Issue link: https://digital.copcomm.com/i/1342648
Working Nurse l WorkingNurse.com 17 February 22-March 29, 2021 THINKING BEYOND THE PANDEMIC ✚ COVID-19 vaccines are in development around the world, but the process is fraught with complications, both political and medical. At this point, no one can predict when a vaccine will be widely available, who will get it and who may refuse it for themselves or their children. We also don't know if any COVID-19 vaccine will be effective long-term. Edward Jenner's smallpox vaccine was much safer and more effective than the crude inoculation practices it superseded, but the vaccine didn't provide lifelong immunity. It took another 184 years for smallpox to finally be eradicated worldwide. What we can do to improve public health and child healthcare right now is advocate that all children receive their other recom- mended vaccinations — including flu shots, if they haven't already been vaccinated this season. On the positive side, the masking, distancing and sanitation precautions most of us continue to practice to avoid COVID-19 may also reduce the incidence of other communicable dis- eases, such as influenza and measles. TODAY, IF SOMEONE told you the surest way to protect your patients or loved ones from a deadly disease was to apply pus from the lesions of an infected patient to open cuts on each uninfected per- son's arms and legs, you would recoil in horror. However, for centuries, this nauseating procedure, known as "variolation," was the best protection medical science could offer against smallpox . Although crude and dan- gerous, variolation was based on a sound scientific theory: If surviving an infectious dis- ease conveys immunity from reinfection, it may be possi- ble to immunize other patients through deliberate exposure to a milder form of the same disease. Did this primitive form of inoculation actually work? The answer is "sometimes." Some patients were lucky, and came away immune to smallpox with no lasting ill effects. Roughly one in every 30– 50 variolated patients died, either of smallpox or of some other disease contracted through the inoculation. Even patients who eventually recovered were often bedrid- den for weeks. Worse, a variolated patient could develop a mild but still contagious case of smallpox. Since such patients often felt fine, they would resume their normal routines, infecting everyone they encountered. RISKY BUT USEFUL Despite its hazards, variolation was often worth the risk. Smallpox epidemics could infect whole populations. Well into the 20th century, case- fatality rates for non-inoculat- ed patients were typically around 30 percent. By the mid-18th century, variolation was widely prac- ticed in the Ottoman Empire, Europe, Britain and colonies in the Americas. Many wealthy and powerful families inocu- lated their children in this way, and some military command- ers variolated entire armies to prevent smallpox outbreaks. In the 19th century, variola- tion was gradually superseded by vaccination using cowpox, which didn't provide perma- nent immunity to smallpox, but was much safer than vari- olation. The far more effective modern smallpox vaccine was developed in the 1950s, and by 1980 had finally eradicated wild smallpox across the globe. WN Variolation This primitive smallpox inoculation was used for centuries before vaccines BY AARON SEVERSON