From Treatment to Cure: Exploring the development of Vaccinations since the eighteenth-century

The year was 400BCE, Hippocrates had just established the theory of the four humours, in which the perfect balancing of the body’s four components (yellow bile, black bile, phlegm and blood) was crucial towards maintaining an individual’s health. Flash forward to the eighteenth century, and this theory remained one of the dominating beliefs in the medical community. So, when Edward Jenner created the first vaccination in 1796 to combat smallpox, he was met with opposition for daring to challenge prevailing and ancient beliefs. Nevertheless, his creation was eventually accepted in the following decades, and the vaccination became the pioneering discovery in the treatment of infectious diseases, which has stood the test of time, continuing into the twenty-first century with the Covid-19 vaccine.

Prior to the eighteenth century, society was characterised by high mortality rates, poor public health, and the rapid spread of infectious diseases. The humoral theory, whilst declining, was still persistent in both the teaching and doctoring of medicine. Another theory that prevailed was miasma, in which disease continued to spread as a result of bad smells. These theories consequently prohibited the advancement of medicine, amplified by societal focus on treating symptoms rather than actively seeking a cure for disease. This was made worse by the rapid spread of a certain disease during the seventeenth century – smallpox.

Smallpox ravaged across the globe, particularly in both Europe and the Americas. It targeted crowded cities, and saw high infant mortality rates. Before Jenner made his breakthrough discovery, the predominant combative measure against smallpox was inoculation. In the context of smallpox, inoculation, also referred to as variolation, is the introduction of the matter taken from an infected smallpox sore, which is then introduced onto the skin of a healthy individual, causing a mild infection that would immunise the individual from contracting the disease. It was a dangerous procedure, with some instances of bloodletting (referring to the over-powering nature of humoral theory), purgative medicine and deep incisions (where utensils would not have been sanitised in-between). Despite these risks, inoculation did prove beneficial in saving many lives, including Jenner himself.

It is often agreed among historians that Jenner was obsessed with curing smallpox. This led to his observation of milkmaids in Gloucestershire, who often worked closely with cows and contracted cowpox, yet these milkmaids never fell ill with smallpox. To test his theory, he inoculated cowpox onto those he knew, including an eight-year-old child, and found these individuals did not contract the disease, thus the cure to smallpox was discovered. Once publishing his findings in 1798, the vaccine gradually began to be adopted throughout Europe and the United States. This acceptance was further seen through the 1840 Vaccination Act enacted by the British government, whereby inoculation of smallpox was prohibited by the threat of punishment for anyone who performed variolation, and the vaccine gained significant traction. As a result, focus began shifting to curing disease, rather than simply treating it. Furthermore, mortality rates began to improve, legislation was implemented to improve public health and further medical discoveries, such as anaesthesia and penicillin, were made. Focusing on vaccination, further vaccines were produced in the years that followed to combat further fatal diseases, including: rabies in 1885, typhoid and cholera in 1896, tuberculosis in 1921 and polio in the 1950s.

Another significant vaccine produced is something the majority of us would have received in recent years. The global impact of the Covid-19 pandemic caused an estimated three million deaths in 2020 alone. However, due to the rapid development of the medicine industry, the first vaccine was developed by the 8th December 2020. The first Pfizer-BioNTech vaccine was given to 90-year-old Margaret Keenan at University Hospital in Coventry. This then led to a gradual introduction of the vaccine to the public in different age demographic groups. As new variants of the disease were discovered, including Omicron, people were given a booster vaccine to help further combat the virus.

Nevertheless, with new medical inventions, debates and ethical issues arise that encompass the discovery, and vaccinations are no exception to this. Jenner faced significant resistance, influenced by both religious and moral objections, as new discoveries challenged God’s will and interfered with divine providence, as well as the deeply rooted stigmatisms surrounding new medical discovers that challenged the status quo. Another interesting reasoning people argued against the smallpox vaccine was that they believed they would begin to develop cow-like features. This fear arguably stemmed from the satirical images and propaganda created at the time by those who opposed the vaccine. Modern viewpoints may coin this an odd belief; however propaganda has continued to be an effective tool to spread misinformation, even in the twenty-first century, which led to many remaining cautious of the Covid vaccine. This has consequently worsened through the growth of mass media, with many arguing that governments were making attempts to alter an individual’s DNA or inject microchips into the public to track the population. Other ethical debates include: informed consent, personal beliefs and superstitions, and whether herd immunity questions an individual’s right to their own bodily autonomy.

So, the development of the vaccine in the eighteenth century evidently represents a significant turning point in medical history, one that has completely revolutionised the practice of medicine into the twenty-first century. The work of Jenner, and the assistance of the cows that helped, has led to a societal shift in curing disease, and the implementation of public health policies, which has allowed for further medical advancements to be established. Despite opposition faced by both the first vaccine and the ones that followed, it is safe to say that his discovery has proved vital in improving patient welfare and strengthening the relationship between the medical community and both the public and the government.

Bibliography

Bennett, Michael, War Against Smallpox (Cambridge University Press, 2020).

Hasselgren, Per-Olof, ‘The Smallpox Epidemics in America in the 1700s and the Role of the Surgeons: Lessons to be Learned During the Global Outbreak of COVID-19’, World Journal of Surgery, 44.9 (2020) pp.2837-2841 <https:doi:10.1007/s00268-020-05670-4>

Rees, Anthony Robert, A New History of Vaccines for Infectious Diseases Immunization – Chance and Necessity (San Diego: Elsevier Science and Technology).

GOV.UK. 2021. ‘UK Marks One Year since Deploying World’s First COVID-19 Vaccine’, GOV.UK <https://www.gov.uk/government/news/uk-marks-one-year-since-deploying-worlds-first-covid-19-vaccine>