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The Last Vaccine

In 1798, a British country doctor announced a new way to prevent smallpox, the scourge of European cities. Edward Jenner scraped a patient’s arm with a bit of pus from the sore on a cow infected with cowpox, a disease that was similar to smallpox. This potion–the first vaccine–gave the patient a mild illness, which provided immunity against the more serious disease smallpox. In Jenner’s honor, the great French scientist Louis Pasteur adopted the word vaccine–from vacca, Latin for cow–to refer to all such substances.

Last week, the U.S. military quietly ended the era of the cow-grown vaccine. It announced that the last lots of calfskin-cultured vaccine would expire on February 29. From now on, recruits will be vaccinated with a new smallpox vaccine that’s grown in laboratory cell cultures. More than 1.2 million troops and contractors were vaccinated with the old vaccine, which is known scientifically as vaccinia.

Acambis, a biotech company, makes the new smallpox vaccine. The Feds paid Acambis several hundred million dollars to develop it, part of the massive infusion of federal cash into bioterrorism preparedness after 911 and the anthrax mailings to Congress. Acambis says it has shipped 192.5 million doses of its new vaccine to the Department of Health and Human Services for stockpiling.

Making the old smallpox vaccine was a grubby process. The calf was strapped to a table, its underbelly shaved, smeared with vaccinia virus and scarred with knives to produce a good place for the virus to grow. It was produced on “vaccine farms.” In Paris, 19th century doctors traveled from neighborhood to neighborhood with a calf in a cart. At each stop, an assistant scraped the vaccine material off the calf’s belly and handed the lancet to the sawbones, who would rub it into a wound on the patient’s arm. Eventually, scientists developed a way to administer the vaccine by lightly pricking the arm with a tiny fork that had a drop of the vaccine solution suspended between its tines.

It was a tremendously effective preventive — the only vaccine ever to exterminate a disease. The last case of natural smallpox infection occurred in Somalia 30 years ago. The Bush Administration tried to stir up new fears of smallpox in 2002 as it was getting ready to invade Iraq. Vice President Cheney essentially ordered the Centers for Disease Control to create a smallpox preparedness plan by vaccinating 10 million Americans. The idea was that somehow terrorists or Saddam Hussein might get hold of the stuff, although there was never any evidence they had.

The last U.S. smallpox vaccine manufacturer, Wyeth, stopped making it 1975, but had a few million doses in storage in 2002. The military started vaccinating its forces against smallpox, but efforts to vaccinate large numbers of civilians failed. Only about 35,000 healthcare and emergency response workers responded to the CDC’s call to get vaccinated. This was partly because the old smallpox vaccine was somewhat dangerous. People with eczema suffered terrible reactions to the vaccine; about one in 300,000 people got a brain infection or systemic skin rashes. During the recent vaccination campaigns, about 1 in 175 new vaccines suffered myocarditis. Why risk it when everyone suspected that Iraqi smallpox was a fairy tale?

The new vaccine is apparently no safer than the old one. It doesn’t stay viable on the shelf as long, and requires more jabs with the vaccine fork to be effective. But it’s made in cell culture, which means it’s easier to assure uniform quality.

Au revoir, Bessie. You served us well.

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