Inoculation Or How To Use The Disease Against Itself
The first attempts to produce immunity artificially were recorded in China approximately a thousand years ago.
Healthy people would inhale a powder made from the crusts of smallpox scabs in order to protect themselves from the disease. They might show mild symptoms, but they were usually resistant to any subsequent exposure. The practice was called inoculation.
Another version of inoculation involved inserting powdered scab or pus from a smallpox pustule into a scratch on the skin made by a sharp instrument.
Inoculation was practiced in Asia and parts of Africa. It reached Europe and America via traveller’s tales and experiences in the 1700s, where it was also called variolation, after the Latin name for smallpoxvariola.
Cotton Mather, an American churchman, was told about inoculation by his enslaved worker, Onesimus who had been inoculated as a child in Africa. In 1721, Mather campaigned for inoculation during an outbreak of smallpox in Boston and met with some successbut also much hostility.
Lady Wortley Montagu, wife of the British ambassador to Turkey, observed the scratch method of inoculation in Constantinople at seasonal inoculation parties. On returning to Britain, she had her children inoculated during a smallpox outbreak in 1721. She introduced the practice to London Society and even King George II had his children inoculated.
Orphans Gave Up Everything To Distribute The Worlds First Vaccine
Spains strategy for rolling out the smallpox vaccine ran into some very 19th-century problems.
When the United States green-lit two coronavirus vaccines in December, it was a rare bright spot during this pandemic: Scientists had developed a vaccine for COVID-19 far faster than any other vaccine in history. The end finally seemed at hand.
Since then, many, many things have gone wrong. In mid-December, Pfizer reported that it had millions of doses sitting around in a warehouse, and no instructions on where to send them. Medical teams trained to vaccinate masses of people have been sitting infuriatingly idle. Health departments originally stuck to banking hours instead of vaccinating around the clock. Governors have slowed things down by relying on confusing guidelines about who can get vaccinated when. Unused doses have expired and been thrown away.
Operation Warp Speed, the federal governments plan to develop and deliver vaccines in the United States, is now sputtering. In mid-December, the federal government floated hopes of distributing 40 million vaccine doses by the end of 2020. That number soon dropped to 20 million. Twelve days into January, just about 9 million people have received vaccines, less than 3 percent of the U.S. population. Meanwhile, Israel has vaccinated 21 percent of its population. Rolling out a vaccine at this speed and scale is not easy, but health agencies have had months to prepare and were still caught off guard.
Receiving Vaccine After Exposure To Monkeypox Virus
The sooner an exposed person gets the vaccine, the better.
CDC recommends that the vaccine be given within 4 days from the date of exposure in order to prevent onset of the disease. If given between 414 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.
Smallpox and monkeypox vaccines are effective at protecting people against monkeypox when given before exposure to monkeypox. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe.
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What Is The Smallpox Vaccine And How Is It Made
The smallpox vaccine is made using a poxvirus that infects cows . Cowpox causes disease in cows, but it rarely causes disease in humans. Because cowpox and human smallpox are similar, infection with cowpox can protect people against smallpox.
The person who first used cowpox to protect against smallpox was Edward Jenner in 1796. Jenner was a family physician who lived in southern England. He noticed that every few years, when smallpox would sweep across the English countryside, women who milked cows were spared the infection. He reasoned that these women were getting infected when they came in contact with blisters on the udders of cows during milking, and that this infection was protecting them from infection with smallpox. So, he took fluid from the blisters of cows and injected it into several people to see if that fluid protected against smallpox. It worked.
The Vaccine Everyone Was Waiting For Polio Vaccine
Parents were scared of the polio epidemics that occurred each summer they kept their children away from swimming pools, sent them to stay with relatives in the country, and clamored for an understanding of the spread of polio. They waited for a vaccine, closely following vaccine trials and sending dimes to the White House to help the cause. When the polio vaccine was licensed in 1955, the country celebrated, and Jonas Salk, its inventor, became an overnight hero.
Late 1950s | Recommended Vaccines
* Given in combination as DTP
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The Claim: Smallpox Killed More Than 300 Million In The 20th Century Was Defeated Through Vaccination
Vaccination has become a much talked about topic since the COVID-19 pandemic and one Facebook post is singing its praises.
“Smallpox killed more than 300 million people in the 20th century alone,” claims Rico Blanco in a .
Blanco states smallpox was never defeated with herd immunity the phenomenon when immunized people within a community or population protect those who lack immunity, essentially serving as human bulwarks against disease transmission only through vaccination.
have also made the case vaccination was responsible for eliminating the deadly disease, which they claim killed “3 out of every 10 people.”
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Stocks Of Variola Virus
Following the eradication of smallpox, scientists and public health officials determined there was still a need to perform research using the variola virus. They agreed to reduce the number of laboratories holding stocks of variola virus to only four locations. In 1981, the four countries that either served as a WHO collaborating center or were actively working with variola virus were the United States, England, Russia, and South Africa. By 1984, England and South Africa had either destroyed their stocks or transferred them to other approved labs. There are now only two locations that officially store and handle variola virus under WHO supervision: the Centers for Disease Control and Prevention in Atlanta, Georgia, and the State Research Center of Virology and Biotechnology in Koltsovo, Russia.
