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EDITORIAL
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 115-116

March of the vaccines


Chief Editor – IJVES, Director - JIVAS, Bengaluru, Karnataka, India

Date of Submission15-Mar-2021
Date of Acceptance15-Mar-2021
Date of Web Publication13-Apr-2021

Correspondence Address:
Kalkunte R Suresh
Chief Editor – IJVES, Director - JIVAS, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_30_21

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How to cite this article:
Suresh KR. March of the vaccines. Indian J Vasc Endovasc Surg 2021;8:115-6

How to cite this URL:
Suresh KR. March of the vaccines. Indian J Vasc Endovasc Surg [serial online] 2021 [cited 2021 May 7];8:115-6. Available from: https://www.indjvascsurg.org/text.asp?2021/8/2/115/313555



The vaccines have indubitably proven to be the most effective armory against prevention, and at times, the elimination of plethora of diseases unleashed by microbes against humanity over centuries, if not millennia. The previous vaccines evolved over decades, sometimes even longer, before they were effective in the majority of humans with minimal side effects. The recent progress of vaccine against the disastrous COVID pandemic, at “warp” speed virtually under a year, is beyond ones most optimistic hopes! And the number of effective vaccines is even more flattering to the scientific/medical community involved in their trials and production! It is good to look to the past to trace the trail of the evolution of vaccines, just to remind us that we are continuing the swath cut out by our outstanding predecessors, although it has no direct bearing on vascular diseases barring a few.

Use of the offending microbe, as inoculation or vaccination, to induce humans to “resist” the disease has been practiced for 3000 years against smallpox and this probably originated in India or Egypt. The observations by physicians such as Thucidides and Rhazes around 430 BC that those affected once by smallpox are protected from further similar infections. This led to “inoculation- injecting infective agent into healthy individuals to induce mild disease, preventing serious illness” was probably practiced in China, India, Turkey, and Africa around 1000AD. There are few sketchy reports from India, but the smallpox epidemic in Goa in 1545, when over 8000 children succumbed to the disease, earned the dubious term “Indian Plague.”

Smallpox was also reported to have wiped out the villages of Native Americans in Canada after the landing of French Jesuits on that continent in 1625. In 1633, it also affected Native Americans and settlers who came on “Mayflower” to Boston area, including the ships only physician! This led to “quarantine” or isolating the infected patients, precursor of today's well-known method of patient isolation. In 1736 son of one most famous Americans, Benjamin Franklin, whose face is still on their mint, lost his son due to smallpox. It could also have been used as a weapon of war in 1776 a British commander deliberately sent recently “variolated” citizens to Continental army camps and about 5000 continental soldiers supposed to have fallen ill from smallpox.

In 1770, Edward Jenner, an English doctor and truly “Father of Vaccines,” became interested in “cowpox.” The folklore states “Jenner heard from a milkmaid that she having caught cowpox, she and her smooth skin, is safe from smallpox!” However, it was only in 1796 that Jenner injected an 8-year-old boy with cowpox which had mild reaction, and later with smallpox inoculum from a patient and the boy remained healthy. He further demonstrated it in 22 patients. This did not receive much acclaim until his colleague Henry Cline used freeze-dried cowpox material, and it offered protection from smallpox. This was indeed the harbinger of future vaccines.

In 1802, physician Dr. Jean De Caro indirectly introduced vaccination to India, and the term inoculation was eliminated, as the latter involved injecting infected material into the subjects.

Abraham Lincoln, perhaps, the greatest of American Presidents, contracted smallpox right after his famed Gettysburg address in 1863 but survived. His driver was not so fortunate and died of the diseases.

Another landmark in the evolution of vaccines was ushered in by Parisian veterinarian Louis Pasteur in the late 19th century. Even as a school boy, he observed rabies spread by the bite of wild dogs. His work started in 1880 when he received the samples of dogs that died of rabies was sent to him by his colleagues. He injected infected materials into rabbit brains and with ingenious work was able to produce a vaccine in 1885. He observed, along with his assistant Emile Roux, drying the virus attenuated its infectivity, and by the series of effective attenuations, he was able to refine the vaccine, and the dogs injected with this were spared of the disease. Later that year, he used on a young boy bitten by a rabid dog, although with controversy, but the boy survived. Later, he presented a series of 350 patients, of which only one succumbed to rabies.

Polio was another scourge affecting humanity in the 19th century, and their first epidemic in Vermont, USA was documented in 1894. Charles Caverly noted the irreversible nervous system damaged by polio, but its contagious nature was not known till 1905. American 2nd world wartime President Franklin Roosevelt was stricken with polio and had paralyzed legs. The initial attempts at vaccine in the USA in 1935 were disastrous! In 1936, Peter Olitsky and Albert Sabin were able to grow poliovirus in the embryonic brain tissue at Rockefeller Institute, New York, but it did not lead to any practical application. Another American virologist Jonas Salk began trials with killed polioviruses in 1952 on Infantile Paralysis. Salk injected himself, his wife and three sons with the experimental vaccine, and the results of the larger trial were announced in 1955 that Salk vaccine was 90%–95% effective against paralytic polio. However, within few weeks, there were reports of paralysis of some vaccinated patients and all these vaccines were produced by Cutter Laboratory in California. This “Cutter Incident” resulted in the suspension of further vaccinations.

Albert Sabin, with help Soviet Health officials, was able to conduct massive vaccination campaign with Oral Polio V (OPV) on 10 million children in 1959. The OPV was licensed in 1960 and eventually led to global polio initiative by WHO across 125 countries 1988. India holds the pride of place – on a single day in January 1997, 127 million children were administered OPV. Following year, another 137 million were vaccinated a day. Moreover, this was achieved by our tireless, unsung heroes – rural health-care workers.

The work on producing vaccines for various diseases – diphtheria, pertussis, tetanus, TB, swine, and H. Flu and more recent endemics/pandemics with the multitude of viruses, now culminating in COVID-19 with its devastating effects on the world – is always a silver lining for humanity to fight these and yet unknown diseases of future. The pioneers and peers from the past have bequeathed on us the processes and systems that can be carried forward to relentlessly combat these microbes now and in future!






 

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