Introducing vaccines - A history

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Long before the causes of disease were discovered, the process of immunisation was being studied and used. It was observed that once a person had been infected with a disease, survivors did not catch the disease again. The Chinese were the first to experiment with vaccination through the process of "variolation". They used matter from the lesions of smallpox sufferers and transferred it to healthy individuals, either by inserting it under their skin or by the uninfected person inhaling the powder. The process of variolation soon spread to other countries around the world, and although it sometimes caused death, it was noted that mortality and morbidity rates due to smallpox were lower in populations where variolation was used.

Smallpox on a child

Picture: Smallpox lesions on the hands and feet of a small child - World Health Organisation

Picture: Edward Jenner

In the late 1700's Edward Jenner, a country doctor in England, began to notice a similarity between smallpox and cowpox. He was particularly intrigued when a milkmaid told him she would not catch the disease because she had had cowpox. In 1796 Jenner deliberately infected a small boy with cowpox, in an effort to determine if he was consequently immune from catching smallpox. He first allowed the boy to recover before injecting him with the smallpox virus. As Jenner had predicted, the boy did not suffer from smallpox. This process of deliberately infecting oneself with cowpox to avoid the more severe form of the disease became popular around the world and was known as 'vaccination'.

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In 1853 the English Government passed an act making vaccination compulsory across the United Kingdom, however, not everyone liked the idea of exposing oneself to 'such filth'. In 1898 another act was produced which recognised the right of the 'conscientious objector', meaning vaccination was encouraged but not compulsory.
Since the first discovery of the smallpox vaccine by Jenner many vaccines have been produced. In the late 1800's Louis Pasture established the germ theory and developed the vaccine against rabies, whilst Emil von Behring and Shibasaburo Kitasato discovered the antitoxins of diphtheria and tetanus leading to the production of vaccines for both diseases. By the end of the 1920s, vaccines for diphtheria, tetanus, pertussis (whooping cough) and tuberculosis (BCG) were all available.

Most of the major vaccines used today resulted from the explosive growth of biomedical research after WWII. Enormous advances were made both in biological knowledge, and in the capabilities of research tools including computers and microscopes. For example, in the early 1900s, diphtheria caused more deaths in Australia than any other infectious disease. But, with the introduction of the diphtheria vaccine after World War II, diphtheria has virtually disappeared, the last case being reported in 1993.

The development of efficient vaccines has resulted in a marked decrease in morbidity and mortality from vaccine preventable diseases in Australia and around the world. Most notably, in 1980, smallpox was declared by the world health organisation to have been eradicated. It is hoped that in the future other diseases such as polio and measles will also be eliminated. Today the fight against vaccine preventable diseases continues with huge mass immunisation programs. Australia currently runs a national immunisation program in order to protect our population from these nasty diseases.

Source websites

NHS immunisation information

Access Excellence @ the national health museum - Vaccines, How and why?

Timeline

A timeline detailing the introduction of various vaccines in Australia.

