Category: Smallpox

Cowpox

Cowpox is an infectious disease caused by the cowpox virus, closely related to the vaccinia virus (En.wikipedia.org, 2019). This disease is transferable between species as can be seen by dairymaids who touched the udders of infected cows and consequently developed pustules on their hands (En.wikipedia.org, 2019). This disease is very similar to the deadly smallpox disease as it has close mild resemblance in the observation of dairy maids. Figure 1 depicts the pustules on a cow’s udder and it can be noted that the way they are formed are similar to Figure 2 (En.wikipedia.org, 2019).

Smallpox

According to the World Health Organization (WHO), smallpox is “an acute contagious disease caused by the variola virus” (World Health Organization, 2019). Smallpox is known as one of the most devastating diseases known to humanity as it would cause a person to have a severe rash with blisters and a high fever that can kill up to one-third of people who contract it (John P. Cunha, 2019) See Figure 2 for how smallpox can affect an individual. Smallpox is a highly contagious disease that is transmitted from person to person by inhalation (John P. Cunha, 2019). However, the infectious virus can remain on surfaces for up to a week and can also be spread through this transmission. (John P. Cunha, 2019). History of smallpox can be traced back to the Egyptians and has continued to affect the world until its recent eradication in 1980 due to the success of the worldwide public health initiative (John P. Cunha, 2019). In 1967 this global campaign was launched, successfully achieving 80% vaccine coverage in each country which provided the area with enough herd immunity to eradicate the disease (World Health Organization, 2019). It was vital for humanity to begin eradicating the disease for a wide range of economic and societal factors. There was an estimated $1 billion in savings as a result of the eradication(World Health Organization, 2019). This is because less people will be needing medical treatment to cure or manage the disease (World Health Organization, 2019). Furthermore, eradication will allow young children and elderly to be less likely, if not impossible odds of contracting the harmful disease protecting them and the ones they love. Smallpox is currently in two contained locations, one in an American lab and one in a Russian lab for further investigation (John P. Cunha, 2019). However, before it was a contained problem, smallpox affected the whole world. The smallpox disease affected European and Asian countries until the introduction of a vaccine created by Edward Jenner, Figure 3, who performed an experiment on a young boy which allowed the disease to steadily decline (John P. Cunha, 2019). The Americas was first exposed to the disease with the introduction of the European settlers. As the Native Americans had not previously been exposed to the disease, the introduction of smallpox wiped out nearly half of the population (John P. Cunha, 2019). The eradication of the disease began with the mandatory vaccinations for individuals in developed countries. This aided in the protection by herd immunity which ensures that the disease cannot spread as rapidly as before leading to its extinction (John P. Cunha, 2019). In 1980, the last case of smallpox was reported and the disease was officially eradicated. Smallpox had positive effects on the public image of science as vaccines as families could protect their loved ones from death of this disease.

MMR Vaccine

The MMR vaccine gives an individual 99% protection against measles, mumps, and rubella in order to protect a person from these diseases (Healthywa.wa.gov.au, 2019). Children are commonly vaccinated twice in order to provide thorough coverage from the 3 diseases as well as chicken pox (Healthywa.wa.gov.au, 2019). Adults are encouraged to get a dose of the vaccine if they had not had one previously (Healthywa.wa.gov.au, 2019). Plus there is no harm in adults receiving another dose of the vaccine in order to be further protected (Healthywa.wa.gov.au, 2019). In order to receive this vaccination, it is vital that the individual states is they aren’t feeling well, have any severe allergies, are pregnant or plan to be pregnant in the next 2 months, have received another live vaccination in the last month, have received blood, blood products or immunoglobulin in the last 3 months, have a disease or having treatment that may lower immunity (Healthywa.wa.gov.au, 2019). Furthermore, to prevent any harm to a developing baby, a pregnant woman shouldn’t receive the MMR vaccine as it is a live vaccine (Healthywa.wa.gov.au, 2019). There is no physical proof of it causing harm, however, it is not recommended (Healthywa.wa.gov.au, 2019). The MMR vaccine is safe, effective, and has limited numbers of side effects (Healthywa.wa.gov.au, 2019). Before the introduction of the vaccine, roughly 100 children died each year from measles whereas today, deaths are rare (Healthywa.wa.gov.au, 2019). The minimal side effects include low-grade fever, muscle aches, soreness, swelling, redness, and a small lump appearing at the injection site.

Vaccines

Vaccines offer protection from infections as they stimulate an immune response. This is done by injecting a version of the disease that will not infect the individual but will be enough to stimulate an immune response and create antibodies in the bloodstream strong enough to fight off the actual disease. Vaccines are the most effective way of preventing smallpox infection (John P. Cunha, 2019) as they are able to successfully immunize a population. The smallpox vaccine arose from a scientist named Edward Jenner who tested his theory of disease protection by inoculating a young boy with a material from a milkmaid who was infected with the milder form of smallpox, known as cowpox (John P. Cunha, 2019). The success of the experiment performed by Jenner led to the development of the smallpox vaccine which helped eventually head towards eradication (John P. Cunha, 2019). The smallpox vaccine is made from vaccinia which is obtained from the disease similar to smallpox. The vaccination is given by an inoculation which is injected with a two-pronged needle dipped into the vaccine solution (John P. Cunha, 2019). This needle then pricks the skin 15 times which can cause soreness, swelling, and a minor fever resulting in a blister that will fall off within two weeks (John P. Cunha, 2019). Even though there were minor side effects on the person who was given the vaccine, the bigger picture of the eradication of smallpox was of far more importance (John P. Cunha, 2019).

Impact of the smallpox vaccine on the public view of science

The smallpox vaccine has had a significant impact of the public views of science (John P. Cunha, 2019). In general, it can be stated that the smallpox vaccine was the start to modern medicine and had a great impact on the way medicine is practised today. The smallpox vaccine was extremely effective in protecting an individual against disease however there were a few minor side effects attached the immunisation of an individual (Edward A. Belongia, 2019). The individual could develop a headache, fever, rash, and soreness at the spot of vaccination (Edward A. Belongia, 2019). These symptoms would more commonly occur for a first time vaccination rather than a follow up one (Edward A. Belongia, 2019). Although the symptoms of smallpox vaccine were less than preferable, the symptoms of receiving the vaccine was clearly better than contracting the disease (Edward A. Belongia, 2019). Through the mandatory vaccination in the 1900’s in America, the disease was able to be slowly eradicated (John P. Cunha, 2019). This has a significant impact on the public’s view of science as the public would be able to live without being fearful of contacting the disease, however, the mild side effects of the vaccination did not satisfy the public’s needs. Before the vaccination smallpox seemed to control many people’s lives, taking away loved ones and causing a great deal of pain. However, with the introduction of the vaccine, it was able to limit the chances of losing a loved one or yourself to smallpox.

