeting cancer treatments, or to focus on universal flu vaccines.
HHS website says they’re “winding down” mRNA vaccine development, as if the need no longer exists. It’s not just wrong—it’s reckless. This will erase decades of progress and leaving us more vulnerable.
RFK Jr. has been an anti-vaccine activist for nearly 30 years. He’s married the politicization and distrust of mRNA vaccines (much he created) with general anti-vaccine sentiment and his authority within HHS to systematically erase one of the most impactful and life-saving fields of therapeutic development.
RFK Jr’s HHS claims to go back to “safer, broader vaccine platforms” that are older, like whole-virus vaccines. Marty Makary, a surgeon who now leads the FDA, has echoed similar false sentiments by claiming mRNA vaccines and the underlying technology is “risky.” Not a scientist, not an expert in regulation, yet he’s been given the reins of FDA while he spreads misinformation and conspiracy theories.
These are lies.
mRNA vaccines are safe, have been in development for decades, and have far broader applications than older vaccine technologies.
But in the current reality we live in, apparently facts don’t matter.
mRNA versus “traditional” vaccines is a false dichotomy.
The current narrative coming from HHS is literally (I am quoting here):
“HHS supports safe, effective vaccines for every American who wants them. That’s why we’re moving beyond the limitations of mRNA and investing in better solutions”
RFK Jr’s rhetoric goes like this: “We trusted vaccines before, but these new mRNA ones? They’re untested, they alter your DNA, they’re experimental.” All of that is flat-out wrong. In fact, mRNA vaccines have been in research and development for decades. Decades.
But more to the point: RFK Jr. didn’t “previously trust” vaccines – this is just his latest attempt to move the goalposts toward his ultimate goal of getting all vaccine approvals revoked. More on that later.
Today, let’s address why the notion that “old” vaccines are superior is wrong and why these lies are dangerous to humanity.
Every vaccine technology was once “new,” even variolation
In fact, every medical intervention was once new. Novelty isn’t a reason to reject technologies, unless you never want to improve humanity and health.
If we took this approach, we might still be using variolation.
In the 1700s, smallpox was rampant. Caused by the Variola virus, smallpox had an average mortality rate of 30-50% and killed millions throughout history. Many who survived had extensive scarring and disfiguration, along with other sequelae (long-term symptoms of infection).
Variola virus is incredibly stable and can remain infectious in scabs, clothing, and bedding for up to a month. The virus was easily transmitted person to person, through clothing even through contact with household surfaces and objects.
In the 1700s, variolation was the method used to provide immunity to smallpox — considered the first immunization (the process of generating immunity).
Variolation was the intentional, but controlled exposure of live smallpox virus to a person, which, if they were lucky, led to milder illness and immunity to smallpox if they were exposed in the future.
Variolation was crude. It involved taking smallpox scabs (filled with virus, although folks in the 1700s didn’t know that specifically), drying them over a fire, grinding them into a powder, and blowing them up the nose of the lucky recipient.
Other methods included slicing open a persons’s arm and rubbing smallpox pus in the wound or bandaging the wound with contaminated cloths. The good old days, amiright?
Variolation was Russian roulette with live, deadly, smallpox virus. Some people did only develop mild illness and once recovered, had lifelong immunity. But others developed smallpox and died.
Variolation reduced mortality from 30% to 3%, a huge improvement when there was nothing available to protect people against a deadly disease. For most people, the math was easy. But can you imagine if a vaccine today had a mortality rate of 3 percent?!
This was not the golden age of medicine. It was a desperate attempt with the limited knowledge at the time when there were no better options.
The practice of variolation only spread because influential people took that risk. Lady Mary Wortley Montagu, who lost a brother to smallpox, introduced it to England in the 1720s. She had her own children variolated and her endorsement helped it spread among Europe’s elite.
Onesimus brought the practice to the US after he was captured and enslaved by Cotton Mather. In 1721, variolation contained an outbreak of smallpox in Boston. Only 6 of 844 deaths occurred among those who were variolated, demonstrating the effectiveness of this immunization method.
The United States of America exists in large part because George Washington made smallpox immunization mandatory for troops during the American Revolution. Washington ordered all incoming Continental Army troops to be variolated in 1777. This move saved the rebellion – and likely is the reason we are a country today. Yes, the irony is not lost on me that an anti-vaccine activist may be the end of our 250-year experiment. Our founding fathers would likely be ashamed.
Variolation saved lives, but still had a cost. Personally, I’m thankful we’ve evolved our scientific tools beyond variolation.
Edward Jenner developed vaccination – a new technology that saved even more lives
In 1796, Edward Jenner, an English physician and scientist, introduced a new (and safer idea) based on observations that people who had contracted cowpox were immune to smallpox. Jenner called the Cowpox virus Variolae vacciniae (smallpox of the cow).
This new immunization technology, the first true “vaccination” (from the Latin, vacca, cow), soon replaced variolation, the “old” method of generating immunity to smallpox.
Why? Well, unlike variolation, vaccination didn’t use live (and deadly) smallpox virus, it didn’t lead to death among those who were immunized, and it didn’t cause secondary outbreaks among immunized people.
