An Early History of Vaccines
We tend to think about vaccinations as a modern and Western medical phenomenon. While it’s true that most major developments in the scientific study of vaccination have taken place in the past 200 years in Europe and the United States, the rich and varied origins of vaccinations go back over a thousand years and to locations all across the globe. The history of vaccinations as we know them today is a prime example of how human advancements occur not in isolation but rather through a progressive journey of both milestones and failures.
A recognition of the concept behind vaccinations—namely that by surviving an infection of a disease a person can become immune to it—is recorded to have been understood as far back as Ancient Greece. Greek historian Thucydides observed in 429 BC that people who contracted but lived through the smallpox plague in Athens were not re-infected with the disease. This observation was also made some 500 years later in China sometime between 900 and 1000 CE, with doctors discovering that exposing healthy people to tissue from the scabs caused by smallpox decreased their chances of dying from the disease. This process, called variolation, was done by either putting the tissue under a person’s skin or inserting powder derived from pulverised smallpox scabs into a person’s nose.
According to written records, a Chinese statesman’s son was successfully inoculated against smallpox in 1000 CE through the powder method. This increased the popularity of variolation in the region, prompting Emperor K’ang, whose father Emperor Fu-lin died of smallpox in 1661, to write a letter in the late 1600s to his descendants supporting variolation. In that letter, he admitted to having tested it on many people and having invested significant resources into its widespread application, despite significant opposition. He claimed that the inoculations he supported had saved millions of lives, and encouraged future generations to take up the practice.
Over in the Americas around the same time, an accidental run-in with variolation resulted in its widespread use in the West. A Boston minister named Cotton Mather was given a gift of a Libyan slave in 1706, and the minister noticed that the slave bore a scar from smallpox variolation back in Libya. The slave claimed that he and others like him who had been variolated were immune to the disease. Upon discovering this, Mather became a strong proponent of inoculation. Another Western advocate of variolation was Lady Mary Montagu, who in 1718 had her six-year-old son variolated with smallpox in Turkey. When she returned to England in 1721, she variolated her two-year-old daughter and became a spokesperson for the practice in Europe.
Given the high number of outbreaks of smallpox in Europe and the Americas in the 1700s, inoculation was a highly publicised topic. Many were highly critical of the practice since 2 to 3 percent of those variolated died of the disease, and since the disease could be spread between those who had been variolated and healthy individuals who had not. But advocates pointed to the fact that the death rate of individuals who naturally contracted smallpox was 20 to 30 percent, making inoculation the safer bet. This assumption was further evidenced in 1738 when smallpox struck Charleston, South Carolina. Of the 441 people who were variolated against the disease, around 4 percent of them died, while the smallpox outbreak was fatal for 18 percent of those who were naturally infected.