Was Lincoln Vaccinated for Smallpox?

By David J. Kent

Washington D.C.

Tuesday, April 27, 2021

A year into the COVID-19 pandemic, many of our Lincoln Group members have received their vaccinations. Most of the rest of us are waiting for an appointment. Getting vaccinated is the single most effective way to get past the pandemic and return to our in-person Lincoln Group dinner meetings.

Abraham Lincoln also caught a life-threatening virus during his time in office. It occurred during and after his trip to Gettysburg to give his famous address:

As he gave his address, Lincoln was already feeling the symptoms of variola, a mild form of smallpox, which kept him bedridden for weeks after his return to Washington. He eventually wrote out several copies of his address, including one sent to Everett to be joined with his own handwritten speech and sold at New York’s Sanitary Commission Fair as a fundraiser for wounded soldiers.

As the Centers for Disease Control and Prevention (CDC) explains, smallpox, like coronavirus, is an infectious disease. Caused by two virus variants, Variola major and Variola minor, initial symptoms of smallpox include fever and vomiting, followed in extreme cases by sores in the mouth and a skin rash. As it worsens, large fluid-filled bumps appear on the skin, which result in characteristic and deforming scars. Like coronavirus, the smallpox virus was spread as people coughed or sneezed and droplets from their infected nose or mouth spread to other people. The smallpox scabs forming on the skin remained contagious until the last scab fell off. Coronavirus doesn’t form the scabs – it attacks the lung tissue rather than the skin – but both smallpox and coronavirus can be spread by residues left on surfaces from bedding and clothes to handrails and elevator buttons. Which is why it is so important during this coronavirus pandemic to practice social distancing, wash your hands often, and avoid touching your face.

Most scholars treated Lincoln’s case of variola as a mild case of smallpox, but some recent researchers suggest it was much more serious and that he could have died. In 2007, for example, two researchers reported that:

When Abraham Lincoln delivered the Gettysburg Address, he was weak and dizzy; his face had a ghastly colour. That evening on the train to Washington, DC, he was febrile and weak, and suffered severe headaches. The symptoms continued; back pains developed. On the fourth day of the illness, a widespread scarlet rash appeared that soon became vesicular. By the tenth day, the lesions itched and peeled. The illness lasted three weeks. The final diagnosis, a touch of varioloid, was an old name for smallpox that was later used in the 20th century to denote mild smallpox in a partially immune individual. It was unclear whether Lincoln had been immunized against smallpox. In that regard, this review suggests that Lincoln had unmodified smallpox and that Lincoln’s physicians tried to reassure the public that Lincoln was not seriously ill. Indeed, the successful conclusion of the Civil War and reunification of the country were dependent upon Lincoln’s presidency.

Indeed, Lincoln’s free African American valet, William H. Johnson, contracted the disease while caring for Lincoln after they had returned from Gettysburg. Johnson ultimately died a few months later. He had traveled with Lincoln from Springfield and, having no other family, Lincoln arranged and paid for Johnson to be buried at Arlington National Cemetery.

It's unclear whether Lincoln had received a smallpox vaccine. There was a vaccine available, but it was not as effective as more modern vaccines and was not as widely distributed, although many in the military were vaccinated. The outbreak was serious, and many people died in Washington, as well as in New York, Boston, Philadelphia, and Chicago. The total number of deaths is unknown, but more effective distribution of a vaccine would have saved lives.

All Lincoln Group members are encouraged to get vaccinated for COVID as soon as they are able. Decisions on when we can re-start our in-person dinner meetings will depend on CDC guidance, case incidence numbers, and the safety of our members. We will keep members posted, but for in-person meetings to happen we all need to do our part. Please get vaccinated.

More information on Lincoln's smallpox case can be found here, and a podcast can be found here.