History Of Vaccination

As-Salam Alaikum and hi everyone!

In the midst of a Covid19 pandemic, now by the Bounty of Allah Almighty the researchers have acquired several vaccines. As the pandemic drags on and authorities around the world decide and plan on vaccine rollouts, let us learn a little about what vaccine actually is.

Smallpox was presumably the first very contagious disease that necessitated the use of something as needful as a vaccine during smallpox epidemics that happened recurrently around the globe for centuries.

"Razi Abu Bakr Muḥammad ibn Zakarīyā, (865 AD to 925 AD) was first to describe measles and smallpox; to observe pupilary reaction to light; to publish a text on children's diseases. He represented Arabic medicine at its best." - NIH U.S. National Library of Medicine.

He is also known as Rhazes in English.

Since ancient times for thousands of years people observed that those who recovered from a contagious disease, never got that particular disease again. Same was observed about smallpox. It was also noted again and again that people who got smallpox and survived could care for others who had the disease and not get sick again which was later termed as 'immunity.' Smallpox was a frightening menace for thousands of years. European explorers brought it to the Middle-East and then to the Americas. The Chinese also brought it to the Middle-East from the east via the Silk Road. For centuries, smallpox had a global mortality rate of 30%.

This is how smallpox pus filled pustules look.

The bumpy rashes looked a bit like chicken pox, but much worse. People who got smallpox were covered with these scary looking rashes all over the face, arms and legs, and also in the internal organs.  Many of them weren't even recognizable. Those who survived had to live with much of the scars forever.  Smallpox was nicknamed the "speckled monster" in medieval Europe. It killed many more across Europe than the deadly black plague.

Some variolation historians surmise that the immunization breakthrough first happened in the "middle ages" in China, but with no convincing evidence. They don't even know the exact period, probably in the 1500s. Even if this version is true, the procedure was too rudimentary, nay gross. Purportedly the Chinese collected smallpox scabs from a patient, dried the scabs, then ground it into powder and puffed it into peoples' noses through a long narrow pipe .. like smallpox sniffing. With the doctor's mouth at one end of the pipe and the powdered smallpox scabs on the other, it was anything but hygienic! Another, a more confirmed and comparatively more refined method of variolation involved taking the pus from the smallpox rash and inserting it with a needle under the skin of a healthy person to be protected. This may have first started in China .. or perhaps in nearby Central Asian regions of Uzbekistan and Turkmenistan. We don't know, we can only speculate. But it is confirmed that by the time inoculation came to Ottoman Turkey in the mid or late 1600s, the method was to dip a needle in a bit of smallpox pus and then scrape the wet needle across the person's arm.

So, the knowledge of variolation for immunity and its method began to spread faster than anticipated. It was a significant topic among traders and merchants traveling along the Silk Road, resulting in plenty of exchange of knowledge that gradually went spiralling across the globe.

Lady Mary Wortley Montagu who was the wife of the British ambassador to Turkey in 1717 became an eager proponent of the needle method of variolation popular in Turkey. When she and her family returned to Britain, she introduced it there. Though researchers and doctors in Britain were initially hesitant, sooner rather than later the monarch gave the permission to utilize this method of inoculation. Prisoners who were poor and those on death row were the first trial guinea pigs.  To begin the process, inoculation was done on six condemned prisoners, claiming it was with their consent but that likely wasn't true. However, all six survived and were released from prison. All six developed immunity against smallpox. It was hurray for them! That's when the coward British 'royals' grew a pair and agreed to get immunized. This was in mid 1700s. The idea then travelled to the colonies in America .. the procedure gradually moving from its rudimentary to more sophisticated stages. It became like a luxury good, a way for the rich to avoid catching the disease of the masses while doctors added bells and whistles equipping the procedure with more attractive features.

Mary Wortley and her child.

There was a little red flag though. The fact of the matter was that people were getting exposed to something as deadly as smallpox by variolation method. A few of them, here and there, would get the disease and die. Few also became carriers of smallpox and source of transmission starting new outbreaks and epidemics. Yet this was the lesser of the woes.  At the end of the day, the overall effect was a distinct decrease in death rates from smallpox.

Search for a safer method of vaccination began in England in the late 18th century when the Dr. Edward Jenner's cowpox and cow maid research made a breakthrough.  Cows developed postules in their udders known as cowpox. Jenner observed that milkmaids who got infected with cowpox from cows (cowpox is similar but less serious than smallpox) never got infected with smallpox. It became common knowledge that milkmaids who have had cowpox do not get smallpox. Jenner took cowpox pus from the milkmaids for purposes of variolation so it was human-to-human transfer. He named the procedure "vaccination" .. 'vacca' reportedly being the Latin word for cow which was the source of cowpox infection.  Initially Jenner’s study was rejected. But after a while, around 1880s or early 1890s it became quite obvious that Jenner's study was correct and logical. That's when thousands of people began protecting themselves from smallpox by intentionally infecting themselves with the similar cowpox virus.

Edward Jenner vaccinating a child against smallpox.

Western history of vaccinology in Turkey's Ottoman Empire always starts with Lady Mary Wortley Montagu (wife of British ambassador to Turkey born 1689 died 1762), variolation of her children and the transmission of this knowledge to Britain and Europe. Apart from the fact that the procedure started in Turkey and was passed to Britain and Europe, western historians also ignore the developments in the field of vaccination by the Ottoman Empire after the departure of Mary Wortley to Britain. Mary Wortley resided in Turkey in 1717. She had contracted smallpox in England in 1715. Though she survived, she was left badly scarred. In 1717 she was very impressed by the groundwork on inoculation prepared by the Ottoman government. British doctor, Edward Jenner's (born 1749 died 1823) works on cowpox vaccine first appeared in 1796, more than 30 years after Mary Wortley's death. The region where Jenner's work on vaccination diffused like wildfire wasn't Europe. It was across the Ottoman Empire, educating the population on this issue and mandating free vaccinations through legislation. Unfortunately the Ottoman rule ended in 1923 and though the Empire's blueprint for universal vaccination was not yet completed, it provided every information of the Ottoman public healthcare agenda to the succeeding Turkish republic of Mustafa Kemal. From then onward, political tactics on modernizing the new Turkish republic got so loud and rampant that Ottoman achievements were purposely blacked out including their works on public health and the groundwork it provided to the succeeding government.

If you look up Ottoman Turkey's history of vaccination after the departure of the Montagus, it's outstanding. Promoting and mandating vaccination had spread across the entire Ottoman Empire, Turkey and beyond - Egypt, Syria, Palestine, Algeria, Tunisia - through specific education, legal decrees proving the compatibility of vaccination with Islam based on scientific study. The challenges were immense no doubt, particularly when it came to convincing and interacting with the rural populace. But these challenges weren't unsurmountable. The early cowpox vaccine came to England in 1796. A more sophisticated version was introduced in Turkey by the Ottomans in 1845. This is a brief outline. The detailed history of vaccination programs by the Ottomans is vast and detailed providing a solid groundwork for contemporary purposes and the future. To read a more thorough account of the history of vaccinology in Ottoman Turkey, take a look at Science Direct.

Smallpox has been totally eradicated through vaccination, Alhumdulilah. It is only by the Bounty of Allah that the skill was granted to humans. Since then, vaccines have emerged to prevent various diseases.   The aspect consistently been observed is that in all cases, vaccinations have led to a huge global decrease in diseases.

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History Of Vaccination