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Vaccines save millions of lives each year, so we owe a lot to the people that pioneered that medical breakthrough. But the concept of a vaccine had already existed for a long time before it was “discovered,” and the real story is way more interesting!

Hosted by: Michal Aranda

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Image Sources:
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https://commons.wikimedia.org/wiki/File:FlorentineCodex_BK12_F54_smallpox.jpg
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Thumbnail Credit: Wellcome Collection
{♫Intro♫}.

Vaccines are among the most  life-saving medical advancements ever. Today, they save between 2 and  3 million lives every year.

So we owe a lot to the people who first brought  the concept of vaccination into our lives. Except, most of the time, credit for that  concept goes to one guy—and it’s the wrong one. The real story behind the  first vaccine involves far   more than one person… and  it’s way more interesting.

Unfortunately, history tends to get written  by the people with power, which means   it’s at best incomplete, if not flat-out wrong. And when it comes to the story of  the first vaccine, both are true. Most history books tend to tell  the story something like this:.

They say that smallpox was a devastating  disease that caused one epidemic after another   around the world, and populations  were completely defenseless. That is, until 1796, when British  doctor Edward Jenner came upon   milkmaids without the telltale  pockmarks of smallpox survivors. According to the story, Jenner  pieced together that the milkmaids   had previously contracted the much  milder disease known as cowpox,   and he hypothesized that this was  somehow protecting them against smallpox.

Then he performed a groundbreaking  experiment to test this hypothesis.  He took the pus from a cowpox  blister on a sick milkmaid and   scratched it into the skin of  his gardener's nine-year-old son. A few weeks later, he exposed the kid to smallpox,   and he didn’t get sick. In other words, as the  story goes, this was the first-ever vaccine.

With that, Jenner went down in history as the  father of immunology, and vaccines became a thing. Which does sound pretty brilliant. The only problem is… that’s not what happened.

Like, we now know that the whole milkmaid  eureka moment is mostly propaganda—other   people at the time were already aware  that milkmaids didn’t get smallpox. Jenner did work on vaccination and test the  concept on a nine-year-old—and he also coined   the term we use today. But the concept  already existed long before his time.

That milkmaid story came about  because, during his lifetime,  . Jenner faced harsh criticism for pushing  vaccination. So his friend and biographer   invented the story to give vaccines  a glow-up in the public eye.

And it stuck. But the true, untold story of the  first vaccine is… much more complex. Here’s how it actually went down.

It all started with smallpox, a disease  that likely emerged around 10,000 B. C. E.   in northeast Africa when the first  agricultural settlements popped up.

While we don’t have direct evidence going that  far back, traces of the telltale pustules have   been found on Egyptian mummies from  as far back as the 3rd century B. C. E.

From there, smallpox made its way throughout  the world as civilizations grew and trade   routes expanded. Written records  show its spread from China to India,   Japan, and Korea over the next few centuries. And it was devastating.

Smallpox killed around 30%  of those who contracted it.   And it left many survivors blind or  disfigured from the pus-filled blisters. Over the next couple of centuries,  outbreaks occurred frequently,   and the virus spread throughout Europe  and the rest of Africa and Asia. Finally, it crossed the Atlantic via  European colonization and the slave trade.

It’s unclear who, exactly, first  developed the idea behind all of   the lifesaving vaccines we have  today. But as early as 430 B. C.

E.,   it was common knowledge that people who  survived smallpox didn’t get it again. Then, well before Jenner was even a glimmer in  the eyes of his great-grandparents, some really   innovative people were like, hmm. If surviving  smallpox keeps you from getting smallpox, then   maybe… we’ll take smallpox crud  and put it into healthy people.

The umbrella term for taking pus or powdered scabs  from smallpox and putting it into healthy people   is called variolation, named after the  variola virus, which causes smallpox. And scholars now know that people  had been doing this for hundreds   of years before Jenner’s legendary discovery. It likely arose independently when  different nations had outbreaks,   starting as early as around 200 B.

C. E. The earliest evidence for variolation  comes from Africa, China, and India,   and over the years, people developed  many different ways of doing it.

Around the 10th century, one favored  method in China involved grinding   up smallpox scabs and blowing them up  healthy people’s noses with a long pipe. In the 18th century, accounts from  British residents in India suggest   that people there used to repeatedly  puncture the skin in a small circle   with an iron needle that had  been dipped into a pustule. And evidence suggests that these procedures  were lucrative.

Like in China, some techniques   were trade secrets. Certain families even passed  the secrets down from generation to generation. And while these techniques originally grew  out of observation and trial and error,   the pioneers of variolation seemed to  have even intuited some basic immunology.

Like, even though they didn’t understand  how immunity works on a cellular level,   they seemed to understand that a weakened  form of smallpox could give someone immunity   without giving them the full-blown disease. We can tell because they often kept the smallpox  gunk at warm or cool temperatures for weeks at a   time, exposed it to steam, or mixed it  with other substances before using it. That would damage and weaken the  virus taken from the pustules.

That way, when they put it in someone else’s  body, their immune system would still attack it,   but the dose was low enough that the  virus wouldn’t wreak complete havoc. And this is similar to some vaccines that  we use today! For example, the vaccine that   protects against measles, mumps, and rubella  is what’s called a live attenuated vaccine.

