From Catherine the Great to the red hippo: history of vaccination in Russia

The mass flu vaccination campaign running for the last three years has covered 20.1 million people. Vaccination was provided both at medical institutions, and in mobile points at metro and the Moscow Central Circle stations, in My Documents centres. This year, you can also get vaccinated in Moscow parks. mos.ru recalls the history of vaccination in Russia and Moscow that started with Empress Catherine the Great.

Catherine II was the first

The first vaccination in the history of Russia is believed to be made on 23 October 1768. It was the most important and powerful patient of the Russian Empire at that time — Catherine the Great. She was vaccinated against smallpox, a terrible disease defeated now thanks to vaccination. But in the 18th century, smallpox epidemic mowed down the population of Europe and Russia. In some years, smallpox killed more than a million people. It was very easy to catch it, since the disease spared no one, making no distinction between classes. The Russian throne was no exception. In 1730, Tsar Peter II died of smallpox at the age of 14.

In those years, smallpox death rate was about 40 percent. In other words, in the 18th century, a sick person had almost equal chances to live or die. However, doctors had already noticed that a person who had suffered from smallpox would never come down with it again. It was about a century before the discovery of the immunity theory, but the doctors of the 18th century started to take advantage of this observation. By today's standards, their vaccination method seems extremely unsafe, but then it was quite acceptable, because the mortality of people vaccinated in this way was only about two percent, 20 times less than in unvaccinated ones. An incision was made on a patient's arm to put in smallpox material taken from an infected person (safe vaccine based on cowpox virus was invented by English physician Edward Jenner in 1796). This method was called arm-to-arm vaccination or variolation. If it went well, a vaccinated person got infected with mild smallpox, after which he or she could not catch the disease once again. This method was discovered in Turkey and later studied by English doctors. First they tested variolation on criminals, then on orphans, and only then, when all these people survived, they vaccinated the Royal family, too.

Catherine the Great feared smallpox greatly. After the death of Countess Sheremeteva in 1768 from this disease, whose fiancé, count Nikita Panin, was her son’s mentor, crown prince Pavel (future Emperor Paul I), Catherine decided to get vaccinated. Doctor Thomas Dimsdale was invited from London. He took 'smallpox matter' from a 6-year old Sasha Markov. In case of her death, the Empress ordered a team of post horses to be kept ready, so that the doctor could escape from the country immediately to avoid lynching. Six days after the vaccination, Catherine began to show signs of malaise, and she retired to Tsarskoye Selo. But all ended well: a week later, the Empress recovered. Immediately after that, following the example of Catherine, 140 nobles signed up for vaccination against smallpox, as vaccination came into fashion.

The Empress ordered to publish the description of the illness, ‘so that others could protect themselves from dangers using the same means’.

The doctor was favoured the title of Baron and the title of physician in ordinary, and a pension of 500 pounds a year. Alexander Markov was granted a noble title and a new surname, Ospenny (Smallpox). His coat of arms showed an arm with a big pockmark above the elbow holding a red rose.

On the occasion of the first vaccination, a commemorative medal was embossed with the image of Catherine the Great and an inscription ‘She has set an example’. The front of the medal ‘For smallpox vaccination’, awarded to doctors, who vaccinated people against smallpox in the 19th century, had a portrait of Catherine the Great. In addition, Italian choreographer Gasparo Angiolini invited to Russia created the ballet 'Defeated Prejudice' dedicated to the Empress' vaccination, with allegorical figures of scientists fighting with superstition figures.

Dimsdale came back to Russia once again later to vaccinate the Empress' grandchildren. By this time, the Russian Empire was one of the leading fighters against smallpox in Europe. While Russia was being vaccinated, king Louis XV died of smallpox in France. ‘What a barbarism, science can treat this disease already,’ said Catherine when she learned about it.

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Before Louis Pasteur invented his vaccine, rabies in Russia was treated with magic spells, wounds burned with hot irons and other methods unrelated to science. For example, in the 19th century, The Official Gazette published the article ‘Treating Hydrophobia in the Russian Steam Room’.

Pasteur's invention in 1885 was a real salvation. People bitten by rabid animals rushed to Paris. The first 2,500 people survived thanks to the vaccine included 16 of 19 people bitten by a rabid wolf in Smolensk province. All of them could be alive, but the aid came too late for some of them, as the meeting of the City Duma in Bely, which was to allocate them 16,000 roubles for the trip, took place three days after the accident, and the victims had to wait for two more days for the doctor to accompany them. 44 people bitten by rabid animals came from Russia to Pasteur — peasants from Smolensk, Oryol, Penza, Vladimir, Tver and Kostroma provinces.

The resolution of Alexander III has survived, written on the letter of the Chief Prosecutor of the most Holy Synod Konstantin Pobedonostsev, who asked to allocate funds for these trips to France: ‘Get 700 roubles from Taneyev. It is urgent to send the sickest peasants to Paris to Pasteur, who is awfully interested in the bites of mad wolves, as he has not yet had such patients before.’ Further, the Emperor donated about 100,000 francs for the opening of the Pasteur Institute in Paris.

