Vaccines – Part One

Today’s blog post is about vaccines that were first named by Edward Jenner in a 1798 pamphlet. He was referring to the “smallpox of the cow” or cowpox. To quote from the 2025 book Vaccines: Mythology, Ideology, and Reality by Dr. Peter McCullough and John Leake, “His proposal for inoculation with a weak form of disease-causing matter to prevent serious illness became the central concept of infectious disease medicine and has remained so ever since.” This post (and the book) is not about the regrettable vaccinated divide that has emerged with the Covid-19 pandemic, but instead how vaccines have been developed for the major diseases that effect humans and sometimes animals.

First Things First

Before we dip into a few of the “early days” vaccines that have been developed over hundreds of years, it’s worth listing significant non-medical public-health interventions.

• Nutrition (food availability and nutrient content) greatly improved public health and disease resistance. Vitamin D fortification of milk in the 1930s further strengthened food for children.
• Public sanitation, including modern sewer systems that carried effluent away from cities as well as from drinking water. This improvement mostly eradicated cholera and typhoid fever by the year 1900.
• Secure water supplies and treatment in filtration systems.
• Pasteurization, refrigeration, and other measures for producing, transporting, and storing milk and other raw food products.
• Improved housing including heating, ventilation, and plumbing, especially for the urban, working poor.
• Labor laws to reduce hazardous and stressful working conditions, including child labor and excessively long hours.
• Introduction of sulfa antibiotics in the 1930s, penicillin in 1943, and erythromycin in 1952 reduced mortality from bacterial infections including diphtheria, pertussis, and tetanus.

Here is a vivid example of science as the only truth vs. common sense and acute observation. In the 1840s, Professor Ignaz Semmelweis taught anatomy at the University of Vienna Medical School. His students worked on cadavers followed by assisting women in the maternity ward. Many of them developed puerperal fever (childbed fever) for an unexplained reason. Semmelweis, after cutting his hand and after observing the infection, had his students wash their hands with chlorinated lime and water after finishing the cadaver work. Childbed fever in the ward fell to almost zero. Semmelweis published his studies comparing two different maternity wards and ardently defended his discovery.

How did the medical universities of Vienna, Paris, and Stockholm respond? They rejected his study because they lacked knowledge of germ theory and believed diseases spread through “miasma” (bad air) rather than microbes. They not only rejected him but drove him out of medicine and into an insane asylum where he died of sepsis, rumored to be from a wound from a guard, two week later.

“Another noteworthy advocate for public sanitation in the 19^th century was the English lawyer and social reformer, Edwin Chadwick,” the book describes. Searching for an answer to a recent typhus outbreak, the government commissioned, for the first time, medical doctors to find out what was causing the outbreak. One of the investigators, Dr. Dyce Guthrie, believed that the lack of clean water and proper effluent drainage was a major cause. Chadwick’s report led to the Public Health Act of 1848. During a major heat wave in 1858, the combination of temperatures in the shade in the 90s and diminished river flow of the Thames, “The Great Stink” occurred, permeating all aspects of London life and health. Parliament finally acted and hired Sir Joseph Bazalgette, a civil engineer, to design and execute a proper sewage system. It took almost twenty years and is still admired by contemporary designers. Doctors continued to claim that cholera was from the air; Bazalgette’s success proved otherwise. The effluent being carried away from London’s water supply was the cure.

Experimentation and Development Era

The first vaccines were developed from 1721 to 1800 with Edward Jenner experimenting with cowpox to inoculate humans against smallpox. His procedure was adopted in England, Europe, and in the U.S. in the 19^th century. Based on the widespread achievement of the vaccine, Congress launched the first mass vaccination campaign. Authors Keane and Dr. McCullough name the next decades, from 1885 to 1945, “Experimentation and Development.” In this period common vaccines developed for tetanus, pertussis (whooping cough), rabies, and typhoid. In 1902, the U.S. Biologics Control Act was passed, “regulating vaccines and antitoxin producers. The passage of the Act resulted in bankruptcy for one-third of antitoxin and vaccine manufacturers.”

In 1945, the first influenza vaccine was approved for military use for troops engaged in wartime. Use for civilians followed in 1946. Future vaccine notables, Dr. Thomas Francis, Jr. and Jonas Salk, lead the research team. Of note: those serving in the military received both effective and sometimes detrimental vaccinations, followed by infant and school age children. By 1948 the DTP shot (diphtheria, tetanus, and pertussis) were combined into one shot and was recommended by the American Academy of Pediatrics for all children.

The Modern Era

A good example of the early modern era is the development of the polio vaccine. According to the authors of Vaccines, “Between 1952 and 1955 Jonas Salk develops the inactivated polio vaccine. Trials involving over 1.3 million children are conducted in 1954. Mass vaccination programs commence in 1955. A vaccine mass produced by Cutter Laboratories’ version infects forty thousand children with polio, paralyzing or partly paralyzing two hundred and killing ten. In 1960, Albert Sabin’s live-attenuated polio vaccine is given orally as drops or on a sugar cube.”

Again, according to the authors, “The polio infection is thought to have been endemic to all human populations since ancient times. With the onset of urbanization from 1650-1950, it’s believed that everyone was exposed to the poliovirus during infancy and early childhood. The first U.S. outbreak was in Vermont in 1894; the first epidemic came much later in the 1950s.

Some of you reading this post may remember the polio outbreak of the 1950s. I certainly do. I volunteered in a summer camp before the vaccine was widely administered, but polio was on everyone’s mind. By now, most households had a radio and under 50% had a television and with mass media, the country was “gripped by polio fear.” A young girl took a fancy to me (a big ego boost) and often sat on my lap. One morning she wasn’t in camp and when I asked the director about her, she said, “she has polio.” While I worried about her recovery I also worried about my own vulnerability. For more than a few nights I woke up to check if my legs were mobile. As I remember that experience, I can see how fear of injury and death can overwhelm an entire population. I saw it again during the AIDS crisis and then during the Covid pandemic. We experience mass fear and want a quick cure!

Jonas Salk

On March 26, 1953, Jonas Salk reported a successful test of a vaccine that was tested on a small group of adults and children. The following year, trials involving over 1.3 million children were conducted. The final public focus on polio occurred on April 12, 1955. A press conference was covered by 150 newspapers, radio, and television reporters at the University of Michigan. Eli Lilly paid $250,000 for the broadcast. It was watched in movie theaters and listened to in department stores. Factories paused production and church bells rang. At the podium was not Jonas Salk but Thomas Francis, Jr. declaring the vaccine safe and effective. Unfortunately, the celebration didn’t last when forty-thousand children in five states received the Cutter polio vaccine that contained live virus. The manufacturer had employed a defective method for inactivating it that caused forty thousand cases of polio, and several hundred children varying degrees of paralysis. The Cutter company’s vaccine was replaced with Albert Sabin’s attenuated polio vaccine, an orally administered dose and much safer. Polio was considered eliminated in North and South America in 1994.

You might want to read more about polio in this highly regarded book.

Part Two of Vaccines will follow this post. I end Part One with this from Vaccines:

“We often make the unexamined assumption that “medical science” is akin to Newtonian mechanics, but this is a gross misconception. The causes of sickness and health – both individuals and in large populations – are immeasurably more complex and multifactorial than most other objects of scientific analysis.”

Photo Credits: Cow – Luke Stackpole, Handwashing – Getty images.