Vaccine Start Dates
1804	Small Pox from England
1917	Small Pox produced in Australia
1917	Tetanus antitoxin for Armed Forces
1924	Diphtheria toxin - antitoxin Melbourne City Council
1925	Tetanus toxoid
1925	Pertussis toxoid used in case contacts and epidemics
1927	Diphtheria toxoid
1932	Community immunisation for the public
?1945-6	Tetanus toxoid available for civilians after World War 2
1953	Diphtheria/Tetanus/Pertussis
1956: May	SALK (polio)
1966 Sept	Polio Sabin (OPV)
1969	Measles
1971: Feb	Rubella
1980	Small Pox Vaccination ceased
1981: July	Mumps
1982	Pneumovax 14 commenced
1983: Feb	Measles/Mumps
1983: Mar	Hepatitis B Vax (Plasma)
1984/85	End of BCG School Program
1986	CDT-DTP 4th Dose (1st Pertussis booster)
1987	Infants 'at risk' commenced birth dose hepatitis B
1987	Pneumovax 23 commenced
1987: Nov	Hepatitis B Vax ll (Recombinant)
1989 June	Measles/Mumps/Rubella (MMR)
1992: May	Haemophilus Influenzae (Hib) (18/12 - 5)
1993: July	Hib (2/12 - 18/12)
1993: July	Hepatitis A (Havrix)
1994	MMR males/females Grade 6
1995	CDT-DTP 5th Dose (2nd Pertussis booster)
1997	Influenza program for over 65's
1997: Oct	Infanrix replaces 4th and 5th dose Triple Antigen HibTITER Multidose expired (contained thiomersal)
1998	Pneumococcal Pneumonia (over 65's)
1998	MMR Primary School Program
1998	4 year old booster DTP, MMR,OPV program prior to school
1998	Hepatitis B Paediatric (3 doses)school program
1999	MMR 18 to 30 year old campaign
1999	Infanrix - 2/12 to 4 years of age inclusive
2000: May	Hepatitis B Birth dose
2000	Comvax (hib-hepatitis B)
2000	Hepatitis B Adult Year 7 school program (2 doses)
2000	OPV ceased in Year 9/10 school Program
2000	Hepatitis B boosters ceased
2000	ADT boosters 10 yearly ceased
2001	Varicella (Chickenpox) (unfunded)
2001	Childhood Pneumococcal Pneumonia - Aboriginal and Torres Strait Islander children only
2001 Dec	Meningitec - Meningococcal C conjugate vaccine (unfunded)
2001	Hib TITER vaccine ceased (only Pedvax available)
2002 Aug	NeisVac C - Meningococcal C conjugate vaccine (unfunded)
2002 Oct	Menjugate - Meningococcal C conjugate vaccine (unfunded)
2003 Jan	Meningococcal C conjugate vaccine at 12 months of age
2003 Jan	1-19 yrs Meningococcal C conjugate vaccination program (till 2006)
2003 Sept	18th month dose DTPa ceased Expanded medical risk group for childhood pneumococcal under 5 years of age
2004 Jan	dTpa (Boostrix) for 15-17 years (Year 10 school program) in place of ADT
2004 Sept	4, 5 and 6 antigen combination vaccines
2005 Jan	Pneumococcal vaccine - Prevenar scheduled at 2, 4 and 6 months of age - catch up in 2005 for children born between 1 January 2003 and 31 December 2004.
2005 Jan	Pneumococcal vaccine - Pneumovax 23 now funded by Federal Government for adults over 65 years of age
2005 Nov	Inactivated Polio Vaccine in combination with diphtheria, tetanus and pertussis scheduled at 2, 4 and 6 months and 4 years of age.
2005 Nov	Oral Polio (Sabin) ceased at 2, 4 and 6 months and 4 years of age.
2005 Nov	Chickenpox (varicella) vaccine scheduled at 18 months of age and for children in Year 7 of secondary school who have not had chickenpox vaccine or the disease.
2007 April	Human papillomavirus vaccine for girls aged between 12 and 13 in Year 7 of secondary school. A 2 year catch-up period to the end of June 2009 for girls aged 14 to 18.
2007 July	Human papillomavirus vaccine for young women aged between 18 and 26 for a 2 year period to the end of June 2009.
2007 July	Rotavirus (RotaTeq) vaccine scheduled at 2, 4 and 6 months of age.
2008 March	Diphtheria,tetanus, acellular pertussis, hepatitis B, poliomyelitis and haemophilus influenzae type b (Infanrix hexa) combination vaccine for babies at 2, 4 and 6 months of age
2008 September	Hiberix vaccine (haemophilus influenzae type b) given at 12 months of age for an infant who has at minimum received Infanrix hexa vaccine at six months of age and is up to date with all vaccines.
2008 September	Pedvax HIB ceased

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