History Of Smallpox Vaccination Research Articles

The willingness of healthcare workers to be vaccinated against monkeypox and their knowledge about monkeypox: A systematic review and meta-analysis

BackgroundVaccination is an important method to address the monkeypox epidemic. We aimed to analyze the knowledge of healthcare workers (HCWs) about human monkeypox and their attitudes toward vaccination.MethodsWe searched PubMed, Embase and Web of Science for articles and performed a meta-analysis using Stata 14.0 with a random-effects model. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. ResultsA total of 34 studies with 43,226 HCWs were included in this meta-analysis. The results showed that 54 % (95 % CI: 0.39–0.69) of the HCWs were willing to be vaccinated against monkeypox, and only 40 % (95 % CI: 0.29–0.50) of the HCWs had good knowledge of monkeypox. By analyzing the vaccination history of HCWs, we found that history of smallpox vaccination did not significantly affect the willingness of HCWs to receive another vaccination (OR = 0.53, 95 % CI: 0.23–1.26), whereas HCWs who had been vaccinated with the influenza vaccine (OR = 2.80, 95 % CI: 1.29–6.11) or COVID-19 vaccine (OR = 3.10, 95 % CI: 2.00–4.81) showed greater willingness to receive the monkeypox vaccine. In terms of income, low-income HCWs were less willing to be vaccinated against monkeypox (OR = 0.69, 95 % CI: 0.54–0.89), whereas middle-income HCWs were more willing (OR = 1.45, 95 % CI: 1.04–2.02). Notably, although HCWs with education related to monkeypox had better knowledge of monkeypox than HCWs without education related to monkeypox, the difference was not statistically significant (OR = 1.83, 95 % CI: 0.80–4.18). ConclusionsPublicity and education on monkeypox should be strengthened so that more people, especially HCWs, can have a good understanding of monkeypox and be willing to be vaccinated.

Defying Disease, Deifying Disease

Abstract With the advent of biomedicine in India, vaccination has been studied in tandem with the colonial commitment to exercise control over imperial subjects. The history of smallpox vaccination in India is entangled with the Goddess Śītalā – “controller” of epidemics. Despite the eradication of the epidemic, faith in the goddess reigns among her devotees. This ethnographic study suggests that Śītalā devotees are informed by a plurality of understandings of body, disease, and prophylaxis in the Covidian age; I argue that Śītalā practices and the irreducible faith in the goddess aid in sustaining trust in biomedical interventions like vaccines among her devotees. Based on fieldwork conducted in West Bengal, I further argue that Śītalā’s place as a “lesser” or “lower-caste” deity worshipped mostly by marginalized sections of society makes their active demand for vaccination an act of assertion.

Features of Mpox infection: The analysis of the data submitted to the ID-IRI network

BackgroundMpox is a rare zoonotic disease caused by the Mpox virus. On May 21, 2022, WHO announced the emergence of confirmed Mpox cases in countries outside the endemic areas in Central and West Africa. MethodsThis multicentre study was performed through the Infectious Diseases International Research Initiative network. Nineteen collaborating centres in 16 countries participated in the study. Consecutive cases with positive Mpoxv-DNA results by the polymerase chain reaction test were included in the study. ResultsThe mean age of 647 patients included in the study was 34.5.98.6% of cases were males, 95.3% were homosexual-bisexual, and 92.2% had a history of sexual contact. History of smallpox vaccination was present in 3.4% of cases. The median incubation period was 7.0 days. The most common symptoms and signs were rashes in 99.5%, lymphadenopathy in 65.1%, and fever in 54.9%. HIV infection was present in 93.8% of cases, and 17.8% were followed up in the hospital for further treatment. In the two weeks before the rash, prodromal symptoms occurred in 52.8% of cases. The incubation period was 3.5 days shorter in HIV-infected Mpox cases with CD4 count <200/μL, we disclosed the presence of lymphadenopathy, a characteristic finding for Mpox, accompanied the disease to a lesser extent in cases with smallpox vaccination. ConclusionsMpox disseminates globally, not just in the endemic areas. Knowledge of clinical features, disease transmission kinetics, and rapid and effective implementation of public health measures are paramount, as reflected by our findings in this study.

