If the global upheaval caused by the coronavirus pandemic has reminded us of anything, let it be that we are nothing more than a group of vulnerable multicellular creatures whose survival is at the mercy of microscopic beings. Fortunately, every time Mother Nature feels like testing us with Darwin’s ‘survival of the fittest’, humans fight back with intellect. In the face of adversity, we step up and momentarily put aside our own delusions of grandeur about our limited existence. Proof of this resides in one of the greatest philanthropic milestones in our journey as a rational animal, which this ABGstories pays tribute to below.
History’s 1st vaccine
Epidemics, together with their high mortality rates, periods of confinement and collective panic, are nothing new to us. From the Plague to AIDS, tragedy is always present. Since smallpox, there is hope for all.
In 1717, Lady Mary Wortley Montagu was an English aristocrat married to the British ambassador in the Ottoman Empire. Within a matter of months, she began to pave the way for the fight against smallpox in the Western world. During her stay in Constantinople, she learned about the advantages of variolation, a procedure based on knowledge from Asia which was being performed there. Lady Mary promoted the practice by leading by example. She inoculated her son in 1718 and her daughter in 1721 in what is considered the first variolation in Anglo-Saxon lands.
Following in the steps of Montagu were six prisoners at London’s Newgate Prison. They all survived. Stamping out the disease was an obsession of not only qualified physicians but also self-taught individuals like the Scotsman John Williamson (nicknamed Johnnie Notions) who successfully administered 3,000 inoculations on the remote Shetland Islands between 1770 and 1790.
Yet no one would revolutionise all of healthcare like Edward Jenner. In 1796, he slightly modified the treatment he administered to his first patient, James Phipps, age 8. The doctor took a sample of cowpox, a virus less dangerous than smallpox, from a wound on a milkmaid’s finger and he injected it into the boy. The child fell ill and later recovered. A few days later, Jenner inoculated him with smallpox. The boy was immune to the virus. History’s first vaccine just took its first major step.
Edward Jenner published his work in 1798, but he did not file a patent for it. Several sources claim that he preferred not to patent it so that the cost of the vaccine would not increase, and it would thus reach the entire world. He himself vaccinated the most underprivileged in his home for free. A lesson in philanthropy that started a trend.
The 1st mass vaccination campaign
The smallpox vaccine was triumphantly introduced in Spain in 1800. It was administered for the first time in Puigcerdà by the doctor Francisco Piguillem i Verdacer. Soon after, the court of King Charles IV of Spain happily welcomed it. Of course! In the years following the height of the Enlightenment, members of the royal family who managed to survive realised that their royal blood provided no protection against smallpox.
All this suggests that the illness of the royal family was an important factor leading to the support and promotion of medical advances not only in Spain, but also in other territories belonging to the Spanish empire. This period was marked by scientific expeditions such as those led by Malaspina, Jorge Juan and Mutis. With the support of King Charles IV and public funds, the Royal Philanthropic Vaccine Expedition set off from A Coruña in the María Pita ship in November 1803. Its mission: to vaccinate the entire colonial population against smallpox. Salvador Fojón, member of the Spanish Geographical Society, defines the journey as “a surprising feat of logistics and organisation which remains unparalleled even today”.
Three individuals have gone down in history thanks to this scientific milestone. They are the military doctors Francisco Xavier Balmis and José Salvany, and the first nurse sent on an international expedition, Isabel Zendal. “Balmis created a network of preventive medicine. He organised Vaccination Campaigns, separate from the healthcare network, which were subsidised by the Crown. Vaccines were administered for free under one condition: that inoculations continue until the pustules of the last person vaccinated dry up, which usually occurred after 15 days. The chain could not be broken”, says Fojón.
Nevertheless, the true heroes were the 22 children who travelled with the vaccine in their body, including the adopted son of Isabel Zendal, director of the Galician orphanage where most of the children came from. “They were vaccinated in pairs and monitored so that they wouldn’t spread the disease. The 22 children were replaced with Creole children after crossing the Atlantic Ocean. In one of the trips between Caribbean islands, there weren’t enough children so Balmis vaccinated 3 child slaves so that the mission could continue. They all played a role in immunising millions of people”, states Fojón.
This expedition, also known as the Balmis Expedition, changed medicine and the mentality of leaders and healthcare providers. Edward Jenner himself said: “I don’t imagine the annals of history furnish an example of philanthropy so noble, so extensive as this”. “We haven’t given it enough credit”, concludes Salvador Fojón.
Throughout the three-year expedition, it is estimated that more than 500,000 people in the territories of Latin America, the Canary Islands, the Philippines and even China were vaccinated.
In 1979, it was announced that smallpox was eradicated.
Edward Jenner was a source of inspiration for the future pioneers of vaccines. He even infected some of them with his altruistic spirit.
The Frenchman Louis Pasteur didn’t patent his vaccines against rabies, fowl cholera or anthrax, although the development and marketing of the latter is what sparked the controversy between industrial property and the public good. In 1853, Pasteur patented his method for fermenting beer and yeast (US 141072A and US 135245A), which IP experts consider to be the first patent to cover a microorganism.
The Spaniard Jaime Ferrán y Clúa also didn’t protect the vaccines that he developed to fight cholera, typhus and tuberculosis (the vaccine of the latter being improved by the findings of Robert Koch). He only registered patents for mechanisms to manufacture screens for producing incandescent light (ES 15074), manufacture phonograph cylinders (ES 23700) and make use of soap residue in water (ES 26982).
In the mid-20th century, North American Jonas Salk was asked on TV “Who owns the polio vaccine?” His answer: “Could you patent the sun?” His role as a Good Samaritan, however, was tarnished when it was revealed that he had tried to patent the vaccine and concluded that it could not be done when he found out that he didn’t meet all the legal requirements to do so.
Someone who was indeed in favour of patents from the beginning was Maurice Hilleman. Thanks to his research (and the funding generated by the results of the same), mankind fights diseases such as measles, mumps, chickenpox, rubella and hepatitis A and B.
To patent or not to patent… Is that really the question? Perhaps the question is how to balance, with Mother Nature in mind, the ideal of altruistic ethics with the ethics of reinvesting profits. Have fun thinking about this controversy.
Aknowledgments: This article has been possible thanks to the graphic contributions and collaboration of Salvador Fojón, member of the Spanish Geographical Society.