Today, Explained - The first global vaccination

Episode Date: January 15, 2021

Was distributed by 22 orphans. Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Gambling problem? Call 1-866-531-2600 or visit connectsontario.ca. So let me tell you a story about the very first vaccine in history and the unusual way that they had to distribute it around the world. The story gets started in the late 1700s with Edward Jenner. He was a British doctor who observed that people who came down with a disease called cowpox would not come down with the related and far deadlier disease of smallpox. And at the time, smallpox was probably the scariest disease on earth. It spread very, very quickly, and people's bodies, their skins, would erupt in these awful, fluid-filled, pus-filled sores.

They got everywhere on your body, including your face, and up to half of all people died of it. And even the survivors were left with nasty scars on their face. They're often stricken blind. So smallpox was a horrible, horrible disease. And Jenner's vaccine was a huge breakthrough because it could prevent smallpox. But in some ways, Jenner discovering this vaccine, the cowpox vaccine, was actually the easy part. The harder part proved to be getting it to people. Remember, this was the late 1700s. They didn't have modern transportation. They did not have modern manufacturing to mass produce vaccines.

And they did not have refrigeration to keep it cold and alive over long distances. So basically, the best way to spread it was from person to person, to do it directly. A doctor, if you had cowpox, would prick the little sore. They would take the fluid from that sore, and they would scratch it into the arm or the leg of another person. They would catch cowpox, then they would be immune to smallpox. So literally, they would take someone's wound and like apply it to someone else? Yeah, it wasn't exactly hygienic.

And nowadays, obviously, we would do things a little different. They didn't have a modern understanding of germs then. And also, you know, there was a risk of infections, but it was better than getting smallpox. So I think people were willing to take that risk. But yeah, that's how they did it. And that worked okay within a town or whatever. It was a little laborious, but it worked okay. The problem started when you had to move from town to town.

They had a method where they could take the lymph, the cowpox fluid, and they could smear it on a piece of silk, a silk strand, or a ball of lint or something. They could let it dry. Sometimes they sealed it in wax to help preserve it. Then they would walk to the next town over. And when they got there, they would mix the dried, crusty fluid with water to reconstitute it. And then they could start

giving it to people there. So you could literally rub some cowpox sore onto some textile, some material, and transfer it from town to town. Yes, exactly.

So getting from town to town, as long as they weren't very far apart, worked. You could spread the vaccine that way. The real problem started when you had to take that crusty lymph and try to get over an ocean with it or something like that. There are stories of the lymph losing its potency, traveling even from London to Paris, which is only about 215 miles.

So traveling across an ocean, which could take weeks, if not months, didn't work, usually, because the virus would lose its potency. And by the time they got there to the Americas or to India or any other place they were trying to get the lymph, it would have lost its potency and it wouldn't work to make people immune anymore. So when the virus, when the lymph started to dry out, the virus would die essentially. And then it wouldn't work by the time they got across the ocean. So what did they do? Well, every once in a while, it did make it across the ocean.

They got one to Newfoundland in 1800. They got lucky, basically. And it kind of started trickling down into North America from there. But most of the time, it failed. And the Americas really, really needed it because they were having apocalyptic outbreaks of smallpox there. There were a lot of native people there who did not have any sort of immunity. And they were living in poverty, which made it really, really deadly. It would spread very quickly, and they had outbreaks where up to half of all people would die, so even higher death rates than they were experiencing in Europe and Asia. And Spain especially had a really, really hard time getting it across the ocean. They had huge colonies in Central and South America,

and it just was not making it there over and over. So the Spanish crown came up with a sort of radical plan, and that was they were going to use living people to take the cowpox vaccine across the ocean. And specifically, they decided they were going to use orphan boys to do this. Orphan boys. Orphan boys, yeah. I'm not sure why they chose boys necessarily, but the reason they chose orphans was essentially the orphans couldn't really resist. They were living in institutions, they didn't have parents, they were kind of at the mercy of these more powerful people, and they kind of had to go along with what they were told to do. I should say the king, King Carlos IV, did give them some incentive to do this. He promised them a free education when they got to the colonies. He promised they would be adopted into a family there. So they were getting something out of it.

But obviously, we would not do this today. That would not fly with ethical rules nowadays. So they gave a bunch of orphans cowpox? Yeah, basically what they did is they got 22 orphans. They put them on a ship. And right before the ship set sail, they gave two of them cowpox. They rubbed it into their skin. Nine or ten days later, they had little pustules, pus-filled pustules, erupt on their skin.

