Search This Blog

Friday, February 18, 2022

THE HISTORY OF VACCINATION

 


There are lots of crazy theories and utter fabrications about vaccines these days, so it is probably a good time to have a look at the history of the medical process -- and the history of disinformation about it, too.

It began with inoculation and the horror story of smallpox, that terrible scourge of humans since the mists of time. Smallpox (called that in England to distinguish it from the 'great-pox', syphilis) was terribly contagious, very disfiguring, and often fatal. It was characterized by high fever, delirium, and a rash of little pustules, which left scars, if the patient survived.  

Because of the spots, it looked a lot like measles, but the two diseases were identified separately over a thousand years ago.  And, while measles is nasty, and in one form can cause profound deafness in the embryo that an infected mother might be carrying, it did not carry quite the same horror as smallpox. And smallpox was indeed a scourge.  It has been estimated that it has killed over 300 million people since the year 1900.

So it was smallpox that was tackled when humankind started to think of immunizing people. The obvious way was to prick the skin of the subject with a needle that had already been inserted into one of the pustules of a smallpox patient.  The Chinese might have been the scientists to do it first, though this inoculation was also recorded in Africa and Turkey.  

This method was brought to England by a heroine of mine, Lady Mary Wortley Montague.


Born in 1689 to a wealthy and liberal family, Mary had access to a huge private library, and educated herself, learning Latin as well as much else.  As it was common in high society back then, she was supposed to enter an arranged marriage, but instead she eloped with a young diplomat. 

Her looks were ruined when she caught smallpox.  For days, she writhed in fever, and though she survived her beauty was ruined.  Even her eyelashes had gone. But her spirit remained, and when her husband was posted to Turkey she was determined to go with him, and even insisted on taking their little boy.  There, she wrote voluminous letters, which were published and are still worth reading.  But one, penned in 1717. is particularly important.

I am going to tell you a thing, that will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless. . . . There is a set of old women, who make it their business to perform the operation, every autumn, in the month of September, when the great heat is abated. People send to one another to know if any of their family has a mind to have the small-pox; they make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nut-shell full of the matter of the best sort of small-pox, and asks what vein you please to have opened. She immediately rips open that you offer her, with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much matter as can lie upon the head of her needle, and after that, binds up the little wound with a hollow bit of shell . . .

And that would have been that, just a curiosity, but then her husband was called back to London ... where there was a smallpox epidemic raging.  So Mary decided to have her son inoculated -- and he had no ill effects, and never got the disease.  He was the first Englishman to be inoculated. 

Mary tried to publicize the treatment, but was met with disdain.  First, she was a woman.  Second, physicians made a lot of money from so-called smallpox treatments.  And what could a Moslem country teach a land of Christians?  

But still she persisted, and when her daughter was born, and when another epidemic threatened, she had her inoculated, too.  The daughter survived and eventually married a prime minister, and so the procedure gained respectability.  All kinds of people demanded to have their children inoculated -- including Caroline, the daughter in law of George I, who applied to him to let her have her children (the heirs to the throne) inoculated.  Instead of agreeing at once, he set up what was probably the first clinical trial, experimenting with orphans and convicts. This was so successful that finally he agreed to allow his female grandchildren to be treated -- but not his grandsons.

Which brings us to Edward Jenner.


Inoculation was the introduction of a live virus into the bloodstream of the patient, which is, of course, very dangerous.  But Jenner introduced a much safer method, which is called 'vaccination' because it was based on the similar but much more mild form of the virus, cowpox.

It was because of a conversation he overheard, in 1762.  It was one dairymaid talking to another.  She said, “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.”  And, though he was only thirteen at the time, for him it had great significance.

As was typical with medical education at the time, young Edward was apprenticed to a surgeon. In a slightly earlier era, he would have served as a barber's apprentice, as the barbers were the recognized treaters of wounds, but a Company of Surgeons had been formed, and so doing an apprenticeship and becoming approved by the supervising surgeon was the route to a medical career. 

Thirty-four years later, fully qualified and a busy practitioner, Jenner remembered what he had overheard, and experimented on an 8-year-old boy, infecting him with the pus from a coxpox pustule, and then exposing him to smallpox a couple of months later.

Highly unethical, and actually not very nice, but it worked.  The boy escaped smallpox, and survived. Vaccines were born, and by 1980 smallpox had been eradicated from this earth.  Now, samples of the virus are only kept for research.

Which brings us to the history of anti-vaccination.

As we have seen with Mary Wortley Montague, opposition to immunization started right away, with her introduction of inoculation to England. With Jenner's vaccination, the uproar was equally loud, the process called 'anti-Christian' because the virus came from an animal. Others simply distrusted science, and had no faith in medicine, politicians, or the press. 

And, as vaccines for other diseases -- measles, diphtheria. rabies, yellow fever, tetanus, whooping cough, you name it -- were developed from the 1880s onwards, rage and suspicion increased.

In England it worsened when the Vaccination Act of 1853 was passed into law, making it mandatory for infants to be vaccinated.  People reckoned that it was an attack on personal liberty. The Anti-Vaccination League and Anti-Compulsory Vaccination League were formed.  There were marches in the street.  Effigies of Jenner were burned.

In America, the situation was even more inflammatory. In 1905 the Supreme Court decided that the states had every right to make laws affecting the citizens' health, which part of the public found infuriating. The uproar increased when vaccination for whooping cough, tetanus, and diphtheria was introduced. Though officially confirmed as safe and effective, there was still vocal opposition.

And the same happened when the measles, mumps, rubella vaccine was promoted. British doctor Andrew Wakefield - who has since been struck off the register, after the discovery that he was paid by lawyers to 'find evidence' to support the claim by some parents that vaccination harmed their children - went to the media with his claim that it caused autism, and the media loved it.

We don't hear much about that controversy now, but anti-vaccination is as active as ever.  Vaccination has saved many millions of lives, but the rabid opposition of a vocal minority has remained unchanged since the year that Mary Wortley Montague introduced a method of preventing smallpox to eighteenth century England.





No comments: