The Story of Vaccines, Part 1: Icky Bugs, and the Man Who Watched Milkmaids

There’s a lot of talk about vaccines. Are they good? Do they work? Are they dangerous? Are schedules too rigorous for infants? Are they necessary? We’ll get to those questions in good time. But before we do, let’s just start at the ground-floor. A biography of the vaccine, if you will. Today, we offer: The Story of Vaccines, Part 1.

In order to have a biography of the vaccine, we need to start long before the vaccine. We need to go back to the beginning of medicine: back with the cavemen and infectious disease. Infectious disease includes everything from microscopic bacteria, to arguably non-living viruses, to worms the length of your arm. One thing that unifies infectious disease? It’s older than dirt, and we’ve always been trying to kill it.

Okay, maybe not older than dirt, but it certainly is older than all of us. We know that the Ancient Egyptians and Ancient Greeks recorded plagues, and that Ramses V, Pharaoh of Egypt, was disfigured by smallpox in the 12 Century BCE. We know that plagues and supernatural explanations for plagues are common throughout religious literature, including the Bible. We know that the oldest piece of epic literature, the Mesopotamian Epic of Gilgamesh from 2100 BCE, has reference to plagues.

Bubonic plague, smallpox, and measles (the biggest killers in history) have destroyed empires (the Han Empire was collapsed by them), killed countless millions, and disfigured more. In one outbreak, bubonic plague killed 40 million people. That’s more than the population of any modern world city. That’s more than the population of Canada, about the population of Poland, or more than half of the population of the UK. Simply, that’s a lot of people. And that’s one outbreak! If you add up the deaths of infectious disease, you are easily into several billion.

Something else as old as infectious disease? Attempts to cure and prevent infectious disease. Otzi the Iceman, a man preserved in a glacier from the Bronze Age who was discovered in 1991, carried tree fungus in a pouch. Many anthropologists believe he was carrying it as some sort of remedy for infections or parasites. Historical medicine is rife with theories of how to kill or prevent disease, with some remedies more or less advisable than others. Dried toads and rat pee show their faces in a lot of Old English remedies.

One of these diseases, smallpox, may not be older than dirt. But it’s as old as mummies. It’s been found in several of them. Variole viruses (like smallpox) are probably about 68,000 years old! And maybe you’ve heard of Queen Elizabeth’s ½ inch of makeup on her face when she died? It was to cover up the smallpox scars. Well, this crazy disease ravaged around for most of human history. As a virus, smallpox invades cells and then hijacks them until they burst open. Smallpox is known for making little sores all over the body. In its friendliest form, it makes a fever and muscle aches. In its angriest form, it causes blood vessels to burst, and a human can bleed out without their skin even breaking. It was basically one of the worst things that could happen to a person for most of human history. Then, a doctor named Edward Jenner noticed something. Milkmaids didn’t get smallpox.

Even when the rest of the household got smallpox, milkmaids never got smallpox. Now, people had already realized that once you got smallpox, you were set for life. No more smallpox for you—if you lived. And as such, a woman named Lady Mary Montagu had introduced a practice from Turkey into England called variolation. Have you ever heard stories of 1950s mothers taking their kids over to the house in the neighborhood with chickenpox in hopes that their child would get it and get it over with? That’s the same idea of variolation. You give the person smallpox, and then they won’t get it again. If they live.

But Jenner noticed something special. Milkmaids didn’t get smallpox, even without variolation. And he realized that the reason why is because they got something called cowpox. And people don’t routinely die of cowpox. It’s really just a nuisance of a sickness that you simply get over. But it’s similar enough to smallpox that, essentially, you have given the blueprints to smallpox to your immune system. Instead of going into panic mode, the immune cells say, “Well, this ain’t my first rodeo!” and promptly destroy the intruder. In 1796, Jenner inoculated 8-year-old James Phipps with pus from the cowpox sores of milkmaid Sarah Nelmes. A few weeks later, he injected the boy with smallpox (okay, so, their sense of medical research ethics was slightly different from ours). And Phipps didn’t get smallpox. And vaccination – from “vacca,” the Latin word for “cow” – was born.

Jenner wasn’t the first to realize this cowpox thing. In fact, at least five other doctors realized it too, and had successfully developed “vaccines.” But Jenner was the first to actually test the hypothesis by then injecting a vaccinated person with smallpox and showing that they were effectively “immunized.”

Then the world was saved from infectious disease and we all lived happily ever after?

Well, not exactly. See, most diseases don’t have that super-convenient “non-lethal disease that makes immune” like smallpox does. So scientists had to get creative.

And that creativity is the next installment of The Story of Vaccines.

Meet us back here for Part 2.

References:

http://www.iceman.it/en/

Early History of Infectious Disease, Kenred E. Nelson and Carolyn F. Williams