Nathanael Mathaeus von Wolf and Johanna Henrietta Trosiener (Schopenhauer). Variolation in the 18th century on the Polish lands according to the guidelines of a doctor and the memoirs of his patient.

Variolation became a popular method in Europe in the eighteenth century. Sources from Gdansk not only illustrate the guidelines that were used for these procedures, but also make it possible to compare that with the memories of the person on whom it was performed. In this case, the primary sources are: a 1772 work by physician Nathanael Mathaeus von Wolf, and the diaries of Johanna Henrietta Trosiener, mother of Arthur Schopenhauer. As the comparative analysis shows, the theoretical assumptions were sometimes changed during the practical implementation of variolation.

America's Original Immunization Controversy: The Tercentenary of the Boston Smallpox Epidemic of 1721.

The CoVID-19 pandemic marks the 300th anniversary of the Boston smallpox epidemic of 1721, America's first immunization controversy. Puritan minister Cotton Mather learned of inoculation for smallpox from Onesimus, a man enslaved to him. When the disease broke out in May 1721, Mather urged Boston's physicians to inoculate all those vulnerable to the disease. Zabdiel Boylston, alone among his colleagues, decided to proceed with the procedure, igniting a heated debate that occasionally grew violent. The division between the advocates and detractors of inoculation were as deep as religion and politics. Puritan ministers supported inoculation, asserting their right to control the lives of their flock. Challenging them were a secular class of medical professionals that proclaimed primacy in medical matters. The controversy was inflamed by a nascent newspaper industry eager to profit from the fear of contagion and the passionate debate. Despite the furor and physical risk to himself and his family Boylston inoculated 282 persons, of whom only 6 died (2.1%). Of the 5759 townspeople who contracted smallpox during the epidemic, there were 844 deaths (14.7%). In America's first effort at preventive medicine Boylston established the efficacy of inoculation, which helped support its acceptance in England, and later in the century, the adoption of Edward Jenner's technique of vaccination in 1796.

Los orígenes de la vacuna / The origins of the vaccine

La medicina china y su cultura ancestral parecen tener los antecedentes más remotos de los intentos por prevenir o curar el azote epidemiológico de esa época: la viruela. Estos conocimientos empíricos llegaron al Asia Central y Europa, y algunos granjeros hicieron observaciones de la utilidad de la inoculación o variolización sin llegar a documentar sus ensayos en la comunidad científica. El mérito de Edward Jenner reconocido como el descubridor de la vacuna antivariólica, radica en haber demostrado con evidencia práctica la protección conferida frente a la enfermedad por la administración en un niño sano de un material proveniente de una persona con lesiones causadas por el cowpox, virus de la viruela vacuna. Desde Europa en el siglo XVIII y comienzos del siglo XIX, la inoculación primero y luego la vacunación llegan a Hispanoamérica por vías informales o por determinación de la corona como un servicio a las colonias. La vacunación antivariólica tuvo el valor agregado de motivar y convencer a las autoridades gubernamentales sobre la necesidad de implementar políticas de salud pública para responder a las necesidades sanitarias de la población. En Chile, Fray Pedro Manuel Chaparro fue el pionero en la aplicación y difusión de la vacuna, realizó la primera campaña nacional y se cuenta entre los padres de la salud pública nacional.

Chinese medicine and its ancestral culture seem to have the most remote history of attempts to prevent or cure the epidemiological scourge of that era: smallpox. This empirical knowledge reached Central Asia and Europe, and some farmers made observations of the usefulness of inoculation or variolization without documenting their trials to the scientific community. The merit of Edward Jenner, recognized as the discoverer of the smallpox vaccine, lies in having demonstrated with practical evidence the protection conferred against the disease by the administration in a healthy child of a material from a person with cowpox lesions. From Europe in the eighteenth and early nineteenth centuries, first inoculation and then vaccination arrive in Latin America by informal means or by determination of the crown as a service to the colonies. Smallpox vaccination had the added value of motivating and convincing government authorities about the need to implement public health policies to respond to the health needs of the population. In Chile, Fray Pedro Manuel Chaparro was the pioneer in the application and diffusion of the vaccine, conducted the first national campaign and is counted among the parents of national public health.