That means it contains a weakened  form of the pathogens that trigger   an adaptive immune response without  making anyone seriously sick. The goal is to train the adaptive immune  system to fight a certain kind of illness.   So when it confronts the more severe version,   it kicks the invaders to the curb  before they can make the host very ill. Back when people were using variolation for  smallpox, recipients did get a mild version   of the illness, and it did kill around one or  two in every hundred people who were variolated.

But that was way better than the higher death rate   from natural infection. So the  benefits outweighed the risks. Eventually, variolation spread to the Ottoman  empire, and from there to Europe in the 18th   century.

So like, long after people in  Africa and Asia were already doing it. It took off in Great Britain after  1717, when Lady Worley Montague,   the wife of a British diplomat in Constantinople,  observed that variolation was common in Turkey. In a letter to a friend, she  explained that every year,   people lined up to have old women rip open their  veins and rub smallpox stuff into their wounds.

She told her friend that while the British  were suffering and dying in droves,   smallpox was practically harmless  in Turkey. They did get sick,   but they survived, and the  pox didn’t even leave scars. She was like, we need to start doing this.

To make the case, Lady Worley Montague and the  Princess of Wales arranged to have some prisoners   and orphaned children variolated in 1721—which  is a horribly unethical way to conduct research. But fortunately, when the subjects were  exposed to smallpox a few months later,   they didn’t get sick. The royal family  received the treatment shortly thereafter,   and by 1722, variolation was not only  acceptable but trendy throughout Europe.

Around the same time, news of variolation was  also making its rounds west of the Atlantic. That was largely thanks to a  Puritan leader named Cotton Mather. Mather was a big deal in colonial Boston—but  he didn’t exactly have the best reputation.   You might remember him as one of the  big figures in the Salem witch trials.

By 1721, when a smallpox outbreak struck the town,   his reputation had been reeling from  the witch trial controversy for a few   years. Turns out people weren’t all  huge fans of executing the innocent. But Mather had a plan to restore a bit of  shine to his name by helping stem the epidemic.

At the time, Boston had already  been through a series of smallpox   outbreaks. And even though surviving  smallpox left a lot of people immune,   each new wave was taking a devastating toll  on children who hadn’t been through it. And Mather thought he could help.

See, he wasn’t just any old minister.  He was a notorious science nerd too,   known for being as well-read  as many physicians of the   time. He was fascinated by how diseases  worked, and he knew about variolation. In 1716, Mather had read a report in  a medical journal about variolation   being done in Turkey.

And as amazing  as it was to learn that people were   preventing epidemics like the one that was  ravaging Boston, Mather wasn’t surprised. That’s because he had already learned  about it in 1707 from a man he’d enslaved,   named Onesimus, who’d been born in Africa. Onesimus had described the procedure  to Mather and showed him his scar,   explaining that it was common among  his tribe.

Other enslaved people in   the area confirmed that they were  familiar with variolation, too. This plus the confirmation from  Turkey was enough to convince Mather,   but he struggled to convince others that  there was a solution to the Boston outbreak. Many European people rejected this  idea because they were prejudiced   against ideas coming from Africa and Asia.

Still, several physicians believed in the idea,   including a Boston physician by  the name of Zabdiel Boylston. As the epidemic continued through 1722,  . Boylston and Mather variolated nearly  300 of the city’s 11,000 people.

Many people thought these guys were being reckless  and blamed them for the spread of the disease.   Someone even threw a bomb through  Mather’s window, but it didn’t go off. But as the outbreak waned at the end of that  year, Mather had what he needed: convincing data. In the end, nearly 6000 Bostonians  were infected, and around 850 died—a   fatality rate of around 15%.

But only six,  or around 2%, of the variolated group died. Their original intention was to variolate  as many people as they could convince,   but in retrospect, they also happened  to be conducting an experiment. It’s actually now considered  one of the first clinical trials   ever.

And it was one of the first examples  of medicine based on quantitative measures. Today, despite his involvement  with the Salem witch trials,  . Mather is remembered as the first  significant American figure in medicine.

But in reality, the credit should go to Onesimus,   as well as other enslaved people who shared  their medical knowledge, and everyone in  . Africa and Asia whose observations culminated  in Mather and Jenner’s so-called discoveries. As you might have noticed, though, this story  still hasn’t returned to that British doctor,  .

Edward Jenner. That’s because this all happened   over half a century before  Jenner entered the picture. And he did make a valuable contribution:  .

He figured out a safer method of vaccination  using cowpox to arm the body against smallpox. He also coined the word “vaccine,” based on the  word Latin word vacca, meaning “cow.” And later   this term became more widely used for other  immunizations, against all kinds of diseases. But the concept of a vaccine had  already existed for a long time—and  .

Jenner had nothing to do with it. This history highlights some problems with  the way science stories are often told. Major scientific advances are often credited  to one scientific bigwig.

But most huge leaps   are built up of small observations  from multiple investigators and eras. On top of that, power dynamics between white  men and everyone else have historically   minimized the contributions of  anyone who was not a white man. But science history is often much  richer than we’ve been led to believe.

And the truth is that those of us  who were born in the last few decades   have a lot of people to thank for the fact  that we don’t have to get smallpox, or rubella,   or any of the 20-some diseases  that can be prevented by vaccines. Thanks for watching this episode of SciShow! And  a special thanks to all our patrons on Patreon,   who make this and all our videos possible.

If  you’d like to find out how you can support us,   check out patreon.com/SciShow. {♫Outro♫}.