Vaccination Arrives in the Philippines
As we have seen, aspects of the Boston smallpox epidemic mirror claims being made about Dengvaxia. Critics in both cases claimed that vaccination was killing people but the facts show otherwise. The controversy also bears conparison with the anti-vaxxer movement and the Andrew Wakefield fraud.
But back to the first vaccination in the Philippines: The Balmis Expedition. It was the public health equivalent of the Charge of the Light Brigade – magnificent, courageous but of questionable success.
Smallpox made its way to Europe with the opening of trade with China, Africa and Turkey. From there it entered Spain. Spanish colonisers took the scourge to the Americas and from there to its Asian outpost, the Philippines. In 1803, Spain decided to try and mend the damage, the Balmis expedition.
By any measure, it was a remarkable effort. With no refrigeration or any other technologies, there was only one way of transporting inoculations: in living bodies. Basically, this involved giving a weak smallpox infection to someone who was not already immune. This would raise a blister, or pustule. The contents of that pustule would then be put under the skin of another person and the process repeated.
The only way of transporting the vaccine, or inoculation across thousands of miles was to have a supply of people. The Balmis expedition acquired 22 orphans accompanied by a nurse and, one by one, as they crossed from Spain to the Americas, each was inoculated, or ‘variolated’ in turn until the ship arrived in Mexico.
That first set of orphans was released in Mexico where another 22 orphans were acquired to continue on to Spanish territories across the Pacific to the Philippines. It landed there in 1805 and the first vaccinations began in the country.
How successful the Balmis expedition really was is difficult to determine. Tremendous social and economic changes, especially population movement and the invention of the steamship, brought more smallpox infections to the country leading to massive epidemics in the 19th century. Problems with distributing an effective vaccine across the sprawling collection of islands, the dependency on local government activity, made tackling Smallpox a challenge at the best of times.
Early failures, with ineffective vaccinations, did lead to scepticism but over time it became an important part of public health in the Philippines.
By 1980 Smallpox was beaten. It no longer existed in the ‘wild’ and today is only found in carefully guarded archives around the world.
As time went on, confidence in the effectiveness of vaccination for a variety of preventable diseases increased and vaccination was an accepted part of life. Almost a rite of passage.
Then came the Dengvaxia controversy and two centuries of trust were destroyed in a matter of two years.