Prior to the introduction of vaccination with material from cases of cowpox (heterotypic immunisation), smallpox could be prevented by deliberate inoculation of smallpox virus, later referred to as variolation to distinguish it from smallpox vaccination. The earliest hints of the practice of inoculation for smallpox in China come during the 10th century.[113] The Chinese also practiced the oldest documented use of variolation, dating back to the fifteenth century. They implemented a method of "nasal insufflation" administered by blowing powdered smallpox material, usually scabs, up the nostrils. Various insufflation techniques have been recorded throughout the sixteenth and seventeenth centuries within China.[114]:60 Two reports on the Chinese practice of inoculation were received by the Royal Society in London in 1700; one by Dr. Martin Lister who received a report by an employee of the East India Company stationed in China and another by Clopton Havers.[115]
1808 cartoon showing Jenner, Thomas Dimsdale and George Rose seeing off anti-vaccination opponents.
Independently of the East India Company's report, sometime during the late 1760s whilst serving his apprenticeship as a surgeon/apothecary Edward Jenner learned of a story, common in rural areas, that dairy workers would never have the often-fatal or disfiguring disease smallpox, because they had already contracted cowpox, which has a very mild effect in humans. In 1796, Jenner took pus from the hand of a milkmaid with cowpox, scratched it into the arm of an 8-year-old boy, James Phipps, and six weeks later inoculated (variolated) the boy with smallpox, afterwards observing that he did not catch smallpox.[116][117] Jenner extended his studies and in 1798 reported that his vaccine was safe in children and adults and could be transferred from arm-to-arm reducing reliance on uncertain supplies from infected cows.[12] Since vaccination with cowpox was much safer than smallpox inoculation,[118] the latter, though still widely practiced in England, was banned in 1840.[119]
French print in 1896 marking the centenary of Jenner's vaccine
Following on from Jenner's work, the second generation of vaccines was introduced in the 1880s by Louis Pasteur who developed vaccines for chicken cholera and anthrax,[13] and from the late nineteenth century vaccines were considered a matter of national prestige. National vaccination policies were adopted and compulsory vaccination laws were passed.[116] In 1931 Alice Miles Woodruff and Ernest Goodpasture documented that the fowlpox virus could be grown in embryonated chicken egg. Soon scientist cultivated other viruses in eggs. Eggs were used for virus propagation in the development of a yellow fever vaccine in 1935 and a influenza vaccine in 1945. In 1959 growth media and cell culture replaced eggs as the standard method of virus propagation for vaccines.[120]
The twentieth century saw the introduction of several successful vaccines, including those against diphtheria, measles, mumps, and rubella. Major achievements included the development of the polio vaccine in the 1950s and the eradication of smallpox during the 1960s and 1970s. Maurice Hilleman was the most prolific of the developers of the vaccines in the twentieth century. As vaccines became more common, many people began taking them for granted. However, vaccines remain elusive for many important diseases, including herpes simplex, malaria, gonorrhea, and HIV.[116][121]