The Smallpox Epidemics in America in the 1700s and the Role of the Surgeons: Lessons to be Learned During the Global Outbreak of COVID-19.

Today's COVID-19 pandemic offers many similarities with previous pandemics hitting our country. In particular, the smallpox epidemics during the 1700s threatened the lives of multitudes and created panic and fear in the society, similar to the situation caused by the coronavirus. Remedies that were instituted, especially inoculations, were met with opposition and even violence when first introduced. The newspapers were filled with headlines reflecting the disputes. There was a "six feet rule" during the smallpox epidemics, although it had a different meaning than today. Politicians and other leaders of the society were engaged in the war against the infection. Boston became involved in the fight against the smallpox by Dr. Zabdiel Boylston's and Rev. Cotton Mather's introduction of inoculations. When George Washington realized the benefits of the procedure and ordered mass inoculations of the Continental Army, it became an important factor in winning not only the fight against smallpox but the Revolutionary War as well. Looking back at history, realizing that we have survived previous outbreaks of devastating diseases, can provide hope during the current pandemic.

Three different paths to introduce the smallpox vaccine in early 19th century United States.

The ancient technique of variolation (inoculation of the smallpox) which was introduced in the United States in 1721 was replaced by vaccination (inoculation of the cowpox) soon after the procedure was published by Edward Jenner in 1798. Benjamin Waterhouse is recognized as the introducer of smallpox vaccination in the United States having conducted the first vaccination in Boston on 8 July 1800, although other American physicians also played an important role in extending vaccination in the East Coast of the United States. A different route of introduction brought the smallpox vaccine from Mexico to New Mexico (March 1805) and Texas (April 1806) which at that time where part of the Viceroyalty of New Spain. The vaccine was brought to California in 1817 by Russian merchants who obtained it in Peru, where the vaccine had arrived in 1806 with the Spanish Philanthropic Expedition of the Vaccine. It took almost 150 years of vaccination efforts before the last natural outbreak of smallpox occurred in the United States in 1949.

Portrayal of Immunization in American Cinema: 1925 to 2016.

The American media often disseminates antivaccination messages. Cinema in particular reaches many individuals and influences attitudes regarding high-risk behaviors such as smoking and alcohol use. We hypothesized that negative cinematic portrayals of immunization have increased over the last 3 decades. Films released in the United States featuring immunization through 2016 were identified on IMDb and viewed in their entirety by 2 reviewers. Themes were recorded, and the portrayal of immunization (positive, negative, or mixed) across each decade was assessed in a logistic regression model. Cultural references attributed to films (eg, television references) were recorded from the "connection" feature on IMDb. Fifty relevant films were identified (1925-2016). Negative/mixed portrayals of immunization were more frequent after 1990 (odds ratio = 4.0, 95% confidence interval = 1.2-13.5), and films with positive immunization portrayals garnered significantly fewer cultural references than films with negative/mixed portrayals (mean = 9.2 vs 56.2, P = .048). American cinema features increasingly negative portrayals of immunization.

Two centuries of immunisation in the UK (part 1).

The impact of immunisation is best understood through a historical lens, since so many of the diseases which placed a burden on our population have been eliminated or controlled through immunisation. The United Kingdom (UK) National Health Service (NHS), which celebrated its 70th birthday in 2018, is responsible for delivering the highly successful universal national immunisation programme. However, the first vaccines used in the UK were not part of a centrally coordinated programme until the 1960s. Resources that summarise the first 200 years of immunisation in the UK are not readily accessible. Here we provide a two part chronological insight into the history of the UK immunisation programme from primary sources. In Part I, we highlight the importance of wartime conditions, unprecedented vaccine development, and the polio outbreaks in the in driving developments in immunisation and discuss subsequent changes in the use of the original vaccines of the immunisation programme, namely, diphtheria, tetanus, pertussis, and polio. In Part 2, we discuss the formation of the Joint Committee on Vaccination and Immunisation and its role, working with public health agencies and advising the UK Governments on vaccine policy, to bring a comprehensive programme to defend the health of the population against serious infectious diseases, highlighting the importance of programme organisation and leadership.

Two centuries of immunisation in the UK (part II).

