The fight against the smallpox epidemic, or the history of the creation of the first vaccinations

Two centuries ago, vaccination became a salvation for millions of people during a terrible smallpox epidemic. Daily Baby has prepared material for you with interesting facts about the history of vaccinations.

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The term vaccination - from the Latin Vacca - “cow” - was introduced into use at the end of the 19th century by Louis Pasteur, who paid due respect to his predecessor, the English doctor Edward Jenner. Dr. Jenner first performed vaccination using his own method in 1796. It consisted in the fact that the biomaterials were taken not from a person who suffered from “natural” smallpox, but from a milkmaid who became infected with “cowpox”, which is not dangerous to humans. That is, something that was not dangerous could protect against a more dangerous infection. Before the invention of this method, vaccination often ended in death.

Vaccination against smallpox, epidemics of which sometimes claimed the lives of entire islands, was invented in ancient times. For example, in 1000 AD. references to variolation—injecting smallpox vesicle contents into a risk group—were in Ayurvedic texts in ancient India.

And in ancient China they began to defend themselves in this way back in the 10th century. It was China that pioneered the method of allowing dry scabs from smallpox sores to be inhaled by healthy people during an epidemic. This method was dangerous because when people took material from smallpox patients, they did not know whether the disease was mild or severe. In the second case, those vaccinated could die.

Dr. Jenner - the first smallpox vaccinator

Observing the health of milkmaids, Dr. Edward Jenner noticed that they did not suffer from “natural” smallpox. And if they become infected, they transfer it in a mild form. The doctor carefully studied the vaccination method, which at the beginning of the century was brought to England from Constantinople by the wife of the English ambassador, Mary Wortley Montagu. It was she who vaccinated her children at the beginning of the 18th century, and then forced herself, the King and Queen of England and their children to be vaccinated.

Finally, in 1796, Dr. Edward Jenner vaccinated eight-year-old James Phipps. He rubbed the contents of smallpox pustules that appeared on the hand of the milkmaid Sarah Nelsis into his scratch. A year and a half later, the boy was vaccinated with real smallpox, but the patient did not get sick. The procedure was repeated twice, and the result was always successful.

Not everyone accepted this method of combating epidemics. The clergy were especially against it, as always. But life circumstances forced the use of Dr. Jenner’s method more and more often: army and navy soldiers began to be vaccinated. In 1802, the British Parliament recognized the doctor's merits and awarded him 10 thousand pounds, and five years later - another 20,000. His achievements were recognized throughout the world and Edward Jenner was accepted as an honorary member of various scientific societies during his lifetime. And in Great Britain the Royal Jenner Society and the Smallpox Vaccination Institute were organized. Jenner became its first and lifelong leader.

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The first large-scale smallpox epidemic was recorded in China back in the 4th century. Four centuries later, the disease claimed the lives of almost a third of the population of the Japanese islands. Around the same period, smallpox struck Byzantium, where it arrived from Africa during the reign of Emperor Justinian.

In the 8th century, outbreaks of the disease were recorded in Syria, Palestine and Persia, Sicily, Italy, Spain and France.

By the 15th century, smallpox had become commonplace in Europe. One of the famous doctors of that time wrote that everyone should get sick from it. After Columbus's voyages, smallpox spread to the American continent, where it claimed hundreds of thousands of lives. By the beginning of the 18th century, when Europe began to accurately record the causes of death among the population, it turned out that the number of deaths from this disease in Prussia reached about 40,000, and in Germany - 70,000 deaths per year. In general, in the Old World, up to one and a half million adults and children died annually from smallpox. In Asia and other continents, things were even worse.

Development in Russia

Vaccination also came to our country from England. Not the first, but the most famous to be vaccinated were Empress Catherine the Great and her son Paul. The vaccination was carried out by an English doctor who took biomaterial from the boy Sasha Markov - he later began to bear the double surname Markov-Ospenny. Half a century later, in 1801, with the light hand of Empress Maria Feodorovna, the surname Vaktsinov appeared, which was given to the boy Anton Petrov, the first to be vaccinated in Russia using Dr. Jenner’s method.

In general, the history of smallpox in our country can be studied by last name. Thus, until the beginning of the 18th century, there were no written references to smallpox in our country, but the names Ryabykh, Ryabtsev, Shchedrin (“pockmarked”) indicate that the disease existed, as elsewhere, since ancient times.

After Catherine II, vaccination became fashionable, thanks to the example of the august person. Even those who had already been ill and acquired immunity from this disease were vaccinated against smallpox. Since then, vaccinations against smallpox have been carried out everywhere, but only became mandatory in 1919. It was then that the number of cases dropped from 186,000 to 25,000. And in 1958, at the World Health Assembly, the Soviet Union proposed a program to completely eliminate smallpox from the world. As a result of this initiative, no cases of smallpox have been reported since 1977.

