The History of Vaccination

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Early Pioneers of Vaccination

Since the dawn of time, humanity has been battling disease and trying to understand why people got sick and died in large numbers throughout history. These early pioneers laid the foundation of vaccination and learned how to treat disease, even though they may not have fully understood it.

1718 – Lady Mary Worley Montagu of England, wife of the British ambassador to Turkey, witnesses the practice of smallpox variolation while living in Turkey and allows her son to be inoculated.

1721 – During a smallpox epidemic, Lady Mary, and Dr. Charles Maitland perform variolation for the first time in England. Her daughter, seven prisoners, and six orphans are successfully variolated and survive.

1770 – English doctor, Edward Jenner, meets a milkmaid who believes she is immune from smallpox because she has already contracted cowpox.

1796 – Jenner scrapes material from the milkmaid’s cowpox sore onto a healthy eight-year-old boy. Two months later, Jenner inoculates him with fresh smallpox sore matter, and the boy remains healthy.

1857 – French professor, Louis Pasteur, finds that fermentation is a biological process performed by tiny organisms. This leads to a better understanding of how microorganisms cause infection and disease.

1862 – Pasteur debunks spontaneous generation, the belief that life can spring from nonliving things. He finds that rotting does not occur when organisms are prevented from growing, leading to pasteurization.

1879 – Pasteur produces the first lab vaccine for chicken cholera using attenuated (weakened) bacteria. A method discovered accidentally when an assistant injects chickens with old bacteria, and they survive.

1884 – Pasteur develops a rabies vaccine for dogs. A year later, he performs post-exposure vaccination on a boy bitten by a rabid dog with a 13-day course of shots with increased doses of rabies virus. The boy survives.

1885 – Spanish physician Jaime Ferran develops the first bacterial vaccine for humans. He vaccinates 50,000 people during a cholera epidemic and later develops vaccines for plague, tetanus, typhus and TB.

Modern Pioneers of Vaccination

The early pioneers of vaccination made great strides in identifying disease and developing methods to control them. This allowed modern pioneers to build on that knowledge and create vaccines that would not only control disease but eradicate it.

1900 – Jesse Lazear and the U.S. Army Yellow Fever Commission discover that mosquitos transmit yellow fever, following massive amounts of casualties of the disease during the Spanish-American War.

1929 – Dr. Phillip Drinker and Dr. Charles McKhann develop the Iron Lung, an artificial respirator for patients suffering from paralysis of the diaphragm and intracostal muscles due to polio.

1936 – Max Theiler develops a yellow fever vaccine. This along with anti-mosquito methods, such as window screens and the prevention of breeding in standing water, majorly reduces infection worldwide.

1955 – American doctor, Jonas Salk, develops the first safe and effective polio vaccine. His research is funded by money raised by the March of Dimes and FDR’s National Foundation for Infantile Paralysis.

1957 – American doctor, Maurice Hilleman, learns of an influenza outbreak in Hong Kong and discovers that only people who survived the influenza pandemic of 1889-1890 are protected. Fearing another pandemic, Hilleman produces a vaccine and is credited with saving 1 million American lives.

1962 – Hilleman develops an attenuated measles vaccine by passing the virus through different cell types over 80 times. The vaccine is treated with gamma globulin antibodies to reduce adverse reactions.

1963 – Hilleman’s five-year-old daughter, Jeryl Lynn, becomes ill with the mumps. He collects a sample by swabbing her throat, isolates the virus in his lab, and develops a vaccine.

1965 – Hilleman uses the experimental mumps vaccine on his younger daughter, Kirsten, with the vaccine developed from the virus he isolated from her half-sister two years earlier.

1971 – Hilleman develops a combined vaccine for measles, mumps, rubella (MMR). Immunity is induced to measles in 96% of kids vaccinated, to mumps in 95% of kids vaccinated, and to rubella in 94% of kids vaccinated.

Additional Vaccination Milestones

900 CE – Measles and smallpox are identified as separate diseases in Persia.

1000 CE – The first written account of smallpox inoculation practices in China.

1768 – Catherine the Great of Russia is successfully inoculated for smallpox.

1800 – Vaccinations are first brought to the U.S.