Three-year-old Rahima Banu with her mother in Bangladesh. Rahima was the last known person to have had naturally acquired smallpox in the world. An 8-year-old girl named Bilkisunnessa reported the case to the local Smallpox Eradication Program team and received a 250 Taka reward. Source: CDC/World Health Organization Stanley O. Foster M.D., M.P.H.
WHO poster commemorating the eradication of smallpox in October 1979, which was officially endorsed by the 33rd World Health Assembly on May 8, 1980. Courtesy of WHO.
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The Schedule From 2011 To Present
Annual updates to both the childhood and adult immunization schedules offer guidance to healthcare providers in the form of new recommendations, changes to existing recommendations, or clarifications to assist with interpretation of the schedule in certain circumstances. The schedules are reviewed by committees of experts from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians.
Important changes to the schedule:
- New vaccines: meningococcal serogroup B vaccine
- Additional recommendations for existing vaccines: HPV , intranasal influenza vaccine
- Discontinuation of vaccine: intranasal influenza vaccine
2020 | Recommended Vaccines
* Given in combination as DTaP** Given in combination as MMR
Who Was Edward Jenner
Edward Jenner was an English doctor who was born in Gloucestershire in 1749 and lived to 74 – an impressive age for his time – before dying in 1823.
Jenner had been inoculated for smallpox using the method of variolation, and he got the idea of using cowpox from farm workers.
A lot of farm workers believed that people, mostly women, who got cowpox while milking did not get smallpox.
Jenner made his first attempt in 1796, and it was successful.
After many more experiments, Jenner published his work in 1801.
He promoted his new method – but sometimes the cowpox samples he sent out became contaminated with smallpox in hospitals, so some people didnt trust his vaccine.
Others were just resistant to change, and some people thought it was dangerous or irreligious for humans to be contaminated with material originating from cows.
A huge step came when variolation was banned by parliament in 1840, and the smallpox vaccination was made compulsory in 1853.
Jenner was given loads of honorary awards, and many a monument in celebration of his work on the vaccine.
And the cow is also celebrated for its role – because the word “vaccine” is from the Latin “vaca”, meaning cow.
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Who Can And Cannot Receive The Smallpox/monkeypox Vaccine At This Time
- The IMVAMUNE vaccine may be offered to adults 18 years of age and older who do not have contraindications.
- Although IMVAMUNE is not authorized for children and has not been studied in this population, they may be at higher risk of severe outcomes from monkeypox infection and may benefit from vaccination. There is a lack of evidence of safety and efficacy of IMVAMUNE pre-exposure prophylaxis or post-exposure prophylaxis in this group, though indirect evidence of clinical testing of other vaccine types indicates that IMVAMUNE components are well tolerated in recipients under 18 years of age.
- IMVAMUNE has been administered to 120 subjects 56 to 80 years of age with no difference in safety and immunogenicity compared to adults up to 55 years old.
Table 1 indicates who should and should not receive the IMVAMUNE vaccine and provides some questions you may be asked before being vaccinated and possible recommendations based on your response. These recommendations are based on the advice of the National Advisory Committee on Immunization .
Statement On July 2003
Two expert reports on the safety of smallpox vaccines were presented to the Global Advisory Committee on Vaccine Safety at its eighth meeting in Geneva, Switzerland on June 11-12, 2003. The reports included a detailed review of the safety of smallpox vaccine based on historical data as well as recent experience, particularly in the United States. The data highlighted the large variation in the pathogenicity of previously used strains and it was noted that safety data gained with the older vaccines may not necessarily apply to newly developed smallpox vaccines and it should not be assumed that they will be safer.
The Committee concluded that there is a real risk of serious adverse events following immunization with smallpox vaccine, including safety issues that have not previously been recognized, that there may be potential risks to contacts of vaccinees, and that implementation of immunization would require capacity and resources. The committee will continue to monitor the safety of smallpox vaccines.
The GACVS is a scientific advisory body established by WHO to provide a reliable and independent scientific assessment of vaccine safety issues in order to respond promptly, efficiently and with scientific rigour to such issues. Membership includes experts from around the world in the fields of epidemiology, paediatrics, internal medicine, pharmacology and toxicology, infectious diseases, public health, immunology and autoimmunity, drug regulation, and safety.
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Different Types Of Vaccine
Smallpox vaccines produced and successfully used during the intensified eradication program are called first generation vaccines in contrast to smallpox vaccines developed at the end of the eradication phase or thereafter and produced by modern cell culture techniques. Second generation smallpox vaccines use the same smallpox vaccine strains employed for manufacture of first generation vaccines or clonal virus variants plaque purified from traditional vaccine stocks, whereas third generation smallpox vaccines represent more attenuated vaccine strains specifically developed as safer vaccines at the end of the eradication phase by further passage in cell culture or animals. Second and third generation vaccines are produced using modern cell culture techniques and current standards of Good Manufacturing Practices .
