Vaccinations against Corona will soon take place in Germany. Expert Karl-Heinz Leven explains how a lucky guy came up with the idea for modern vaccination. And why opponents will not be convinced.

The world has been suffering from the coronavirus for months, vaccines should help fight the pandemic. There is great hope, because with the help of modern vaccination, mankind has already managed to control other diseases that eradicate even the dreaded smallpox. Medical historian Karl-Heinz Leven explains in a Chillreport conversation why we owe this blessing to a “lucky one” who used to “harden” himself against the plague with snake meat and why there will always be opponents of vaccines.

Chillreport: Professor Leven, the coronavirus has been scaring people all over the world for months, now vaccines will soon help contain the pandemic. But to whom do we really owe the “invention” of vaccination?

Karl-Heinz Life: In a way, an eight-year-old boy who was infected with smallpox by the British country physician Edward Jenner in 1796. The child, the son of Jenner’s gardener, did not get sick. It was a medical sensation.

The child was spared because Jenner had previously infected the child with cowpox.

I agree. Jenner had made an interesting comment. At the time, farmers preferred to use women to milk their cows already suffering from human smallpox. Because there was a risk that the milkmaids could get cowpox from the animals. It is a relatively mild disease, but the women were unable to work during that time.

So Jenner suspected a link between human smallpox and the animal variety in livestock?

He was absolutely right about that. So he first infected the boy with cowpox and a little later to test with smallpox. Because Jenner was a bit smarter than the farmers: he thought, if human smallpox protects against cowpox infection, why not the other way around?

Karl-Heinz Life, Born 1959, teaches history of medicine at the University of Erlangen-Nuremberg and is also director of the Institute for History and Ethics of Medicine. The licensed physician and historian is, among other things, an expert in the history of epidemics. His book was published in 2019 “History of Medicine. From ancient times to the present day“in the third edition, Life will be published next year”Epidemics. A story from ancient times to the present day“.

Success no doubt proved that Jenner was right. But from a modern ethical standpoint, his behavior was extremely dubious.

Jenner was scientifically trained and systematic; From today’s perspective, he has conducted daring human experiments. Nobody would approve of such a thing in our presence. But what can you say: we owe the modern vaccination to this lucky guy. Because Jenner had theoretically thought about the problem for a long time before, she only then started infecting people. Jenner, however, was absolutely sure that people wouldn’t get smallpox if he tried to vaccinate them. And he was right.

To illustrate the dimension of Jenner’s discovery of modern vaccination, what is the danger of pathogens against smallpox?

Smallpox was an extremely contagious viral disease with a death rate of about 25 percent of those infected. Smallpox has been an almost inevitable danger for centuries, especially for children. Thanks to Jenner’s invention of vaccination, smallpox was initially controlled and lastly eradicated worldwide – in 1979 – thanks to extensive vaccination programs. At this point I would like to emphasize once again how revolutionary Jenner’s discovery was: he developed a relatively harmless method of preventing the outbreak of a very dangerous disease; this was all the more important as the disease itself was hardly treatable. Jenner did this at a time when no one knew about microorganisms. In other words, the inventor of the vaccine had no idea what he was doing. But it worked.

Karl-Heinz Leven: The medical historian rates the new corona vaccines as exceptional. (Source: Karl-Heinz Leven)

How did people imagine the reasons for infection at the time?

Infectious diseases have been around for a long time; of course, scientists and those affected have thought about it for centuries. Thus, the idea arose in ancient times that the transfer of some type of poison would make you sick: you couldn’t see it, but something must be wrong. And what did people who thought they were dealing with poisoning?

They took an antidote.

Correct. It was called “Theriak” and contains the ancient Greek word for “animal”. You can still see old apothecary jars with this inscription on them. So if you ingest small amounts of Theriac, you would be “hardened” against the poison, as it were; at least that’s the idea.

What exactly is Theriac made of?

All possible ingredients are combined, including snake meat.

That sounds like a really bitter medicine …

But it made sense to our ancestors. The Black Death and other epidemics were thought to be a form of poisoning; a broth with snake meat was considered an antidote to the plague. Little is said about the success of these preventive measures.

In fact, there was some sort of vaccination for some time before Jenner.

That’s right. Lady Mary Wortley was the wife of the British ambassador to Constantinople, the capital of the Ottoman Empire, around 1717. At that time, like Jenner later, she also made an interesting observation: mothers brought their children to smallpox parties, then they vaccinated some dust from children with smallpox on their skin.

SCREEN

So a more or less controlled form of vaccination against smallpox.

It was called variolation, i.e. the vaccination of real smallpox. That was also taken over in England. The good news was, it actually protected against smallpox.

And the bad?

This vaccination method was very dangerous: you could even get smallpox very quickly.

Fortunately, this method had become obsolete since Edward Jenner. In the 19th century, medicine subsequently discovered other pathogens.

Smallpox vaccination, which celebrated its breakthrough after 1800, was the great success of medicine at the time. After 1860, the era of microbiology finally began, in which science began to assign individual diseases to their respective pathogens. Special vaccines were also developed early on.

Researchers such as Louis Pasteur, Robert Koch and Emil von Behring are still admired. The latter was the first to receive the Nobel Prize in Physiology or Medicine in 1901.

Paul Ehrlich is also one of them, thanks to whom great strides have been made in the field of immunology. Before and after 1900, countless researchers not only did groundwork, but also tried to do the same thing as Jenner.

Have daring vaccination attempts been made?

The development of vaccinations became an absolute area of ​​progress that had many triumphs, but also drawbacks. There are questionable vaccination attempts and failures. It has taken decades for the current standard to become established in vaccine development and testing. Our current vaccinations, as recommended by the Standing Vaccination Commission (Stiko), are safe and effective.