A History of Smallpox Vaccination in Modern China: Vaccine Techniques, Instruments, and Localization.

This paper examines how smallpox vaccination has been implemented in China from a technological perspective. It is an attempt not only to investigate the impact of technology and instruments on medical advances, but also to deepen the understanding of modern Chinese society through smallpox vaccination. Smallpox vaccination helps people develop immunity to smallpox by inoculating into them pus from cowpox which is an infectious disease that affects cows. In 1805, Alexander Pearson succeeded in smallpox vaccination using the arm-to-arm transfer method for the first time in China thanks to the arrival of the vaccine in Macao. As Pearson and Quixi, who followed in the footsteps of Pearson, used the arm-to-arm method, they did not have much interest in vaccine containers. However, the vaccine administration technique changed: the vaccine obtained from people was inoculated into cows, and then again, into people. It thus resulted in the manufacturing of various vaccine containers including glass vials and tubes. The development of tools contributed to the expansion of cowpox vaccination. In addition, cowpox vaccines were imported directly from foreign countries. Advertisements which remain to date indicate that vaccines were widely imported. Pharmacies promoted vaccines, contending that the sale and import of vaccines was for the Chinese people. On the other hand, there were voices against imported vaccines, saying that they were expensive and foreign-made. Under the banner of patriotism and nationalism, people demanded that vaccines be made in China, which led to the production of vaccines in large cities such as Shanghai and Beijing. Along with the aforementioned efforts to obtain vaccines, techniques for smallpox vaccination can also be understood in the Chinese context. For example, traditional Chinese medicine maintains that acupuncture can be used as a vaccination lancet. Since traditional Chinese medicine already embraced the use of cowpox for protection against smallpox, they advocated using acupuncture instead of western instruments in order to expand the influence of traditional Chinese medicine. The belief that inoculation should be done into acupuncture points in the upper arms shows the significant influence of traditional Chinese medicine. On the other hand, Chinese people being reluctant to leave vaccine marks show the general view of what was considered as beautiful at the time, rather than the Chinese traditional perspective. Consequently, smallpox vaccine techniques in China, while following the technological advancement in general, could not help but be adapted to the Chinese context under the influence of modern Chinese society. Thus, smallpox vaccine techniques provide clues for understanding modern Chinese society. As such, historians who conduct research mainly with literature should also take interest in medical technology and instruments as well.

Efficacy of smallpox vaccines against Mpox infections in humans.

The Mpox virus (MPXV) is endemic in certain countries in Central and West Africa, where several mammalian species, especially rodents, are natural reservoirs. However, the MPXV can infect nonhuman primates and cause zoonotic infections in humans after close contact with an infected animal. Human-to-human transmission of MPXV can also occur through direct close contact with an infected individual or infected materials. In May 2022 an initial cluster of human Mpox cases was identified in the UK, with the first case confirmed in a patient who had recently travelled to Nigeria. The infection subsequently spread via human-to-human transmission within the UK and Mpox cases began to appear in many other countries around the world where the MPXV is not endemic. No specific treatments for MPXV infection in humans are available. However, data from studies undertaken in Zaire in the 1980s revealed that those with a history of smallpox vaccination during the global smallpox eradication campaign also had good cross-protection against MPXV infection. However, the vaccines used during the global eradication campaign are no longer available. During the 2022 global Mpox outbreak over a million doses of the Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) smallpox vaccine were offered either as pre or postexposure prophylaxis to those at high risk of MPXV infection. Here, we review what has been learned about the efficacy of smallpox vaccines in reducing the incidence of MPXV infections in high-risk close contacts.