And at that point, a doctor on board would prick the pustule, it would take the fluid and give it to the next two boys in the chain. And then they would wait nine or ten days after that. And after that point, they would give it to the third pair of boys in the chain and so on. And the hope was that if they had good winds and a little bit of luck, the last pair of boys would have pustules on their arm when they arrived in the Americas. They could hop offshore and start vaccinating people there. This sounds both ingenious and deeply, deeply unethical. Yeah, it is clever when you think about it.

I mean, if they had done it with, you know, actual cows or something like that, we'd probably be hailing them as these, you know, these really brilliant innovators. But the fact that they did choose these orphan boys does make it look quite dubious, especially because they were pretty young. The oldest of these boys was only nine years old, and the youngest of them was only three years old. So you can imagine, you know, tearing this little three-year-old out of the orphanage, the only place it's ever known, putting him on a ship and, you know,

the rolling around in the ocean, they were doing it over the winter, so it was cold and choppy there. The kid has no idea what's going on. It's getting pricked to get this little wound on its arm. It really was not a very pretty picture. Yeah, I actually can't imagine it. Like, being an orphan wasn't bad enough. Now you're an orphan child on a ship crossing the Atlantic in the winter, given a disease by the Spanish crown? Yeah, that pretty much sums it up, yeah.

They did actually take the head of the orphanage along, a woman named Isabel Zendal Gomez. She was actually in charge of the orphan boys, in charge of caring for them on the ship. And she was the only woman on board. And she actually proved kind of vital because, you know, if something happened to these boys, then the entire plan would fall apart, essentially. So she had kind of this vital role of caring for them, making sure they got there, especially because if these boys did get there and they looked awful or sickly or something like that, no one in the Americas was going to take this vaccine from them. They would say, you know, I'm not going to get some fluid from this sickly looking kid.

So they brought her along basically to make sure that they were cared for and that they looked good when they got there because they knew that appearances would matter. No one was going to take this strange new medical treatment if the people who had it before were looking awful. So she kind of played this very important role. So we know who the head of the orphanage was. Do we have any idea who these orphan boys were? We really don't.

There's a monument. There was a movie made about them a couple years ago, I've heard. But we really don't know much about them, especially after they got to the Americas. They just sort of disappear. So, no, we don't know a whole lot about them beyond the fact that they seem to have been foundlings, which were babies that were abandoned by their parents. So what happens when they get to the Americas? Well, they barely made it there.

They planned it out pretty well, but they got to Venezuela, modern Venezuela, around Caracas, and they had one single sore left on the arm of one boy. So they were very close to having that pop. And if that had happened, then the entire plan would have been for naught. But they did make it there. And the head of the expedition hopped off the ship and immediately started vaccinating people on shore. So it spread pretty quickly from there. So it ultimately was successful in getting it to the Spanish colonies in the Americas. Do we have any idea how many lives these orphan boys from Spain may have saved? The estimates vary a lot, but once they had a foothold

and once they actually started vaccinating people in South America, it spread very, very quickly from there. The doctors in charge of the mission actually split into two at that point. One group went up through Mexico and the other group went down into South America. And by all accounts, they vaccinated at least hundreds of thousands of people. So we know that they did that. And because they vaccinated all those people,

it prevented outbreaks as well. So the estimates are they probably saved millions and millions of lives through these orphan boys. Sam Kean writes about science history. His most recent book is called The Bastard Brigade, the true story of the renegade scientists and spies who sabotaged the Nazi atomic bomb. More with Sam in a minute. I'm Sean Ramos from This Is Today Explained. Thank you. Support for today explained comes from Ramp. Ramp is the corporate card and spend management software designed to help you save time and put money back in your pocket. Ramp says they give finance teams unprecedented control and insight into company spend. Thank you. ramp. You can go to ramp.com slash explained ramp.com slash explained r a m p.com slash explained cards issued by Sutton Bank member FDIC terms and conditions apply. So, Sam, it's an incredible story about these orphaned boys. And just remind me, this is like the first full vaccination effort in the history of mankind?

This is the first modern vaccine campaign in that it was really global because the head of the expedition actually took off from the Pacific coast of Mexico and went over to Spanish colonies in the Philippines and started vaccinating people there. And from there, he went up to China, vaccinated tens and tens of thousands more people. So it really spread around the world.

