It has been over 50 years since there has been a case of smallpox anywhere in the world. It remains the only human disease to be eradicated worldwide thus far. Through surveillance, contact tracing, education and vaccination, a disease that has killed and maimed hundreds of millions of people for over 3,000 years is no more.
Three out of 10 people who were infected with smallpox died and many of those who survived were left scarred or even blind. It is estimated that 130,000 colonists died from smallpox around the time of U.S. independence. That represented over five percent of the population at the time.
Caused by the variola virus, early attempts to prevent the disease were through variolation – introducing the virus to a healthy person by scratching the skin with material from a pustule of an infected person. Alternatively, dried smallpox scabs were ground up and the particles blown into the nose (insufflation). People did get ill after variolation and insufflation, but fewer people died.
Dr. Edward Jenner (1749-1823), an English physician, is credited with the first effective vaccine in 1796. He observed that people infected by cows with cowpox were immune to smallpox. The story goes that he inoculated his gardener’s 8-year-old son with cowpox from a milkmaid. The boy became mildly ill with fever, body aches, etc., but recovered quickly. Two months later, Jenner exposed the boy to smallpox several times and he did not become ill. This was the first successful vaccine, named so after the Latin word for cow, vacca, for obvious reasons.
There are different types of vaccines that are manufactured nowadays. Many vaccines are made from live-attenuated (weakened) or inactivated (dead) bacteria or viruses. Some vaccines are synthetically manufactured versions of the disease-causing parts called antigens. There are messenger RNA (mRNA) vaccines that provide the instructions to produce the antigen, which allows our immune system to make antibodies to the specific antigen. Some vaccines are developed against the toxin produced by bacteria or viruses called toxoids.
It is amazing how far we have come in just over 200 years since the first vaccine was developed. While we are no longer inoculating children as Jenner did so long ago, a new vaccine can be introduced for general use after years of research and staged trials. Currently, there are 31 disease-preventable vaccines according to the World Health Organization.
In the U.S., we are recommended to be vaccinated against 18 different diseases. Other vaccines may be needed if traveling to areas where certain diseases are endemic. Many other vaccines are in the works, to treat diseases from malaria to HIV.
Other promising areas of research include recombinant vector vaccines and DNA vaccines. These offer quicker production and longer-lasting immunity once developed. Further uses for mRNA technology are being developed as well. It seems the sky is the limit to what scientists are able to develop to reduce mortality and its pain and suffering.
Whether you are being vaccinated, immunized, given a shot or a jab, the results are the same. Vaccines can provide you with short-term to long-lasting immunity to diseases with low risk of getting seriously ill.
Jessica Lowery is the Manager of Infection Prevention and Control at Lutheran Medical Center.