A few words about smallpox

According to scientists, this highly contagious infection appeared on our planet between 66-14 millennia BC. However, according to the results of recent scientific research, humanity began to suffer from smallpox only about 2000 years ago, contracted from camels.

In typical cases, the disease was accompanied by fever, general intoxication, as well as the appearance of peculiar rashes on the mucous membranes and skin, which successively passed through the stages of spots, blisters, pustules, crusts and scars.

Anyone can become infected with smallpox unless they have immunity from vaccination or a previous illness. The disease is transmitted by airborne droplets, making it extremely difficult to protect against. At the same time, infection is possible through direct contact with the affected skin of a patient or any infected objects. The patient poses a danger to others throughout the entire illness. Even the corpses of those who died from smallpox remain infectious for a long time.

Fortunately, in 1980, the WHO declared complete victory over this disease, so vaccinations are not currently carried out.

Louis Pasteur

A huge contribution to the invention of new vaccines and science was made by the French scientist Louis Pasteur, whose name gave the name to the method of disinfecting products - pasteurization. Louis Pasteur grew up in the family of a tanner, studied well, had a talent for drawing, and if it were not for his passion for biology, we could have had a great artist, and not a scientist, to whom we owe a cure for rabies and anthrax.

In 1881, he demonstrated to the public the effect of anthrax vaccination on sheep. He also developed a vaccine against rabies, but chance helped him test it. On July 6, 1885, a boy was brought to him as the last hope. He was bitten by a mad dog. 14 bites were found on the child’s body; he was doomed to die delirious from thirst, being paralyzed. But 60 hours after the bite he was given the first rabies injection. During vaccination, the boy lived in the scientist’s house, and on August 3, 1885, almost a month after the bite, he returned home as a healthy child - after 14 injections, he still did not get rabies.

After this success, the Pasteur station was opened in France in 1886, where they vaccinated against cholera, anthrax and rabies. It is noteworthy that 17 years later, Joseph Meister, the first boy rescued, got a job here as a watchman. And in 1940 he committed suicide, refusing the Gestapo’s demand to open the tomb of Louis Pasteur.

Louis Pasteur also discovered a method for weakening bacteria to make vaccines, so we owe the scientist not only vaccines against rabies and anthrax, but also future vaccines that may save us from deadly epidemics.

Early methods of fighting

From the moment when smallpox epidemics began to break out here and there, attempts were made to find a cure for it. Moreover, sorcerers were involved in the “treatment”, who fought the infection through spells and wearing red clothes designed to draw out the infection from the body.

The first more or less effective method of combating smallpox in the Old World was variolation. The essence of this method was to extract biological material from the pustules of convalescent patients and inoculate them into healthy people by pulling infected threads under the incised skin.

This method came to Europe in 1718 from Turkey, from where the wife of the British ambassador brought it to Europe. Although variolation did not provide a 100% guarantee, among those vaccinated, the percentage of people who became ill, as well as their mortality rate, decreased significantly. The fear of smallpox was so great that after some time members of the family of the British monarch George the First ordered such vaccinations.

How vaccines changed the world. History of vaccinations from the 18th century to the present day

© Getty Images This is how rabies vaccination took place at the Pasteur Institute in Paris at the beginning of the twentieth century.
The Covid-19 pandemic has forced humanity to remember how dangerous and destructive outbreaks of infectious diseases can be, and how vaccines in such cases are the only hope for a return to normal life.

Coronavirus is not the first enemy against which mass vaccination should be a weapon. Hundreds of millions of people around the world were lucky to remain alive because justice was found for the invisible killers who were terrorizing the world. Of course, if they lived where there is access to medical care.

Here are some examples of how vaccines have changed people's lives.

Smallpox

Smallpox vaccination is perhaps the biggest success story in this field.

This highly contagious viral disease killed more than 300 million people in the 20th century alone. The number of victims in earlier eras cannot be counted.

About 30% of those infected with smallpox died, often in agony, because their entire body was covered with purulent abscesses. The rest went blind or were left with terrible marks on their skin for the rest of their lives.

For centuries, people desperately searched for a cure for smallpox - and eventually, they created the first vaccine.

The idea that an artificially induced mild form of the disease can create immunity in a person probably originated in China. According to sources, already around the year 1000, people there inhaled powder from finely crushed scabs of smallpox patients through their noses or inserted pieces of cotton wool soaked in smallpox pus into their ears.

In Africa, a thread soaked in pus was pulled through the skin with a needle.

In 18th-century Britain, smallpox vaccination was passionately promoted by the famous aristocrat and intellectual Lady Mary Montagu, who herself had smallpox in her youth and became acquainted with the corresponding practices in Turkey, where her husband served as ambassador.

The method was not reliable. Approximately every thirtieth patient became severely ill with smallpox and died.