And it was a pretty amazing accomplishment in that they got all this done by around 1805. So within 10 years of Jenner's first vaccine, they had spread it around the world, which is just a staggering achievement given the technological limitations of the time. You mentioned that they got the vaccine all the way over to Asia. Was it the same deal as getting it to the Americas? Did they do it using, you know, orphans that they sent out to the East?

They did use small boys again, but these boys that went over to the Far East were not orphans. They came from families on the Pacific coast of Mexico. And basically they paid them and hired their boys as vaccine mules, essentially, to transport it across the Pacific Ocean. Okay, so not orphans, but still dodgy ethical practices. Yeah, paying families to hire their boys would not fly nowadays, but that's what they did at the time. Did the families get their boys back? It seems that they did, yeah. Again, they are kind of lost to history at some point,

but it seems that they did put them on a ship and send them back across, yeah. So we found your story, how orphans helped distribute the smallpox vaccine in the Atlantic, where people can read it right now. We've been talking about vaccines for about a year now. What made you want to tell this story right now? This story really seemed appropriate now because we're rolling out the vaccine for the coronavirus, obviously. And I just got to wondering, you know, how did they do that way back when in the 1800s when they did not have refrigeration, didn't have modern transport, things like that. And the fact that they used these orphan boys really startled me. I think it would startle anyone who heard that for the first time because you think, you know, how can they do that?

How did they get away with that? But that was the choice that they made at the time. Of course, now we do have refrigeration. We do have the internet. We have airplanes. We have rocket ships. We have smartphones. We've got, you know, more technology in our bathrooms that it took to win World War II. And yet we're still struggling, Sam. Does that surprise you? It doesn't surprise me in that vaccine rollout campaigns are always difficult. They're always fraught. And this one especially, we're trying to go, understandably, very, very fast.

It does get frustrating in that we had months and months to prepare for it. And it still seems like a lot of health agencies were caught off guard with this. But they're always messy. They've always been messy. And especially in a country as big as the United States, it's going to be difficult. And this one presents some unique challenges in that at least some of the vaccines for coronavirus need to be kept at very, very cold temperatures, which just adds a layer of complexity to it.

So reading about these orphans and learning about them, I guess, made me appreciate how difficult it had always been to get vaccines out there. As I said before, in some ways, the vaccine's the easy part. It's getting it into people's arms, into their bodies, that often proves the trickier part. It's funny, though. I mean, my perception reporting on this and making episodes about vaccine development for the past nine months was that it felt like this impossible task to get the vaccine made this quickly, that we were breaking the sound barrier all over again with this vaccine. Yeah, and I think that's another reason why it's so frustrating, because a lot of us were

focused just get to the vaccine, get to the vaccine, get to the vaccine. And when it finally came and got approval, I think we kind of mentally let our guards down and said, OK, we can see the end now. We're almost there. We sort of forgot the fact that it still had these other steps to go where we had to get it to people. So I think that's fueling a lot of this frustration is we thought we were close to being done. And it turns out there is a lot more work to do.

Do you see other countries doing a much better job than the United States at vaccination? It is a little discouraging to see that other countries have higher percentages. Israel, for instance, has vaccinated something like 20% of their population. And the U.S., we're hovering right around 3% right now. You know, 100 years from now, 200 years from now,

when, you know, your great-great-great-grandchild is telling the story of the COVID-19 vaccine and its rollout, what do you hope the story is? I hope the story is that there was a bit of a 2020 hangover at the beginning of the year, and there were some stumbles, but that once we had ironed things out, things went very, very quickly. And I do think we'll look back on this, especially the development of the vaccine as a really, really amazing story. I assume, you know, knock wood, everything goes well. The rollout part will be sort of ironed over in history and it'll just be sort of, it'll be just another vaccine

rollout hiccup that we've experienced and we'll probably be focused more on the development of the vaccine. It's just unfortunate that we have to live through this moment now in real time and can't jump to the historical perspective. And at least no orphans were harmed. Not that we know of, no. Jesus, do you think some orphans were harmed? No, no, no. No, no, no. No orphans were harmed in the making of this vaccine.

Sam Kean, he's a writer and also a podcaster. His podcast is called The Disappearing Spoon and features more stories like this one. We here at Today Explained are off Monday for MLK Day. It's a day of service. Consider doing something nice for someone who needs it. More soon. Thank you.