1801 – The Empress Dowager of Russia encourages vaccination by naming the first orphan successfully given the smallpox vaccine, Vaccinoff, and provides her a pension for life.

1802 – Massachusetts is the first state to provide smallpox vaccinations with 19 initial volunteers.

1813 – President James Madison signs the Act to Encourage Vaccination requiring the U.S.P.S. to carry smallpox vaccine material for free so all citizens can have access to vaccinations.

1840 – Britain bans variolation and replaces it with vaccination. The National Vaccine Act provides free vaccinations for infants, the first instance of free medical service in England.

1853 – The UK Vaccination Act makes smallpox vaccination mandatory for infants under three months.

1855 – Massachusetts passes the first U.S. vaccination law mandating vaccinations for schoolchildren.

1874 – Germany enacts a compulsory smallpox vaccination law causing death rates to drop rapidly.

1881 – Pneumococcal bacterium responsible for pneumonia and meningitis is discovered.

1883 – The bacterium responsible for Diphtheria is discovered.

1892 – A relationship between chickenpox and shingles is first suggested in Hungary.

1905 – Last yellow fever epidemic in North America occurs in New Orleans.

1906 – Whooping cough bacteria is isolated.

1908 – Poliovirus identified, replacing previous assumptions that polio is caused by bacteria.

1911 – Last documented outbreak of Cholera in the U.S.

1914 – Typhoid vaccinations become widely available to the U.S.

1916 – Measles antibodies identified.

1918 – Freeze-dried vaccinations produced for use in tropical climates.

1936 – Yellow fever vaccine is developed.

1938 – The March of Dimes fundraising efforts begin, raising millions of dollars toward developing a vaccine for polio.

1945 – First influenza vaccine approved for the military, with civilian use approved a year later.

1949 – Last case of naturally occurring smallpox in the U.S. occurs in Texas.

1952 – Jonas Salk begins early polio vaccine tests on human subjects.

1953 – Chickenpox virus isolated.

1955 – Polio vaccine announced and distributed.

1963 – Measles vaccine licensed in the U.S. and nearly 19 million doses would be given over 12 years.

1967 – FDA licenses the mumps vaccine.

1969 – FDA licenses the rubella vaccine.

1971 – FDA licenses the combined measles, mumps, rubella (MMR) vaccine.

1972 – The U.S. ceases smallpox vaccinations in children as the disease disappears.

1977 – In Somalia, Ali Maow Maalin contracts the last case of naturally occurring smallpox.

1979 – Last case of polio in the U.S.

1980 – Smallpox is destroyed worldwide through vaccination.

1994 – In Peru, the last case of polio in the Americas is reported in a three-year-old boy.

1995 – FDA licenses the chickenpox vaccine.

2000 – Measles is declared eliminated in the U.S., however, residents remain at risk for imported cases.

2002 – Polio declared eradicated in Europe with the last case was reported in a young boy from Turkey.

The History of Pandemics

430 B.C. – The first pandemic recorded in history was described by Greek historian, Thucydides. The Peloponnesian War between Athens and Sparta led to a great pestilence war, which many believe to be smallpox. More than 30,000 people in Athens died, somewhere between 20-30% of the city’s population.

541 A.D. – The Plague of Justinian (named for the emperor Justinian I) kills 10,000 people per day in Constantinople and more than 50 million people in the Mediterranean, Middle East, and Asia over the next two centuries. This plague is considered the first known bubonic plague pandemic (infected fleas on rats) in recorded history.

1334 – The Great Plague of London actually started out in China and made its way along trade routes, killing off entire towns along the way. Florence, Italy loses a third of its population with 90,000 deaths in the first six months of the outbreak. Approximately 25 million people die across Europe.

1347-1351 – The Black Death or bubonic plague decimates Europe by killing approximately 25 million people, one-third to one-half of Europe’s entire population. Some estimates claim as many as 200 million people (nearly half the world’s population at the time) died from the plague in four just years.

1519 – Hernando Cortes arrives in what is now Mexico and infects the native population with smallpox, killing up to 8 million people within two years. Over the next century, more than 25 million native inhabitants die from smallpox and other communicable diseases introduced by European explorers.

