Scientists developed vaccines less than a year after Covid-19 was identified, a reflection of the remarkable progress in vaccine technology. But progress in delivering the vaccine is another story.
Many issues that emerged from vaccine launches decades ago are still debated today. How should local and federal authorities coordinate? Who should be vaccinated first? What should the authorities do about resistance in communities? Should the hardest hit places be prioritized? Who should pay?
Some answers can be found in the successes and failures of vaccine initiatives over the past two centuries.
In 1796, when scientist Edward Jenner discovered that people infected with smallpox became immune to smallpox, doctors went from city to city in England, deliberately spreading smallpox by scratching infected material in people’s arms.
The implantation worked at the local level, but how could it be distributed to people in distant places, such as in the Americas, where smallpox had devastated populations? In 1803, the Spanish government placed 22 orphans on a ship to their territories in South America. The chief physician, Francisco Xavier de Balmis, and his team injected bovine smallpox into two of the boys and, after the wounds had developed, removed material from the wounds and scratched it in the arms of two more boys.
When the team arrived in the Americas, only one boy was still infected, but that was enough. The distribution of vaccines in Spanish territories was unsystematic, but in the end, members of the Spanish expedition worked with local political, religious and medical authorities to establish vaccination clinics. More than 100,000 people in Mexico received free vaccines in 1805, according to a newspaper article, “The World’s First Immunization Campaign”, in the Medical History Bulletin.
1947: Smallpox, again
In the 20th century, when scientists determined how to store and mass produce smallpox vaccine, outbreaks had generally been contained.
But a 1947 outbreak in New York City, just before Easter Sunday’s parade on a hot weekend, posed a major problem. The city’s health commissioner at the time, Israel Weinstein, asked that everyone be vaccinated, even if they were vaccinated as children. Posters across the city warned: “Be sure. Be safe. Get vaccinated! “
The launch was quick and well orchestrated. Volunteers and health professionals went to schools, delivering vaccines to students. At the time, the public had a strong faith in the medical community and the modern anti-vaccination movement barely existed. In less than a month, more than six million New Yorkers were vaccinated, and the city ended up with just 12 infections and two deaths.
1955: polio
On April 12, 1955, the United States government licensed the first polio vaccine, created by Dr. Jonas Salk, after scientists announced that day that it was 80% to 90% effective.
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Answers to your vaccine questions
While the exact order of vaccine recipients may vary by state, most will likely put doctors and residents of long-term care facilities first. If you want to understand how this decision is being made, this article will help you.
Life will only return to normal when society as a whole obtains sufficient protection against the coronavirus. Once countries authorize a vaccine, they will only be able to vaccinate a few percent of their citizens, at most, within the first two months. The unvaccinated majority will still remain vulnerable to infection. An increasing number of coronavirus vaccines are showing robust protection against disease. But it is also possible for people to spread the virus without even knowing they are infected, because they have only mild symptoms or none at all. Scientists still do not know whether vaccines also block coronavirus transmission. For now, even vaccinated people will need to wear masks, avoid crowds indoors and so on. Once enough people are vaccinated, it will be very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we, as a society, achieve this goal, life may begin to approach something normal in the fall of 2021.
Yes, but not forever. The two vaccines that will potentially be authorized this month clearly protect people from getting sick with Covid-19. But the clinical tests that provided these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. This remains a possibility. We know that people naturally infected with the coronavirus can transmit it as long as they have no cough or other symptoms. Researchers will be studying this issue intensively as vaccines are launched. In the meantime, even vaccinated people will need to consider possible spreaders.
The Pfizer and BioNTech vaccine is given as an injection into the arm, like other typical vaccines. The injection will be no different than the one you took before. Tens of thousands of people have already received the vaccines and none have reported serious health problems. But some of them experienced short-term discomfort, including pain and flu symptoms that usually last for a day. People may need to plan a day off from work or school after the second injection. Although these experiences are not pleasant, they are a good sign: they are the result of your own immune system facing the vaccine and developing a potent response that will provide lasting immunity.
No. The Moderna and Pfizer vaccines use a genetic molecule to prepare the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inward. The cell uses mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any given time, each of our cells can contain hundreds of thousands of mRNA molecules, which they produce to make their own proteins. As soon as these proteins are produced, our cells fragment the mRNA with special enzymes. The mRNA molecules that our cells make can survive just a matter of minutes. The mRNA in vaccines is designed to resist the cell’s enzymes a little more, so that cells can produce extra proteins from the virus and stimulate a stronger immune response. But mRNA can only last a few days at most, before being destroyed.
The next day, The New York Times reported in a headline on the front page: “The stock is running out, but production will be rushed.
State and local health officials were responsible for distributing it to children, who were most at risk of contracting the disease.
“Young African-American children were being beaten, but were not at the top of the priority list because of the social conditions of the time,” said Dr. René F. Najera, editor of the Vaccine History project at the College of Physicians of Philadelphia . Noting that it was difficult for parents in working-class jobs to take time off to stand in line with their children at the clinics, Dr. Najera said, “You see this continuously, history repeats itself.”
Soon after the start of implantation, the program was suspended after reports that children contracted polio in the arms where they received the vaccination, and not in the legs, which was more typical of the disease.
More than 250 cases of polio have been attributed to defective vaccines, caused by a manufacturing error by one of the California-based drug manufacturers, Cutter Laboratories, according to the Centers for Disease Control and Prevention.
The so-called Cutter Incident led to stricter regulatory requirements, and the vaccine’s launch continued in the fall of 1955. The vaccine prevented thousands of cases of disabling diseases, saved lives and ended the annual threat of epidemics in the United States.
1976: swine flu
The H1N1 flu virus, which originated in Mexico, attacked in the spring of 2009, not in the typical flu season.
By the end of the summer, it became clear that the virus caused fewer deaths than many strains of seasonal flu and that some of Mexico’s early reports had been exaggerated. That was one of the big reasons why many Americans avoided the flu vaccine when it was ready in the fall. It wasn’t just the anti-vaccination movement, although that was a factor.
The H1N1 virus was difficult for children and young adults and appeared to have a disproportionately high mortality rate among pregnant women. Because of these factors, the first groups to be vaccinated, after health professionals, were the people most at risk of complications, pregnant women and children.
The last group eligible for the vaccine were healthy people over 65, who were the least likely to get it because they seemed to have some resistance to it.
Donald G. McNeil Jr. contributed reports.