History of Vaccination

What does it mean for Humanity?

The big topic of our time, indeed the top topic of conversation around the world, is most likely vaccinations against coronavirus.And it looks like this topic will be with us for at least the next two years.Some speak of vaccination as a curse, while others call it a blessing.

Before we address the coronavirus vaccine specifically, let’s first take a look at the history of human vaccination. What may be most surprising is the fact that vaccines have not been around for as long as one might assume.

The age of the scientists

It was recognized early on that people who had survived the plague and smallpox  apparently had some protection against the deadly diseases when later epidemics broke out. As a result, scientists began intentionally infecting people in order to make them immune to infectious diseases.

We owe the development of important vaccines to researchers such as Louis Pasteur (1822-1895), Robert Koch (1843-1910), Emil von Behring (1854-1917), and Paul Ehrlich (1854-1915).

A long path to modern vaccinations

It wasn’t until slightly more than two hundred years ago, in 1796, that a vaccine that meets the modern definition of one was produced for the first time to combat smallpox. Vaccines against other infectious diseases such as measles, mumps, rubella, chickenpox, hepatitis A and B, pneumonia, influenza, meningitis, and meningococcal diseases were not developed until the late 19th and 20th centuries. Despite intensive research, vaccines have not, to date, been developed for all infectious diseases, such as AIDS.

Smallpox

In Europe, 60 million people died of smallpox, mostly in the 17th and 18th centuries. 40% of cases were fatal.

Closely connected to the history of vaccinations is the name of the  country doctor and English surgeon Edward Jenner, who lived from 1749 to 1823. He took a completely innovative path in his search for a preventive treatment. He was a student of the experimental surgeon John Hunter. He observed that people who had become infected with a specific vesicular rash caught from the udder of cows (“cowpox”) never got smallpox.

Smallpox was widespread in Europe and Asia and almost one in seven deaths at the time was due to smallpox.

As recently as 1870-71, a smallpox epidemic in Germany claimed 125,000 lives. Edward Jenner conducted a crucial experiment in 1796 to prove a causal relationship. He vaccinated James Phipps, an eight-year-old boy who had previously not had the smallpox, with the pustular secretion of a maid who had suffered from cowpox. James fell ill. Six weeks later, then, Jenner inoculated the boy with smallpox secretion and, as he expected, the child did not become ill. After this vaccination, however, his brain was damaged and he died at the age of 21.

“Nevertheless, Jenner is considered a winner in medical history. He infected children with smallpox and the children were spared this life-threatening disease. Jenner also knew it was a big deal because he was convinced that his method would eradicate smallpox. And he was right, although it took another 200 years”, explains Professor Karl-Heinz Leven, Director of the Institute for the History and Ethics of Medicine in Erlangen.

Although smallpox vaccination was considered a breakthrough in modern vaccination, it remained controversial for decades. Edward Jenner’s house is now a museum and is used by the British Society for Immunology (BSI) for symposia. Today, smallpox is considered extinct, but it is not certain that it will remain that way. Nobody knows whether forgotten samples of the pathogen are still hiding somewhere in the world.

For science, the return of the smallpox pathogen could be the worst conceivable disease outbreak imaginable. Since large parts of the world population have never been vaccinated nor have they ever come into contact with the pathogen, smallpox is a risk because it is many times more contagious than the flu.

According to scientific estimates, up to a third of those infected would die if the contagion were to spread globally. See: Infectious diseases: Smallpox watch – Frozen mummies and envelopes of scabs could contain remnants of one of history’s most prolific killers. By Sara Reardon. It wasn’t until 1979 that the WHO declared the world free of smallpox.

And there’s measles

The first measles vaccines were developed by Thomas Chalmers Peebles and Nobel Prize winner John Franklin Enders. The MMR vaccine was developed by Maurice Hilleman. The measles vaccine was first approved in the USA in 1963 and is undisputed among medical professionals, even if there are people who remain opposed to this vaccination to this day.

In 1970, it was East Germany that became the first country in the world to make measles vaccination mandatory. In West Germany, inactivated vaccines with a killed version of the germ were first approved for use against measles in 1966, but they were not made compulsory. In 2013, around 85% of the world’s children had been vaccinated against measles.

In 2012, 92.4% of first-graders in Germany had already received two rounds of measles vaccinations. Nevertheless, 365,000 people are infected with measles each year. 140,000 people in the world still die of the disease each year. In the 1980s, there were still around 2.5 million deaths from measles, due to its extremely high infection rate, especially among children.

Starting 1 March 2020, people living in community and health facilities in Germany will be required to be vaccinated against measles according to a law recently passed by the Bundestag. The Measles Protection Act was passed because measles is highly contagious and can lead to serious complications.

In detail, the law says: When children enrol in a day-care or school, parents must provide evidence that they are adequately vaccinated against measles or have immunity against measles. Immunity to measles can be documented with a medical certificate.

Any contraindications (e.g. allergy to components of the vaccine serum) must also be certified by the doctor. Such a certificate must then be presented in place of the vaccination certificate. The obligation to provide proof also exists for educators, teachers, child minders, and other employees in healthcare and community settings as well as for residents in holiday camps or asylum and refugee accommodation.

The flu: chills, high fever, body aches

Dangerous viruses: influenza is one of the deadliest and most dangerous viral infections we know today. It affects around 10 to 20% of the world’s population every year. An average of up to 500,000 people die from it each year.

In the case of an aggressive variant, as occurs regularly, this number can also be significantly higher. Older people with pre-existing conditions are particularly at risk. The Robert Koch Institute therefore recommends older people in particular to be vaccinated against influenza viruses.

The general population was first vaccinated against flu viruses in 1942. The vaccination should be given before the beginning of flu season, i.e. preferably October or November in the northern hemisphere. Unfortunately, the seriousness of the flu is often underestimated; it is not a normal cold, but a serious illness that can be fatal if it is severe.

However, German Wikipedia notes:”The effectiveness of the influenza vaccines approved up to now has fluctuated considerably, but is only around 50%, and has therefore been significantly lower than that of vaccines against other pathogens for decades. But, to date, there is no better medical protection against influenza. The previous influenza vaccines have to be adapted every year to the currently circulating influenza viruses, so an annual vaccination is recommended.

The Fluzone High-Dose Quadrivalent vaccine was approved at the end of 2020. This is approved for vaccinating adults ages 65 and over and, according to the German Federal Ministry of Health, is to be used primarily in senior citizens’ and nursing homes.

Compared to “normal” influenza vaccines, this vaccine, which has not yet been available in Germany, contains four times the amount of antigen. The Federal Ministry of Health (BMG) was able to procure 500,000 doses of the US-approved vaccine.

And, for 2021, the next flu season, they will have to adapt the vaccine accordingly to predictions.

The following vaccines have been successfully developed so far: smallpox (1798), rabies (1885), plague (1897), diphtheria (1925), tuberculosis (1927), tetanus (1927), and yellow fever (1937).

After the Second World War, science made further advances and was able to develop more vaccines: polio (1955), measles (1964), mumps (1967), rubella (1970), and hepatitis B (1981). All are on the World Health Organization’s List of Essential Medicines.

Stay alive and well!