If you want to generate lively discussion these days, mention vaccines. COVID-19 has brought the topic of immunization against disease to the forefront. Like many of you, I have friends who are on both sides of the debate. I’ve heard comments like “Vaccines work, get vaccinated!”as well as “I have a strong immune system and don’t need shots!”
For the record, I am a vaccine supporter and had my double-dose COVID-19 vaccination as soon as I could get it. I also keep up-to-date on other immunizations appropriate for my specific health needs, and I have already received a COVID-19 booster. But this commentary is not to promote one stance or another—it’s to provide a history of vaccines, how they came to be, who was instrumental in their development, and what the future may hold.
VACCINES FOR HEPATITIS A AND B, ZOSTER, HUMAN PAPILLOMAVIRUS, AND NOW SARS-COV-2 ARE THE LATEST ADDITIONS TO THE IMMUNIZATION ARSENAL.
The first use of a vaccine-like approach to prevent disease may have taken place in China around 1000 AD.1 The process was called variolation, and it was initiated to stem the spread of smallpox. Smallpox had been a scourge for centuries. While the origin of smallpox is unknown, mummies from ancient Egypt show signs of being infected with the disease, suggesting smallpox has existed for more than 3,000 years.2 The variolation technique involved rubbing the scabs or pustules of infected individuals to create a powder (from the scabs) or a serum (from the pustules). The powder or serum was then rubbed into a superficial flesh wound of an uninfected individual, who would develop pustules and symptoms similar to a naturally infected individual. Variolation and inoculation were terms used interchangeably, as variolation did involve inoculating an individual with the virus. Hopefully, the variolation procedure would typically lead to immunity. The mortality rate among those who underwent variolation was about 1% to 2% compared to 30% among those who contracted smallpox naturally.3 Edward Jenner is credited with creating the first injectable vaccine in 1796, when he used cowpox material to inoculate humans against smallpox. Interesting to note that when Jenner was 8 years old, he was inoculated with smallpox through variolation and thus became immune.4
Other vaccine milestones include Louis Pasteur’s rabies vaccine in 1885, followed by vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, and tuberculosis. These were developed via the newfound study of bacteriology. In the mid-twentieth century as viruses became a focus, additional vaccines were developed to combat measles, mumps, rubella, influenza, and polio.1 Vaccines for hepatitis A and B, zoster, human papillomavirus, and now SARS-CoV-2 are the latest additions to the immunization arsenal. Along with successful vaccines, there have also been vaccine failures. Most notably, a polio vaccine manufactured by Cutter Laboratories in Berkeley, California, contained a live version of the polio virus, leading to five deaths and 51 cases of paralysis in 1955.5
What does the future hold? The new mRNA vaccines (like the one for SARS-CoV-2) will continue to be studied and developed along with nucleic acid-based, recombinant DNA, peptide vaccines, and others. The targets for these include cancers, autoimmune diseases, Alzheimer disease, and more. We’ve come a long way from variolation. It will be interesting to see where we go from here.
Jill Rethman, RDH, BA
Editor in Chief
- The College of Physicians of Philadelphia. The History of Vaccines. Available at: historyofvaccines.org/timeline/all. Accessed August 14, 2021.
- United States Centers for Disease Control and Prevention. History of Smallpox. Available at: cdc.gov/smallpox/history/history.html. Accessed August 14, 2021.
- United States National Library of Medicine. Smallpox—A Great and Terrible Scourge. Available at: nlm.nih.gov/exhibition/smallpox/sp_variolation.html. Accessed August 14, 2021.
- Riedel S. Edward Jenner and the history of smallpox and vaccination. Available at: ncbi.nlm.nih.gov/pmc/articles/PMC1200696/pdf/bumc0018-0021.pdf. Accessed August 14, 2021.
- United States Centers for Disease Control and Prevention. Historical Vaccine Safety Concerns. Available at: cdc.gov/vaccinesafety/concerns/concerns-history.html. Accessed August 14, 2021.
From Dimensions of Dental Hygiene. September 2021;19(9):6.