30 January 2021

The Atlantic: “How Orphans Helped Distribute the Smallpox Vaccine”

The real trouble started when doctors tried to vaccinate people who were far away. The lymph could lose its potency traveling even the 215 miles from London to Paris, let alone to the Americas, where it was desperately needed: Smallpox outbreaks there were verging on apocalyptic, killing up to 50 percent of people who got the virus. Every so often threads of dried lymph did survive an ocean journey—a batch reached Newfoundland in 1800—but the lymph was typically rendered impotent after months at sea. Spain especially struggled to reach its colonies in Central and South America, so in 1803, health officials in the country devised a radical new method for distributing the vaccine abroad: orphan boys.

The plan involved putting two dozen Spanish orphans on a ship. Right before they left for the colonies, a doctor would give two of them cowpox. After nine or 10 days at sea, the sores on their arms would be nice and ripe. A team of doctors onboard would lance the sores, and scratch the fluid into the arms of two more boys. Nine or 10 days later, once those boys developed sores, a third pair would receive fluid, and so on. (The boys were infected in pairs as backup, just in case one’s sore broke too soon.) Overall, with good management and a bit of luck, the ship would arrive in the Americas when the last pair of orphans still had sores to lance. The doctors could then hop off the ship and start vaccinating people.

Sam Kean

A nice piece of historical context for the people loudly and aggressively complaining that vaccine development and distribution is too slow. We fail to properly appreciate the many conveniences of modern life (refrigeration and fast worldwide travel to name those more relevant here), so easily forgetting how recently they became widespread. On the flip side, some aspects of modern life also facilitate the spreading of pathogens, travel first and foremost; before the 20th century, an obscure bat virus from China would have never reached the entire planet in a matter of months.

Smallpox vaccine delivery Americas
When Balmis’s crew started vaccinated people in the Americas, cathedral bells rang, priests said Masses of thanksgiving, and people shot off fireworks and held bullfights in their honor. (Lithography De Manini)

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