Evaluate the impact of scientific research, devices, and applications on world health and human wellbeing in relation to vaccination programs for the eradication of disease

Scientific research devices and applications

The smallpox vaccine had a significant impact on the development of future vaccines and the health of our society. As previously stated the smallpox vaccine was the start to modern medicine and had a great impact on the way medicine is currently practiced. Edward Jenner is well known for his innovative contribution to immunization and the ultimate eradication of smallpox (Riedel, 2019). As a result of Jenner’s vaccinations, the origin of smallpox as a natural disease has been lost in prehistory (Riedel, 2019). For many years, Jenner had heard the tales that dairymaids were protected from smallpox after having suffered from cowpox (Riedel, 2019). From this knowledge, Jenner was able to conclude that cowpox not only protected against smallpox but could be transmitted from one person to another as a deliberate mechanism of protection, now known as a vaccination (Riedel, 2019). Jenner went on the test this hypothesis by using a young dairymaid who had fresh cowpox lesions on her hands and arms, Figure 4 (Riedel, 2019). Following this, in 1796 Jenner inoculated an 8-year-old boy with matter from the milkmaid’s lesions(Riedel, 2019). The boy went on to develop a mild fever and discomfort (Riedel, 2019). Two months later, Jenner inoculated the boy again, this time with matter from a fresh smallpox lesion (Riedel, 2019). No disease developed for the boy and this allowed Jenner to conclude that the cowpox inoculation protected the young boy from contracting smallpox. This finding had a significant impact on the growth of modern-day medicine and lead the path of similar vaccinations to be created for other diseases.

World health and human wellbeing

Vaccinations had a significant benefit to the health and wellbeing of the world population (Ochmann and Roser, 2019) as less people got sick and less people died from the viral infection. Through the efforts of Jenner and the development of the smallpox vaccine, smallpox was able to be eradicated allowing for the suffering of humanity due to this disease, a problem that is no longer (Ochmann and Roser, 2019). Vaccinations serve as a great prevention of disease. As a result of the smallpox vaccination, the smallpox disease could be eradicated (Ochmann and Roser, 2019). As Figure 5 shows, each country eradicated the disease at different points in history leading to the full eradication in 1997 (Ochmann and Roser, 2019). Australia, New Zealand eradicated the disease in the 1910s due to the smaller population. This can be brought down to easier herd immunity for the smaller population (Ochmann and Roser, 2019). In the 1920’s Germany, Bulgaria, Serbia, Hungary, Austria, and Finland among some other countries managed to eradicate the disease but took them slightly longer than the other countries due to their larger population (Ochmann and Roser, 2019). In the 1930s Russia, Ukraine, and Poland, among some other surrounding countries eradicated the disease, in the 40s Greece, Italy, America, and Canada among other countries eradicated the disease (Ochmann and Roser, 2019). This can be brought down to higher populations as well as America’s compulsory vaccination program pushing the eradication to occur sooner than expected (Ochmann and Roser, 2019). Following this, Japan, South Korea, Vietnam, Portugal, Venezuela, and Mexico, as well as some other small countries eradicated the disease (Ochmann and Roser, 2019). The majority of countries that eradicated the disease in the 60s was the majority of South America, majority of Africa, and China (Ochmann and Roser, 2019). This can be due to the developing nature of these areas, meaning they have less access to doctors and vaccination resources meaning it will take longer to achieve the desired herd immunity (Ochmann and Roser, 2019). Finally, the last countries to eradicate the disease were Brazil, Nigeria, Sudan, Ethiopia, Somalia, Tanzania, Democratic Republic of Congo, Botswana, Iraq, Iran, Afghanistan, Pakistan, India, Bangladesh, and Indonesia (Ochmann and Roser, 2019). This can also be said that it was a result of the lack of medical resources in order to achieve the necessary herd immunity to protect the community(Ochmann and Roser, 2019).

Eradication of disease

Vaccinations in general have benefited humanity in several ways. Through vaccinations, less people have contracted deadly disease saving their lives. The community has become stronger as loved ones specifically elerly and young children are less likely to lose their life due to a deadly infectious diseases such as smallpox. Before the vaccination, smallpox caused death to an approximated 30% of people who caught the disease 10 to 16 days after the individual began feeling symptoms (Ochmann and Roser, 2019). The vaccination also benefited humanity as there was no treatment for smallpox (Ochmann and Roser, 2019). Once a person was infected it was impossible to treat them, doctors could only helplessly let the disease run its course and hope that the human immune system would be able to adequately fight off the disease (6). If the disease still existed it could be possible that modern-day antiviral drugs would allow treatment (Ochmann and Roser, 2019). However, at the time where disease was around and thriving, there was no treatment for an individual. As a result, the vaccination was able to provide an individual with a way to protect themselves from the initial infection and essentially death as almost a third of infections resulted in the death of the host (Ochmann and Roser, 2019). As a result of global vaccination programs successfully achieving 80% vaccinated individuals in each county the number of reported smallpox cases significantly decreased (Ochmann and Roser, 2019). As can be seen in Figure 6, the number of reported smallpox cases underwent significant changes that led to the eradication of the disease (Ochmann and Roser, 2019). In 1920, there was 400,00 reported cases, 3 years later there was a significant decrease to where there was 179,400 reported cases globally (Ochmann and Roser, 2019). From this to the officially eradication in 1978, there were several spikes in reported cases and several rapid decrease (Ochmann and Roser, 2019). The major spike occurred in 1948 where there was 632,858 globally reported cases, by far the year with the most reported cases in this data graph (Ochmann and Roser, 2019). Following this event, the numbers continued to drop with a few smaller spikes where the individuals were exposed more to the virus leading to the total eradication in 1978 (Ochmann and Roser, 2019). These trends can be due to vaccination programs in schools and the worldwide efforts to get 80% of the people in each country to have vaccination coverage (Ochmann and Roser, 2019). This eventually lead to the eradication of the viral disease and the overall well-being of humanity (Ochmann and Roser, 2019).

Examine a contemporary scientific debate and how it portrayed in mainstream media. You must examine the accuracy of the information, validity of data and reliability of information sources. In your research, you will identify the aim of your scientific area of research by writing inquiry question and a scientific hypothesis

Inquiry question

How does misrepresentation of science impact societies views on vaccination

Aim

To determine contemporary issues in science that have had a significant impact of societies views of the effectiveness of vaccinations

Hypothesis

Vaccinations are a useful tool to prevent against disease. Over time societies views on science has changed due to various media platforms. How can we address and fix societies views on science?

Journal articles

The misproven article, by Andrew Wakefield, which explained that the MMR vaccination causes autism has had a significant impact of the way humanity views the effectiveness of vaccinations. The falsely claimed side effects of vaccinations has been believed by some of the public, resulting in a large group of people fearing these side effects which have been disproved countless times having a significant impact on the public’s view of science.

In 1998, Andrew Wakefield and 12 of his colleagues published a case series which suggested that specific vaccines such as the measles, mumps, and rubella (MMR) may predispose children to developmental issues (Sathyanarayana Rao and Andrade, 2011). Despite the small sample size, the uncontrolled design and the speculative nature of the conclusions that the team reached, the paper received wide publicity and the MMR vaccination rates began to drop because parents were concerned about the risk of vaccination. Although immediately afterward, epidemiological studies were conducted and published, refuting the posited link between MMR vaccination and autism, the public still to this day expresses concern that this article could contain elements of truth (Sathyanarayana Rao and Andrade, 2011). The logic that the MMR vaccine causes autism was also questioned because a temporal link between the two is almost predestined by design or definition, occurring in early childhood (Sathyanarayana Rao and Andrade, 2011). This fear that the public felt resulted in the MMR vaccination rates dropping as parents were concerned about the risk of autism after vaccination (Sathyanarayana Rao and Andrade, 2011). This was detrimental as the amount of people contracting these harmful diseases were on the rise. 10 of the 12 of Wakefields co workers retracted the interpretation of the original data by expressing ‘no causal link was established between MMR vaccine and autism as the data were insufficient’ (Sathyanarayana Rao and Andrade, 2011). The Lancet, which is a weekly peer-reviewed general medical journal, completely retracted the Wakefield paper in February 2010 admitted that several elements in the paper were incorrect, contrary to the findings of the earlier investigation. Wakefield was held guilty of ethical violations as they has conducted invasive investigations on the children without obtaining the necessary ethical clearances and scientific misrepresentation (Sathyanarayana Rao and Andrade, 2011).

