Health Articles

Smallpox: From nobility to the masses 

Many mark Edward Jenner’s smallpox vaccination as the first human venture into immunology, however, inoculation against smallpox actually began in the 10th century with Ottoman, Asian and African dynasties. The practice of variolation (injecting human bacterial matter into another human) made its way to European nobility in the early 1700s when Lady Mary Montague chose to variolate her daughter against smallpox. 

It was Jenner that questioned the effectiveness of variolation some 200 years later. 

In 1796, Jenner inoculated an 8-year old boy with the bacterial matter from a cowpox sore. He then injected the boy with viral matter from a human smallpox sore. Remarkably, the patient remained healthy - Jenner had hit the jackpot! 

Through the isolation of animal viral matter, Jenner became the pioneer of mass extraction of an effective viral matter. This led to the first public health initiative in the Western world, with all infants being immunised within 40 years of the discovery. 

It is because of Jenner’s push to the masses that we are celebrating 41 years of global smallpox eradication in December. 

Rabies: Tackling attenuation 

Next came Louis Pasteur - the brains behind the discovery of weakening viruses. His finding continues to play a vital role in the development of vaccines today. 

After extracting the rabies virus from two infected dogs, Pasteur underwent the process of ‘attenuation’ - or weakening of the virus -  in rabbits. The French biologist injected the diseased matter into the spines of rabbits with the knowledge that rabies directly affects the central nervous system. He found that, because of the fast-mutating nature of the virus, virions naturally weaken as they pass through species. Thus, Pasteur was able to create a consistently virulent source of attenuated rabies vaccination. 

After being bitten by an infected animal, nine-year-old Joseph Meister was the first human to be inoculated with the weakened viral matter. Pasteur injected the child with the increasingly virulent matter at daily increments, inoculating him first with the weakest form of rabies virion and finishing the trial with the fully virulent matter. This course of injections showed that not only had the boy survived the rabies bite, he had also remained healthy under reinoculation. 

The French professor had created the first live, attenuated vaccine. 

BCG: On the brink of elimination 

Tuberculosis (TB) was one of the 19th century’s most deadly diseases, killing one in seven people in the United States and Europe. Due to the work of two French scientists in the 1900s, the WHO estimates that global elimination of the respiratory disease could be possible by 2035. 

Albert Calmette and Camille Guerin harvested the pathogen responsible for TB on a surface made from glycerin, potato and ox bile. Although the first lab-developed vaccine was created by their colleague Pasteur, Calmette and Guerin had successfully created one of the first lab derived vaccines for humans. 

The two scientists struggled through the First World War, hit by the refocusing of medical research to suit the war effort - not to mention the shortage of potatoes! Trials ground to a halt. 

It was in 1921 that the scientists administered the oral vaccine to an infant whose mother had died after contracting TB. Thanks to rigorous animal testing, the child was left unharmed. A fast rollout of the vaccine meant that by 1928, 114 000 European infants were vaccinated. 

The respiratory symptoms caused by TB pathogens are undoubtedly very similar to those experienced by Covid-19 symptoms, and so too are the viral strains. There is increasing evidence to show that countries with a sustained BCG vaccination programme have lower rates of coronavirus today. Although this vaccine is in short supply, could the BCG be a key player in the search for a Covid-19 vaccine?  

Polio: The dead or alive debate 

Polio was arguably the most feared disease of the 20th century, causing damage to the central nervous system and resulting in paralysis. The height of the panic was in the 1950s, when cases peaked at over 57,000. 

Affecting everyone from kids to the President of the USA (Roosevelt), the virus resulted in a mass exodus from the streets, the closing of public amenities and the sealing of front doors in the months that became known as ‘polio season’. 

In 1953, John Salk came to the rescue. After growing poliomyelitis pathogens on cultures of monkey kidney cells, the American scientist managed to kill them with formaldehyde. In 1954, a mass trial was conducted with over 2 million children being jabbed with the dead form of the virus. This provided evidence that the injection of dead viral matter causes the release of antibodies. The trial was a success and by 1955 Salk reported that the technique was 90% effective. 

All the while, Albert Sabin had reservations. The polish scientist doubted the large amount of viral matter needed to stimulate antibody release and believed that only live, weakened forms of the virus could provide immunity. 

Sabin conducted numerous autopsies and found that the polio virus could also affect the intestinal tract. From this he harvested three trains of the virus that stimulated antibody release upon injection but didn’t cause paralysis. 

Sabin and Salk went head to head for funding with Sabin losing out in the US - so the live polio trial was performed by the Soviet Union Health Ministry. The study was highly successful and by 1961, the live vaccine was adopted by WHO as the main source of immunisation against polio.

Although polio virus has been eradicated from the western hemisphere since 1994, it was only in August of this year that Africa declared itself free of wild polio. It’s obvious that we have vaccines to thank for global eradication, the polio vaccine caused a monumental revolution in modern medicine. 

So this is all proof that vaccines have worked throughout (modern) history and just how important it is that we continue immunisation programmes.

It is crucial that you continue to have routine, non-coronavirus vaccines throughout this crisis. Public Health Wales has already warned that its seen a small drop in vaccination numbers since the pandemic began, with Dr Phil White saying that people should be 'equally afraid' of diseases such as measles and meningitis. Read more here.

We know that anti-vax sentiments are on the rise, with conspiracy theories now focussed on targetting coronavirus vaccine efforts. If you are worried about the new vaccine, please read our guide to vaccine anxiety.