Meanwhile, English farmers have long noticed that cowpox is contagious to humans, but not fatal. Having studied this phenomenon, the doctor Edward Jenner created a reliable and safe vaccine based on cowpox.

On May 14, 1796, Jenner vaccinated the eight-year-old farmer's son James Phipps with it, who later lived to old age, and two years later he published the famous brochure “Investigation of the Causes and Effects of Cowpox” - at his own expense, since the Royal Scientific Society was distrustful of Jenner's method.

Doubts disappeared when members of the British army and navy were vaccinated against smallpox by order, and nothing bad happened to anyone.

Almost a hundred years later, Louis Pasteur, out of respect for Jenner, proposed calling all drugs based on the principle of creating artificial immunity vaccines: from the French word vache - “cow”.

In poor countries, smallpox continued to rage for more than a hundred and fifty years. The WHO's massive smallpox vaccination program, which started in 1967, helped practically put an end to it.

It is believed that 80% of the population must be vaccinated to achieve herd immunity. It was impossible to vaccinate several billion people.

But the tactics of targeted immunization, first tested in eastern Nigeria, turned out to be quite effective: quickly identify smallpox outbreaks and vaccinate neighboring residents. Smallpox was eradicated from a region of 12 million people with just 750,000 vaccinations.

Currently, live smallpox viruses remain in only two places on Earth: high-security laboratories in Russia and the United States.

Polio

This disease killed far fewer people than smallpox, but was much more cruel to those who survived.

It is mainly contracted during childhood. The virus enters the body through the mouth, then enters the bloodstream and attacks the nervous system, often causing incurable paralysis. It mostly affects the legs, but one in ten patients die from suffocation as a result of paralysis of the pulmonary muscles.

The only hope for such patients was artificial ventilation inside special chambers created in the 1920s, called “Iron Lungs”. People spent weeks in these metal cocoons, sometimes the rest of their lives.

Since polio, unlike smallpox, has no external signs, its infectious nature was established only in 1905 by the Swedish doctor Ivar Vikman.

By that time, improvements in the quality of drinking water in large cities had reduced both the total number of polio cases and the percentage of people who were immune to it. Disease outbreaks have become more noticeable.

There was an opinion, which later turned out to be incorrect, that polio was a problem mainly in developed countries.

In 1952, American doctor Jonas Salk created the polio vaccine. In 1961, his colleague Albert Sabin came up with an improved version that could be swallowed rather than injected. The incidence rate in the US and Europe has sharply declined.

One of the worst mistakes in the history of vaccination is associated with polio vaccinations. In 1955, the American company Cutter Laboratories mistakenly released more than one hundred thousand doses of the drug containing live polio virus. Ten children died and 160 were paralyzed for life.

And in 1988, WHO announced the launch of a program to eradicate polio worldwide. In 1994, the United States was declared free from the disease, nicknamed “parental horror,” followed by China, Japan and South Korea in 2000, Europe in 2002, and Southeast Asia in 2014.

According to expert estimates, thanks to the polio vaccine, one and a half million people in the world are alive and 18 million can walk.

Now polio makes itself felt only in Afghanistan, Pakistan and Nigeria, the number of cases is in the dozens per year.

Measles

Measles vaccination is both a success and a failure.

The Ebola outbreak in Africa, which has attracted worldwide attention, has killed about 20 thousand people. Measles quietly killed 207,500 last year, even though a vaccine has been available for it since 1963.

The highly contagious virus is spread through droplets of saliva from coughs and sneezes or through direct contact and causes high fever and rash, and in severe life-threatening cases, diarrhea, pneumonia and inflammation of the meninges.

Before the invention of the vaccine, measles claimed an average of 2.6 million lives per year. But it was not possible to completely overcome it, since due to its high contagiousness, collective immunity occurs only when 95% of people are vaccinated.

In the US and Europe, the incidence of measles has begun to rise again in recent years due to the views of “anti-vaxxers”, widely spread thanks to social networks.

How Russians get measles and what do anti-vaxxers have to do with it?
Another deadly virus. While the world is fighting Covid-19, measles deaths are rising and vaccinations are being disrupted

They were given impetus by British physician Andrew Wakefield with a sensational article published in 1998 that the combined measles, mumps and rubella vaccine supposedly causes autism in children. Although these articles were later refuted, and Wakefield himself was stripped of his medical license for scientific dishonesty, the seeds he sown bore fruit.

© Reuters In 26 countries, routine measles vaccinations for 94 million people were postponed due to quarantine, and resumed in only eight of them (Brazil, Nepal, the Philippines, South Africa, the Democratic Republic of Congo, Nigeria, Ethiopia and Somalia).

While in developed countries people with measles still die relatively rarely, in Africa the situation is worse. A measles outbreak in the Democratic Republic of Congo killed more than 7,000 people, mostly children, last year.