Implications of these journal articles

Scientists and organizations across the world spent a great deal of time and money refuting the results of a minor paper in the Lancet and exposing the scientific fraud that formed the basis of the paper in order to mend societies views on vaccinations (Sathyanarayana Rao and Andrade, 2011). Parents across the world refused to vaccinate their children with the MMR vaccine among several other vaccines out of fear that they would cause autism (Sathyanarayana Rao and Andrade, 2011). This exposed the children to the risk of the disease and the WHO saw a rise in the reported cases of measles. As Figure 7 depicts, measles were on the rise until the year 1997 where the numbers slightly drop (World Health Organization, 2019). From the publishing of the article in 1998, we can see the public beginning to stop vaccinating children at the year 2003, where the number of reported cases jumps to 4 million (World Health Organization, 2019). Ever since then, the number of reported cases have been on a steady incline (World Health Organization, 2019). This shows the effect that the article had on the public’s view of science as society has lost trust with science and the success rate of these vaccinations (World Health Organization, 2019).

Reliability, validity, and accuracy of the original journal article

The paper written by Andrew Wakefield is a false article regarding that the MMR vaccination can result in the development of autism. Due to the fraudulence of this article it can be deduced that the reliability, validity, and accuracy is limited. The sample small size indicates that the paper was limited in its accuracy as not enough people were tested to achieve a true conclusion. The way that the experiment was carried out was uncontrolled showing that this test cannot be considered valid. Finally, the speculative nature of Wakefield’s conclusions allows readers to come to the conclusion that the journal article is not reliable. Therefore, the Wakefield journal article was fraudulent and cannot be considered reliable, valid and accurate.

Reliability, validity, and accuracy of the Lancet journal article

The Lancet journal article essentially proved the original Wakefield article false. Due to the reputation of the Lancet, it can be stated that the source is reliable. Furthermore, the Lancet article can be considered valid as several tests and controls were used in order to state that Wakefield’s paper was fraudulent. Finally, the Lancet article can be considered accurate as they conducted several tests to ensure the truth of the claimed side effect of autism from the MMR vaccine. Therefore, the Lancet journal articles can be said to be valid, reliable, and accurate.

Reliability, validity, and accuracy of the media

The media played an important role in the large problems that this article caused surrounding the public’s views of science. The media cannot be considered accurate as it is common that they source their information from places that will not provide them with the most correct answers. The media cannot be considered reliable as the information that is presented is commonly from one source, whereas to make it more reliable it would need to be sourced from at least three accurate sources with similar information. Furthermore, the media cannot be considered valid as the common interest of the media is to grab the public’s attention and through manipulating information they way they present different topics cannot be considered valid.

Conclusion

The past events of cowpox, smallpox, and the recent problems surrounding the MMR vaccine has had significant implications on the public’s view of science. Vaccination programs, scientific research, and other devices has had a significant impact on the success of the global smallpox vaccination initiative and as a result, benefitting humanity’s wellbeing. Although the success and positive reaction to vaccinations, the moder

Thesis:

The opposition to vaccination was cultural and built upon societal value in money which resulted in the spread of mass religious hysteria, propaganda, and falsified data.

Smallpox is a disease where small blisters pop up on the face, arms, and body. These then fill up with pus and customs develop a rash. It’s a deadly disease. Vaccinations and the anti-vaccination movement go hand in hand with the rise and eradication of Smallpox.

During the 15th and 16th, Century Smallpox was at its peak. Because it was easily transmitted, it was hard to control. Medical practices were still backward. Doctors believed that the color red and bloodletting were the best treatment options. “Between 20 and 60 percent of the infected died” and those who survived were left with life-altering scars or disabilities. One doctor remarked that those who could afford treatment were doing worse off than those who couldn’t. This didn’t stop him from prescribing eccentric treatments though. ()

Besides backward medical practices, scientific knowledge had advanced during this time. Germ theory was forming, and rudimentary “vaccines” could be found. Vaccination did not start in Europe, many other cultures and areas including China, Africa, and India had their own system of “inoculation“. It was general knowledge that once one bore the tell-tale scars of Smallpox he or she couldn’t get sick again. Doctors interpreted this and began inoculation via different methods, including ingesting nasally or injecting. By the 17th century, western Europe had begun utilizing methods they’d seen in Turkey known as Variolation. This was the process of removing pus or liquid from the smallpox sores on a mildly infected person and either inhaling them or scratching the liquid into the arm of a healthy person. The variolated person would then develop the symptoms of Smallpox. Variolation had a higher survival rate than Smallpox itself but it was not staggering and was quite questionable. Much of the time the infection spread too quickly to control. Many argued that the act of inoculation was adding to the risks to the epidemic and not decreasing the number of deaths. ()

In 1763 variolation was banned in France. The experimentation going on that time would have been banned by today’s standards because it was not controlled or ethical. Variolayed patients were not quarantined or given proper care, and the diseases spread to those who were not participating. This made people nervous and distrustful, keep in mind that we doctors still practicing bloodletting with leeches, people still believed diseases were caused by supernatural sources and curses. It made better sense to let the disease run naturally instead of bringing it to the population manually. ()

By the second half of the 18th century, smallpox was at its most destructive stage in Europe. Variolation was not working well enough, and the public was losing confidence. “There was an observation among country folk in several parts of Europe that milkmaids were rarely pockmarked, and the local belief was that they were protected because of an infection acquired from cows”. Dr. Edward Jenner of Gloucestershire, England was very interested in this. He had spent many years studying variolation and felt that this phenomenon may lead to a better system. In May 1796 he tested this cow theory by inoculating an eight-year-old boy, with discharge collected from a cowpox-infected dairy maid’s hands. The boy only developed a mild fever and experienced discomfort near the incision. Jenner inoculated the boy two months later, this time with pus from a fresh smallpox lesion. No disease developed, and he concluded that his inoculation worked. Jenner then arranged a paper depicting this case alongside 13 different people who had contracted either horsepox or cowpox before being presented to smallpox. The Royal Society dismissed this paper and proposed that Jenner stop his cowpox investigations due to speculation that he tampered with the data. (Riedel, 2005)

However, Jenner privately published a small booklet entitled An Inquiry into the Causes and Effects of the Variolae Vaccine, a disease discovered in some of the western counties of England, particularly Gloucestershire and Known by the Name of Cow Pox. It was a report on his findings and a manual for doctors to repeat his inoculations. It was a successful paper. So much so that vaccination was taken up with remarkable speed all over Europe and in the newly independent United States of America. Vaccine production was conducted without any sort of state control. Physicians maintained their own stocks of ‘humanized’ vaccines by arm-to-arm inoculations. The Spanish Royal Philanthropic Expedition to brings smallpox vaccination to the New World and Asia due to Edward’s efforts.

“The distrust and skepticism which naturally arose in the minds of medical men.. has now nearly disappeared. Many hundreds of them, from actual experience, have given their attestations that the inoculated Cowpox proves a perfect security against the Smallpox; and I shall probably be within compass if I say, thousands are ready to follow their example.” wrote Jenner. He was confident in his findings and felt that smallpox was “the most dreadful scourge” and that his vaccination method would help end it. Smallpox was eradicated in 1980 by the World Health Organization, largely due to vaccination efforts, just shy of Jenner’s 200 prediction.

