Smallpox vaccine

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The smallpox vaccine was the first successful vaccine to be developed. The process of vaccination was discovered by Edward Jenner in 1796, who acted upon his observation that milkmaids who caught the cowpox virus did not catch smallpox.[1] Prior to widespread vaccination, mortality rates in individuals with smallpox were high—up to 35% in some cases.[2]


Pre-vaccination history

Before the introduction of a vaccine, the mortality of the severe form of smallpox—variola major—was very high. Historical records show that a method of inducing immunity was already known. A process called inoculation, also known as insufflation or variolation was practiced in India as early as 1000 BC.[3]. This interpretation is disputed, however: other investigators contend the ancient Sanskrit medical texts of India do not describe these techniques.[4] The first clear reference to smallpox inoculation was made by the Chinese author Wan Quan (1499–1582) in his Douzhen xinfa (痘疹心法) published in 1549.[5] Inoculation for smallpox does not appear to have been widespread in China until the reign era of the Longqing Emperor (r. 1567–1572) during the Ming Dynasty.[6] In China powdered smallpox scabs were blown up the noses of the healthy. The patients would then develop a mild case of the disease and from then on were immune to it. The technique did have a 0.5-2% mortality rate, but that was considerably less than the 20-30% mortality rate of the disease itself.

Variolation was also practiced throughout the latter half of the 17th century by physicians in Turkey, Persia, and Africa. In 1714 and 1716 two reports of the Turkish method of inoculation were made to the Royal Society in England, by Emmanuel Timoni, a doctor affiliated with the British Embassy in Constantinople,[7] and Giacomo Pylarini. Lady Mary Wortley Montagu, wife of the British ambassador to Ottoman Constantinople, is widely credited with introducing the process to Great Britain in 1721. Source material tells us on Montagu; "When Lady Mary was in the Ottoman Empire, she discovered the local practice of inoculation against smallpox called variolation." [8] The procedure had been performed on her son and daughter, aged 5 and 4 respectively. They both recovered quickly. In 1721, an epidemic of smallpox hit London and left the British Royal Family in fear.[7] Reading of Lady Wortley Montagu’s efforts, they wanted to use inoculation on themselves. Doctors told them that it was a dangerous procedure, so they decided to try it on other people first. The test subjects they used were condemned prisoners. The doctors inoculated the prisoners and all of them recovered in a couple of weeks. So assured, the British royal family inoculated themselves and reassured the English people that it was safe.

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