1633-1634 – Smallpox is brought to the Americas by the first Europeans (France, Great Britain, and Netherlands). The disease is thought to have wiped out over 70 percent of Native Americans.

1793 – Yellow fever hits Philadelphia, spread by mosquitoes from Caribbean refugees ships. People flee the city, including signers of the Declaration of Independence, but an estimated 2,000-5,000 people out of 45,000 still die.

1830-1851 – The Second Cholera Pandemic starts in India and is brought to the U.S. through global trade. It spreads across the country by settlers traveling the Oregon and Mormon trails, killing 150,000 Americans.

1860-1890 – The Modern Plague kills more than 12 million people in China, India, and Hong Kong. It takes 30 years until they realize how the bacterial infection is spread, and a vaccine is created.

1918-1819 – The Spanish Flu spreads quickly as a result of soldiers living in such close quarters during WWI. Contrary to its name, it is not from Spain. An estimated one-third of the world is infected, and approximately 30-50 million people die in less than a year, with 675,000 deaths in the U.S.

1952 – A Polio Epidemic spreads throughout the U.S., causing entire towns to be quarantined and travel between cities prohibited. More than 58,000 cases are reported with 3,100 deaths, and 21,000 left paralyzed.

1957-1958 – Asian Flu Pandemic kills 2 million people worldwide, including 70,000 deaths in the U.S. Many Americans over 65 were immune as a result of the 1918 outbreak, but a vaccine is developed to younger people.

1962-1965 – Rubella pandemic causes tens of thousands of U.S. women to suffer miscarriages or elect to have abortions due to rubella infection. More than 20,000 babies are born with congenital rubella syndrome, causing deafness, blindness, mental disabilities, and physical deformities.

2009-2010 – The Swine Flu affects 74 countries and infects 89 million people, with 18,500 confirmed deaths. Nearly 140 million doses of vaccine are given in the U.S., minimizing the spread of the disease.

Disease Cases in the U.S. for 2014

Smallpox: 0 cases reported. A viral disease with fever and pustules that is spread through social contact and contaminated surfaces. Virus eradicated worldwide in 1980.

Cholera: 0 cases reported. A bacterial disease of the small intestine that is spread through infected water, social contact, and contaminated surfaces.

Yellow fever: 0 cases reported. A tropical viral disease that affects the liver and kidneys and is spread by mosquitoes or animal bits.

Polio: 0 cases reported. A viral disease that may cause paralysis and is spread by social contact and contaminated surfaces.

Anthrax: 0 cases reported. A bacterial disease of cattle and sheep that is spread to humans by contact or inhaling spores.

Diphtheria: 1 case reported. A bacterial disease that affects the mucous membranes and is spread by social contact.

Rabies: 1 case reported. A viral disease that causes madness in dogs, bats, coyotes, foxes, skunks, and raccoons. It is spread to humans by animal bites, insect bites, or blood transfusions.

Bubonic plague: 5 cases reported. A bacterial disease that is the most common form of plague in humans and is transmitted by fleas. It is spread by animal bites, insect bites, and social contact.

Ebola: 6 cases reported. A viral disease that causes bleeding and organ failure and is spread through social contact.

Typhoid fever: 299 cases reported. A bacterial disease that causes red spots and severe intestinal irritation that is spread by social contact and contaminated surfaces.

Measles: 645 cases reported. A viral disease with fever and red rash, typically affecting small children. It is spread by social contact, contaminated surfaces, and from mother to child during pregnancy or breastfeeding.

Mumps: 20,000 per year. A viral disease causing swelling of the parotid salivary glands in the face and is spread by social contact and contaminated surfaces.

Rubella: 20,000 per year. A viral disease (also called German measles) causing a red rash that is spread through social contact or from mother to child during pregnancy or breastfeeding.

Pertussis: 20k to 200k per year. A bacterial disease (also called whooping cough) that affects the respiratory tract and is spread by social contact.

Chicken Pox: 20k to 200k per year. A viral disease that causes fever and itchy, blister-like rashes that is spread through social contact, contaminated surfaces, and from mother to child during pregnancy or breastfeeding.

Scarlet fever: 20k to 200k per year. A bacterial disease that causes fever and a scarlet rash caused by strep throat, most commonly in children 5-15. It is spread through social contact.