Regardless of Jenner’s naivety in his support, the smallpox vaccination faced opposition since its conception. At the beginning of the 19th century, the educated public was receptive to Jenner’s idea. “Unlike many other diseases that were common at the time, smallpox struck at all levels of society and was the object of much dread. Variolation had by then been widely accepted; Jenner’s vaccine was a way of providing the advantages of variolation without the risks either to the person inoculated or to his fellows” (Smallpox and its eradication – Red Book, 2019). But Jenner was not without critics. Other scientists were particularly critical of Jenner. They argued that the disadvantages of vaccination, especially the danger of transmitting syphilis by arm-to-arm vaccination.

Members of the Church raised objections that vaccination was interfering with the will of Go. English theologian Reverend Edmund Massey. argued that “diseases are sent by God to punish sin and that any attempt to prevent smallpox via inoculation is a diabolical operation.” (Watling,2019). Average God-fearing citizens already distrusting of a halfway successful science were now angered by the blatant disrespect of God, especially by their kings and queens. Priests also preached that Satan was the original vaccinator because of the bible story in which Satan tortures a man with boils. Priests accused doctors of subverting the divine plan by changing who lives and dies. Lastly, Priests argued that diseases like Smallpox were a form of birth control for the poor families who had too many children and that God taking those children out of misery. () Keepin mass hysteria about diseases alive provided churches with a steady influx of god-fearing church goers and a steady source of income.

Doctors who had been living comfortably because of the lengths wealthy patients were willing to go to and because of the fees they charged for treatments began to incite fear in the public. They published reports that vaccinations made from a cow would turn you into a cow. And later resorted to publishing images depicting people growing horns, tails, or whole cows after being vaccinated in newspapers to spread their message to the illiterate of Europe.

Average citizens did not understand how putting “poison’ into themselves could protect themselves from future diseases. And now, not only were their doctors telling them to stop vaccinating, but their religious leaders were as well. The performed sermons and published reports reached citizens in numbers that honest doctors and vaccine supporters could not copy.

Mandatory vaccination laws were passed in England from 1853 to 1871, the first of their kind. These permitted parents to be fined until their child was vaccinated, made negligent parents liable, and in default of fines and costs, parents could be jailed. Citizens were outraged, especially those working in factories as this was the time of the industrial revolution.

“Compulsory vaccination conflicted with growing sentiments favouring personal freedom of choice” ( The History Of Vaccines And Immunization: Familiar Patterns, 2017 Workers were already angered by the situation that they had to work in and felt that employers requiring them to take vaccinations, regardless of the personal benefit was another infringement upon their personal liberties. It was another instance in which employers were not seeing their workers as individuals but simply as a means of creating good and that they were just simply fixing machinery to make it more efficient. The opposition of factory workers against mandatory vaccinations was connected to Socialism efforts.

Gradually, individuals found organized means of expressing their discontent, creating AntiCompulsory Vaccination Leagues, to convey the sentiments of the rural population and the agricultural middle classes. ‘In retrospect, the movement was part of a wider public reaction against the advance of `new science’ and scientific medicine. Fear, distrust, and the human tendency to cherish `natural’ methods of treatment and `sanitary’ methods of prevention could be overcome only by educational means.” (Belloginia, 2003) This would have required the cooperation of physicians and lawyers which was absent at this time. Instead, the laws were repealed.

During this time, influential people in the anti-vax movement in Europe came and visited the US to spread their message and gain support. They left behind the seed’s for the anti-vax movements in the US. “British reformer William Tebb began spreading anti-vax propaganda to Americans in the 1870s, including the (fictitious) statistics that 25,000 British children were ‘slaughtered’ each year because of vaccines and that 80 percent of smallpox deaths were among people who had been vaccinated.” (The History Of Vaccines And Immunization: Familiar Patterns, 2019).These arguments encouraged anti-vaxxers in the U.S.

The American anti-vaxx movement was also strengthened by patent medicines and homeopathic ‘cures’ in the mid-to-late 19th century. Anyone could call themselves a physician and claim that lifestyle, diet and medicinal herbs were enough to ward off even the most serious diseases. Vaccination programs directly threatened these salesmen—and they fought hard against them.

One of these influential “physicians”, DD Palmer, founded Chiropractic Medicine in 1895. He had very out-of-the-norm practices including magnetic healing and convinced much of the American public to believe in his case for an all natural approach. He hated vaccines, after all they prevented much what his business was based on. “The idea of poisoning healthy people with vaccine virus… is irrational. People make a great ado if exposed to a contagious disease, but they submit to being inoculated with rotten pus, which if it takes, is warranted to give them a disease”. Palmer not only rejected the idea of smallp]ox vaccinations, he outright rejected smallpox’s deffintion ‘If we had one hundred cases of smallpox, I can prove to you, in one, you will find a subluxation and you will find the same condition in the other ninety-nine. I adjust one and return his function to normal… There is no contagious disease.” (Gleberzon, 2013).

Another saleswoman was Lora Little. In 1906 she had a son named Kenneth Marion Little. In April 1896 he died. Lora blamed his death on the smallpox vaccine. She began a crusade against vaccines and published a book, Crimes of the Cowpox Ring: Some Moving Pictures Thrown On The Dead Wall of Official Silence, where she details and records the photographs of the accounts of vaccinations gone haywire. One of the patients photographed is Benjamin Olewine. He is close to the end of his life and has got very large soft tissue tumour, most likely a sarcoma, growing out of his upper chest. It’s on the same side that he was vaccinated, but nowhere near the vaccination site. Little has a sarcastic footnote to his photograph: “saved from smallpox by vaccination”. Her book sold thousands of copies, her loss of her son coupled with the public’s appetite for gore and scandal about the government-backed vaccination programs labelled it a success.

The obvious lack of science and fact-based research was conveniently overlooked But, as the Children’s Hospital of Philadelphia notes, “…Mrs. Little’s son, Kenneth, was vaccinated in September 1895 and died in April 1896. Between the time of inoculation and death, he suffered recurrent ear and throat infections, measles and diphtheria. The latter was the ultimate cause of his death. Mrs. Little pointed to ‘the artificial pollution of the blood,’ [that] had fatally weakened his constitution and left him at the mercy of the subsequent infections.” (“Lora Little: The Vaccine Liberator | History of Vaccines,” 2019)

So in the best case scenario, Keneth did not die because of his vaccination. Regardless, Little’s story resonated with the rest of America.”If you look at what was happening to American children at that time, then you will see that his run of bad luck was by no means exceptional. At that time, only six out of ten American children actually lived to count ten candles on their birthday cake” (Williams,2011). Parents saw their tragedies in Littles trauma, and with pressure from other influential people such as Palmer, vaccination rates dropped and participation in ANti-Vaccination leagues skyrocketed in America at this time. Both Palmer and Little grew rich as a result and the mortality rate of Smallpox and other preventable diseases, which had just begun to drop, started to rise again.

Fast forward almost a hundred years after the eradication of smallpox. Largely due to the education of the general public and multiple smallpox scares.

