The importance of vaccines has been debated extensively in 2021, but from a historical perspective, there is no debate. As with all things, vaccines and their abilities have evolved over many years. With each generation, the evolution continues. Early inventions of any kind are never perfect. They always necessitate enhancement, and medical treatments were no exception to this concept. There are also always those that doubt the work, theory, analysis, etc. As the saying goes, “there are two sides to any argument.”
The history of infectious diseases has shifted society and the world in various ways with each century. A cholera epidemic in London during 1853-1854 had to be dealt with very differently than the global influenza pandemic that traveled the globe in the post-World War I year 1918-1919. A review of cases during the London epidemic of cholera revealed some correctable causes within the city’s water supply by two of the three major water companies.[1] When countries did not consider the placement of a water source around a sewage drain, this was a hard-learned lesson. Analysis conducted by John Snow revealed a pattern that led to the water sources before and after the sewage drain for the city into the Thames. Today, we consider that shared knowledge to not put your water source downriver from the sewage output. Where originally water sources predated the increased volume of citizens until the epidemic revealed the issue, but this was discovered through Snow’s analysis. In 1884, Robert Koch took the theories and suggestions that Snow wrote down in a book published in 1866 and advanced them in a cholera vibrio, confirming Snow’s assertions almost twenty years later.[2] The use of cleanliness measures made a drastic difference in the volume of people in a cholera outbreak and how long it persisted.
The pandemic of the Spanish flu, incorrectly named because it started in the United States in 1918-1919, was not so simple to analyze and prevent. The outbreak was localized to an initial military base, Camp Funston, Kansas.[3] Doctors had a similar desire to understand the Spanish Flu as Snow did the cholera causes in London. With the Spanish flu turning global swiftly due to World War I moving people rapidly around the globe, many more scientific minds were needed to unlock the cause and solution to the disease. Where cleanliness helped with the cholera outbreaks plaguing London and elsewhere, the answer for the Spanish flu would be much more difficult. The condition did not act like a regular version of influenza. It targeted what was typically a much less infection portion of the population, ages 20-40. At that time, an advancement called a vaccine was required to help stop the crisis.
Edward Jenner’s 1796 smallpox efforts to Louis Pasteur’s 1885 rabies vaccine showed that the first flu vaccine was needed very severely on a global scale.[4] By 1918-1919 the tool used globally was still relatively early, advancing successful vaccines and creating one quickly. The cholera vaccine created in 1885 by Jaime Ferran helped to slow the progression of the disease but not stop it completely.[5] In 1882, there were anti-vaccination arguments against newly developed studies toward smallpox and cholera vaccine attempts. As with other vaccines that took decades to study, develop, test, and eventually be effective, the influenza vaccine was just as painfully long time in development. The final vaccine that was viable to use for the flu was not successful until the 1940s.[6] The lack of the ability to quickly develop a vaccine and military movements worldwide due to WWI caused approximately 20 to 30 million deaths by the Spanish flu.
As history has shown, nothing can stop a virus completely. Varying factors can slow it down, move it from one place to another, or even stop it temporarily, but not completely. The postbellum period of testing vaccines with smallpox and cholera versions helped continue advancements with each terrible epidemic and pandemic after that. At that same time, the anti-vaccine debate raged. The one main constant at that debate was from a health and safety point of view. The postbellum period saw more remarkable advancement and brought more attention to the need for advancing infection disease studies and vaccination development.
Sources:
College of Physicians of Philadelphia. The History of Vaccines. January 1, 2011. https://www.historyofvaccines.org (accessed November 4, 2021).
Freedman, David A. “Statistical Models and Shoe Leather.” Sociological Methodology, 21 (1991): 291–313. accessed November 4, 2021. https://doi.org/10.2307/270939.
Stockdale, Nancy L. “Influenza Epidemic of 1918-1919.” In Daily Life through History, ABC-CLIO, 2021. Accessed November 4, 2021. https://dailylife2-abc-clio-com.ezproxy.liberty.edu/Search/Display/1839741.
[1] David A. Freedman, “Statistical Models and Shoe Leather.” (Sociological Methodology, 21, 1991: 291–313). 295-297.
[2] Ibid., 299.
[3] Nancy L. Stockdale, “Influenza Epidemic of 1918-1919.” (In Daily Life through History, ABC-CLIO, 2021) 1.
[4] College of Physicians of Philadelphia. The History of Vaccines. (January 1, 2011. https://www.historyofvaccines.org). Timeline.
[5] Ibid., Timeline 1885.
[6] Ibid., Timeline 1918.