NEPA Vital Signs - Winter Spring 2018 - 17

WINTER/ SPRING 2018

Feature

Looking Back...The First Vaccines
orld history has been marked by
epidemics of infectious diseases for
millennia. We are all familiar with the horror
stories surrounding epidemics of Smallpox
and Polio. We've seen the pictures of disfigured victims of smallpox and the hospital
wings filled with iron lung machines. We're
thankful that these pictures are from the
past and that we'll never have to worry about
meeting that same fate. But how could that
possibly be true? Infectious diseases are still
very much a presence around the world,
yet we never hear of diseases like polio or
smallpox permanently altering the course
of someone's life anymore. Vaccination,
or inoculation, as it was called in its early
days, made it possible to rid most parts of
the world of these illnesses and changed
the face of medicine along the way.
Smallpox has been around for thousands
of years. It is believed to date all the way
back to the 3rd century BCE (Before the
Common Era) during the Egyptian Empire,
as mummies with smallpox-like lesions were
discovered. The first written record of Smallpox, however, is from the 4th century CE
(Common Era) in China. Global expansion
and settlement of new land masses allowed
the disease to spread to nearly every continent by the 18th century, killing thousands
upon thousands of people in the process. In
the 1600s, doctors in Asia recognized that
those who survived the infection could not
be infected again. Thus, the technique of
variolation - named for the Variola virus
which causes Smallpox - took hold. This
process involved inhaling dried scabs from
an infected person and suffering through
a shortened and less grueling course of
the illness. Variolation was not a perfect
solution; 3-4% of people who underwent
the procedure still died of smallpox. Additionally, variolated individuals could spread
smallpox to others, causing an epidemic.
However, those that were variolated and
survived never caught full-blown smallpox.

This process gained popularity across
Europe and America, although these cultures
inoculated by introducing dried disease
material through a puncture made in the
skin (CDC, 2016).
Variolation was not a flawless process,
and many, including Dr. Edward Jenner,
were on the lookout for new ways to eliminate the blight of smallpox from society. In
1796, Edward Jenner, an English physician,
noted that milkmaids who had come into
contact with cows infected with cowpox
were immune to smallpox. Cowpox, also
a member of the Variola family of viruses,
caused a similar rash to smallpox, but it
was localized to the milkmaids' hands. The
disease had a much milder course than
smallpox. Jenner believed that he could
more safely inoculate people with cowpox
rather than smallpox and provide the same
immunity as variolation. Jenner tested his
theory on his gardener's son, taking scabs
from the hands of a milkmaid infected
with cowpox and placing the material in a
puncture wound on the child's arm. Many
months later, Jenner exposed the boy to
smallpox repeatedly, and he never fell ill.
He experimented many more times on other
people, and published his work "On the
Origin of Vaccine Inoculation" in 1801. In
this document, he summarized his findings
and voiced hope that "the annihilation of
the smallpox, the most dreadful scourge of
the human species, must be the final result
of this practice" (CDC, 2016).
Jenner's discovery gained traction, and
countries around the world began adopting
the practice of inoculation with cowpox
rather than variolation. In 1959, the World
Health Organization announced their plan
to rid the world of smallpox, but due to
lack of funding and vaccine shortages,
the program did not kick off until 1967,
under the name Intensified Eradication Program. Janet Parker, a medical

CDC. (2016, August). History of Smallpox. Retrieved December 12, 2017, from Centers for Disease Control and Prevention:
https://www.cdc.gov/smallpox/history/history.html
CDC. (2016, February 1). Immunization Schedules. Retrieved December 12, 2017, from Centers for Disease Control and Prevention:
https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

N E PA

VITAL SIGNS

photographer at
the Birmingham
UniversityMedical School,
was the last
person to die
of smallpox.
She died on
September 11,
1978. Finally,
Dr. Edward Jenner
on May 8, 1980,
t h e 3 3 r d Wo r l d
Health Assembly officially announced that the world was free
of smallpox (CDC, 2016).
The importance of vaccination has been
recognized by countless scholars and scientists since variolation was discovered. Today,
we have vaccines for many different diseases,
including Measles, Hepatitis, Diphtheria,
and Tetanus. Children receive as many as
24 vaccinations before their 2nd birthday
to protect them against these once-deadly
diseases (CDC, Immunization Schedules,
2016). Without the work of Jenner and other
scientists of his time, vaccinations would
not exist in the capacity they do today, and
the diseases they prevent would still be very
real threats to our society.
JANARA KOEHLER is an MD2
from Dallas, PA, and plans to pursue
a residency in Neonatal/Perinatal
Medicine after graduating from medical
school.

https://www.cdc.gov/smallpox/history/history.html https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

NEPA Vital Signs - Winter Spring 2018

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