History Of Smallpox Vaccination And Global Eradication
Smallpox has been a scourge against humanity for at least the past 1500 years, and perhaps much longer than that. There is no mention of the disease in ancient Greek writings, but plagues of pustular disease in the Roman Empire bore a strong resemblance to smallpox. The literary record suggests that smallpox became established in the Mediterranean by the third century AD, and it was described in China around the same time. Smallpox subsequently changed the course of history and killed millions of people in both the New World and the Old World.
The earliest smallpox prevention efforts date back to at least the 10th century in China, when physicians found that nasal inoculation of susceptible persons with material from smallpox lesions would sometimes provide immunity. The practice of inoculation appears to have arisen independently in several other regions prior to the 17th century, including Africa and India, but the practice did not gain popularity in western Europe until the 18th century. The wife of an English ambassador, Lady Montagu, observed inoculation in Turkey, and later had her own child successfully inoculated during a smallpox epidemic in England. In this procedure a lancet or needle was used to deliver a subcutaneous dose of smallpox material to a susceptible person. The procedure, also known as variolation, was controversial. It generated immunity in many cases, but it also killed some people and contributed to smallpox outbreaks.
Allergic Reaction To The Vaccine
Inactivated polio vaccine can cause an allergic reaction in a few people since the vaccine contains trace amounts of antibiotics, streptomycin, polymyxin B, and neomycin. It should not be given to anyone who has an allergic reaction to these medicines. Signs and symptoms of an allergic reaction, which usually appear within minutes or a few hours after receiving the injected vaccine, include breathing difficulties, weakness, hoarseness or wheezing, heart rate fluctuations, skin rash and dizziness.
Vaccine And Immunoglobulin Administration
Dose, route of administration and schedule
Smallpox vaccine is administered by scarification into the epidermis, usually in the deltoid area of the non-dominant arm, by using the multiple-puncture technique with a bifurcated needle, packaged with the vaccine and diluent. According to the product labelling, 15 punctures are recommended for vaccination. A trace of blood should appear at the vaccination site after 15 to 20 seconds if no trace of blood is visible, additional insertions should be made by using the same bifurcated needle without reinserting the needle into the vaccine vial. If alcohol is used to cleanse the skin before immunization, the skin must be allowed to dry thoroughly before the vaccine is administered, to prevent inactivation of the vaccine by alcohol.
Other methods of administration, such as multiple pressure method are possible in case bifurcated needles are not readily available. Refer to the product label for detailed instructions.
Health care workers providing direct patient care should keep their vaccination sites covered with gauze in combination with a semipermeable membrane dressing to absorb exudates and to provide a barrier for containment of vaccinia virus to minimize the risk of transmission the dressing should also be covered by a layer of clothing. Similar precautions should be used for vaccinated persons in close contact with children or other persons at high risk of serious complications of vaccinia.
Booster doses and re-immunization
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In 1796 After Gathering Some Circumstantial Evidence From Farmers And Milkmaids Jenner Decided To Try An Experiment
Its said that Jenner was psychologically scarred by that experience, some of his motivation was just how horrific he’d found it, says Owen Gower, manager of Dr Jenners House Museum. He was thinking, I want to find an alternative, something that’s safer, that’s less terrifying.
In 1796, after gathering some circumstantial evidence from farmers and milkmaids, Jenner decided to try an experiment. A potentially fatal experiment. On a child.
He took some pus from cowpox lesions on the hands of a young milkmaid, Sarah Nelms, and scratched it into the skin of eight-year old James Phipps. After a few days of mild illness, James recovered sufficiently for Jenner to inoculate the boy with matter from a smallpox blister. James did not develop smallpox, nor did any of the people he came into close contact with.
Although the experiment worked, by todays standards it was ethically problematic.
Edward Jenner, memorialised here in a statue vaccinating his son, swerved ethical concerns to see whether a cowpox vaccine could save lives
It really wasn’t a clinical trial and the choice of who they vaccinated really makes you uncomfortable, says Sheila Cruickshank, professor of immunology at the University of Manchester.
