There are many factors that differentiate the current monkeypox outbreak of which gave rise to COVID-19 pandemic. The first and most important is that it is not a new disease, since we have known about it for many years. The second is that an important part of the population is already vaccinated. It is true that it is not with a vaccine against monkeypox, but against human smallpox. It seems that this offers a 85% protection, so it makes a clear difference with the unvaccinated. But why are some people immunized and others not? Why is the smallpox vaccine no longer in our vaccination schedules? And, above all, why is a vaccine that was administered decades ago still effective?
These are questions that have been asked a lot in recent days and have a simple answer. The smallpox vaccine was discontinued because it was no longer needed. Basically because it is the only human disease that has been totally eradicated so far. Precisely thanks to vaccines. And it is a very effective vaccine for a very stable virusso you don’t need memories.
Fortunately, vaccines are still preserved. In fact, there are improved versions of that first vaccine that have been approved by health authorities such as the US FDA or the European Medicines Agency (EMA) for administration to health personnel at risk or military. In addition, a few samples of the human virus have been kept in high security laboratories, in case it is needed. Perhaps a biological war was thought, but finally the vaccine is necessary again for something much simpler. A fairly widespread outbreak of his prima african, the monkey pox.
The history of the smallpox vaccine
The smallpox vaccine actually arose from a much older process, known as variolation.
This began to take place in the 16th century, in China and India. There, healthy people were made to wear the clothes of smallpox patients, so that they came into contact with the suppurations of their skin lesions. The objective was to generate the disease in a mild way, so that their body would generate a defensive response that would last in the face of a future real infection. Later, in the ottoman empire A version was developed consisting of taking samples of the pustules of the sick and inserting them under the skin of healthy people through a cut made in it.
The first smallpox vaccine arose from a much older process known as variolation.
This mechanism was brought to Europe in 1718 by Lady Mary Wortley Montagu, the wife of an English ambassador who was amazed by the process and wanted to try it with her own children. Already in Europe it began to be carried out first among members of the aristocracy, but later in a more widespread way in the rest of the population. The problem was that it was not a very safe mechanism, so it is true that many people were protected, but many others died. After all, they were introducing smallpox into their system.
He was an English country doctor named Edward Jenner who in 1796 found the solution to this security problem. He discovered that milkmaids who worked milking cows often caught the cowpox. As the monkey pox, is a milder virus than the human, but is closely related to it. For this reason, although the milkmaids did not become seriously ill, when they later faced smallpox they did not become infected. Jenner decided to take samples of the pustules of one of those women and inoculate them to healthy people, thus developing what is considered the first vaccine in history. Although he was not the one who gave it that name. That was the task of Louis Pasteurwho practically a century later decided to baptize them as vaccines in honor of the cows that infected the milkmaids.
That smallpox vaccine saved millions of lives around the world. Although at that time there were anti-vaccines, his speech did not penetrate as much as it does now. Possibly because they had seen the wolf’s ears very closely. That’s why the vaccination campaigns they were very well received, everyone wanted to be vaccinated and little by little the disease subsided until it disappeared. The last person to get smallpox was Janet Parkera medical photographer who got sick in 1978 while working in a laboratory at the University of Birmingham. Unfortunately, he passed away. Those were the last throes of a disease that finally it was declared eradicated on May 8, 1980.
Once the disease was eradicated, it was not necessary to continue vaccinating, so little by little the vaccine was withdrawn from vaccination schedules around the world. This included the african countriesdespite the fact that there it had been proven that it also protected against monkey pox.
Immunity against monkeypox
In 1970 a 9-year-old boy fell ill in the Democratic Republic of Congo of what was initially thought to be human smallpox. This disease was eradicated in Africa in 1977, so it was possible. However, it was soon found that it was actually monkeypox, a disease discovered in 1958 in laboratory apes.
Although it was not human smallpox, there was something that caught the attention of the health workers who treated the little boy. And it is that the rest of his family, all vaccinated against smallpox, had not fallen ill. He was the only one who had not yet been immunized and the only one who got sick. Therefore, the vaccine was found to be Also effective against monkeypox.
DNA viruses, such as monkeypox, are usually very stable
Today it is estimated that it offers 85% protection. Therefore, most older people 42-45 years They are quite protected.
Here a typical conspiracy question arises in these times. How can someone be protected against smallpox 42 years after being vaccinated, but against COVID-19 we have already had three doses and we can still get it?
The answer is very simple. For starters, they are different viruses. SARS-CoV-2, which causes COVID-19, is a RNA viruses. Instead, viruses of the genus Orthopoxvirussuch as monkey or human pox, are DNA virus, much more stable than those of RNA. This means that they mutate much less and the same vaccine can serve for a long time.
On the other hand, coronavirus vaccines they are not sterilizing vaccines. They decrease the ability of the virus to replicate, shortening the time of infection and complicating infections. In addition, the symptoms are much milder than if there is no vaccine. But contagion is not prevented.
It is not necessary to talk about coronavirus or smallpox. Our vaccination calendars have an infinity of vaccines that require memories from time to time. Even some such as tetanus require re-administration in a risk situation if it is too long since the last dose.
For this reason, if the situation arises where we have to vaccinate against monkeypox, at least we know that precisely the elderly, those who were most vulnerable to COVID-19They are already protected. The others will see if we have to vaccinate. It is a disease that requires very close contact for contagion to occur, so containing it should be easier than with the coronavirus. Time will tell what steps need to be taken. For now, the best conclusion we can draw from this whole story is that vaccines save lives. Although we already knew that.