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April 9, 2021

Lesson plan: The history of vaccination – and opposition to it

Dashon Bates, 28, receives his COVID-19 vaccine as eligibility expands to anyone over the age of 16 at the Bradfield Community Center through Health Partners of Western Ohio in Lima, Ohio. March 29, 2021. REUTERS/Megan Jelinger

 

For the Google link, click here.

Introduction

How did vaccination evolve among medical practitioners over the last 1000 years? Why have some people feared taking vaccines? This lesson explores the invention of various vaccines to fight against serious illnesses over time and asks you to think about the implications of vaccine development.

Background:

What is “vaccination?”

Traces of smallpox pustules found on the head of the 3000-year-old mummy of the Pharaoh Ramses V. Courtesy: World Health Organization (WHO)

Vaccination began more than a thousand years ago, when smallpox sores were ground up and inhaled, or inserted by needle (“variolation”) under the skin, in China and India. There are some claims that the practice might have been even older than that, perhaps dates back to the ancient world. The long ago rationale remains the same as it is today: people’s immune systems set up to fight against disease are triggered by small and weakened exposure to the disease itself.

Vaccines contain small amounts of proteins or toxins from infected cells. When enough citizens of a population have been vaccinated, “herd immunity” results and the disease virtually disappears. This is why diseases like smallpox and polio have been eradicated. Unfortunately, reluctance to vaccinate has always been a factor in the evolution of vaccination.  George Washington took a smallpox vaccination to overcome fear among Americans and recently, discredited fear of autism has reintroduced some diseases like measles among unvaccinated children in the United States.

Source: Centers for Disease Control

How do vaccinations work?

Variolation in Colonial Massachusetts

Cotton Mather (1663-1728) was a Massachusetts minister most known for his role in the Salem Witch Trials. Despite his extreme religious views, he was a progressive supporter of health through smallpox variolation throughout the Massachusetts Bay colony.

An enslaved person he was given had a smallpox variolation scar. Mather found out that many enslaved people had been variolated and they did not get the disease.

Mather read about variolation in medical journals from England and promoted the practice throughout Massachusetts. He variolated his own son and kept detailed records of everyone who had been treated and how well they did through smallpox outbreaks, which demonstrated for the London scientists the efficacy of the practice.

An early victim of anti-vaxxers, he was attacked and his house was bombed.

Source: HistoryDaily.org (image) and Wikipedia

FOCUS QUESTION: From the picture above, what was the anti-vaxxer objection of some colonists to Mather’s vaccination?

 

George Washington’s vaccination of the Continental Army against smallpox

Washington came down with smallpox when he traveled with his brother to Barbados at the age of 19, when the mortality rate for the disease was as high as 50% in some outbreaks. If you look carefully at portraits of Washington, you can see the smallpox scars on his rough complexion.

When Washington was commander-in-chief of the Continental Army, he ordered mandatory inoculation for troops as a smallpox epidemic began.

An earlier massive outbreak of the disease among colonial troops in Canada had cost the continental army a victory against the British in Quebec.

As President, he received a smallpox vaccination publicly, to encourage Americans to take the inoculation.

Source: Image and History (text)

FOCUS QUESTION: Why are military divisions particularly susceptible to the spread of disease?

 

Edward Jenner and the Cowpox Vaccine, 1796

Edward Jenner (1749-1823) was an English doctor who noticed that milkmaids who milked cows with cowpox seemed to be immune during smallpox epidemics. The dairy workers developed sores on their own hands and did not get sick. Science shows now that the cowpox and smallpox viruses are in the same family.

Dr. Jenner inoculated 8-year-old James Phipps with material from a milkmaid’s cowpox sore. The little boy felt weak for a few days but he recovered. Then Jenner injected matter from a human smallpox sore into James, and the boy remained healthy.

In the 19th century, smallpox vaccination became widespread in England, Germany and the United States.

We get the name “vaccination” from the Latin word for cow, “vacca.”

Source: Wikimedia.org

FOCUS QUESTION: Often the advancement of medicine, and science altogether, derives from random observations outside the normal process of laboratory experiments. (For instance, how was penicillin discovered?)