Jenner conducted the first published human challenge studies to demonstrate the effectiveness of Cowpox vaccination against smallpox.
In May 1796, Sarah Nelms contracted cowpox while caring for cows on the farm. Jenner took a pustule from her and scratched the material into the skin of an 8-yr old boy named James Phipps. James developed mild symptoms for ~9 days. In July that year, Jenner deliberately exposed James to smallpox, and James did not develop smallpox. He published his findings in 1797/1798, and by 1800, this practice began spreading across Europe. Jenner devised and documented a scientific method, which allowed it to be spread globally: that’s the goal of public health.
This approach led to the evolution of the current smallpox vaccine (which we keep in stockpiles) that uses another related virus, Vaccinia virus.
And because we didn’t stick with the old method and instead, adopted new science, we literally eradicated smallpox from existence on this planet. Yes, smallpox, a viral illness with 30-50% mortality rate, has been ERADICATED from the planet because of vaccines.
This was science’s first great immunological upgrade: replacing the virulent and deadly pathogen for a harmless mimic that still trains the immune system. That’s always been the goal for vaccine development, and it started 200 years ago: safer, more precise, and more effective vaccines.
Imagine if people in the 1700s refused to accept scientific progress like RFK Jr, Marty Makary, and their MAHA allies are doing now?
New vaccines didn’t stop there. The shift from DTP to DTaP? More scientific progress in action.
Let’s fast forward to the 20th century. The DTP (Diphtheria, Tetanus, and Pertussis) vaccine was approved in the US in 1948 and was standard for children. It protects against 3 bacterial diseases: diphtheria, tetanus, and whooping cough.
The symptoms of diphtheria and tetanus are caused by a toxin produced by each respective bacterium (Corynebacterium diphtheriae and Clostridium tetani), whereas pertussis symptoms are caused by direct action of that bacterium (Bordetella pertussis).
The DTP contained intact whole killed Bordetella pertussis cells, as opposed to isolated or select groups of bacterial cell components (antigens) that would stimulate the immune response. The DTP vaccine induced a very robust immune response, providing long-lasting and strong protection against all 3 diseases. However, because the pertussis component contained the entire killed bacterium, it also elicited strong reactogenicity–adverse events related to the immune response to the vaccine.
DTP vaccination could cause fevers, prolonged crying, local swelling, and occasional febrile seizures. Fever could occur in up to 50% of infants, local swelling in up to 40%, and persistent crying lasting more than 3 hours in ~1% of vaccinated children. Febrile seizures were less common but still occurred in 1 in every 1,750 doses.
Science enabled us to develop a new diptheria, tetanus, and pertussis vaccine. We changed from DTP to DTaP in 1991.
New technology enabled the creation of a safer vaccine that still protects against deadly diseases. Instead of the whole Bordetella pertussis bacteria (which contains thousands of antigens that contribute to that robust immune response but also the reactogenicity), the new vaccine included an ‘acellular’ component containing key bacterial molecules (antigens) that stimulate an immune response: pertussis toxin, Filamentous hemagglutinin (FHA), and pertactin.
DTaP reduced the incidence of fever and local swelling by over 80% and febrile seizures were no longer associated with vaccination. DTaP is still a 5-dose regimen that protects against diphtheria, tetanus, and whooping cough (pertussis), but is far safer than its predecessor.
Anti-vaccine activists love to point out that immunity to DTaP immunity wanes faster than DTP, while simultaneously screaming that scientists and healthcare providers don’t care about children’s health.
Yeah, DTaP immunity does wane faster than DTP – but that doesn’t mean DTP was “better,” because when the risk/benefit analysis of a medicine is conducted (vaccines are medicines), it factors in the effectiveness of the vaccine AND the safety of it. Safety is paramount.
Yet somehow, we don’t care about safety even though scientists did what we’ve always done: trade some immunogenicity for better safety. Make it make sense, please.
While you may need to get a Tdap booster every 10 years (have you done that?!) for optimal protection against these illnesses, you can also rest assured that vaccines today are far safer than ones in decades past.
In this case – and in many other examples – new is safer. And safer means superior.
Vaccines have been evolving throughout human history.
New vaccine technologies are developed because scientists have tools and the knowledge to make something more elegant or complex that wasn’t possible previously. It’s the same exact reason we have more vaccines today than we did in the 1960s. Scientific progress.
Live-attenuated vaccines (measles, mumps, rubella, yellow fever) give long-lasting immunity, but have theoretical risks for immunocompromised people.
Inactivated vaccines (polio, hepatitis A) eliminate the small risks associated with attenuated vaccines, but depending on the pathogen, may require boosters throughout life.
Subunit and conjugate vaccines (Hib, HPV, pneumococcal) provide exquisite precision against specific pathogens with minimal side effects.
Recombinant and vector-based vaccines (hepatitis B, Ebola) utilize decades of molecular biology and genetic engineering knowledge to produce large quantities of vaccine that can be adapted quickly.
mRNA vaccines (COVID-19, others in development for cancer, flu, RSV, etc) are the next rung on the ladder: molecular instruction manuals that never enter the nucleus, never alter DNA, and disappear within hours to days after doing their job. They provide the template to produce an antigen that your immune system develops protection against. mRNA vaccines are further removed from a disease-causing pathogen than any of the “old” vaccines.