The need for WHO to maintain an emergency reserve of smallpox vaccine following eradication was recognized in 1980 when WHO was given a set of formal responsibilities for maintaining capacity and expertise to respond to a re-emergence of smallpox in the post-eradication era as both a component of a preparedness strategy and a possible deterrent to intentional release. The Smallpox Vaccine Emergency Stockpile was originally created by consolidating WHO Member State donations given in support of the Intensified Smallpox Eradication Programme.
Vaccine Risks Vs Monkeypox Disease
For most persons who have been exposed to monkeypox, the risks from monkeypox disease are greater than the risks from the smallpox or monkeypox vaccine.
Monkeypox is a serious disease. It causes fever, headache, muscle aches, backache, swollen lymph nodes, a general feeling of discomfort, exhaustion, and severe rash. Studies of monkeypox in Central Africawhere people live in remote areas and are medically underservedshowed that the disease killed up to 11% of people infected.
In contrast, most people who get the smallpox or monkeypox vaccine have only minor reactions, like mild fever, tiredness, swollen glands, and redness and itching at the place where the vaccine is given. However, these vaccines do have more serious risks, too.
In certain groups of people, such as people with serious immune system problems, complications from ACAM2000 can be severe. If you have concerns about whether you should receive ACAM2000, talk to your healthcare provider. This vaccine has the potential for more side effects and adverse events than the newer vaccine, JYNNEOS.
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Why Did Smallpox Vaccine Scar
The smallpox vaccine holds a live virus. It creates a controlled infection that forces your immune system to defend your body against the virus. The exposure to the virus tends to leave a sore and itchy bump behind. This bump later becomes a larger blister that leaves a permanent scar as it dries up.
Safety Of Smallpox Vaccination
Extract from report of GACVS meeting of 3-4 December 2003, published in the WHO Weekly Epidemiological Record on 16 January 2004
GACVS has previously considered the safety of smallpox vaccination.4 The Committee was provided with an up-dated account of the safety of smallpox vaccination, based on 38 759 persons vaccinated in the United States since January 2003, covering 65% of health care workers and at least one health care worker in 45% of hospitals. There is, in addition, a pregnancy registry of 160 women exposed to smallpox vaccine during or immediately before pregnancy, identifiable by testing. Consistent adverse effects reported in smallpox vaccinees have been myopericarditis and dilated cardiomyopathy the frequency of each adverse effect exceeds what might have occurred by coincidence.
4 See No. 32, 2003, pp 282284
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How Mary Wortley Montagu’s Bold Experiment Led To Smallpox Vaccine 75 Years Before Jenner
A new book celebrates the trailblazing work of the English aristocrat, who successfully inoculated her daughter
It was a daring and dangerous experiment that paved the way for the development of the first safe vaccine and saved countless lives. Yet when Lady Mary Wortley Montagu deliberately infected her own daughter with a tiny dose of smallpox successfully inoculating the three-year-old child in 1721 her ideas were dismissed and she was denounced by 18th-century society as an ignorant woman .
Three hundred years later, on the anniversary of that first groundbreaking inoculation on English soil, a new biography will aim to raise the profile of Wortley Montagu and reassert her rightful place in history as a trailblazing 18th-century scientist and early feminist.
If she had not inoculated her daughter, we would not then have gone on ultimately to find a cure for smallpox, said Jo Willett, author of The Pioneering Life of Mary Wortley Montagu, which will be published on Tuesday. She should be heralded for that yet shes not really well known, and I think partly thats because she was a woman.
Wortley Montagu, a smallpox survivor with a disfigured face, took the risky decision to inoculate her daughter by making tiny cuts on her daughters skin and rubbing in a small amount of pus from a live smallpox sore.
If Wortley Montagu hadnt inoculated her daughter, we may never have gone on to find a cure for smallpox.
Safety Of Smallpox Vaccines
Extract from report of GACVS meeting of 2-3 December 2015, published in the WHO Weekly Epidemiological Record of 22 January 2016
GACVS had previously considered the safety of smallpox vaccination.16 The Committee was provided with updated safety information for 1st, 2nd and 3rd generation smallpox vaccines in order to make informed decisions regarding emergency smallpox vaccine stockpiling and future use. The safety update also included an overview of the safety of smallpox vaccines used in the smallpox eradication efforts. Detailed safety information was provided for the currently licensed replicating 2nd generation ACAM2000 and the non-replicating 3rd generation Imvanex/Imvamune smallpox vaccines.
GACVS noted that overall, no new safety concerns have been observed with the ACAM2000 and Imvanex/Imvamune smallpox vaccines. There is little safety information on these newer smallpox vaccines among pregnant women and it is not known whether the safety profiles of these vaccines differ depending on ethnic background. There are also no data in pediatric subjects and GACVS noted that in the absence of circulating smallpox, these vaccines should not be used in pediatric populations. The vaccines have been shown to be immunogenic and protective against lethal orthopoxvirus challenge in animal models.
16 See No. 3, 2004, p. 20.
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