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Mount Pleasant Cemetery, in Toronto, in March, 2016. 'Immunizations have saved more lives than any other public health intervention in the 20th-century,' said Eileen de Villa, Toronto’s medical officer of health, in an April 24 news release recognizing immunization week.Fred Lum/The Globe and Mail

It’s National Immunization Awareness Week, a time to remember how vaccines have changed our world. To mark the occasion, I went for a walk in a graveyard.

The Toronto Necropolis stands on the edge of the Don Valley in the city’s downtown east end. It’s an atmospheric place, with mildewed tombstones, an ornate white gateway and a Gothic Revival chapel by architect Henry Langley, who is buried in Section O, Lot 255.

Among the other notables interred there are William Lyon Mackenzie, Toronto’s first mayor; the NDP’s Jack Layton; and George Brown, publisher of the Globe, the forerunner of the newspaper you are reading.

The first interment took place on May 22, 1850. Life in Toronto was precarious back then. Diseases of all descriptions threatened to carry off its residents: dysentery, scarlet fever, tuberculosis, typhoid, cholera, smallpox. The mean age of adults buried in the Necropolis in the early 1850s was 44 for men, 42 for women.

The poor and the young were most vulnerable. In the cemetery’s first half-century, about four out of 10 of those interred were infants. One much-feared illness, whooping cough, or pertussis, sent small children into paroxysms of coughing that left them gasping for breath.

But even privileged families weren’t safe. Just steps inside the gate, I found a handsome monument to William and Susannah Lapsley. The inscription shows they lost three children: Mary Helen (Aug. 12, 1865 – April 28, 1866), Alexander Lorne (March 28, 1874 – May 2, 1875) and Gertrude Annie (March 5, 1876 – March 21, 1877).

A few steps further, I came on a headstone dedicated to the “sacred memory of the beloved children of John & Ellen Conroy.” They all died within a single week in 1875 – Henrietta on Feb. 7 at two years, seven months; Colin Alexander on Feb. 11 at four years, two months; and Ellen on Feb. 14 at two weeks.

Toronto’s pioneering public-health officers eventually identified the main source of fatal disease – dirty water – and pressed the city to build sewers, sewage plants and filtration plants. Over time, life expectancy improved. By the end of the 1800s, the mean age of adults buried at the Necropolis had grown to about 56 for both men and women.

But communicable diseases such as smallpox, diphtheria and polio continued to take a toll well into the 20th century – until the start of mass immunization.

The English doctor Edward Jenner employed the first vaccine in 1796 when he inoculated an eight-year-old boy with elements of cowpox sore from a milkmaid’s hand, drawing on a centuries-old practice from Asia of using traces of the smallpox virus to prevent the onset of the disease. As knowledge advanced, scientists created vaccines for one disease after another: polio, pertussis, measles, mumps, diphtheria, cholera, tetanus, influenza, yellow fever.

“Immunizations have saved more lives than any other public health intervention in the 20th-century,” said Eileen de Villa, Toronto’s medical officer of health, in an April 24 news release recognizing immunization week. “They have eradicated smallpox and controlled other diseases that once killed or disabled children in large numbers.”

In the 21st century, a new generation of vaccines has taken centre stage. Developed in record time in the midst of a global pandemic, inoculation against COVID-19 has saved millions of lives. They remain by far the best weapon we have against this stubborn virus. As Dr. de Villa put it, “Vaccines are safe, effective and one of the most important ways to improve health worldwide.”

That message is especially important now. Canada has done a good job at getting people vaccinated against COVID-19. As a result, the country’s death rate is much lower than that of the United States, which by no coincidence also has a much lower rate of vaccination. Toronto alone has administered close to seven million doses.

But a significant minority of Canadians have still not received their shots. Only about half have had a third dose. Many people, young and old, have been missing their routine vaccinations for other diseases, too. Misinformation about vaccines abounds, as we saw during the trucker protests.

It was the same in Toronto a century ago when the city faced a smallpox outbreak: “Some people believed that vaccination was unproven scientifically, that it polluted the body, and that catching smallpox was unlikely in any case,” an online history of the city’s public-health efforts says.

Yet nearly half of Toronto residents agreed to get inoculated at the time. Common sense prevailed. Science won. It can win again, if only we remember the way things used to be, before immunization and other wondrous advances in public health.

On my way out of the Necropolis, I passed a flat tombstone partly obscured by earth and leaves. Pushing the debris aside, I found the names Patrick MacGregor and Marion Kerr. Five children are listed with them. Two, John (1870-1921) and Agnes (1863-1930), lived to adulthood. Another two, Jemima, born in 1868, and Patrick, born in 1880, did not make it through their first year. The fifth, Marion, born in 1875, survived only till 16.

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