The now ex-doctor Andrew Wakefield connected vaccinations to Autism. Autism has been around for a long time and can be argued that it is on the rise again and there are lots of specialists setting themselves up, with a particular interest in autism. Andrew Wakefield published a paper in 1998, in the Lancet, “claiming to have found a connection between vaccination with MMR, Measles, Mumps, Rubella, and the subsequent development of gut disease, Crohn’s disease, and also with autism in children”. This was published in the Lancet, one of the top three highest profile medical journals on the planet. It actually too over a decade to get Wakefield’s paper properly reviewed and critiqued and retracted.It has now turned out, thanks to a fairly exhaustive investigation by the BMJ that this was science-driven by money. Andrew Wakefield was hired by a solicitor to help a group of parents sue the vaccine manufacturers.

This is a cycle seen throughout history. People of great societal standing, whether religious or scientific scum to the greed of money and publish findings or data and preach against the evils of a service designed for the public good.

Yearly we are told to go receive our annual flu shot, and when we are cut by metal or bitten by a dog we are sent to get a tetanus shot or a rabies shot. When you are born you are given a vaccination for Hepatitis B, but what evoked the idea of such practices?

Vaccines were created to help fight viruses, also known as viral diseases that attack the human body. Viruses are very complicated parasites and they are extremely small. These parasites are made up of four main parts: an envelope to protect the virus with glycoproteins on the outside for attachment, the capsid or protein coat inside the envelope, and the DNA or RNA segments that are held inside the capsid that make up the virus. Viruses are actually not alive, they can not reproduce or metabolize without a host cell. A virus works by entering the body and finding live host cells and, since they need the host cell to live, the virus attaches to it. After the virus has attached to the cell, the virus will inject its own DNA/RNA into the host cell. The host cell will then copy the DNA/RNA and protein coats that they are held in. Eventually, the cell will break apart and this action will spread new virus cells throughout the body for the same process to repeat. Viruses are tricky because they basically have to be caught before initial infection. The immune system is the only true defense that one has against viruses, but there are ways to boost the immune system, and that is where the idea of vaccines came from. Vaccines are made today by using the capsid to introduce the virus formation to the immune system. The protein coat won’t harm the immune system. In fact, it helps it to make antibodies so that if one was introduced to the virus the immune system knows how to fight it off quickly and efficiently. Smallpox was a very big agent in the discovery of all of these ideas. The virus smallpox changed the world by introducing ideas that have helped the world develop into what it is today.

Smallpox is an infectious disease that is well known around the world. Its scientific name is Variola major virus and it is well known for being an epidemic, a spreading of disease or virus in a certain area, that later turned into a pandemic, a worldwide virus or disease. The virus is hard to track back in time because its occurrences started happening a very long time ago, and a lot of the sicknesses were not documented, but it is believed to have originated in Africa from which it spread to other civilizations through trade. Things like the Nile River and the Silk Road probably lead to the spreading through China, and from China to Europe. The virus was then brought to the Americas’ by travelers from the region. For example, “Spaniards brought the virus over during their explorations and conquests, and Europeans brought it through explorations of new territory” (“Smallpox”). The virus being brought to these areas only made matters worse because these people had no natural immunity. Natural immunity occurs when one is exposed, even slightly, to a bacterium or virus, and these indigenous populations had no natural immunity built up. In fact, in the article “Smallpox Devastates Indigenous Populations” the author states that “Introduced into the New World by Spanish explorers and African slaves, smallpox killed as much as 75 to 90 percent of the indigenous population, which had no natural immunity to the disease”(1218-1219). Eventually, smallpox could be found all over the world, and it needed to be stopped. Terrible epidemics broke out all over the world and “In 1721, nearly half the residents of Boston (Massachusetts) contracted the disease, establishing the record for the worst epidemic to hit the New England town” (“Smallpox”). Smallpox was becoming a very big issue and methods for stopping the virus needed to be found.

As smallpox spread, new ideas arose about how to fight off the infection. Many people during this day in age didn’t actually know what a virus was. Scientist also could not look at viruses under a light microscope because viruses are too small, so smallpox was not known to be a virus until the electron microscope was created. People started to come up with their own means of fighting the virus. One way, was used by the Chinese, was when “they had a practice to grind the scabs of a smallpox victim and blow the powder through a tube into the nose of a healthy person. People inoculated in this way would suffer a brief illness themselves and would be contagious for a period, and a few would contract a serious infection and die; but the risk of dying was far less than in a smallpox epidemic (roughly 2 percent, compared with 20 to 30 percent), and the benefit of immunity was clear” (“Smallpox”). This action is similar to receiving FluMist through the nose to get immunity rather than through a needle, though the practice of the Chinese was not nearly as safe as what FluMist is today. The reason the practice worked was because they used scabs that had fallen off so it was a weakened form of the virus, it acted as a less strong agent that was easier for the immune system to create antibodies for. This is why the death rate was decreased so much by this practice. Another mean to try to cure those who had the virus was through bloodletting. The idea was “the general approach of 17th-century English physician Thomas Sydenham, which included procedures such as bloodletting, induction of vomiting, and administration of enemas in order to ‘keep the inflammation of the blood within due bounds.’”(“Smallpox”). Bloodletting wasn’t the most practical because the virus spreads through the lymph nodes and the white blood cells in your bloodstream. The person would most likely die of bleeding to death if bloodletting was continued for long periods of time to try to flush the body of toxins. There was one more way than many people used to try to fight the virus before smallpox allowed for the first vaccine to be created. Inoculation was the closest thing to a vaccine at the time. This practice was the most accepted practice throughout Europe and it allowed for some relaxation. After Lady Mary Wortley Montagu introduced the practice to Europe, a lot of people started to get Inoculated. The process of the procedure involves the pustule of a victim being cut open to get the virus onto a knife and from there the same knife is used to cut another victim, therefore introducing a weakened strain of the virus to the one who has been cut. Inoculation still would probably be used today if not for the fact that it became unsafe. In the article “Smallpox”, found in Gale in Context, the author states that “inoculation was a double-edged sword. Because few people died from inoculated smallpox, they dropped their defenses and failed to take quarantine precautions; a mild case of inoculated smallpox was still contagious and could spawn a deadly natural epidemic. There were also side effects from these inoculations, such as blindness, tuberculosis, eye diseases, and disfiguring pock marks” (“Smallpox”). The world needed a better solution that could be controlled easier, but what could we find?

The answer to the world’s problems came from Dr. Edward Jenner. Jenner was a European scientist who found interest in the virus. He was interested in finding newer and safer ways to protect against the deadly virus. Jenner then developed an idea based off of observation that would later lead to an experiment. Jenner used the scientific method to create the first vaccine. He had “noticed that cattle handlers infected with a related disease called cowpox did not contract smallpox” (Shmaefsky 199-202). This idea lead to a hypothesis that most likely resembled: If I inoculate someone with cowpox, then they will be immune to smallpox because the milkmaids I observed are immune to smallpox, and they have had cowpox. From this point, Jenner conducted an experiment. James Phipps was inoculated with cowpox found on a milkmaids hand, and after a few days, James was introduced to natural smallpox. James had no reaction to the smallpox, and the first vaccination had been made. All pox viruses are in the same family, so smallpox and cowpox must be similar if cowpox works to get the immune system to create smallpox antibodies. Jenner’s experiments allowed for the world to begin the fight against smallpox.

