Vaccination in the Philippines
Vaccines against Dengue may be new but vaccination itself is 215 years old in the islands. It may, in fact, be older, but that is just a matter of complete speculation. The history of Smallpox vaccination shows a number of similarities to the present controversy surrounding Dengvaxia.
Smallpox is an ancient scourge. Signs of its characteristic ugly blisters, or pustules, have been found on Egyptian mummies around 4,000 years old. Knowledge of smallpox immunity may be as old as the disease itself.
Deadly, disfiguring and disabling though the disease was, it was known that those who survived it – epidemics in the Philippines in the 1700s could kill a third of those infected – did not get it again. Around 430 BCE smallpox sufferers were being cared for by those who had already survived the disease. Although the mechanism for this was not known at the time techniques were developed in an attempt to induce immunity.
In China, the dried scabs of Smallpox scars were ground up and blown into a patient’s nose. By the 17th century, immunity was being induced in people who had not previously had smallpox by using a small, sharp instrument called a lancet to extract matter from a pustule of a smallpox sufferer and insert it under the skin of the person to be inoculated. The technique produced a blister, called a variol, and mild symptoms of smallpox which abated after a few days and the patient acquired immunity. The technique did have its drawbacks but it worked well enough for the time. Used in Asia and Africa it was unknown in the West until it was passed through the Ottoman Empire.
Once in Europe, it entered Spain and from Spain it passed to the Americas. When Spain colonised the Philippines through Mexico, it is widely believed that Smallpox came with it. However, the islands that today constitute the Philippines were already trading with China before the arrival of the Spanish so it is not inconceivable that the Philippines had pre-hispanic exposure to Smallpox.
Epidemics hit the Philippines in the 18th and 19th centuries. At least one community responded by isolating itself in the forests of Cotabato during an epidemic in 1871 – the controversial Tasaday.
Immunisation against Smallpox was building strength by then. The controversy about Dengvaxia is a reflection of similar controversies that surrounded Smallpox vaccinations as well as the fraudulent claims about measles vaccines causing autism in children.