But the Spanish king, Carlos IV, decided to make them a few promises: They would be stuffed with food on the voyage over to make sure they looked hearty and hale upon arrival. They’d been abandoned by their parents, were living in institutions, and had no power to resist. Given the era, it’s likely that no one asked the orphans whether they wanted to participate-and some seemed too young to consent anyway. The doctors could then hop off the ship and start vaccinating people.
(The boys were infected in pairs as backup, just in case one’s sore broke too soon.) Overall, with good management and a bit of luck, the ship would arrive in the Americas when the last pair of orphans still had sores to lance. Nine or 10 days later, once those boys developed sores, a third pair would receive fluid, and so on. A team of doctors onboard would lance the sores, and scratch the fluid into the arms of two more boys. After nine or 10 days at sea, the sores on their arms would be nice and ripe. Right before they left for the colonies, a doctor would give two of them cowpox. The plan involved putting two dozen Spanish orphans on a ship.
Spain especially struggled to reach its colonies in Central and South America, so in 1803, health officials in the country devised a radical new method for distributing the vaccine abroad: orphan boys. Every so often threads of dried lymph did survive an ocean journey-a batch reached Newfoundland in 1800-but the lymph was typically rendered impotent after months at sea. The lymph could lose its potency traveling even the 215 miles from London to Paris, let alone to the Americas, where it was desperately needed: Smallpox outbreaks there were verging on apocalyptic, killing up to 50 percent of people who got the virus. The real trouble started when doctors tried to vaccinate people who were far away. The process was straightforward but laborious. Then they’d scratch the fluid into the arms or legs of people there to give them cowpox. They would head to the next town over and mix the crusty lymph with water to reconstitute it. Doctors would prick open the sores, smear the lymph on silk threads or lint, and let it dry. People with cowpox developed blisterlike sores filled with a fluid called lymph. So in 1796, he began giving people cowpox intentionally, rendering them immune to smallpox and creating the first vaccine.īut the breakthrough introduced another dilemma: How could doctors deliver vaccines to people who needed them? Within Europe, distributing the vaccine was manageable. The British doctor Edward Jenner observed something strange, however: People who caught a related disease called cowpox never came down with its deadlier cousin.
Huge numbers of people died from the disease, and many survivors were struck blind, or left with severe scars. It spread alarmingly quickly, and every inch of people’s skin, including their face, would erupt with thousands upon thousands of painful, pus-filled sores. When the very first vaccination campaign got under way, in fact, it faced such daunting barriers-technological, geographical, and medical-that today’s distribution challenges seem minor in comparison.Īt the end of the 18th century, smallpox was probably the scariest disease on Earth. Vaccines have been around since the late 1700s, and the rollouts have often been precarious-full of blunders, accidental deaths, dashed hopes, and dubious ethical decisions. In some ways, developing vaccines has always been the easy part getting them into people’s arms is the challenge. These missteps are troubling, but they’re hardly surprising. Rolling out a vaccine at this speed and scale is not easy, but health agencies have had months to prepare and were still caught off guard. Meanwhile, Israel has vaccinated 21 percent of its population. Twelve days into January, just about 9 million people have received vaccines, less than 3 percent of the U.S. In mid-December, the federal government floated hopes of distributing 40 million vaccine doses by the end of 2020. Operation Warp Speed, the federal government’s plan to develop and deliver vaccines in the United States, is now sputtering. Unused doses have expired and been thrown away.
Governors have slowed things down by relying on confusing guidelines about who can get vaccinated when. Health departments originally stuck to banking hours instead of vaccinating around the clock. Medical teams trained to vaccinate masses of people have been sitting infuriatingly idle. In mid-December, Pfizer reported that it had millions of doses sitting around in a warehouse, and no instructions on where to send them. Since then, many, many things have gone wrong. When the United States green-lit two coronavirus vaccines in December, it was a rare bright spot during this pandemic: Scientists had developed a vaccine for COVID-19 far faster than any other vaccine in history.