Through the creation of the World Health Organization (WHO) and their vaccination programs, the world was eventually deemed naturally created smallpox free. Sadly, the world still fears smallpox. Even after smallpox was eradicated, the world kept stock of the virus “Stocks of variola major were kept in only two countries, the United States and Russia, which had cultivated the virus as part of their biological weapons programs during the Cold War” (“Smallpox”). There are many fears that smallpox might be used as a biological weapon to inflict serious harm onto a country or certain group of people. Some people debate on if smallpox is an actual candidate for a biological weapon or not. For example, “Dr. Rick Hall, of the Centre for Applied Microbiological Research, said that there would have to be a means of getting the virus into the living cells, and out again, and it would have to be stored so that it wouldn’t degrade – for example, by freezing it. By contrast, anthrax is easy to cultivate in a fermentation brew, like making beer and is easy to store in its spore form”(Laurance 3). Smallpox would be hard to cultivate and come by, but if obtained it could still become extremely dangerous. Also, bioterrorism would be more successful with a virus vs a disease because diseases can be treated with antibiotics. Juli Berwald stated otherwise by saying “The variola virus is extremely virulent and is among the most dangerous of all the potential biological weapons” in her article “Variola Virus” ( 226-227). When looking at the facts about smallpox, it seems to be a strong possible agent for a bioterrorism attack, and if one of these attacks was to occur, may the storage of the virus allow for vaccines to save us all.

In the end, smallpox has changed the world for the better and for the worst. If not for smallpox, we might not have ever made the biological discoveries that we did such as vaccines. Smallpox also brought the world together in the fight to eradicate it, but if a terrorist attack were to occur using the virus, then the world could be torn apart. The world would be very different today if not for smallpox and Edward Jenner’s experiments. The next time you get a vaccine, think about the hard work and trial and error that allowed you to be protected from viruses.

Introduction:

Smallpox is a disease that attacks the skin cells, spleen, bone marrow, and lymph nodes and causes rashes, vomiting, and high fever. It is also an airborne disease which makes it especially dangerous because they tend to spread easily through coughing, sneezing, and other methods of contact with bodily fluids. 30% of infected people died within the first two weeks of having the infection. Smallpox is the only disease in the world that has been successfully eradicated. According to the online Smithsonian website “An estimated 300 million people died of smallpox in the 20th century alone”. In the 16th Century, the process of variolation was frequently used as a treatment for smallpox in China and India. Edward Jenner, an English doctor, displays the effectiveness of using the cowpox infection in protecting people from smallpox, forming the basis for vaccination.

Definition of Key Terms:

Britannica defines Smallpox as an acute infectious disease that begins with a high fever, headache, and back pain and then proceeds to an eruption on the skin that leaves the face and limbs covered with cratered pockmarks, or pox. Smallpox is also often referred to as variola due to the infection being caused by either variola major or variola minor.

Merriam Webster has defined Variolation as the deliberate inoculation of an uninfected person with the smallpox virus (as by contact with pustular matter) that was widely practiced before the era of vaccination as prophylaxis against the severe form of smallpox.

According to the Oxford dictionary, Epidemics are defined as the widespread occurrence of an infectious disease in a community at a particular time.

As per Merriam Webster Cowpox is defined as a mild eruptive disease of the cow that is caused by a poxvirus (species Cowpox virus of the genus Orthopoxvirus) and that when communicated to humans protects against smallpox.

Vocabulary.com defines Ring Vaccination as the act of administering vaccine only to people in close contact with an isolated infected patient; prevents the spread of a highly infectious disease by surrounding the patient with a ring of immunization.

Lexico defines Vaccines as a substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease. Vaccination derives from the Latin word ‘Vacca’ which means cow, because of the early use of the cowpox virus against smallpox was very significant.

According to The Food and Drug Administration (FDA), Lyophilization is defined as a process in which water is removed from a product after it is frozen and placed under a vacuum, allowing the ice to change directly from solid to vapor without passing through a liquid phase (freeze-drying).

Description of Event:

1570-1085bc

The earliest traces of smallpox were believed to have appeared at around 10,000 BC, during the time of the first agricultural villages in northeastern Africa. It was most likely originated from such groupings to India and China through ancient Egyptian traders. The earliest evidence of skin lesions matching those of smallpox is found on faces of mummies from the time of “the 18th and 20th Egyptian Dynasties (1570–1085 bc). The embalmed head of the Egyptian pharaoh Ramses V (died 1156 bc) shows evidence of the disease. Around that time, smallpox was expressed in the ancient Sanskrit texts of India.

1800’s

In the 18th century in Europe it was estimated that around “400,000 people died yearly of smallpox”, and “one-third of the survivors went blind”. The signs of smallpox, or the “speckled monster” as it was known in 18th-century England, appeared abruptly and the consequences were disastrous. “The case-fatality rate varied from 20% to 60%, and in infants, it was even higher, approaching 80% in London.

May 1796

Edward Jenner was born on May 17, 1749, and over the course of many years, he had heard and understood folk tales that said dairymaids were immune to smallpox after naturally having suffered from cowpox. In May 1796, he began to take steps toward proving his theory. Jenner found a young dairymaid named Sarah Nelms, who had newly formed cowpox lesions on her body. He used scabs from the pustules and attempted to inoculate James Phipps. Following that he began to develop a fever which he eventually recovered from. A few months later, Jenner injected him with smallpox, and he was immune therefore proving Jenner’s theory.

1905

Jacobson vs Massachusetts was a legal case that was fought between Pastor Henning Jacobson and The Commonwealth of Massachusetts. Jacobson argued that it was a “invasion of his liberty” to force him to get his son vaccinated. He said that the vaccine caused him great pain and was reluctant to vaccinate his son. He lost the case and was fined.

1965

In 1965, the plan to eradicate smallpox globally were revitalized, with the establishment of the Intensified Smallpox Eradication Program.

Current Situation (1965)

In the 1960s, smallpox was still endemic. However, the practice of using vaccinations did not spread to the rest of the world, despite the vaccine’s success in Europe. There were an estimated 10 million cases of smallpox worldwide by the mid-1960s, specifically in South America, sub-Saharan Africa, India, Burma, Bangladesh, and Indonesia. The World Health Organisation (WHO) was working with countries in South America, Asia, and Africa to eradicate smallpox. The first attempt in 1958 to globally eradicate smallpox was not successful due to obstacles such as- lack of funds, commitments from countries, and a lack of vaccine donations.

Religious Barriers and Public Rejection

Religious groups were skeptical towards using the smallpox vaccine and truly believed that if God (or Gods) had chosen to give them smallpox, to interfere with his plans would be inappropriate. Some religions even had smallpox deities for example: shapona, sakpata, shitala, babalú- Ayé etc. People’s strong faith was a complicated obstacle which deterred them from accepting the vaccines. Another major problem was that this was the first time people were taking animal products and inoculating it into humans. Those who found it unnatural and revolting were hostile towards the inoculates. Early 19th-century illustrations showed cow parts growing out of the bodies of people who were vaccinated, this propaganda lead to the increased fear of vaccinations.

Bifurcated Needles

Dr. Benjamin Rubin created one of the most important tools used in mass vaccination campaigns in the year 1965, the Bifurcated Needle. The appropriate dosage of the reconstructed (freeze-dried) smallpox vaccine was held in the two prongs of the needle. The prongs were ideal as they would puncture into the skin easily to the essential depth. It was also much more cost effective, reliable and easy to transport and operate with.