Contemporary cartoon of Edwards Jenner's vaccination method: People would turn into cows. (Source: image images / Photo12)Contemporary cartoon of Edwards Jenner’s vaccination method: People would turn into cows. (Source: Photo12 / image images)

Nevertheless, today, as in the past, there is a significant number of people who are critical of vaccinations.

Strangely enough, vaccination against cowpox in the 19th century, when the disease was still a serious threat, met massive opposition. Those who opposed the vaccination often came from the middle class camp, including doctors. Some of their arguments were completely rational. It has been argued that children would be vaccinated with an animal product. This argument cannot necessarily be dismissed: because the species barrier has actually been crossed.

This was offset by the benefit of immunization against a potentially fatal disease.

Naturally. Other arguments of the opponents of the vaccination were, for example, that the effectiveness has not been statistically proven, or that the vaccination does not offer permanent protection.

The latter was correct: it was necessary to refresh the vaccination with a revaccination.

Exactly, the opponents of vaccination simply dramatized some aspects of the vaccination. Interestingly, however, vaccine opponents were mostly from middle class backgrounds. Simply put, the lower class followed the state-sponsored, later legally required vaccination.

Today, “unconventional thinkers” and “QAnon” supporters are storming against the upcoming corona vaccinations.

When vaccinating against corona it is important to keep a cool head; the newly developed vaccines raise high expectations. Sworn opponents of vaccination will not be able to convince them of any vaccination. Conspiracy myths play a decisive role here. Nevertheless, it can be expected that the vaccinations can control the corona pandemic in the medium term.

Opponent of the vaccination: According to expert Leven, you will not be able to convince these people with scientific arguments. (Source: image images / Müller-Stauffenberg)Opponent of the vaccination: According to expert Leven, you will not be able to convince these people with scientific arguments. (Source: Müller-Stauffenberg / image images)

Many opponents of vaccination are unimpressed by the undeniable successes of the past.

Opponents cannot be convinced.

In the German Reich, a Reich vaccination law had existed since 1874: in extreme cases, children were accompanied by the police to be vaccinated against smallpox.

Which also caused back pressure: Before World War I, there was a huge association of anti-vaccine opponents in Germany – with about 300,000 members and its own magazine. As a result, compulsory vaccination was no longer prescribed for decades. Strangely, even during the Nazi era, there were no compulsory vaccinations; at least for the civilian population, these were merely recommendations.

Last but not least, the gross esotericism and the strange preference of some Nazi greats such as Heinrich Himmler for ‘alternative’ medicine certainly played a role.

Yeah right.

Which impact the so-called vaccination accident in Lübeck of 1929, in which 77 children died?

It was a real catastrophe, also known as the Lübeck Dance of Death. The cause was a contaminated tuberculosis vaccine. Since the disaster in 1931, extensive guidelines have been developed to prevent such a thing in the future. However, it took decades for these standards to prevail.

The vaccinations against the coronavirus will start soon, according to a new procedure.

In fact, there has never been such a thing as the mRNA vaccine. Experts assure that this really is a big breakthrough. Despite all the professional skepticism, as a medical historian I am thrilled to be a contemporary witness to this special event.

Great Britain: 100-year-old Ethel Sinclair (left) has been vaccinated against the corona virus. (Source: dpa / Liam Mcburney)Great Britain: 100-year-old Ethel Sinclair (left) has been vaccinated against the corona virus. (Source: Liam Mcburney / dpa)

How can the novelty of the mRNA vaccine be summed up?

With the mRNA vaccine, our bodies become vaccine producers themselves. So far, the antigen has, as it were, been manufactured in the factory and then injected into the human body. Then the immune system gave the answer. The new vaccine, on the other hand, is produced in us – and evokes the body’s own immune response.

Some people fear the novelty and changes in our genetic makeup.

The vaccine has undergone complex tests, but you have only a few months of experience with it. As yet nothing can be said about possible long-term consequences, which are very unlikely. Children, adolescents and pregnant women should not be vaccinated with the mRNA vaccine for the time being.

Are you – please – if you are older than yourself, are you concerned about the vaccine?

For people in their seventh decade of life, the risk of vaccination against possible infection with the disease must be weighed. I’m not worried about the vaccination for myself.

Opponents of vaccination could answer this question a lot.

Convinced opponents of vaccination cannot be convinced with arguments. In the case of those who are against vaccination, there is fear behind it. At this point I would like to quote the sociologist Niklas Luhmann …

… who wrote that ‘fear cannot be scientifically disproved’.

That is the point. Luhmann was referring to the nuclear dangers of the 1980s. But the mechanism is the same.

Taking stock: what would our life be like without the possibility of vaccination?

Much more dangerous; because vaccinations keep the infant mortality rate so low, especially in developed countries. 200 years ago, half of our children died. Just think of diphtheria, against which we owe the vaccine to Emil von Behring and Paul Ehrlich, which is extremely dangerous for children. Without vaccinations, the suffering in the world would be much greater.

Now mankind will soon have effective prophylaxis against the coronavirus. Will there be anything left from the time of this crisis?

It will be some time before the vaccination makes the corona pandemic manageable; the experts agree on that. Premature hope for a return to the old “normalcy” is inappropriate. Much is unclear. A seemingly simple question, but one that plays a role in pediatrics: What are the consequences of the increased hygiene requirements for children, especially small children? Will this increase the tendency for allergies? We have entered an era with new hygiene rules. This will affect many areas of life and the consequences are incalculable.

Professor Leven, thank you very much for speaking to us.

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