While such practices as inoculating a child was widely viewed as unethical at the time and certainly would be today (not to mention illegal), it is important to discuss the implications of Jenner’s work. Read The Conversation’s Judging Jenner: was his smallpox experiment really unethical?

  • What do you think of Dr. Jenner’s decision to inoculate eight-year-old Phipps? Why was Jenner’s work in immunology soon accepted?

Dig deeper: Throughout various periods in U.S. history, Black Americans have been the target of medical racism, including the Tuskegee Experiment and have been taken advantage of without knowledge or compensation such as in the case of Henrietta Lacks and the wide use of her cells in research to this day. Use this lesson to learn about the history of medical racism in the U.S.: Lesson Plan: Race and vaccine hesitancy in the U.S. and to address the question: How has the U.S. health care system’s treatment of Black citizens led to distrust and a lack of confidence?

 

Louis Pasteur and the Cholera Vaccine, 1879

French scientist Louis Pasteur was working on developing a vaccine for cholera, a disease found often in shellfish that passes virulently into the lower intestines of humans.

As part of his research, Pasteur injected chickens with cholera bacteria to observe the progress of the disease. He told his assistant to inject the chickens with a fresh batch of live bacteria, but the assistant forgot to do so and went on holiday. One month later, when the assistant returned and injected the chickens with fresh bacteria; the chickens sickened but survived. The neglected bacteria had apparently become weakened by exposure to the air.

When the somewhat diseased chickens had recovered, Pasteur injected them again with live bacteria and they did not become ill.

Source: Image and VBI Vaccines

FOCUS QUESTION: Often vaccines and medicines are derived from members of the animal kingdom. We get snakebite anti-venom from opossums. We have seen the roles of cows and chickens. Can you find other examples?

 

Spanish Influenza Pandemic of 1918-1919

Many tried to use the past methods to develop a vaccine for the deafly pandemic that killed many millions, more than the entirety of World War I, but bacterial vaccines like those of the past did not work. The pandemic was caused by a virus, not bacteria. Influenza viruses were not even identified until the 1930’s and the first influenza vaccines did not arrive until the 1940’s.

Source: Image and Stanford.edu

FOCUS QUESTION: Why were scientists unable to find a vaccine for the Spanish flu?

 

Dr. Jonas Salk and the Polio Vaccine, 1953-54

Polio crippled children more than adults, and terrorized parents kept their children away from playgrounds, birthday parties and public pools. They even feared children’s classrooms. Outbreaks were particularly severe in the early 1950s.

President Franklin Delano Roosevelt was one of the adults who had contracted polio at the age of 39, and never walked unaided again. Roosevelt started the National Foundation for Infantile Paralysis (the medical title for polio), which was renamed the March of Dimes Foundation.  The March of Dimes, inspired by millions of small donations, provided the funds for Dr. Jonas Salk’s vaccine trials. It was a public relations coup, advertised by movie stars like Elvis Presley and even by Mickey Mouse in movie theater and television advertisements.

Salk injected himself, his wife and their three sons with his experimental polio virus vaccine. The United States was the site of a massive trial of his vaccine involving 1.3 million children, the beginning of the largest vaccination effort in U.S. history up until today’s coronavirus vaccination campaign. Dr. Salk refused to patent his vaccine and did not accept profit from it in order to encourage its use around the world. Polio was eradicated.

Watch this March of Dimes movie theater clip:

Source: History.com

FOCUS QUESTIONS: Have you seen television ads encouraging COVID vaccinations? Why don’t they involve children, like the polio ads?

Why did Dr. Salk not patent his vaccine? What would that likely have meant if he had? What does his decision say about his character?

 

MMR and chicken pox vaccinations

In 1971, a combination vaccination against measles, mumps, and rubella was licensed by the U.S. government. Testing showed that reactions to all three vaccines together were no greater than from any of the individual vaccinations. In 1995, a chicken pox vaccine, Varivax, was added to the schedule of vaccinations that American children receive during the first years of their lives. Before Varivax, 4 million Americans contracted chicken pox every year, and 10,000 of them were hospitalized with severe outcomes.

