Overview

The talk describes the devastating effects of pandemics such as plague, TB and smallpox, prior to the advent of vaccination. I describe how the remarkable Lady Mary Wortley Montague, wife of the Ambassador to the Ottoman Empire, introduced a process known as variolation, which greatly reduced deaths from smallpox. Vaccination proper starts with Edward Jenner, who used cowpox to protect people against smallpox, after an outrageous experiment on his gardener’s son! The star of the talk is Louis Pasteur, who develops vaccines against a variety of diseases. I explain how the early 20th century saw increasingly widespread outbreaks of polio and how Jonas Salk developed the first vaccine against it. I finish by describing how mRNA vaccines were developed to fight Covid.

Lynn’s Review

Dr Ian Goodall, last presented to us in January 2024 on Genetic Fingerprinting. This month, his talk was equally informative; a subject on which we have all had first- hand experience in one way or another. Ian, a biology teacher, has also held the position of Head Teacher at Yateley School (the largest secondary school in north east Hampshire.

My review covers an outline of Ian’s talk with a few extra bits of information discovered on the internet, together with links to articles and documents which may be of interest for discussion.

Ian introduced the story of vaccines by reflecting on past diseases such as the bubonic plague/black death, from which, estimates suggest, a possible 50% of Europe’s population died in the 14^th Century.

Possible factors for greater illness/disease at this time were: poor diet, poor sanitation, a prevalence of parasites and crowded living conditions.

Ian also mentioned tuberculosis which, evidence suggests, has existed for thousands of years. It continues to present a global health problem, and has possibly killed a billion people.

Smallpox, of which traces have been found in Egyptian tombs, spread through trade routes; crusades and the movement of settlers and explorers. Generally, around a third of those who contracted the disease, died, a third were left with terrible scaring and a third survived with no real ill effect.

Live Vaccination

Lady Mary Wortley Montagu, a writer and a poet, suffered scaring after contracting smallpox. She lived in Constantinople for some time, when her husband was appointed ambassador to turkey and there she witnessed how women practised “engraftment”: taking a sample of pus from someone afflicted with smallpox and applying it to wounds on the wrists and ankles of volunteers, so introducing the pus into their bloodstreams. Smallpox in Turkey, had become less virulent because of this.

Variolation or vaccination, began to be widely used in England in 1721.

Methods of vaccination were:

placing smallpox material onto scratched skin;
blowing powdered smallpox scabs up the nose of the recipient
inoculation by introducing smallpox material into the skin with a needle.

Edward Jenner 1749-1823 would have been variolated before going to school. He became a GP in Gloucestershire and has been revered for eradicating smallpox by using cowpox (for more discussion on this see the link below). Observing that milk-maids who contracted cowpox were protected from smallpox, Jenner scratched cowpox, taken from Sarah Nelmes, a dairymaid, onto a young orphan boy called James Phipps. James then received two inoculations with smallpox several months apart and suffered no ill effect.

It was also observed that a vaccination with cow pox could cause cow pox transmission, so spreading immunity from smallpox. James Phipps received reward, for his part in the experiment, in the form of a cottage for his lifetime.

Dr Goodall referred to the start of movements against vaccination. In researching the beginnings of anti- vaccination leagues, I discovered the following: (to read more, use the link at the end)

The smallpox vaccination was made statutory for all new born children in 1853 and between 1864 and 1868, during a mild epidemic, enforcement of vaccination became rigid, with penalities for not complying. After reports of serious and also fatal side effects, an anti-vaccination league began, chiefly in Leicester; however stricter measures were introduced in 1871 leading to 6000 prosecutions in Leicester alone.

The last natural case of smallpox was in 1977 in Somalia, and the last case, was Janet Parker a medical photographer who worked at the Birmingham medical school, which housed a smallpox laboratory.

Louis Pasteur, discovered pasteurisation (the heat treatment of foods). He believed in germ theory; the activity of microorganisms being responsible for disease. His investigations into cholera amongst chickens led to his discovery of how to make vaccines by attenuating, or weakening, the microbe involved. His continued research led to vaccines for Anthrax and rabies. His first human patient, for the rabies vaccine, was Joseph Meister, a nine-year-old boy who would otherwise have died. He lived to tell the tale.

Pasteur also speculated on ways in which the body can rid itself of foreign matter, and supported the view that phagocytes are agents of immunity.

Other Notable Figures from the past:

During a cholera outbreak in 1854, a physician, John Snow mapped the area of Soho and famously identified a specific water pump as the source of the disease, leading to the removal of the pump’s handle and, as a result, a significant reduction in the spread of infection.

Ignaz Semmelweis, a C19th Hungarian physician was described as: “The saviour of mothers and the father of infection control,” when he discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics. He thoroughly investigated possible causes and reached the conclusion that medical students carried “cadaverous particles” on their hands from the autopsy room to the patients they examined. He instituted a policy of using a solution of chlorinated lime for hand washing, and the death rate dropped.

Joseph Lister, inspired by Louis Pasteur’s germ theory, applied it to surgery. He experimented with carbolic acid (phenol) as an antiseptic, using it to clean wounds, instruments, and the operating room air. His antiseptic methods dramatically reduced post-operative infection and mortality rates, and his Antisepsis System forms the basis of modern infection-control.

Polioviruses: Paralytic polio affects 0.1% - 0.2% of infected, symptomatic people. Paul Alexander, who developed this form of polio survived in an iron lung machine for 71 years. Franklin Roosevelt, the 32^nd president of the USA, was diagnosed with polio in 1921, at the age of 39. He founded the National Centre for Infantile Paralysis, asking people to give a dime to fund research into polio (The March of Dimes).

In the 1950s poor sanitation, improper sewage disposal and lack of access to clean water, together with overcrowding, caused a rise in polio outbreaks. During this time, the National Centre for Infantile Paralysis funded the research of Jonas Salk. Salk created an inactivated vaccine by using formaldehyde to kill the poliovirus without destroying its antigenic properties (the vaccine can still trigger an immune response).

The Covid 19 mRNA vaccine concluded Dr Goodall’s talk, and this led to much discussion, as Covid 19 and all associated with it has so recently affected the global population in so many ways.

Ian explained how this novel approach worked, it being neither a live nor inactivated vaccine; instead it could be likened to a computer algorithm, as it sends instruction via mRNA telling cells how to manufacture the coronavirus spike protein. Indeed, it was created (according to Moderna) in 42 days with the help of Artificial Intelligence.

A simple explanation of how it works: The mRNA introduced into muscle cells contains a blueprint for the spike protein. Ribosomes follow this set of instructions, assembling amino acids to form the spike protein. The immune system recognises this as a foreign body and an immune response is triggered.

This being a novel approach to triggering an immune response, there has been much controversy surrounding it, and to the strict global measures applied and their consequences. Discussion after the presentation, brought up questions and comments linked to adverse reactions and the reporting of them. A I, when asked the question, states that under reporting of adverse events is 90%.

I have found many articles to which there are links below:

Lady Mary information:

https://www.historic-uk.com/HistoryUK/HistoryofBritain/Lady-Mary-Wortley-Montagu-Campaign-Against-Smallpox/

variolation:

https://blogs.ncl.ac.uk/speccoll/2021/07/28/the-roots-of-vaccination-300-years-of-variolation-in-england/

cowpox, Edward Jenner, insights:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3758677/

Anti- vaccination league (Smallpox)

https://pmc.ncbi.nlm.nih.gov/articles/PMC1628897/pdf/archdisch00727-0091.pdf

Louis Pasteur

https://www.sciencehistory.org/education/scientific-biographies/louis-pasteur/

Puerperal Fever