Tuesday, August 31, 2010

The First Vaccine Ever Invented: Smallpox Vaccine


Many people think of vaccination as a modern invention, but the actual concept of vaccination originates in 1798 when the smallpox vaccine was developed.  The virus which combats smallpox was discovered a few years later, is still the exact virus we use in our current vaccine. Other vaccines developed in the early 1900's include vaccines for the Plague, Diphtheria, Pertussis (whooping cough), TB and Tetanus.  Over the years many more vaccines have been developed. There are currently two vaccines (Hep B and HPV) which have the power to combat cancer.

Vaccination is the best, most cost effective, and easiest mode of disease prevention in the entire world!
Today I wanted to write about the history and miraculous outcome of the very first vaccination ever created, THE SMALLPOX VACCINE.

CURRENTLY SMALLPOX IS COMPLETELY ERADICATED WORLD-WIDE; THIS IS DUE TO VACCINATIONS

In the early 1900's 13 million people died from smallpox and it has mortality as high as 80% in children.
                                                                    smallpox 1912
The smallpox virus is one of the largest, most complicated viruses in nature. Smallpox virus has the longest genome of any virus in the world,187 genes, in comparison HIV/AIDS virus only has 10 genes! 

The earliest account of  smallpox"virulation" (i.e. vaccination)  is from as early as 1000 BC in India physicians would take a scab from a smallpox sore and grind it to powder.  The ground powder would then be blown into patients noses. Perhaps of more significance is,  Lady Mary Wortley Montagu was the wife of a Brittish Commissioner serving in the Ottamin Empire of Turkey, when she learned about the ancient practice of virulation, she "vaccinated" her children, then brought the vaccination/concept to her country of origin, Brittian. The "vaccination" was used in the royal family which fueled support from the European public.

The problem with this powder "vaccination" was that 2-3% ended up contracting smallpox from it, and ultimately dying as a result of the illness.  Despite this 2-3%, the use of this "vaccine" reduced contraction of smallpox and therefore the death rate ten fold and determined worth-the-cost.

Edward Anthony Jenner was the creator and inventor of the current vaccine.  He discovered that you could use "cow-pox" instead of "human-pox" (i.e. smallpox), without the 2-3% mortality rate.  This was discovered by following a patient of his whom was a milk maid.  Milk maids, were known to have very beautiful skin.  Their beautiful skin was because these maids never contracted smallpox, therefore they never developed the insidious scarring which results from smallpox.   Jenner found that milk maids  contracted "cow-pox," as a few lesions, only on their hands.  It became apparent to him that exposure to the "cow-pox" created a type of immunity against smallpox.  So Jenner made a vaccine from the cow-pox, eliminating that 2-3% mortality, and vaccinated his own son to prove it's efficacy.

Even though Jenner's smallpox vaccine was developed in the 1790's,  smallpox still raged on, because of production and transportation limitations.

In 1855 the US government mandated that all school age children get vaccinated for small pox, this legislation promoted mass production and access nationwide.
                                     D.A. Henderson with his Presidential Medal of Freedom in July 2002

For a while the last cases of US small pox were in 1949, of 8 people and two died. That was until we utilized mass air-travel.  This travel gave the US access to India and Brazil which had raging epidemics of smallpox.  The CDC calculated how quickly smallpox could spread via air travel,  only 14-21 days to a raging epidemic.  This air-travel dilemma fueled the desire to eliminate the epidemic entirely.  In 1967 Dr. Donald Henderson led a team with the goal to completely eliminate smallpox epidemics worldwide.  WHO workers vaccinated 25 million people but, there were still many un-vaccinated persons.  With a disease that's as infectious as smallpox, you MUST HAVE 98% of the population vaccinated in order to prevent spread.  The next mass vaccination of smallpox was started soon after in Sierra Leone, which had the highest levels of smallpox world wide. Within 9 months small pox was eradicated entirely in Sierra Leone.

WHO officially certified smallpox elimination,  December 1979. This declaration occurred 2 years after the last case of recorded smallpox in a 23 year old man named Ali Maow Maalin from Somalia.   
This eradication included the use 
of over 100 million vaccines worldwide

After many, many years presently the smallpox vaccine is no longer needed or used (except for the Commander in Chief and possibly the militia).  Three vials of the smallpox virus exist, they are held in three, level four, high security facilities and are carefully guarded.

In some states routine vaccinations are not mandatory.  But, please it is my personal opinion which is also shared by the medical community at large, THAT YOU PLEASE VACCINATE, I hope this story proves to be an excellent example of vaccination miracles!
As always remember I am a Physician Assistant student, I am not certified (yet!) and I am not a physician.  The comments on my blog come from lectures I attend in school, personal thoughts and opinions on the subject and other sources.  Before making any health care changes, please talk with your doctor first! Kim :)

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