In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.  -- Benjamin Franklin

Benjamin Franklin never lived to see the invention of modern vaccinations; he died about six years before the discovery of the smallpox vaccination.

Prior to this, people used an effective, yet vastly more dangerous method of creating lifetime immunity against the disease. This process, known as inoculation, directly inserted live infected cells into a scratch on the host, giving them a milder form of the infection.

Even though milder, it killed about 1 in 1,000 who received it -- still substantially lower than the 1 in 3 death rate when the disease was left unchecked.

It's almost impossible to comprehend this kind of a death rate in the modern world, but it was common place in the 18th-century world of the Founders. In 1752, almost 40 percent of the population of Boston contracted smallpox, an enormous death toll amassed from just one outbreak.

This was the world they lived in, one where they would take a 1 in 1,000 gamble to save their family from an otherwise certain death.

The smallpox vaccine was introduced to America during John Adams' presidency, but it was Thomas Jefferson who took up the cause of vaccinations.

On learning of the successful trials of the new vaccine, Jefferson wrote:

Every friend of humanity must look with pleasure on this discovery, by which one evil more is withdrawn from the condition of man; and must contemplate the possibility, that future improvements and discoveries may still more and more lessen the catalogue of evils.

While there is no record of the exact numbers, Jefferson was so impressed with the value of the smallpox vaccine that he personally financed it to be given to at least a few hundred Native Americans, including one delegation he personally spoke to. He also ensured that part of the gear of Lewis and Clark was a supply of this new vaccine.

Jefferson didn't just give vaccines lip-service -- he believed in them.

The 21st Century Vaccination Debate

The last case of smallpox in the United States was in 1949; the last naturally occurring case in the world was reported 3 decades later.

Due to effective containment, isolation, and compulsory vaccination, smallpox is a disease that has been cured in practical terms. Others diseases still remain.

Polio, the other of the most feared viruses, used to cripple an average of 35,000 people each year. It has been eradicated from the United States, but still exists in parts of Asia and Africa.

In many ways, the vaccination debate is a first world problem.

We no longer have to see the deaths -- like Benjamin Franklin having to see his own son die of smallpox.

Without the constant reminder of the horrors our forefathers faced, we can afford to speculate on the value, efficacy, or side effects of the vaccines that were once considered a godsend.

Choosing not to vaccinate is not without its risks. In 2010, 9,120 cases of pertussis (whooping cough) were reported in California, mostly clustering in areas with abnormally high non-vaccination rates.

Areas with concentrated non-vaccination rates threaten the entire population, vaccinated or not.

As the world continues to globalize, America is going to be increasingly exposed to diseases that were once thought to be eliminated. Diseases like the mumps, measles, diphtheria, rubella, and pertussis are still common place in the rest of the world, and enter into the United States every day.

Global travel increases every year. In 2014, 1.1 billion tourists traveled abroad -- each one potentially carrying the next epidemic to their destination.

The question should not be if we should vaccinate; it is a proven process with small risks, yet enormous rewards.

The focus should be on how we will protect ourselves from the reemergence of these diseases, which will only come from improving existing vaccines and widespread vaccination.

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