Nor did Jenner know the science underlying the discovery. There was no understanding that smallpox was caused by the variola virus, and the functioning of the bodys immune system was still a mystery at the time.
Measles Mumps And Rubella
Measles, Mumps, and Rubella are viral infections that have each caused widespread, deadly disease outbreaks. Throughout the 1960s, individual vaccines were developed for each of them, but a decade later, they were combined into one.
Measles was the first of the three to receive its own vaccine in 1963, followed by mumps in 1967, and rubella in 1969. Two years later, in 1971, Maurice Hilleman of the Merck Institute of Therapeutic Research developed a combined vaccination that would provide immunity for all three viruses.
Hilleman was credited with creating the first measles and mumps vaccine, and began researching ways to incorporate a system of immunity for each virus. Using his previous research and a rubella vaccine developed by Stanley Plotkin in 1969, he created the first successful MMR vaccine in just two years.
According to the CDC, “One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.”
“Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.”
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A Little Help From A Cow
Variolation remained an important practice throughout Asia and Africa, reaching Europe and the New World colonies by the early 18th century, where it was first used to stop the Boston smallpox epidemic of 1721.
In the late 18th century, English physician Edward Jenner arrived at the observation that dairymaids were protected against smallpox because of their contact with cowpox, a now rare, self-limiting disease transmitted through lesions on the udder and teats to humans. Jenner postulated that to confer biological protection, much like with variolation, cowpox could be deliberately acquired through some sort of inoculation.
In May 1796, Jenner collected pus from the fresh scabs of a young dairymaid recently infected with cowpox and injected it into a 8-year-old boy. While testing what was essentially a live vaccine a vaccine containing a weakened or attenuated form of a virus on a human subject is ethically disconcerting, the young boy did not develop smallpox when injected with it six weeks later.
Vaccination, as the practice eventually came to be known, from the Latin for cow or vacca, was considered a groundbreaking medical discovery, gaining acceptance throughout Europe and paving the road for future vaccines. In the U.S., Jennerian vaccination was encouraged partly thanks to Thomas Jefferson, who conducted small vaccine trials himself and made it one of the new nation’s first health priorities when elected president in 1801.
Koprowski Polio Vaccine Tests
So when was the polio vaccine invented?
In the late 1940s, Dr. Hilary Koprowski of Lederle Laboratories in Philadelphia successfully administered a vaccine for type 2 poliovirus. He chose to test it on himself and his assistant after trying it on chimpanzees. They both drank the vaccine and observed no adverse effects.
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Effective Herd Immunity Depends On Vaccination
Because immunity varies with age and not everyone can get vaccinated such as those who are immunocompromised, have specific allergies or pregnant women with certain types of vaccines herd immunity is a crucial protective phenomenon.
To establish it, one important factor is the number of immunized people within a population has to be at a certain percentage or threshold. According to the WHO, this figure was eight out of every 10 people for smallpox, based on its early eradication effort.
And because pathogens are not confined by geographical borders, this 80% immunization or higher is not a threshold restricted to one population it has to be shared by all, whether at a local, national or global level. This means if any populations have vaccination rates below the threshold, there is a great risk for disease transmission to other unvaccinated or vulnerable individuals, even in populations with adequate herd immunity, such as in the case with measles outbreaks in recent years.
For smallpox, this homogeneity in vaccination rates across varying populations was only successfully achieved with mass smallpox vaccination, as claimed by the Facebook post.
Routine smallpox vaccination in the U.S. was stopped in 1972, after it was declared eradicated. The CDC only recommends the vaccine to lab workers who work with smallpox or smallpox-like viruses, and to those who need long-term protection like military personnel.
