You can’t currently listen to the news without hearing hearing at least once the word vaccine. This past week has been about the Johnson and Johnson single dose vaccine to fight COVID-19. We have been hearing about shipments, doses, and levels of efficacy. But, this isn’t the first time vaccines have been in the news, and it is likely that it will not be the last. If you can think back to 2016, there was an furor about the efficacy or lack of efficacy for that year’s flu vaccine. And, you can point to other high profile news items about developments of vaccines, such as the ones for polio, yellow fever, and the human papillomavirus. But, what do you know about the origins of vaccines and the practice of vaccinations?
Back in 2016, I investigated this question because I was curious about how each year’s flu vaccine was developed. (Typically, the make up of the current year’s flu vaccine is based upon tracking of the types of flus that are circulating, and a team makes an educated guess as to which strains are potentially to be prevalent during the next year.) Yet, the question is a bit more fundament. Where did the idea about using a vaccine to help prevent disease come from?
The history of vaccines is longer than one might think. In 429 BC, the Greek historian Thucydides documented an observation that individuals who survived smallpox did not get re-infected. Similar observations were made elsewhere as the Chinese and other individuals in Africa and Turkey documented a practice where individuals were exposed to scabs or puss from individuals who suffered from smallpox. The practices became termed variolation. According to Dr. Stefan Riedel in his history of smallpox and vaccination, the practice of variolation was introduced to Europe via communications with travelers from Istanbul. But, it was the advocacy of Lady Mary Wortley Montague (1689-1762), a smallpox survivor, and some high profile successes of the practice (treatment of two of the daughters of the Prince of Wales) that allowed the practice to gain acceptance.
Once the practice was accepted, the variolation procedure began to be practiced on a large scale. It was still not without risk. It is estimated that up to 3% of variolated persons died from the disease or became the cause of a new outbreak. There was also the risk of transmitting other diseases such as tuberculosis or syphilis from the procedure. Variolation was also practiced in the colonies. Yet, it would take another observation, this time by Dr. Edward Jenner that would change the practice of variolation to what we now recognize as vaccination.
Dr. Jenner, born in 1749, apprenticed to an apothecary at 13, and then with George Harwicke in 1764; developed a new potential method of protecting against smallpox by inoculating with serum derived from cowpox. Apparently, Dr. Jenner made the connection between cowpox and smallpox through the tales told by dairymaids; “I shall never have smallpox for I have had cowpox.” In 1796, Dr. Jenner tested this theory by inoculating an 8-year-old boy with a serum from fresh cowpox, and then tested the potential protection by inoculating the boy two months later with smallpox. When the boy did not show signs of contracting smallpox, Dr. Jenner concluded that he was protected from the disease. This discovery meant that exposure to a less harmful disease could provide protection to against the more dangerous one. The success of the practice resulted in a name change from variolation to vaccination due to the Latin origin of the word for cow, vacca. While the practice of vaccination spread, it did have its detractors. Dr. Jenner’s initial report was not accepted by the Royal Society. Some did not believe it really worked. When talk of compulsory vaccination was discussed, there was debate similar to what we see today. Yet, it was the success of Dr. Jenner and his colleagues like Dr. Benjamin Waterhouse that led to the development of other vaccines. Dr. Waterhouse, a professor, and co-founder of the Harvard Medical School, is credited with performing the first successful vaccination in the United States (on July 8, 1800). Dr. Waterhouse administered the Jenner cowpox vaccine imported from Britain to his five-year old son and a “servant” boy in a effort to protect them from contracting smallpox.
A vaccine for rabies was developed by Louis Pasteur in the 1880’s. Vaccines for diphtheria and tetanus were developed by the work of Emil von Behring in the 1890’s. All of this contributed to work on other vaccines including yellow fever, typhoid, whooping cough, and tuberculosis, and by the end of the 1920’s many vaccines were available.
Today, we are seeing the continuation of that work, and are beneficiaries of the continued research and investment. And, it is because of work that has been ongoing, such as the work to find a vaccine for the SARS virus that has led to the development of the current COVID-19 vaccines. There are other researchers that are working in other areas to help find vaccines for other diseases. Additionally, we now have protocols and safety measures in place to help prevent unsafe vaccines from being distributed. While vaccines aren’t perfect, they do provide levels of protection that were not available to the generations that came before.