Heil und Verderben

This article explores the early cultural and literary history of vaccination – to be precise, the history of smallpox vaccination in the late 18th and early 19th century where the transition from the dangerous technique of smallpox inoculation to the rather harmless one of cowpox inoculation took place. The establishment of cowpox vaccination – developed by British country doctor Edward Jenner – was accompanied by an immense wave of popularization in all European countries. It included public vaccination facilities and church sermons as well as didactic literature, articles in newspapers and journals as well as medical treatises, and, above all: creative literature and art. Poems in sublime style, dramas of sensibility, comedies and tragedies, etchings and caricatures appeared in Great Britain, France and Germany; they altogether formed a singular and forgotten ‚media hype‘ which was seriously Janus-faced: Jenner and his new technique of prevention were either glorified and transformed into a sacred gift of nature or, contrastively, demonized and declared as a hellish contamination and hybridization of the human body. Bearing in mind that this early vaccination entertainment was both fundamentally ambivalent and deeply emotional, one can draw analogies to our current Covid vaccination discourse and to the equally unsettling role that international mass media play here.

The Cowpox Controversy: Memory and the Politics of Public Health in Cuba

Vaccination played an important role in the formation of a national consciousness in Cuba, and vaccination's earliest promoters dominate nationalist narratives of medical achievement on the island. This article investigates the intense hostility exhibited by the creole medical elite toward a pivotal figure in the history of smallpox vaccination in Cuba, Spanish physician Dr. Vicente Ferrer (1823-83), the first in the Americas to mass produce smallpox vaccine using calf vaccinifiers. I argue that anger and mistrust of both Ferrer and his innovatory vaccine production technology originated in the relationship between medical politics and cultural identity in late nineteenth-century Cuba. By the late nineteenth century, smallpox vaccination was linked to glorified memories of a Cuban creole-led vaccination program and a disinterested medical profession. Both Ferrer and his private institution for the mass production of "cowpox" became associated with destructive changes in public health, challenging cultural narratives and regional power structures.

Does smallpox vaccination modify HIV disease progression among ART-naive people living with HIV in Africa?

We examined the association between a history of smallpox vaccination and immune activation (IA) in a population of antiretroviral therapy-naïve people living with HIV (PLHIV). A cross-sectional study was conducted in Senegal from July 2015 to March 2017. Smallpox vaccination was ascertained by the presence of smallpox vaccine scar and IA by the plasma level of β-2-microglobulin (β2m). The association was analysed using logistic regression and linear regression models. The study population comprised 101 PLHIV born before 1980 with a median age of 47 years (interquartile range (IQR) = 42-55); 57·4% were women. Smallpox vaccine scar was present in 65·3% and the median β2m level was 2·59 mg/l (IQR = 2·06-3·86). After adjustment, the presence of smallpox vaccine scar was not associated with a β2m level ⩾2·59 mg/l (adjusted odds ratio 0·94; 95% confidence interval 0·32-2·77). This result was confirmed by the linear regression model. Our study does not find any association between the presence of smallpox vaccine scar and the β2m level and does not support any association between a previous smallpox vaccination and HIV disease progression. In this study, IA is not a significant determinant of the reported non-targeted effect of smallpox vaccination in PLHIV.

The Antivaccine Heresy: Jacobson v. Massachusetts and the Troubled History of Compulsory Vaccination in the United States by Karen L. Walloch