Tuberculosis: 20k to 200k per year. A bacterial disease that affects the lungs and is spread by social contact.

Influenza: 3 million per year. A viral disease that affects the respiratory system, including lungs, nose, and throat. It is spread by social contact and often creates epidemics.

How Vaccines Work

Vaccines work by pretending to be pathogens.
Pathogens are agents that carry diseases through the body.
Pathogens are covered with molecules called antigens.
Antigens trigger a specific response from the immune system.
Vaccines introduce antigens that are similar to the pathogen.
When a vaccine enters the body, the immune system thinks it is a pathogen.
The immune system prepares a defense and attacks the impostor pathogen.
Cells are created that remember that specific pathogen and how to defeat it.
If the real pathogen ever enters the body, the cells immediately recognize it.
The immune system attacks with speed and aggression because it knows how to fight it.

How Vaccines are Made

For many viral vaccines, small amounts of a specific virus are grown in cells.
Various cell types may be used, such as those from chicken embryos.
For bacteria vaccines, bacteria are grown in bioreactors that work like fermenters.
Antigens from the virus or bacteria are then released, isolated, and purified.
A substance that enhances the body’s immune response to the antigen may be added.
Stabilizers to prolong shelf-life or preservatives for multi-dose vial safety may be added.
The vaccine is then mixed in a single vessel, poured into vials or syringes, and shipped.
Some vaccines are freeze-dried and rehydrated on location at the time of administration.
Section 8: Bacteria vs. Virus

Bacteria are single-celled microorganisms that exist in humans, animals, plants, soil, and water.
Viruses are acellular (no cell structure) and requires a living host to survive.
Bacteria can be either beneficial or harmful to living hosts.
Viruses are always harmful, causing illness to a host, triggering the immune system to respond.
Bacteria are living organisms.
Viruses are thought to be nonliving structures that interact with living organisms.
Bacteria are small, 1000 nanometers (nm).
Viruses are smaller, 20-400 nanometers (nm).
Bacteria are intercellular organisms, meaning they live in-between cells.
Viruses are intracellular organisms, meaning they infiltrate a host cell and live inside of it.
Bacterial Diseases: Pertussis, bubonic plague, diphtheria, cholera, scarlet fever, typhoid fever and tuberculosis, and anthrax.
Viral Diseases: Measles, smallpox, mumps, rubella, chicken pox, polio, yellow fever, ebola, rabies, and influenza.
Section 9: Important Terms

Inoculation: Introduction of a small amount of viral matter, usually through the skin, to introduce the virus to the immune system and teach it how to destroy it. Inoculation makes the body sick in a localized area, but once the virus is destroyed the body will be protected from future infections.

Variolation: Inoculation against smallpox using live smallpox virus. Variola is Latin for spotted.

Vaccination: Inoculation against smallpox using live cowpox virus. Edward Jenner first coined the term to give homage to the cow. Vacca is Latin for cow. Louis Pasteur later proposed that the term be used for all preventative disease inoculations.

Immunization: Introducing immunity to an infectious organism through inoculation or vaccination.

Attenuation: The process of weakening a virus or bacterium through repeated inoculation or growth in a different culture medium.

Citations:

http://www.historyofvaccines.org/content/timelines/pioneers
http://jenniferleecarrell.com/variolation-vs-vaccination/
https://en.wikipedia.org/wiki/Lady_Mary_Wortley_Montagu
http://www.rwjf.org/en/culture-of-health/2013/12/the_five_deadliesto.html
http://www.neatorama.com/2009/04/27/5-deadliest-pandemics-in-history/
http://www.cnn.com/interactive/2014/10/health/epidemics-through-history/
http://www.naturalnews.com/026178_flu_influenza_bird.html
http://www.marchofdimes.org/mission/eddie-cantor-and-the-origin-of-the-march-of-dimes.aspx
http://healthland.time.com/2013/01/29/5-things-you-should-know-about-chickenpox-and-shingles/
http://www.historyofvaccines.org/content/how-vaccines-work
http://www.historyofvaccines.org/content/how-vaccines-are-made
http://www.diffen.com/difference/Bacteria_vs_Virus

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