Vaccination: From Milkmaid to Malaria

Two hundred years ago, smallpox was one of the most feared infections., At the end of the eighteenth century it was the cause of one fifth of all deaths in Britain and ninety per cent of these deaths were children under five,. In 1796 Edward Jenner observed that the incidence of small pox was much lower amongst milk maids. Following the observation he went onto demonstrate that inoculation with material from patients infefected with cowpox, a closely related milder infection provided protection against smallpox. He used the term vaccination derived from vacca, the Latin for cow. One hundred and seventy-six years later, smallpox virus was extinct.

Jenner's first vaccine, eight year old farmhand James Phipps, wax treated with fluid from a pustule on the hand of dairymaid Sarah Nelmes. (Rather him than me!) Although somewhat rudimentary, this experiment illustrates the principle of active vaccination. The aim is to challenge the body with an altered from of the infectious agent. The body's defences (immune system) respond by mounting a protective immune response. Because the immune system has 'memory', the protection afforded is long-lasting.

Within a few years of Jenner's discovery, thousands of people were being vaccinated across Europe. There was already an anti-vaccination lobby making its views known. Perhaps it was the very idea of injecting material taken from cows that sparked off such fears in people: a cartoonist named Gilray drew vaccine recipients growing cow-like parts and lots of inaccurate information was spread concerning the risks. Because of this, the Government introduced a series of Acts of Parliament making vaccination available to all free and in the end compulsory.. parents were fined repeatedly until their children were vaccinated. Needless to say, legislation making it compulsory was unpopular and was finally repealed in 1948.

During this century the anti-smallpox programme became global.. The world's last case occurred in Somalia in 1977 and by May 1980 the World Health organisation accepted that it had been eradicated worldwide. The elimination of smallpox was facilitated by the fact that the virus can only infect humans and to date it is the only complete success.