Learning from vaccine history

Kim Myung-ja
The author, a former environment minister, is the president of Seoul Forum for International Affairs (SIFA) and honorary chair of the Korean Federation of Science and Technology Societies.

Mankind battled with diseases throughout the age. Smallpox was one of the earliest and longest infectious disease that claimed many lives. The disease arrived in the New World with European explorers, killing 70 to 90 percent of the local population. The deadly rash accompanied by a high fever killed 300 to 500 million people in the 20th century. Ironically, the first type of vaccine was made from a less harmful pox virus. English scientist Edward Jenner got the idea upon observing that milkmaids were generally immune to smallpox. The term vaccine derives from variolae vaccinae (smallpox of the cow). He pioneered the concept of vaccine in his 1798 publication of “Inquiry into the Causes and Effects of the Variolae vaccinae” to argue on the protective effect of cowpox against smallpox. After lengthy deliberation and exploration on side effects and resistance to inoculation, in 1980, smallpox became the first infectious disease to get eradicated, according to the World Health Organization.

The most fatal pandemic record in human history was the pestilence, known as the Plague or Black Death. Fleas living on black rats travelled on slave ships from Asia to reach Europe in 1346, and in the peak in 1346-1353 killed 200 million out of the 500 million people in Europe and Asia. Although curable with timely use of antibiotics, at least 20,000 cases are still found annually. Although there is a plague vaccine, cleared by the U.S. Food and Drug Agency in 1940, production ceased in 1999 due to severe side effects and little efficacy on the deadly pneumonic plague.

The Spanish flu that spread in 1918 cost the most lives in the shortest time. After it developed into a pandemic through World War I, as many as 500 million of the world population of 1.8 billion to 1.9 billion were infected, of which 50 million to 100 million died. Richard Shope in 1932 discovered that a virus caused human influenza while studying pigs. Wilson Smith expanded the research and was able to isolate human influenza A virus to develop the first type of vaccine in 1933. The second type vaccine effective on influenza B was produced in 1942 and inoculated soldiers during World War II. The third type came out in 1978 and fourth in 2012. During the novel influenza spread in 2009, Korea carried out a vaccine program with home-grown shots.

Since the late 19th century, disease-causing microorganisms for malaria, tuberculosis, typhoid, and cerebral meningitis have been identified. Among them, FDA cleared vaccines for cerebral meningitis in 1981 and a vaccine for typhoid in 1989. The malaria vaccine, which helps reduce the fatality rate, is still in clinical trials. The BCG vaccination for tuberculosis was approved in 1909 but is still under development due to low efficacy on adults. Polio vaccines have become available by injection (1955) or mouth (1961), helping to end the disease in western Europe in 1994 and 2000 in the Pacific region, including Korea.

In the mid 20th century, vaccines for chicken pox, measles, hepatitis, Rotavirus, and human papillomavirus were discovered. It had taken two decades for the development of vaccines for hepatitis, Rotavirus and HPV. The measles vaccine was produced in 1963 upon identification of its cause in 1953 and can be effective with just one jab in a lifetime. Korea has recommended the vaccine since 2001 and by 2014 eliminated the disease.

Until the vaccines for Covid-19 that became available in just 10 months since the outbreak, the vaccine for mumps virus made the fastest vaccine to come out. In 1963, Maurice Hileman of Merck & Co took samples of the mumps virus her five-year-old daughter caught and applied the chicken embryo cell culture that was approved for breeding vaccines for measles in the drug maker’s lab. Her four-year work led to the first effective mumps vaccine, making it the fastest development. A vaccine for the Ebola virus that first broke out in 1976 was approved in Europe and the U.S. only in late 2019. Vaccines for Zika virus and HIV are still nonexistent even though as many as 38 million have died from HIV since 1981.

The same vaccines are priced selectively. Middle or higher income economies are charged more, whereas 73 countries in the low-income category are supplied at cheaper prices through the Global Alliance for Vaccines and Immunization (GAVI). For example, nine types of child vaccines approved by the WHO cost $1,100 to $1,300 in the U.S. But they are bought by GAVI at $28. Yet poor countries are battered with traditional and novel diseases to undergo a vicious cycle of poverty and disease outbreak.

Science and technology evolve through trial and error. Vaccines are no different. Composite vaccines must be developed to respond to new types of pandemics. Through curable vaccines, obstinate diseases must be combated. If a vaccine gap from national wealth exists with sporadic temporary aid, sustainable co-prosperity of the global community cannot be achieved. The breakthrough and coalition of Covid-19 vaccines must set the momentum for co-sharing.

Translation by the Korea JoongAng Daily staff.