Reviewed by: The Antivaccine Heresy: Jacobson v. Massachusetts and the Troubled History of Compulsory Vaccination in the United States by Karen L. Walloch Alan M. Kraut Karen L. Walloch. The Antivaccine Heresy: Jacobson v. Massachusetts and the Troubled History of Compulsory Vaccination in the United States. Rochester, N.Y.: University of Rochester Press, 2015. xi + 339 pp. Ill. $125.00 (978-1-58046-537-3). Candidate Donald Trump met with antivaccine activists during his campaign for the presidency in summer 2016. Those present found the candidate to be interested and open-minded on the matter of vaccination, while provaccine advocates criticized Trump’s refusal to enthusiastically support compulsory vaccination as another example of his willingness to ignore scientific studies for the sake of [End Page 814] political expedience. Though mandatory vaccination has been part of American public health policy since the early nineteenth century, the controversy over the pros and cons is alive and well. Karen L. Walloch masterfully tells the history of this debate in The Antivaccine Heresy: Jacobson v. Massachusetts and the Troubled History of Compulsory Vaccination in the United States. A professor of history at the University of Wisconsin–Madison, Walloch’s volume is the perfect scholarly commemoration of Pastor Henning Jacobson’s 1905 unsuccessful legal challenge to the Massachusetts law that required all residents of the state to have a smallpox vaccination. Meticulously, Walloch leads readers through the history of smallpox vaccination in nineteenth-century Massachusetts, first made mandatory in 1809, chronicling the state of medical knowledge of smallpox and vaccination techniques. Some physicians made one puncture, while others preferred several scratch lines and still others abraded the skin. Discovering that bovine lymph sometimes resulted in infection, physicians added glycerin as a germicide. They soon learned that glycinerated virus had only a limited shelf life when it could be administered without risk of infection. As Congress deliberated federal regulation of vaccine production, Massachusetts established its own vaccine farm as a way to ensure vaccine purity. The smallpox epidemic of 1901–2 tested the power of government to marshal the social resources necessary to battle the disease. Boston’s chief health officer, Dr. Samuel Durgin, tirelessly advocated for compulsory vaccination, but he could not completely calm public alarm as antivaccinationists aroused fears of complications such as tetanus. Walloch is especially effective in describing Massachusetts antivaccinationists’ varied motivations. Rather than dismissing all as “antigovernment libertarians,” she offers a nuanced picture of “thoughtful people who posed legitimate questions about state interference in individual health matters, matters they believed should remain between a patient and her doctor” (p. 102). The author sees antivaccinationism as a kind of “populism.” Most wanted government to “ensure fairness in the medical marketplace as well as for their personal health concerns” (p. 103). Their battle was not only against intrusions by the state in the “personal realm of health,” but against the “predations of an elite group of physicians who sought to hijack American government to serve selfish commercial interests” (p. 113). The battle against Massachusetts’s compulsory vaccination law was fought in the political arena and even in the streets when health officials sent squads of health department physicians with police escorts into lodging house districts to forcibly vaccinate. Was the police power of the state being exercised in excess? The matter ended up in the courtroom where antivaccinationists were prosecuted in criminal proceedings. In 1902, in the midst of a smallpox epidemic, Cambridge Board of Health chairman E. Edwin Spencer swore out criminal complaints against six resisters, including the Reverend Henning Jacobson, a forty-six-year-old Swedish Lutheran minister who had arrived as an immigrant in 1869. Jacobson appealed his conviction, taking his case all the way to the Supreme Court, where he lost. Walloch skillfully navigates her readers through the majority opinion written by Justice [End Page 815] John Marshall Harlan. Jacobson had contended that compulsory vaccination was an abuse of the police power of the state, an “assault upon his person.” Harlan asserted that the Constitution “does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint” (p. 209). Though Jacobson lost the appeal, it is likely that he...

Development of HIV-1 vaccines based on replication competent Tiantan vaccinia vector in China