Soon, Pasteur stations started to open all over the world, with Russia becoming one of the leading countries in this regard. The first rabies vaccination station in the Russian Empire (and the second one in the world) opened in Odessa on 11 June 1886, and a month later, one more station was opened in Moscow. On the occasion of its opening, Louis Pasteur sent his autographed portrait. It is still stored in Mechnikov Moscow Research Institute of vaccines and serums, opened on the station's base. Nikolai Sklifosovsky was one of the initiators of the Moscow station.

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By 1912, there were 28 Pasteur stations in Russia, and by 1938, 80 stations opened in the USSR (apart from several hundred branches). The Moscow station became the major centre for rabies control in the USSR. Since then, thousands of lives have been saved with anti-rabies vaccines.

How Soviet scientists defeated polio

In the middle of the 20th century, the world experienced a new disaster — polio. About 10 percent of the cases died, another 40 percent became disabled. USA President Franklin Delano Roosevelt, science fiction writer Arthur C. Clarke, Director Francis Ford Coppola suffered from polio.

In the Soviet Union, the first epidemics started in 1949 in prosperous Baltic States, Kazakhstan and Siberia. The disease claimed about 12,000 lives annually.

In 1955, the United States started production of polio vaccine (Salk vaccine). At the same time, virologist Albert Sabin developed another vaccine, more cheap, efficient and safe. But it was not possible to test in America — why, if it already had a good vaccine.

Meanwhile, three Soviet scientists, Mikhail Chumakov, his wife and colleague Marina Voroshilova and Anatoly Smorodintsev, a virusologist from Leningrad, were sent to the United States. Sabin and Chumakov agreed to continue vaccine's development in Moscow. They brought from the United States several thousand doses of vaccine in an ordinary suitcase and made the first vaccinations.

‘In 1960, I was 9 years old. First, the vaccine was tested on us, Chumakov's children, Smorodintsev's granddaughters, relatives and colleagues. I remember being injected with Salk's vaccine earlier. It was an intramuscular injection in my forearm. It was normal state of things , since developers always test their developments on themselves and their children. My parents were sure that it was safe. The relatives were all for it, too, as everyone understood the dangers of polio and believed that the vaccine would protect children from the disease,’ told Mikhail Chumakov's son, Professor, Doctor of Biological Sciences Pyotr Chumakov.

But it was very difficult to get the permission of the Ministry of Healthcare, as officials doubted. Since the Americans gave up the vaccine, so why we have to test it? Chumakov managed to break the vicious circle of refusals with the help of a real crazy attempt: he dialled Anastas Mikoyan, who was in charge of healthcare, using an unattended phone in the Kremlin.

Mikoyan asked: ‘Mikhail, is this a good vaccine?’

‘It is.’

‘Do it.’

Mikoyan had grandchildren, too.

300,000 doses of vaccine were sent in the Baltic States bypassing the Minister of Healthcare. Polio was defeated, and for 1.5 years the epidemic in the USSR was over. In 1960, 77.5 million people were vaccinated against polio in the USSR.

When the Soviet delegation reported on successful vaccination at a conference in Washington, someone from the audience shouted that no one in the West trusted Soviet information. Then the Soviet delegate said: ‘I can only assure you of one thing: we love our children as much as you love yours.’ And the audience applauded.

In 1963, Mikhail Chumakov and Anatoly Smorodintsev received the Lenin Prize. The world's leading scientists from the United States, Japan, Europe and China came to the USSR to attend annual Symposium at the Institute of Polio and Viral Encephalitis of the Academy of Medical Sciences of the USSR. The vaccine produced by the Institute was imported by more than 60 countries.

Japanese mother demanded the Soviet vaccine

In the 1950s and 1960s, Japan suffered a real tragedy: thousands of polio cases had been reported in this small country. Living vaccine produced in the USSR could stop the epidemic. But for the Japanese government, registering and authorising the import of medicine from the Soviet Union was an unthinkable precedent.

Then mothers of polio-stricken children took to the streets, demanding permission to import the Soviet vaccine. They achieved their goal: an urgent import of the vaccine was arranged. 20 million Japanese children have been saved from disease.

In 1988, Director Alexander Mitta made a Soviet-Japanese two-part film 'Step' based on this story, with Leonid Filatov and Komaki Kurihara, Oleg Tabakov, Yelena Yakovleva, Vladimir Ilyin and Garik Sukachyov starring. The film featured Sukachyov's song 'My Little Babe’.

The story is centred around an epidemic in Japan that took place in 1959. Salk vaccine applied in the country is only 60 per cent effective, moreover, it runs out. Keiko, a Japanese woman, who has lost her eldest son, wants to protect her younger son from polio at all costs and decides to go to the USSR and bring a new Soviet vaccine to Japan.