The main problem in developing countries is not prejudice, but the lack of vaccine and the lack of medical infrastructure, especially in remote places. WHO has asked UN member states for $255 million in additional funding for measles vaccinations.

Malaria

Scientists believe humans have been suffering from malaria, also known as swamp fever, since prehistoric times.

And today, approximately half of humanity is at risk of contracting malaria, and 400 thousand people die from it every year.

About half of all malaria deaths occur in Africa.

The disease is caused by a single-celled parasitic bacterium, Plasmodium falciparum, which enters a person’s bloodstream when he is bitten by a malarial mosquito.

The world could be free of malaria by 2050. How?

The main ways to combat malaria are draining the swamps where mosquitoes breed, mosquito nets and drugs that suppress the disease at an early stage - and there is evidence that Plasmodium has begun to acquire resistance to them.

It has not yet been possible to create a vaccine against malaria that forms immunity, despite 32 years of intensive work and $700 million spent.

The only prototype is being tested in Ghana, Malawi and Kenya, which should be completed in 2023. So far, according to available data, it protects against malaria in an average of 40% of cases and for a period of no more than four years - very weak results compared to vaccines against other diseases. In this case, it is necessary to receive not one or two, but four vaccinations.

Experts express cautious optimism, but warn that the vaccine is unlikely to become a panacea for malaria.

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Moscow epidemic

Today it’s hard to believe, but 300 years after the first smallpox vaccination was made in Russia (you already know who knows), an outbreak of this terrible disease occurred in the capital of the USSR. It was brought from India by an artist who was present at the ritual burning of the deceased barmin. Upon his return, the man infected seven of his relatives, and nine of the staff and three patients of the hospital, where he was taken due to an illness, the cause of which the emergency doctor could not diagnose. The artist himself died, and the epidemic affected more than 20 people. As a result, out of 46 people infected, three died, and the entire population of the capital was vaccinated.

POTENTIAL HAZARD

“Of course, tomorrow, humanity most likely will not need mass vaccination against smallpox,” continues Tatyana Nepomnyashchikh. “Although, in our country, for example, cases of people becoming infected with cowpox periodically occur.

- How dangerous is this?

—For humans, cowpox, fortunately, is not lethal. Let me remind you that the mortality rate for smallpox reached 80%, and when infected with monkeypox - about 10%, this is also a very high number. Cowpox needs to mutate very strongly to cause significant harm to humans. But for the monkeypox virus, this path is, in theory, easier to follow.

By the way, there is a hypothesis that in the process of human evolution, a virus similar to smallpox, with a very high mortality rate, arose several times. But the populations were small, the tribes lived separately. It wasn’t like it is now: within 24 hours you can find yourself anywhere on the planet. Therefore, the virus led to the death of some isolated population and disappeared, since there was no one else to infect.

In the near future, humanity will most likely not need mass vaccination against smallpox.

Photo: Vladimir VELENGURIN

In short, the potential danger still exists today. And those vaccines that were invented 225 years ago have remained virtually unchanged. They have many side effects. For example, today, if after being vaccinated against coronavirus, people develop a fever, their hands turn red, and their joints ache, people already think, “Oh, what a terrible side effect.” After the classic smallpox vaccine, the temperature often lasts below 40 degrees for several days. At the site of injection of the drug, there is not just redness and swelling, but a real ulcer (after it, everyone over forty had those famous pit scars on their forearm for the rest of their lives. - Author).

Further history

The first smallpox vaccination in Russia, administered to the empress, made variolation fashionable, and many aristocrats followed the example of their monarch. It is known that over the next 2-3 months about 140 courtiers were inoculated. The matter reached the point of absurdity, since even those who had already suffered from this disease and had acquired immunity from it expressed a desire to be vaccinated.

By the way, the Empress was very proud that it was she who received the first smallpox vaccination in Russia and wrote about the effect that her action had on her friends and relatives abroad.

WE NO LONGER HAVE IMMUNITY TO SMALLPOX

“Historically, I devoted 15 years of my work at Vector to topics related to smallpox,” says Tatyana Sergeevna.

“Most people are sure that we defeated smallpox long ago and completely, even vaccinations against it were stopped as unnecessary. Is there something we don't know?

— Of course, the natural smallpox that caused epidemics and claimed millions of human lives in the past has been defeated. Since 1980, children have stopped receiving smallpox vaccinations. Therefore, living generations of people do not have collective immunity to smallpox. And not only to it, but also to closely related poxviruses (from the English pox - smallpox + viruses).

To eradicate smallpox, people were vaccinated with the so-called vaccinia virus, explains Tatyana Nepomnyashchikh. This is a closely related virus belonging to the same family of poxviruses, Poxviridae. Despite the complete elimination of smallpox in the modern world, there remains a possibility that this disease will rear its head again, scientists warn.