The Journey of India’s First Vaccine

The world’s first vaccine – one for smallpox – arrived in India in 1802. Indians had been afflicted with the disease for centuries by that time. Smallpox was always present in larger cities. Every few years, it erupted in epidemic form in rural areas, especially in South India.

English physician Edward Jenner published his thesis in 1798 claiming that inoculation with cowpox, a pustular disease found on cows’ udders, offered complete and healthy immunity against smallpox.

In 1799, clinical trials in London supported his findings and over the next year, cowpox or vaccine inoculation, as it was then known, gained recognition in England and drew interest from all over the world, including colonial India.

Jenner saw his breakthrough as a universal good and worked to make the vaccine widely available. Cowpox was a concern since it was uncommon even in England. Vaccine availability has always depended on vaccine practice.

A vesicle on a vaccinated child’s arm was lanced in order to provide lymph for other infants. Lymph was also dried on cotton threads for potential use and to be distributed to colleagues to help spread the procedure.

Jenner and others began sending vaccine samples to India by sea from 1800 onwards but the vaccine had a limited shelf life, particularly in the hot and humid climate areas. Thanks to packaging changes made in 1802, they were able to send the viable vaccine from Vienna to Baghdad. The Indian Express reports that in Baghdad, fresh vaccines were propagated and thereafter transmitted to Bombay.

In June 1802 in India, the first vaccination took place. Anna Dusthall, a young mixed-race girl in Bombay at the time, was the patient. Other children were vaccinated using the vesicle that had been on her arm. The procedure was developed locally samples were provided for shipment inland to Poona, and then town-to-town down the Malabar coast, up to Madras, and then by sea to Calcutta.

The live vaccine was kept alive by vaccinating children in one district and then escorting them to another to go arm-in-arm with children in that district. For about 20 years, all vaccinations in India were obtained from stock derived from the Bombay baby.

Vaccination, on a large scale, took place in the British monitoring areas. Indian practitioners were paying for the number of people vaccinated during the presidency of Madras, and hundreds of thousands of people were vaccinated in just a few years. Swamy Naik, an army surgeon, is believed to have administered 900,000 vaccines during his service, a world record.

There were bound to be difficulties in spreading the activity throughout India. Sanskrit, Hindi, Tamil, and other languages were used to translate vaccination texts. Initially, there was some possibility that Hindus would embrace the cow’s association. Although many Brahmins supported the new method, there was understandably some trepidation about inoculating an animal with a disease and transmitting it across religious and caste lines. Poor parents were always enticed to carry their children forward with doles of rice and trinkets in order to maintain a supply of the vaccine.

To assuage some of the fears, Indian rulers, many of whom employed western physicians, led the charge in getting their families vaccinated.

In 1805, when Krishnaraja Wodiyar III took a second wife who was still vulnerable to smallpox, vaccination was already well-regarded at the royal court of Mysore. It was determined that she would be vaccinated before her marriage, an event commemorated by Irish-born painter Thomas Hickey in a group portrait in which the young queen is portrayed pointing to the vaccination spot, according to historian Nigel Chancellor

Over a million vaccines were administered in India within the first decade of the procedure. India became a hub of vaccination activity, spreading the practice across the Indian Ocean and Southeast Asia region and experimenting with new distribution methods.

Hundreds of millions of Indians were vaccinated over the next 150 years, with some success in containing the disease’s ravages. Smallpox, however, remained a major public health concern at the time of India’s Independence, due to an increasing and more mobile population, logistical difficulties and vaccine failures, distrust of western medicine, and sheer apathy. In India, over 25,000 people died of smallpox as late as 1963.

Only a determined vaccination programme sponsored by the World Health Organisation, involving mass mobilisation of health workers and people in surveillance and containment measures, was effective in eradicating the disease locally in 1975.

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