Major Parties Involved and Their Views

Soviet Union

Viktor Zhdanov was a Soviet virologist who played a critical role in the movement to eradicate smallpox. He had seen smallpox contained in the Soviet Union in the 1930s and didn’t understand why the same methods couldn’t be used elsewhere. Zhdanov was not only experienced in running an eradication campaign, but he also believed in a technique known as lyophilization or freeze-drying. Evidence from the 1950s had shown that several medicinal products could be preserved in this way, the smallpox vaccine was one of them. The freeze-dried vaccine was easy to transport and can be reconstructed when needed. Zhdanov believed that freeze-dried vaccines would be an essential tool in the WHO’s smallpox eradication program, and said his government was ready to furnish WHO with supplies. Zhdanov convinced the WHO Member States to support his plan, and at the next World Health Assembly, in 1959, they voted in favor of starting an intensified global smallpox eradication campaign. If Zhadanov had not lobbied his idea to the UN it is likely that things would be very different.

UN Involvement, Relevant Resolutions, Treaties, and Events (before 1965)

The WHO came into existence in 1948. At that time the smallpox virus was killing hundreds of thousands of people worldwide. In many ways, it was exactly the kind of issue that the WHO was expected to take on, a disease that was beyond the scope of any individual nation to combat. In 1953 at the annual World Health Assembly, the topic of eradicating smallpox was discussed, but there wasn’t much enthusiasm towards the idea. In the 1950’s it seemed impossible that any disease could be eradicated globally, even though it was becoming more realistic because countries like the US had their last (natural) outbreak of smallpox in 1949.

Resolution: Regional Committee for the Western Pacific, 009. (‎1958)‎. Smallpox eradication (‎Resolution)‎. Manila: WHO Regional Office for the Western Pacific. WP/RC9.R9 – http://iris.wpro.who.int/handle/10665.1/8795

Possible Solutions

Emphasizes the importance of easy access to volunteers from the SEP to the public health officials of member nations through regular progress report to determine effective next steps.

SEP officials would be trained and experts in the effective techniques to contain and prevent the spread of diseases. The SEP should be able to effectively assign staff to where they need to be.

Urges member nations to negotiate the terms of variola virus stocks stock to prevent the weaponization of smallpox.

Merriam Webster defines bioterrorism as terrorism involving the use of biological weapons. Evidence shows that there is a possibility that smallpox has been used as a biological weapon during the colonization of North America. Were British colonialists in the 18th century gave smallpox-infected blankets to Native Americans.

Encourages the SEP to operate in smallpox-specific hospitals to prevent the further spread of diseases,

Though hospitals are thoroughly cleaned and extensive protocols are in place, it is impossible to ignore the fact that hospitals hold sick people in close proximity. Due to the easily contagious nature of smallpox, it would be safer to have separate hospitals/ camps for smallpox.

Hospital staff and volunteers should be aware of hospital protocols and should remain cautious.

Notes the benefits of Anti-vaccination fines.

In The United Kingdom, the Vaccination Act was implemented in 1853. Which made it compulsory for children to be vaccinated against smallpox in the first three months of their lives. Vaccinations from an early age which are provided by the hospital make it convenient for parents to vaccinate their children.

​Useful Links/Works Cited

1. WHO. Bugs, Drugs and Smoke Stories from Public Health. World Health Organization, 2011.
2. CDC. “The Spread and Eradication of Smallpox | Smallpox | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Aug. 2016, www.cdc.gov/smallpox/history/smallpox-origin.html.
3. WHO. “Smallpox.” World Health Organization, World Health Organization, 2 May 2018, www.who.int/csr/disease/smallpox/en/.
4. WHO. “The Smallpox Eradication Programme – SEP (1966-1980).” World Health Organization, World Health Organization, 22 May 2014, www.who.int/features/2010/smallpox/en/.
5. CDC. “History of Smallpox | Smallpox | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Aug. 2016, www.cdc.gov/smallpox/history/history.html.
6. CDC. “History of Smallpox | Smallpox | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Aug. 2016, www.cdc.gov/smallpox/history/history.html.
7. TED-Ed, Simona Zompi. “How We Conquered the Deadly Smallpox Virus – Simona Zompi.” YouTube, YouTube, 28 Oct. 2013, www.youtube.com/watch?v=yqUFy-t4MlQ.
8. Flight, Colette. “History – British History in Depth: Smallpox: Eradicating the Scourge.” BBC, BBC, 17 Feb. 2011, www.bbc.co.uk/history/british/empire_seapower/smallpox_01.shtml.
9. Geographic, National. “Smallpox.” Information and Facts | National Geographic, 17 July 2019, www.nationalgeographic.com/science/health-and-human-body/human-diseases/smallpox/.
10. Riedel, Stefan. “Edward Jenner and the History of Smallpox and Vaccination.” Proceedings (Baylor University. Medical Center), Baylor Health Care System, Jan. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/.
11. Discovery, DCODE by. “Can Smallpox Be Weaponised?” YouTube, YouTube, 10 Oct. 2018, www.youtube.com/watch?v=DgBQtrG_7EE.
12. Garon, Julie, and Walter A. Orenstein. “Learning from Smallpox: How to Eradicate a Disease – Julie Garon and Walter A. Orenstein.” YouTube, YouTube, 10 Mar. 2015, www.youtube.com/watch?v=oBSandHijDc.
13. Atkinson, Jason. “Small Pox │ Full Documentary.” YouTube, YouTube, 8 Sept. 2016, www.youtube.com/watch?v=d2rNvII842w.
14. “SMALLPOX Eradicating an Ancient Scourge.” Https://Www.who.int, Https://Www.who.int, www.who.int/about/bugs_drugs_smoke_chapter_1_smallpox.pdf.
15. Ochmann, Sophie, and Max Roser. “Smallpox.” Our World in Data, 28 June 2018, ourworldindata.org/smallpox.
16. “Smallpox.” World Health Organization, World Health Organization, 12 Oct. 2011, www.who.int/biologicals/areas/vaccines/smallpox/en/.
17. “Smallpox.” World Health Organization, World Health Organization, 13 Jan. 2014, www.who.int/biologicals/vaccines/smallpox/en/.
18. Center for Global Development. “CASE 1: Eradicating Smallpox.” Center For Global Development, www.cgdev.org/page/case-1-eradicating-smallpox.
19. Riedel, Stefan. “Edward Jenner and the History of Smallpox and Vaccination.” Proceedings (Baylor University. Medical Center), Baylor Health Care System, Jan. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/.
20. Gathany, James. “Bifurcated Needle.” Global Health NOW, www.globalhealthnow.org/object/bifurcated-needle.
21. Rienzi, Greg. “18th-Century Cow Hair, a Two-Pronged Needle, and the Eventual End of Smallpox.” The Hub, 12 Jan. 2015, hub.jhu.edu/2015/01/12/smallpox-exhibit-welch-medical-library/.
22. Milton, Donald K. “What Was the Primary Mode of Smallpox Transmission? Implications for Biodefense.” Frontiers in Cellular and Infection Microbiology, Frontiers Media S.A., 29 Nov. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3509329/.
23. WHO. “Smallpox Eradication (‎Resolution)‎.” World Health Organization, World Health Organization, 2 Jan. 2014, apps.who.int/iris/handle/10665/141748.
24. Regional Committee for the Western Pacific, 009. “Smallpox Eradication (Resolution).” World Health Organization, World Health Organization, 1 Jan. 1970, iris.wpro.who.int/handle/10665.1/8795.
25. Thompson, Helen. “Should We Destroy Our Last Living Samples of the Virus That Causes Smallpox?” Smithsonian.com, Smithsonian Institution, 1 May 2014, www.smithsonianmag.com/science-nature/should-we-destroy-our-last-living-samples-virus-causes-smallpox-180951321/.
26. Kiger, Patrick J. “Did Colonists Give Infected Blankets to Native Americans as Biological Warfare?” History.com, A&E Television Networks, 15 Nov. 2018, www.history.com/news/colonists-native-americans-smallpox-blankets.