BackgroundA vaccine is the best solution to stop the AIDS pandemic, but how to develop a vaccine is an unprecedented challenge to the global scientific community. The HIV vaccine programme of the China Center for Disease Control and Prevention (CDC) is being developed through careful selection of the representative circulating HIV-1 strain CRF07 in China, through a nationwide molecular epidemiology survey involving all provinces. The replication competent Tiantan vaccinia (VTT, smallpox vaccine in China) was used as an AIDS vaccine vector. A DNA/rTV HIV-1 vaccine containing gag, pol, and env genes has been developed. In preclinical tests in monkeys, this vaccine gives high protection (more than 80%) against homologous SHIV (SHIV97001) challenge and partial protection (50%) against heterologous SHIV (SHIV SF162 P3) challenge when boosted with HIV-1 envelop protein. The aim of this study was to test the safety and immunological effect of the HIV-1 vaccine in healthy human volunteers. MethodsA double-blind, placebo-controlled phase 1 trial was done at the Peking Union Medical College Hospital, Beijing, China. We enrolled HIV-1 uninfected healthy adults with or without history of smallpox vaccination. The subjects were randomly assigned to receive DNA alone (DNA 4 mg, DNA-H/rTV (DNA 4 mg), DNA-L/rTV (DNA 2 mg), or placebo. Randomisation was done by the Division of Health Statistics, China CDC, using SAS version 9.1.2. Participants, site staff, laboratory personnel responsible for endpoint assays, and investigators were blinded as to treatment assignments during the trial. Participants were primed with DNA vaccine (4 mg, intramuscular) three times at 1 month intervals and boosted once with rTV (5×104 plaque-forming units, skin scratches). The participants were monitored for safety and immunological outcomes. Vaccine-induced immunogenicity were measured by the enzyme-linked immunospot assay, intracellular cytokine staining, and antibody assays. All available data were used, according to randomization assignment. The analyses for the primary objectives of safety and tolerability were descriptive. For the secondary analyses of immunogenicity, we used assay-specific predefined positivity criteria to categorise each individual as a responder or a non-responder at each time point. Between-group comparisons were based on Fisher's Exact Test for binary data and Wilcoxon rank sum tests for the magnitude of the response. The protocol was approved by the ethics committees of PUMCH and National Center for AIDS/STD Control and Prevention, China CDC. All participants provided written informed consent. This trial was registered at chictr.org, number ChiCTR-PRC-10001287. Findings36 HIV-1 uninfected healthy adults with or without history of smallpox vaccination were enrolled; ten participants were women, and the mean age of the participants was 28·28 years (6·46). Among the participants, 23 were vaccinia-naive, and 13 were vaccinia-vaccinated. Six participants received DNA alone, 12 participants received DNA-H/rTV, 12 participants received DNA-L/rTV, and six participants received placebo. 34 (94%) participants completed all study visits. Results of the completed phase 1 trial showed that DNA/rTV vaccines were well tolerated in participants. We detected HIV-1-specific binding antibody against gp140 protein and V1V2 in all volunteers. T-cell responses induced by the vaccines were found in two-thirds of participants and were multi-functional (IL2/IFN-g/TNF-α). Typical skin reaction in all rTV vaccinated 22 participants, enlargement of the lymph nodes under the same arm receiving rTV (13 cases), and slight fever (37·6°C for 1 day, 1 case) were observed. No severe adverse events related to the vaccines were found. InterpretationThe DNA/rTV vaccines are safe and stimulate an immunogenic response. In order to protect primate against heterologous SHIV challenges, HIV envelop proteins needed as a boosting immunogen. Study is required to further test the safety and immunogenicity of DNA/rTV vaccine in high-risk groups to HIV infection. It is worthwhile to compare the non-replicating pox vector of the Pox Protein public Private Partnership (p5 project) with the replicating Tiantan vector. The China CDC and US National Institutes of Health (NIH) have planned a joint phase 2b vaccine trial of the DNA/rTV of China CDC and gp145 of US NIH. FundingNational Science and Technology Major Projects for Infectious Diseases Control and Prevention (2008ZX10104 and 2012ZX10001008).

The XIX century smallpox prevention in Naples and the risk of transmission of human blood-related pathogens.

Vaccines are the most successful strategy developed in Medicine to prevent and even eradicate the most dreadful epidemic infectious diseases. The history of smallpox vaccination in Naples is quite unique. Although Galbiati established the retro-vaccination (1803) and developed the “calf” lymph vaccine, recognized and implemented since 1864 as the optimal smallpox vaccine in the following hundred years, Naples general population was mainly vaccinated with “human” lymph from abandoned children until 1893. Mini-epidemics of syphilis and serum hepatitis were periodically reported as results of arm-to-arm procedure. The risk of transmission of blood-related pathogens was higher in Naples where >80% of abandoned children, used as repository of cowpox virus, were dying in their first year of life. Recent vaccinology standards finally eliminated the risk of adventitious contaminating pathogens. Implementation of hepatitis B vaccination since 1991 eventually contributed to current HBV prevalence in Campania region <1%, within the range of the European Countries.

Cowpox and a cat

In August, 2001, three people, a boy aged 14 years, a woman aged 20, and a man aged 54, living in neighbouring households in Schirnding, Germany, were scratched while playing with a cat. 2 days later, the 20-year-old woman had an itchy nodule, surrounded by erythema, on her right forearm where she had been scratched. She also had malaise, night sweats, and painful right axillary lymph nodes. The next day, further lesions developed on her right arm and in her left groin. She was admitted to the Department of Dermatology, University of Regensburg. While she was there, the nodule on her forearm increased to 4×2·5 cm (figure) with a necrotic black eschar in the centre with a raised rim by day 20. The other two people had similar lesions, but these remained localised and neither had any malaise. The 54-year-old had a history of smallpox vaccination in childhood. The cat had an ulcerated nodule on its right ear.