The centrally coordinated response that controlled the polio epidemics of the 1950s through immunisation led to the development of a national immunisation strategy in the UK and the formation of the Joint Committee on Vaccination and Immunisation (JCVI) in 1963, which oversees the immunisation programme and advises the UK Department of Health on new vaccine introductions. As a result of technological advances in vaccine development and scientific advances in immunology and microbiology over the 56 years since then, and the formation of a comprehensive public health surveillance system for vaccine-preventable disease, the National Health Service immunisation programme now covers 18 serious diseases of childhood, with an astonishing impact on child health. Here we consider the formation of the JCVI and the development of the national immunisation programme and review the introduction of vaccines over the past half century to defend public health.

Study on the Procedure for Lot Release of Vaccines in Japan.

Biological products, such as vaccines, blood products, antitoxins, and antivenoms, are released into the market following a lot release conducted by National Regulatory Authorities or National Control Laboratories, even if their manufacturing and marketing have been authorized. Independent lot release by regulatory authorities is not a procedure unique to Japan, but is performed worldwide. Previously, Japan carried out lot release mainly by laboratory tests, and the manufacturers' in-house test records were used as a reference, not involved in the decision of lot release. Conversely, the international standard procedure promoted by the World Health Organization (WHO) includes a document review of the manufacturers' summary protocols, and laboratory tests are listed as an optional procedure. To harmonize with the WHO recommended international method, Japan modified the procedure and introduced a document review in addition to laboratory tests for vaccines in 2012. Since then, substantial knowledge regarding vaccine quality has been obtained during the process of summary protocol reviewing. Here, we outline the current status of the lot release procedure in Japan. We shed light on its history and show recent research based on the knowledge obtained from the protocol review to improve efficiency of laboratory testing and international harmonization.

A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data.

Surveillance systems for varicella in Europe are highly heterogeneous or completely absent. We estimated the varicella incidence based on seroprevalence data, as these data are largely available and not biased by under-reporting or underascertainment. We conducted a systematic literature search for varicella serological data in Europe prior to introduction of universal varicella immunization. Age-specific serological data were pooled by country and serological profiles estimated using the catalytic model with piecewise constant force of infection. From the estimated profiles, we derived the annual incidence of varicella infection (/100·000) for six age groups (<5, 5-9, 10-14, 15-19, 20-39 and 40-65 years). In total, 43 studies from 16 countries were identified. By the age of 15 years, over 90% of the population has been infected by varicella in all countries except for Greece (86·6%) and Italy (85·3%). Substantial variability across countries exists in the age-specific annual incidence of varicella primary infection among the <5 years old (from 7052 to 16 122 per 100 000) and 5-9 years old (from 3292 to 11 798 per 100 000). The apparent validity and robustness of our estimates highlight the importance of serological data for the characterization of varicella epidemiology, even in the absence of sampling or assay standardization.

[The court physician, the clergyman, a learned society and smallpox]. / De hofarts, de dominee, een geleerd genootschap en de pokken.

Variolation was introduced in England in the first half of the 18th century. The positive effects of this new method for preventing smallpox were already known in the Netherlands around 1720, one of whom was the Dutch physician Boerhaave. In spite of this, it took another 30 years before variolation was used in the Netherlands. Despite receiving positive advice and information from his learned English friends Sloane and Sherard, Boerhaave did not apply nor advise the use of variolation. There were various arguments for this restrained approach. In 1754 Thomas Schwencke found that conditions were favourable for the introduction of variolation in The Hague. There was support from the House of Orange-Nassau (the current royal family in the Netherlands) and from a learned society; a highly motivated clergyman acted as ambassador for the new technique and the court physician Schwencke was willing to take the lead. A similar combination had previously been effective in England, though the ambassador there was not a clergyman but an influential noble lady.

Relocating Pastorian Medicine: Accommodation and Acclimatization of Pastorian Practices against Smallpox at the Pasteur Institute of Chengdu, China, 1908-1927.