Simultaneous Administration With Other Vaccines
In non-emergency situations , smallpox vaccine can be administered simultaneously with any inactivated vaccine. To avoid confusion in ascertaining which vaccine might have caused post-vaccination skin lesions or other adverse events, varicella vaccine or live herpes zoster vaccine should not be administered concomitantly with smallpox vaccine there must be an interval of at least 4 weeks between administration of varicella or live herpes zoster vaccines and smallpox vaccine. Smallpox vaccine can be administered simultaneously with other live parenteral vaccines if not administered simultaneously, there must be an interval of at least 4 weeks between smallpox vaccine and other live parenteral vaccines.
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Key Facts About Vaccination
Smallpox vaccination is based on a thousand-year old technique called inoculation, in which a small sample of infected matter is deliberately introduced into the body in order to prevent the full disease from developing.
A vaccine stops you from getting an infectious disease by stimulating your body’s immune system to produce chemicals called antibodies that will combat a future infection.
The first vaccine was developed to protect against smallpox, a deadly disease that killed thousands of people until the 1800s. Thanks to vaccination, smallpox was completely eradicated in 1979.
An antitoxin is a blood-based product that ‘borrows’ immunity from another person or animal to help you fight an infection, once you already have it.
The sciences of microbiology and immunology have produced different vaccines and antitoxins to prevent and combat a range of infectious diseases.
For a long time people observed that you rarely get the same infectious disease twice, or if you do its usually much milder the second time round.
What if you could artificially expose a person to a safer form of the disease before they encountered a potentially lethal version of the full disease? That might prevent them getting the full-blown disease if they encountered it in the future. This is the basis of vaccination, which itself is based on the thousand-year-old practice of inoculation.
Vaccination has saved millions, mostly children, from many potentially fatal diseases.
The Spread Of Variolation
In Europe, where the medical profession was relatively organized, the new methods of variolation became known quickly among physicians. Since there was also a demand for protection against smallpox, physicians soon began the variolation procedure on a massive scale. Although 2% to 3% of variolated persons died from the disease, became the source of another epidemic, or suffered from diseases transmitted by the procedure itself, variolation rapidly gained popularity among both aristocratic and common people in Europe. The case-fatality rate associated with variolation was 10 times lower than that associated with naturally occurring smallpox. In the 1750s more European princes died of smallpox, giving further impetus for the use of variolation . Among those variolated were Empress Marie-Therese of Austria and her children and grandchildren, Frederick II of Prussia, King Louis XVI of France and his children, and Catherine II of Russia and her son. King Frederick II of Prussia also inoculated all his soldiers. In fact, variolation was widely practiced in Europe until Jenner’s discovery.
In 1757, an 8-year-old boy was inoculated with smallpox in Gloucester he was one of thousands of children inoculated that year in England. The procedure was effective, as the boy developed a mild case of smallpox and was subsequently immune to the disease. His name was Edward Jenner.
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Vaccination Campaigns Are Hard
oV-2 take off, it seems increasingly likely that vaccination is the only way the pandemic will be brought under control. In theory, the high efficacy shown in clinical trials should be sufficient to stop the virus cold. Yet only a few vaccines have ever brought epidemics to an abrupt halt. Even in modern times, many campaigns have fallen short of the impact covid-19 jabs will need to have for pre-pandemic lifestyles to resume.
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The first efforts to make humans in the West immune to common diseases were ineffective. By the 15th century, Chinese doctors were grinding up dried smallpox scabs and blowing them into the nostrils of healthy children. In the early 1700s Lady Mary Wortley Montagu, an English aristocrat, saw women in Ottoman Istanbul conducting variolationa process designed to induce a mild infection and then immunity, in which pus taken from smallpox blisters is applied to scratches on the skin.
Montagu variolated both of her children, who survived. She later argued successfully for the procedure to become widespread. Yet during the next 80 years, the share of deaths in London caused by smallpox actually rose to nearly 9%, from just over 6% in 1640-1720. Variolation could cause deadly infections among the victims were two sons of King George III.
With governments around the world making vaccination against SARS
What Are The Lessons From History For Covid
Firstly, the public will tolerate risk of harm from a vaccine if their fear of the disease exceeds their fear of the vaccine.
