Vaccine development represents a landmark achievement in disease prevention, biomedicine, and the world at large. Vaccines are saving millions of lives, as they curtail the spread and drastic impacts of microbes. However, vaccines have a history that is packed with essential themes for subsequent vaccine development in today’s biomedicine.
The history of vaccines may begin with Edward Jenner, who performed the first vaccination in the world in 1796. Jenner took the lesion of cowpox on the hand of a milkmaid and inoculated a boy, Phillip James, with it. After six weeks, he variolated two spots on the arm of Phillip with smallpox. Still, Phillip was not affected by this and subsequent exposures. Jenner went on to make twelve of similar experiments as well as sixteen case histories previously collected as far back as the 1770s.
He then published a volume which would rapidly become a classic in history: Inquiry into the Causes and Effects of the Variolae Vaccine. According to Jenner, the cowpox, when injected protects humans from smallpox infection. This simple assertion represents the very foundation of modern vaccinology. However, one may ask why a young doctor could come up with a historical idea.
Jenner owes his discovery to his knowledge and customs of several farming societies and how cowpox infected milkmaids were immune to periodic smallpox outbreaks in the area. Also, as a learned young man with a good grasp of the science of experimentation and observation, Jenner could come up with a substitute to variolation. Variolation is the deliberate transfer of pus from a person’s smallpox lesion into the arm of another, typically subcutaneously with the help of a lancet. This had been long practised among the Asians as far back as 1600, in Europe as well as Colonial America as far back as the 1700s.
However, until 1885, vaccines meant only the inoculation of cowpox for smallpox. Then, in 1885, Louis Pasteur formulated a vaccine for rabies. Not only that, but he also went further to expand the meaning of vaccine to comprise inoculating agents generally. Thus, we owe Pasteur for the present-day meaning of vaccine. However, as we shall soon see, Jenner’s legacy has a strong bearing on the pressing issues in vaccines today.
Soon after Jenner’s inoculation became a necessity for national health projects, rulers and presidents leveraged vaccination programmes at a mass-scale to demonstrate the federal commitment to science and public health. Case in point was 1800 Europe when 100,000 persons got vaccinated for smallpox and the same time, President T. Jefferson and Professor B. Waterhouse began the same vaccination in the US. In 1803, King Charles from Spain, sent a Balmis Expedition to send the same vaccination to Spain’s American colonies.
Overall, governments diverted investments in vaccines. Vaccines became a marker of national development that vaccines possession became an issue of national prestige – of course before it became a public health necessity. As such, as of the 19th century, vaccination of smallpox was already compulsory under North America and Europe’s state laws. As of the 20th century when measles, rubella, mumps and diphtheria caused severe public health concerns, vaccination was considered integral to addressing them, so much that it became a requirement for attendance in public schools.
Also, the WHO and UNICEF helped to globalise vaccines even further. For instance, from 1974, when WHO launched the Expanded Programme on Immunisation to increase vaccination rates to present, there has been a series of remarkable efforts to spread vaccination. Of note is the stamping out of smallpox in Somalia during the 1960s and the 1970s, which remains a landmark success in the history of vaccines. This series of success would become the motivation for significant philanthropies fifty years later.
Although many hoped that commercial hands would lead to more availability, and reduced cost of vaccines, regulatory barriers have discouraged efforts made in this regard. This, for instance, led to the shortage of the flu vaccine in the US in 2004.
At the same time, it paved the way for a sort of monopoly of vaccines whereby only one company was producing ten childhood vaccines, including chickenpox and measles-mumps-rubella. To avoid the scenario whereby a failure of this one company to produce vaccines would put the world at risk, the National Vaccine Advisory Board increased vaccine funds for companies. Even though the outcome is not as expected, it helped to break the seeming monopoly and encourage more private vaccine production.
Be that as it may, vaccines always came with a challenge of safety. In Jenner’s pre-germ era, there were no modern sterilisation and quality control methods. So, people often raised concerns about contracting diseases through vaccination. Also, considering that Jenner’s method consists in transferring pus from one person to another, microorganisms often accompany vaccines from one person’s arm to another’s.
As a result, diseases like syphilis, scrofula and erysipelas often followed the vaccines. And even as the use of sterilisation and quality control methods became popular; these concerns remain – though less likely than in Jenner’s days.
Also, some antivaccination movements arose, most notably in 1830, due to concerns of privacy intrusion and integrity of the body. In Britain, for instance, the compulsory vaccination laws were viewed by the working class as direct assaults by the ruling class. As part of efforts to demonstrate the public health and public-good logic on which compulsory vaccination rode, states like the US Supreme Court ruled that public health protection through mandatory vaccination outweighed personal privacy rights.
This paved the way for a scientific concept of herd immunity requiring that 85 – 95 per cent of a population must be immunised for protection.
Finally, the history of vaccine is no doubt a combination of ingenuity, diplomatic skills, and scientific breakthroughs. If anything, the record shows us that when one of these is missing, shortage of vaccine, insurrection and host of other consequences arise. From inception till the present, vaccines have stimulated biological, cultural, political, and social developments which also come with their shortcomings.