Argument Revising the diffusionist view of current scholarship on the Pasteur Institutes in China, this paper demonstrates the ways in which local networks and circumstances informed the circulation and construction of knowledge and practices relating to smallpox prophylaxis in the Southwest of China during the early twentieth century. I argue that the Pasteur Institute of Chengdu did not operate in a natural continuity with the preceding local French medical institutions, but rather presented an intentional break from them. This Institute, as the first established by the French in China, strove for political and administrative independence both from the Chinese authority and from the Catholic Church. Yet, its operation realized political independence only partially. The founding of this Institute was also an attempt to satisfy the medical demand for local vaccine production. However, even though the Institute succeeded at producing the Jennerian vaccine locally, its production needed to accommodate local conditions pertaining to the climate, vaccine strains, and animals. Furthermore, vaccination had to conform to Chinese variolation, including its social and medical practices, in order to achieve the collaboration of local Chinese traditional practitioners with French colonial physicians, who were Pastorian-trained and worked at the Pasteur Institute of Chengdu. Thus the nature of the Pastorian work in Chengdu was not an imposition of foreign standards and practices, but rather a mutual compromise and collaboration between the French and the Chinese.

Barriers to Immunizations and Strategies to Enhance Immunization Rates in Adults with Autoimmune Inflammatory Diseases.

For as long as there have been immunizations, there have been barriers to them. Immunization rates in the United States are below target. Rheumatologists and rheumatology practitioners need to understand the issues of immunizations in patients with autoimmune inflammatory disease to identify and overcome barriers to immunization. Several strategies for overcoming these barriers are discussed.

Inmunizar contagiando. La práctica de la inoculación como tratamiento preventivo frente a la viruela en la Capitanía General de Chile a fines de Siglo XVIII / To immunize while infecting. The practice of variolation as preventive treatment against smallpox in the General Captaincy of Chile in the late Eighteenth Century

Este artículo examina el estado en que se encontraba la inoculación a fines del siglo XVIII en la Capitanía General de Chile, a través de una epidemia de viruela que afectó a Concepción y sus alrededores entre 1789 y 1791. Una de las preguntas centrales de este estudio es en qué medida la inoculación puede considerarse como el primer tratamiento preventivo para enfrentar la viruela y el papel que la población jugó en ello. Buscamos también determinar la importancia que tuvo la variolización en la configuración y aceptación de la noción de inmunización en la sociedad del periodo, pues más allá del número de personas que se sometieron a la práctica, su implementación se tradujo en la discusión temprana de nociones como prevención y universalidad. Dichas nociones fueron fundamentales en el desarrollo de las posteriores medidas que se utilizaron para enfrentar la viruela en la sociedad chilena (AU)

This article delves onto the state of variolation at the end of the eighteenth century in the General Captaincy of Chile, by studying a smallpox epidemic which affected Concepción and its surrounding areas. One central question of this study is to what extent variolation might be regarded as the first preventive treatment against smallpox and the role played by the population. It also aims to determine the importance of variolation for both the configuration and acceptance of the notion of immunization by the society of the period. This is because beyond the amount of persons who adopted this practice, its implementation led to an early debate on notions such as prevention and universality. Such notions were fundamental for the development of further measures against smallpox in Chilean society (AU)

An examination of John Fewster's role in the discovery of smallpox vaccination.

Edward Jenner is recognised today as the father of vaccination but, as this paper explores, he was not the only Gloucestershire doctor to be linked to this discovery. John Fewster, a local surgeon and apothecary, is also said to have experimented with vaccination, many years before Jenner. This claim is made in a letter addressed to John Coakley Lettsom, written by John Player, a Quaker farmer. Player describes in detail Fewster's realisation that cowpox could be used to protect against smallpox. This letter is frequently cited but has not previously been subjected to critical analysis. We have identified several inconsistencies, including conflicting dates and a possible ulterior motive in that Player's son was to marry Fewster's daughter. We think it unlikely that Player, a devout Quaker, would have consciously fabricated evidence, but argue that the discrepancies in his account undermine the assumption that Fewster carried out vaccination experiments prior to Jenner. We also explore the assertion that Fewster presented a paper in 1765 on the subject of cowpox and its protective effect over smallpox. We conclude that, although there is no doubt that Fewster did pre-empt Jenner's discovery of vaccination, he did not realise the significance or importance of this momentous medical advance.