The immediate response of many countries to news of rare but serious cases of blood clotting occurring in people given the AstraZeneca COVID-19 vaccine was to suspend use of the vaccine, at least for younger adults.
In public health, the precautionary principle means acting to prevent harm. Arguably, this is an example of inappropriate use of the precautionary principle . Perhaps there was not sufficient consideration of the possibility that suspending vaccine delivery was a disproportionate response which would alarm the public and increase vaccine hesitancy.
Although the risk of blood clotting with the AstraZeneca vaccine is extremely low, at times when there is almost no COVID-19 circulating the risk of dying from blood clotting due to the vaccine is slightly higher than dying from COVID-19.
In Australia, a concentration on individual risk at a single point in time ignores the benefits to the community of widespread vaccine uptake.
And as soon as COVID-19 incidence rises, the risk of dying from COVID-19 massively outweighs any slight vaccine risk.
Indeed, COVID-19 itself is far more likely to cause blood clots than the vaccine. However, contravening autonomy by making vaccination mandatory threatens civil liberties and should only be considered in extreme circumstances.
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Twentieth Century And Eradication
Modern smallpox vaccine production began in Canada in 1916. Nevertheless, a notable outbreak occurred in Windsor, Ontarioin 1924. Sixty-seven unvaccinated people contracted the disease and thirty-two died. Smallpox persisted in Canada until 1946, when vaccination campaigns eliminated it. The World Health Organization declared it globally eradicated in 1979 aftera 10-year campaign in South America, Africa and Asia. Smallpox is the first major disease to have been wiped out by public health measures.
Canadian scientists played a key role in the eradication. Connaught Laboratories, based in Palmerston, Ontario, consulted on vaccine production across the Americas.Between 1980 and 2001, Connaught and its successors kept smallpox samples in a deep-freeze in case the vaccine was needed in the future. After 9/11, in the context of new fearsof bioterrorism, pharmaceutical company Aventis Pasteur retrieved the stocks to create a new stockpile of the vaccine.
Cultivating Poliovirus In Human Tissue
Scientists in New York City grew the poliovirus in embryonic brain tissue, allowing them to study how the virus spread. However, they were reluctant to create a vaccine in this manner due to the risks associated with using nervous system tissues. This particular study did at least advance the medical communitys understanding of the poliovirus ability to multiply.
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Rare Severe Vaccine Responses
These responses also occur as the immune system responds to the vaccine. They include responses such as a severe allergic reaction to an ingredient in the vaccine, or a low platelet count , febrile seizures, HHE , or prolonged crying.
Anaphylaxis can be treated and is therefore rarely life threatening. Other severe responses may or may not require treatment to help them resolve and rarely result in any long-term consequences.
The History Of Vaccinations And How Smallpox Was Eradicated
by Amanda Z. Naprawa , University of California – Berkeley
It was called the “most dreadful scourge of the human species.” It killed at least one-third of the people it infected. It decimated entire populations, striking old and young, rich and poor alike.
“It” is smallpox, a horrifying, deadly, and disfiguring disease caused by the variola virus. Early symptoms include high fever and fatigue, followed by a characteristic pus-filled rash, particularly on the face, arms, and legs. Smallpox is spread primarily through airborne respiratory droplets or saliva. Because the contagious period starts before symptoms begin and lasts until the last blister scab falls off, the disease spread easily from person to person. If it did not kill you, it often left disfiguring and tell-tale deep pockmarks on the skin.
Smallpox was one of the most terrifying diseases in history. Today, however, we do not live in fear of it because smallpox no longer exists in the wild. That’s right. In 1979, after an intensive and very effective worldwide vaccination campaign, smallpox was declared eradicated. This means that the smallpox virus is no longer circulating anywhere in the world. Let me repeat. Smallpox, which once killed millions of people and left thousands disfigured, no longer exists in the wild. It might show up in a forgotten government storage fridge, but that is not the point. The point is, it doesn’t exist naturally in the population.
From milkmaids to mass vaccination
Numbers can’t lie
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