In the Soviet Union, Keiko gets her vaccine and buys another thousand doses for her compatriots, further confiscated at the customs, as under the Japanese law, any medicine imported into the country must undergo two-year tests. Japanese mothers arrange protests and demand to import the Soviet vaccine immediately, but bureaucrats of both states ban it. Due to joint efforts of Keiko and other mothers, on the one hand, and the Soviet doctor Gusev, on the other hand, Japan gets its vaccine.

Sweet drugs

In the 1950s and 1960s, Marat Confectionery Factory produced sweets against polio.

Mikhail Chumakov was looking for the best way to deliver the vaccine to the intestines, so that the useful virus is not lost taken orally, as it does not multiply in the mouth, but to a greater extent gets to the destination. Finally, he came up with the idea of making a vaccine in the form of dragee. In March 1959, Marat Factory (in 1971 it was incorporated with Rot Front Factory, to join in 2002 the United Confectioners company) produced anti-polio dragee by order of the Chumakov Institute, wax-coated capsules made of sugar and starch syrup. Sweets weighing 1g stored in the refrigerator.

Children loved them, and from now on, qualified medical staff was no longer required for the vaccine's introduction.

These sweet vaccines were produced at the Marat Factory until the late 1960s. On the occasion of the Food Industry Workers Day, celebrated on 20 October 1968, Ogonyok magazine published a small article ‘Sweets against disease’. It had a photo of the women workers and told about the most amazing factory products — medical sweets, with the factory producing them being a monopolist in polio dragee production.

How to escape the virus from the past in 19 days

Sometimes terrible viruses, which seem to stay in the distant past, remind about themselves.

Famous Soviet poster artist Alexei Kokorekin travelled to India in 1959. After returning home, he felt unwell, and was taken to the Botkin Hospital, where he died.

His disease was not diagnosed immediately: in India, the artist contracted smallpox, which was eradicated in the USSR in 1936. Intelligence agencies found out all potential contacts of the deceased man. There were about nine thousand of them. One thousand people with the highest risk of infection were isolated in the Botkin Hospital, and almost the entire population of Moscow (at that time more than six million people) was urgently vaccinated.

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Smallpox outbreak was localised in 19 days, with 46 people falling ill, and 3 people died of smallpox — a receptionist in a thrift store (where Kokorekin's relatives handed over the things he had brought from India), a nurse in the infectious diseases building and an infectious disease physician.

A few scientific laboratories still store smallpox virus.

‘In the 1990s, the World Health Organisation demanded the destruction of all smallpox strains. My father was against it. OK, we can destroy all strains in laboratories, but God forbid there will be a new outbreak if the virus from burial grounds gets to the soil or water, then there will be nothing we could do,’ Pyotr Chumakov recalls.

Smallpox has been completely eradicated since 1980, as there have been no cases of the disease since then.

Pyotr Chumakov recalls some cases of dangerous viruses that can be discovered even at scientific symposiums.

‘In the 1970s, there was a leprosarium not far from Pereslavl-Zalessky town. An Indian scientist lived there. He came to the USSR to attend a scientific symposium. Our doctors noticed on his face symptoms of leprosy, since they are difficult to miss, like the absence of eyebrows. At that time, there was a law on compulsory isolation of patients with leprosy. And the Professor was taken to the leprosarium to live there for the rest of his life,’ he told.

‘Everyone, from an elephant to a fly, must be vaccinated against jaundice’

In the USSR, vaccination campaign was held all around the country. It was featured on the TV screens in renowned cartoon of 1966 'About a Hippo Who Was Afraid of Vaccinations'. Its story tells about a chicken-hearted Hippo who was the only one of the animals to escape from the clinic. First, grey and joyful, then white from fear of vaccination, Hippo becomes yellow because it gets sick with jaundice, and at the end of the film it blushes with shame for the fact that it was scared of injection. Millions of Soviet children watched this funny cartoon. What vaccinations did they get?

All those born after the war were vaccinated against tuberculosis, diphtheria and polio. Over time, vaccinations against whooping cough, tetanus, measles and mumps were added. Children born before 1979 were vaccinated against smallpox, and since 1980 smallpox has been considered eliminated worldwide, and vaccination was cancelled.

A double rubella vaccination, a second measles vaccination and a hepatitis B vaccination were added to the national calendar in the late 1990s, with a Hemophilus vaccination for at-risk children and a pneumococcal vaccination added in the 2010s.

Large-scale vaccination against flu in Russia started in connection with the threat of a pandemic in 2009-2010. Now vaccination, included in the national calendar, is provided by state healthcare organisations free of charge. Last year, according to the Rospotrebnadzor (Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing), 49% of the Russian population — 70.8 million people — were vaccinated. The doctors stated that the incidence of flu has declined almost 200 times since 1997 — from 5,173.8 cases per 100,000 people to 26.5.