The Center for Disease Control (CDC) publishes a suggested vaccination schedule. Most American families bring their children to pediatricians to follow that schedule. It includes the MMR and Chicken Pox vaccines as well as pneumonia and flu shots. Eleven and 12-year-old boys and girls are encouraged to take the human papilloma (HPV) virus vaccine which protects against certain cancers later in life.

Source: Image and Children’s Hospital of Philadelphia

FOCUS QUESTION: How many of these vaccinations have you had?

 

The COVID-19 vaccination

Normally it takes years for a vaccine to be developed, tested and marketed. However, COVID-19 (officially SARS-CoV-2) is one of several coronaviruses that were already under research and vaccine development at the National Institutes of Health, so that vaccines were developed much faster than normal.

Scientists at the NIH Vaccine Center were working on a “prototype” coronavirus which could protect against several diseases, including the common cold. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH, led a team of the researchers who were studying the “spike protein” which appears on the surface of all coronaviruses. Those spikes give the virus its characteristic shape and the name “corona,” Latin for “crown.” The spikes latch onto our cells, which immediately start to produce antibodies, spike proteins, to protect us.

Sandra Lindsay, a nurse at Long Island Jewish Medical Center, is inoculated with the coronavirus disease (COVID-19) vaccine by Dr. Michelle Chester from Northwell Health at Long Island Jewish Medical Center in New Hyde Park, New York, Dec. 14, 2020. Mark Lennihan/Pool via REUTERS

The scientists knew that they did not have enough time to make enough spike proteins to follow the usual path of making sufficient proteins to inject into everyone. A faster way to get spike protein into bodies was to inject RNA instructions into our own muscle cells, which then manufacture spike proteins for our bodies.

The COVID-19 outbreak started in China in December of 2019. Immediately, researchers in China published the DNA sequence of SARS-CoV-2, providing a head start on international research. By early February 2020, a first vaccine candidate was designed and manufactured by the Moderna pharmaceutical company, followed soon after by the Pfizer corporation and others across the world. The vaccines were approved for immediate trials to many thousands of people to ascertain that they were safe and that they did not produce bad side effects.

A schedule was developed in all 50 states and U.S. territories to vaccinate the population, starting with health care workers, proceeding to the elderly and most vulnerable, and then to younger people.

Despite the vaccination progress, Americans still have to wear masks in public and socially distance from others to prevent the spread of the infection. Vaccinated people could still get the virus, although their symptoms would be mild, and further study is taking place regarding how vaccinated people might pass the disease onto unvaccinated citizens.

There are groups of people who do not wish to get vaccinated. There is a long tradition, as you have seen above, of those who fear the after effects of even the safest vaccine.

Andrew Wakefield, a British physician – now ejected from the medical profession –published a fraudulent study in 1998 that falsely claimed a link between the measles, mumps, and rubella (MMR) vaccine and autism. Since then, some parents have refused vaccination of their children, fearing autism.

Some Black families knowing about the medical abuse of their ancestors are also reluctant. Black citizens were used as guinea pigs for the treatment of syphilis (the “Tuskegee experiment”), gynecological surgery without anesthesia, grave robbing and more. See this lesson plan to study this issue more.

Politics also entered the scene, causing some to be resistant to wearing masks and even to vaccination, because the initial 2020 messages from President Donald Trump had originally downplayed the danger. Trump’s followers now comprise the majority of the 30% of Americans who resist vaccination. COVID deaths continue, much abbreviated, with a total of more than 560,000 dead.

Source: Image and PBS NewsHour 

FOCUS QUESTION: What percentage of citizens in your state have received at least one vaccination shot? Do you know anyone who is hesitant to get the COVID vaccine? What are some facts you could share that might make them feel more comfortable receiving the vaccine?

Standards

C3 Framework:

D2.His.3.6-8. Use questions generated about individuals and groups to analyze why they, and the developments they shaped, are seen as historically significant.

D2.His.3.9-12. Use questions generated about individuals and groups to assess how the significance of their actions changes over time and is shaped by the historical context.


Syd Golston is a past president of the National Council for the Social Studies. She has served as a history teacher, school administrator, and curriculum writer for many decades. She is the author of Changing Woman of the Apache, Death Penalty, Studies in Arizona History and other publications and articles.

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