Each development in vaccine science aims to improve safety and ease of development while maintaining strong protection (effectiveness). This is a feature of modern science–not a bug.
Progress in science and health is not something to reject
If we held all the past vaccines that RFK Jr and his allies are romanticizing to the standards critics demand today, we’d have no vaccines at all.
If we froze vaccine science in the 18th century, we’d still be variolating kids with live pathogenic smallpox. If we froze it in the 1950s, we’d be shrugging our shoulders at febrile seizures after DTP.
If we freeze it now, what RFK Jr, Marty Makary, and their MAHA allies are trying to do, we abandon future breakthroughs: cancer vaccines, universal flu vaccines, mRNA platforms ready to pivot against the next pandemic in weeks instead of years.
Science isn’t nostalgic—it’s pragmatic. It’s about accruing knowledge, adjusting and correcting with new information, and relentlessly pursuing safer, smarter tools to improve health.
Safety or effectiveness isn’t based on how “old” a medicine is, but by how it performs. mRNA vaccines went through rigorous Phase I, II, and III clinical trials, with tens of thousands of participants. They’ve been administered to billions of people around the world, and have been rigorously monitored in real-world conditions. They have saved millions of lives. Their safety record is not just solid — it’s on par with, and in some cases better than, “historic” vaccine platforms.
RFK Jr.’s “Old Tech” lie will cause preventable illness and death
RFK Jr. spins a seductive story: “traditional” vaccines are safe, mRNA is experimental. It’s the same pseudoscience marketing with a vintage veneer. It’s wrong. And it’s dangerous.
Traditional once meant blowing smallpox scabs up people’s noses.
Traditional was whole-cell bacterial vaccines with higher side-effect rates.
Traditional once meant iron lungs during polio summers.
What we consider old vaccine technology today carried risks now considered unacceptable. Our vaccine technology today is a result of targeted design, safer ingredients, superior manufacturing, and the ability to prevent millions of deaths with fewer side effects than aspirin. That’s progress.
Calling mRNA vaccines experimental while romanticizing old vaccines is like saying horse-drawn carriages are safer than cars because they’re “time-tested.” Vaccines don’t get better because they’re old. They’re better today because science improved them.
If we rejected progress, smallpox would still exist. Life expectancy would be 40. Infectious disease would still top the charts as the leading cause of death, and nearly a third of children wouldn’t live past age five.
Progress saves lives.
Variolation paved the way to smallpox vaccination. Smallpox vaccination eradicated smallpox from the planet. DTP paved the way for DTaP. Every “old” vaccine platform was a stepping stone to an improved, safer therapy.
mRNA is the latest rung on that centuries-long ladder of progress—one that can lead to interventions for cancer, autoimmunity, and other infectious diseases. But only if we don’t let anti-science profiteers drag us backward.
Science doesn’t move in reverse. And neither should we. Our lives depend on it.
Now, more than ever, we all must join in the fight for science.
Thank you for supporting evidence-based science communication. With outbreaks of preventable diseases, refusal of evidence-based medical interventions, propagation of pseudoscience by prominent public “personalities”, it’s needed now more than ever.
More science education, less disinformation.
- Andrea
ImmunoLogic is written by Dr. Andrea Love, PhD - immunologist and microbiologist. She works full-time in life sciences biotech and has had a lifelong passion for closing the science literacy gap and combating pseudoscience and health misinformation as far back as her childhood. This newsletter and her science communication on her social media pages are born from that passion. Follow on Instagram, Threads, Twitter, and Facebook, or support the newsletter by subscribing below:
Superbly done!! I loved this statement, "Science isn’t nostalgic—it’s pragmatic. It’s about accruing knowledge, adjusting and correcting with new information, and relentlessly pursuing safer, smarter tools to improve health."
A thought about a previous post about sterilizing immunity. If those folks don't get the MMR vaccine, they could get "sterilizing nonimmunity".
The mRNA vaccines are absolutely necessary and saved millions of lives.
It is also true that vaccine-induced long covid is a real phenomenon, with a non-trivial rate of occurrence, even if it's also true that developing long covid is more likely to happen by catching the virus while unvaccinated.
I'm disappointed that this article suffers from the same issue that a lot of otherwise good science communication does - it fails to acknowledge this real phenomenon that is ruining people's lives, and in so doing, undermines trust and credibility in a message that needs to be heard and understood (with some modification).
I would love to hear you engage seriously with that topic. What are the rates of vaccine-induced long covid between Novavax and the mRNA vaccines? Can we quantify that mRNA vaccines do, in fact, cause this less than prior vaccine technology? What is our best understanding of why these vaccines are causing long covid? What research is being done to get to the bottom of this? What kind of tracking is being done to monitor how big of a problem this is? How can we do more monitoring, more research, and more funding to solve this problem? Why are science communicators (in general) so hesitant to talk about this?