A Pox On Your House

With the recent news about vaccine fears and concerns people may be tempted to avoid vaccinating entirely. In order to bring about some more education we’re going to do a couple of articles about vaccines going through the history of vaccines looking at a variety of interesting examples from smallpox all the way to the Pandemrix. Part one is on the birth of vaccines and the eradication of smallpox.

Lots of people know the original story of Edward Jenner, cowpox, and questionably ethical experimentation on children. But even before this people were already protecting themselves against smallpox through a set of practices called inoculation. Our first evidence of this comes from China in 1500 AD but it likely started earlier. The initial method involved crushing scabs from the pox of infected children and introducing them intra-nasally (an alternative involved introducing pus to skin with a needle). This was made popular in the UK by Lady Mary.

Even this early method had its opponents. Medical professionals attacked the practise due to its origin and being brought in by a woman. Religious bodies felt it was an attempt to deny the wrath of god. Fortunately, both of these were ignored and the practice spread – inspiring Edward Jenner’s work into smallpox vaccination. His theory was that he could inoculate people using cowpox rather than smallpox (reducing risk of infection from the inoculation itself) culminating in his successful experiments in 1796. This also had its opponents – again for religious reasons, however the fight was easier thanks to the groundwork set by the inoculation.

Interestingly, this first inoculation and vaccination campaigns were directly arm-to-arm bringing with it all the issues with it. This led to novel strategies like bringing children on to ships in order to create a chain of infected people allowing the practice to spread to other countries.

Sweden was an early proponent of compulsory vaccination in 1816 which led to a huge decrease in smallpox infection. Britain followed approximately 40 years later in 1853 with the second version of the Vaccination Act which mandated vaccination in infants. As smallpox vaccination spread around the world it helped contribute to the successful eradication of the disease in 1980.

Join us in our next part looking at what was supposed to be our next big eradication success and why we haven’t quite succeeded yet.

“In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way,” he wrote. “I long regretted bitterly, and still regret that I had not given it to him by inoculation.

“This I mention for the sake of 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

Author Details: Dr. Eliot Hurn, Foundation Year 2 County Durham and Darlington Foundation Trust.

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