A vaccine is defined as a harmless derivative of a pathogen that triggers the body’s immune system response to act against the harmful pathogen. The history of the development of modern vaccines stems from the ground-breaking research undertaken by Edward Jenner, now more famously known as the father of immunology. His revolutionary and pivotal discovery of the smallpox vaccination laid the foundations for modern-day medicine practices. He pioneered the movement of inoculation as a preventive measure for rampant maladies saving countless lives in the process and paved the way to the eradication of two major worldwide viral infections: smallpox and rinderpest. The arsenal of available vaccinations continues to expand yearly in order to tackle the ever emergence of new potentially dangerous contagions such as the Ebola and Zika virus epidemics in 2014 and in 2016 respectively. The innovative future of immunization is heading into a new era of prevention and modulation of non-infectious disease such as addiction, hypertension, diabetes, and Alzheimer’s disease (Greenwood, 2014). Indisputably vaccinations have made and will continue to make the greatest contribution to global health. Its development and success as a public health tool will ever be attributed to Jenner and his experiments with cowpox.

The long and difficult pathway that led to the discovery of vaccines begins with the story of smallpox and the work of a brave research pioneer and clinician Edward Jenner. Smallpox was an infectious, disfiguring, and often fatal disease that plagued humanity for centuries. The earliest substantiation of skin lesions those of mirroring those of smallpox was discovered on the faces of mummies from the 18th and 20th Egyptian Dynasties (1570-1085 BC). However, Smallpox was first believed to have emerged around 10,000 BC concurrently with the first agricultural settlements in north-eastern Africa. The introduction of smallpox to Europe was alleged to have been sometime between the 5th and 6th centuries and was later brought to the New World by Spanish and Portuguese conquistadors, where it annihilated and devastated the native populations.

Smallpox spread by exposure to the Variola virus and infection. Symptoms typically began in a similar fashion to the common cold. The victim would experience headaches lethargy, fever, and muscle pains. After a few days, an inflammation would appear on the face and skin, with abscesses forming inside the mouth, throat, and nose. Fluid-filled pustules would develop and enlarge, covering extensive areas of the skin. By the third week, if the victim endured the viral infection, scabs formed and separated from the skin. During the 18th century, smallpox was extensive and prevalent in Europe, claiming an estimated 400,000 lives each year, including five reigning monarchs. Researchers approximate that between 20% and 60% of all infected adults, and 80% of infected children, perished from the illness. Survivors often were left with a large degree of permanent scarring with several individuals losing their lips, nose, or ear tissue. Smallpox additionally was the cause of corneal scarring. It alone was responsible for one-third of all blindness.

Early scholars established that survivors of smallpox developed immunity to the disease after the initial pestilence. As early as 1000 CE, Chinese healers commenced the inoculation process of their patients by scratching matter from a smallpox sore and blowing the powdered material up the nose of a healthy individual.

Variolation was the term used to describe the earliest form of vaccination that provided protection against the Variola virus. This was initially introduced to Europe and North America during the 18th century. This process involved rubbing powdered smallpox scabs or fluid from pustules into superficial scratches made in a healthy individual’s skin resulting in the subsequent development of a milder form of smallpox within the patient identified by the presence of painful boils on their skin. Variolation was not without risks, however, as there was a significant risk of the recipient either suffering from the full extent of the smallpox disease itself, becoming infected by an alternative illness unintentionally transferred by the procedure for example syphilis or even death.

In 1757, Edward Jenner who was only eight years old at the time was one of the thousands of children treated by variolation. As a boy, Jenner demonstrates a keen interest in science and nature, leading him to the study of medicine, surgery, and even geology (Ford, 2003). Eventually, Jenner settled in rural England, outside of London, and commencing his medical practice and performing variolation on his patients

It was in this rural setting and whilst working with the agricultural community, Jenner heard tales of the country folklore that milkmaids never caught smallpox. They were renowned for their beauty and flawless complexions, which were unmarked by smallpox scarring. However, they inevitably caught cowpox due to the nature of their work. He also observed that he could not successfully inoculate such persons with smallpox. Jenner hypothesized that a bout of cowpox produced immunity against smallpox, even encountering locals who claimed to have deliberately infected themselves to provoke such a response and thus confirming his suspicions. As a forward-thinking doctor who enjoyed experimentation, Jenner wanted to prove his theory. In May 1796 Jenner encountered a young dairymaid, Sarah Nelms, who had fresh cowpox lesions (Riedel, 2005). Using material from her lesions, Jenner inoculated an eight-year-old boy James Phipps. Subsequently, the child developed a mild fever and discomfort in his axillae. Nine days after the procedure Phipps developed cold sweats and loss of appetite. However, after ten days the boy was fully recovered and in good spirits. In July of that same year, Jenner inoculated the boy again, this time with fresh a fresh smallpox lesion. No disease developed and Jenner inferred that protection was complete (Willis, 1997). Jenner continued to inoculate children with cowpox with similar results. He named this procedure variolae vaccinae meaning “smallpox of the cow” which in today’s society has been anglicized and shortened to “vaccination.” Jenner was unable to determine the reasoning behind the logic of his theory. Today, however, we now know that the initial infection by the cowpox virus enabled the individual’s immune system to gain the ability of the memory T cells to recognize the similar smallpox virus from its similarly shaped antigens and was able to defend against it more effectively and rapidly.

As a result of his experiment, Jenner unknowingly during his time had laid the groundwork for what would become live, attenuated vaccines. Today, several of the most common vaccines including measles, mumps, yellow fever, and others, use a comparable approach. Viruses can be attenuated by passing the virus through a foreign host, including other live animals or embryonated eggs. The offspring of each virus progressively evolve over time becoming less capable of creating a strong infection in humans. These weaker, less virulent viruses can be fought off in a more effortless and straight forward manner by our immune systems, leading to long-term protection.

Edward Jenner was not the first to endeavour to overcome the smallpox pandemic nor did the problem terminate with him, nevertheless, his work represented the first scientific attempt to control a contagious disease by the deliberate use of vaccination. In coming years, the practice of smallpox vaccination spread across the globe and ultimately saved millions of lives. In 1980, the World Health Assembly announced that “the world and all its people have won freedom from smallpox, which was the most devastating disease sweeping in epidemic form through many countries since earliest times, leaving death, blindness, and disfigurement in its wake” and to cease vaccination as the preceding recommendation into the prospective future (The Global Eradication of Smallpox, 1980). Jenner’s work captured the imagination of scientists all over the globe and set the stage for future exploration, bringing the world into the age of modern vaccine research.

References

1. The Global Eradication of Smallpox. (1980). Final Report of the Global Commission for the Certification of Smallpox Eradication. Geneva: World Health Organisation.
2. Willis, N. (1997). Edward Jenner and the Eradication of Smallpox. Scottish Medical Journal, 42(4), pp.118-121.
3. Riedel, S. (2005). Edward Jenner and the History of Smallpox and Vaccination. Baylor University Medical Center Proceedings, 18(1), pp.21-25.
4. Ford, J. (2003). Edward Jenner, MD FRS (1749–1823). Journal of Medical Biography, 11(4), pp.241-241.
5. Greenwood, B. (2014). The contribution of vaccination to global health: past, present, and future. Philosophical Transactions of the Royal Society B: Biological Sciences, 369(1645), pp.20130433-20130433.