By Dr. Satish K Gupta*
History of Vaccination
(Vacca = Cow) in Latin, (in=inoculation)
Americans, Indians, British and Chinese can be proud today and rightly so, after all they have produced more than 11 billion doses of Covid Vaccines and stacked them in the path of Corona Virus to slow down its speed – an act which can be acclaimed beyond doubt, to have saved the millions of lives.
Today’s proud moments call for remembering and thanking lesser known pioneers for laying the strong foundations of vaccine development.
Today’s focus seems to have shifted from making a vaccine to making a vaccine ‘faster’.
The Earliest Lamp Post
Small pox – the deadly killer with 30% mortality as against 3% initial mortality of SarsCov-2.
China was the torch bearer with nasal vaccine to intradermal route
Early attempts to protect people against smallpox were reported in China as early as in the 16th century. Those days Smallpox scabs would be crushed and blown into the recipient’s nostrils or scratched into their skin.
(Akin to intradermal injection today)
Europe takes the lead in 18th century
Variolation was a method of immunizing patients against smallpox by infecting them with substance from the pustules of patients with a mild form of the disease (variola minor).
The practice, of “variolation” came into vogue in Europe in 1721, but it soon met with public outcry as 2-3% of people died after inoculation, and further outbreaks were triggered.
Father of vaccination is born
Curious observation that dairy farmers did not catch smallpox. Then 18th century English physician, Edward Jenner, hypothesised that prior infection with cowpox – a mild illness spread from cattle – might be responsible for the suspected protection against smallpox. And so, he started to work on a number of experiments, now considered the birth of immunology and vaccine therapy.
From “variolation” to “inoculation” which turned out to be much safer than variolation, originated in 1796, when Jenner inoculated an eight-year-old boy by taking pus from the cowpox lesions on a milkmaid’s hands and introducing the fluid into a cut he made in the boy’s arm. Six weeks later, Jenner exposed the boy to smallpox, but he did not develop the infection then, and even on 20 subsequent exposures.
As the time followed, Jenner collected evidence from a further 23 patients inoculated with the cowpox virus, to lend support to his his theory that immunity to cowpox did indeed provide protection against smallpox.
The origin of term “vaccination”
The earliest vaccination – the origin of the term comes from the Latin for cow (“vacca”). Jenner’s vaccination initially optional but quickly became the mandatory method of preventing smallpox around the world.
Luis Pasteur makes a strong building over the foundation laid by Edward Jenner
After a long wait of almost a century after Jenner, in 1885, the French biologist, Louis Pasteur, saved a nine-year-old boy’s life after he was bitten by a rabid dog, by injecting him with a ” *weakened form of the rabies virus” every day for 13 days. The boy never developed rabies and the treatment was heralded a success. Pasteur coined his therapy a “rabies vaccine”, expanding the meaning of vaccine beyond its origin.
The pioneering work and global clout of Louis Pasteur led to the expansion of the term vaccine to include a long list of treatments containing live, weakened or killed viruses, typically given in the form of an injection, to produce immunity against an infectious disease.
20th Century – explosion of new vaccines!
Scientific advances in the first half of the 20th century led to an explosion of *vaccines that protected against whooping cough (1914), diphtheria (1926), tetanus (1938), influenza (1945) and mumps (1948). Thanks to new manufacturing techniques, vaccine production could be scaled up by the late 1940s, setting global vaccination and disease eradication efforts in motion.
Vaccines against polio (1955), measles (1963), rubella (1969) and other viruses were added to the list over the decades that followed, and worldwide vaccination rates shot up dramatically thanks to successful global health campaigns.
First to come, First to go – Small Pox
The world was announced smallpox-free in 1980, the first of many big vaccine success stories, next in race of eradication being Polio but there was still a long way to go with other infectious diseases and new viruses keep adding to challenges.
Covid-19 heralding an era of fastest vaccine development in just few weeks
The fastest any vaccine had previously been developed, from viral sampling to approval, was four years, for mumps in the 1960s. No one could imagine that a vaccine would be ready for inoculation in 9 months especially when earlier attempts against Sars and MERS failed and vaccination against Ebola took several decades.
Also read: Treating COVID-19: Why is Novavax not offered as 3rd dose booster?
As genome sequence of the virus was released on the open access Virological website (http://virological.org/) early on January 11, 2020 the race for vaccine development started
True global emergency ignited the fire. Recipe was made using the templates created by years of previous research on related viruses, driven by enormous funding, facilitated by regulators that allowed multiple trials to run in parallel with unprecedented international cooperation. And results were thrilling. Not one but more than a dozen vaccines could be developed in record time and many were manufactured in advance on mass scale for timely delivery to save millions of lives.
Can the vaccine be developed faster than COVID vaccine?
In 2020 the COVID vaccine could be developed and vialed in short period of 12 to 14 weeks, rest of the time was taken for field trials. Can this trial time be shortened further would be thing for future research. Computer Simulated Models with human immunological correlates can break the barriers. Institutions like Milinda Bill Gates Foundation who have arsenal of computer knowledge as well as funds should try to cut the ice.
Some of those factors might translate to other vaccine efforts, particularly speedier manufacturing platforms. Continued momentum and enthusiasm with political patronage and financial support can change the world map of infectious diseases in years to come.
*Dr. Satish K Gupta is an MD in Medicines, a Visiting Senior Consultant Physician and Internist at Max Super Speciality Hospital, and a Clinical Assistant Professor at GS Medical College, Chaudhary Charan Singh University, Meerut. He is the author of Journey of COVID in India: A Doctor’s Perspective.
