Five Past Vaccine Drives and How They Worked

Scientists developed vaccines less than a year after Covid-19 was identified, a reflection of remarkable progress in vaccine technology. But progress in vaccine distribution is another story.

Many questions that arose in vaccine rollouts decades ago are still debated today. How should the local and federal authorities coordinate? Who should get vaccinated first? What should officials do about resistance in communities? Should the hardest-hit places be prioritized? Who should pay?

Some answers can be found in the successes and failures of vaccine drives over the past two centuries.

In 1796, once the scientist Edward Jenner discovered that people infected with cowpox became immune to smallpox, doctors went from town to town in England, deliberately spreading cowpox by scratching infected material into people’s arms.

The rollout worked on a local level, but how could it be distributed to people in faraway places, like in the Americas, where smallpox had devastated populations? In 1803, the Spanish government put 22 orphans on a ship to its territories in South America. The lead doctor, Francisco Xavier de Balmis, and his team injected cowpox into two of the boys, and then, once cowpox sores developed, took material from the sores and scratched it into the arms of two more boys.

By the time the team arrived in the Americas, only one boy was still infected, but that was enough. Vaccine distribution in the Spanish territories was unsystematic, but eventually, members of the Spanish expedition worked with local political, religious and medical authorities to establish vaccination clinics. More than 100,000 people in Mexico received free vaccinations by 1805, according to a journal article, “The World’s First Immunization Campaign,” in the Bulletin of the History of Medicine.

By the 20th century, when scientists had determined how to store and mass produce the smallpox vaccine, outbreaks had generally been contained.

But an outbreak in 1947 in New York City, just before an Easter Sunday parade on a warm weekend, posed a major problem. The city’s health commissioner at the time, Israel Weinstein, called for everyone to get vaccinated, even if they had received the vaccination as children. Posters across the city warned: “Be Sure. Be Safe. Get Vaccinated!”

The rollout was swift and well orchestrated. Volunteers and professional health care providers went to schools, delivering vaccines to students. At the time, the public had strong faith in the medical community, and the modern anti-vaccination movement barely existed. In less than a month, more than six million New Yorkers were vaccinated, and the city ended up recording only 12 infections and two deaths.