Thomas Michael Nowell and his 'Matière de Boulogne': a neglected figure in the history of smallpox vaccination.

Thomas Michael Nowell and his 'Matière de Boulogne': a neglected figure in the history of smallpox vaccination.

The history of smallpox vaccination in Germany: a first step in the medicalization of the general public.

Although vaccination against smallpox was the first public health measure that affected nearly the whole population, its history has seldom been investigated as part of the process of medicalization which characterized the nineteenth century. The vaccine's introduction, which was sanctioned by state authorities and executed by medical professionals, marked the first time that the German population became the object of a large-scale medical action which had its origin in recent scientific discoveries. Thus it appeared as 'the first step in the medicalization of the general public and in the medicalization of the life-cycle of contemporary man'.2 Medicalization, a term first used by Michel Foucault, refers to the gradual disappearance of traditional, more or less fatalistic attitudes towards health and illness, and the extension of professional medical services to those social strata in which the professional medical practitioner had hitherto remained unknown. As the process of medicalization advanced, it became increasingly common to appeal to competent experts, to the medical professionals. This process was accompanied by a loss of independence on the part of the patient, and at the same time resulted in an increase in the power and status of the medical profession. The following article will examine several aspects of the process of medicalization, as illustrated by the case of the smallpox vaccine: the common and different interests of the state and the medical profession; the public response to this new measure of public health care, ranging from scepticism to open opposition; and finally, the strategies employed by the state to overcome these manifold forms of resistance. Although smallpox had been known in Europe since the Middle Ages, its character and consequences were long underestimated. For centuries

What is the function of DNA restriction enzymes?

The message of these figures is that in terms purely of economic cost it would make sense to mount a global vaccina- tion program against smallpox, even if the disease could never be eliminated. The hope of eradicating smallpox altogether rests on the fact that there seems to be no animal reservoir from which the human population can be reinfected, nor do the viruses remaining in healed pocks seem to last very long. Peter Razzell, a London University sociologist who has studied the history of smallpox vaccination (and has cast doubt on the interpretation of some of Jenner’s experiments) believes that ‘conli- dence in eradication of the disease could be premature’. In a recent article in Ne,r

Two unusual neuropathologically proven cases of multiple sclerosis from bombay

Two unusual cases of multiple sclerosis (MS), both from Bombay, have been reported with detailed clinical and histopathological findings, which evidenced dissemination in time and in space. They were both women in their twenties, with total duration of the neurological illness of 5–6 months. The first patient had initial signs related to the optic nerves and then, after remission, to the brain stem and spinal cord. There were chronic plaques in the medulla, in 1 optic nerve and lesions of varying stages throughout the cervical spinal cord, with glial cellular and fibrillar reaction, and some preservation of axons. This appeared to be a case of MS with features simulating neuromyelitis optica. The second patient had initial signs related to the lumbar cord, like a transverse myelitis and then, after a remission, evidence of a progressive cerebral disorder with clinical and ventriculographic findings suggesting a space-occupying lesion in the corpus callosum and frontal lobes. The more chronic demyelination was in the spinal cord. The brain showed large, recent, symmetrical, periventricular plaques, with total absence of myelin except in some of the U-fibres, throughout the frontal and parietal lobes and anterior corpus callosum. There was moderate lymphocytic reaction in and around the vessels, extensive accumulation of myelin breakdown products in histiocytes (gemistocytes and gitter cells) with some preservation of axons and early gliosis. This appeared to be a case of MS with some features of diffuse cerebral sclerosis, or what is often called transitional type of MS. A history of smallpox vaccination 5 weeks before the illness in the first case, and the chronic inflammatory reaction in the second, together with the rapid tempo of the disease in both, which determined the characteristic patterns of clinical and pathological changes, has led us to discuss the infectious and allergic hypotheses of aetiology in MS.