Vaccination, then and now

Epidemics have been around as long as humankind. History records how people have lived and died with disease through the ages, such as the bubonic plague, the Black Death, typhoid, cholera, Spanish flu, bird flu, AIDS, and now COVID-19. Humans eventually adapt to disease naturally or by finding a cure; that is as sure as you can spell Sinovac. Distributing the cure in the Philippines, however, is another story. If we are to believe Sen. Panfilo Lacson’s suspicions, the vaccine will get to us as surely as you can spell “Kickvac.”

Rereading textbook history during the pandemic made it clear to me that the story lines are biased toward American contributions in education and public health, contrasted of course with Spain, whose outstanding historical contribution was oppression, which resulted in the Philippine Revolution.

Textbooks focus on the tail end of the Spanish period and the struggle for independence, such that students hardly remember that the San Lazaro and San Juan de Dios hospitals were established in late 16th-century Intramuros, and the University of Santo Tomas was founded in the 17th century. Contrary to popular belief, public health was not an innovation from the American period, because we had smallpox vaccination in the Philippines in 1805, the University of Santo Tomas graduated Filipino doctors in 1877, the forerunner of the present Department of Health—the Superior Board of Health and Charity—was founded in 1883, and a Laboratorio Municipal de Manila was established in 1887 to examine food and water.

Before he rose to become a general in the Philippine-American War, Antonio Luna was appointed to the Laboratorio as a chemist in 1895, undertaking studies on the purity of carabao milk and water from the Pasig.

Current discussions on COVID-19 vaccines led me to search online, where I found out that the most relevant Philippine surname today is “Vacunador” (Vaccinator). Two relevant primary sources are downloadable for free: The Gaceta de Manila, dated Feb. 10, 1895, contains vaccine regulations approved by the Junta Superior de Sanidad and implemented by the government; and the 1873 Reglamento de Vacuna de las Islas Filipinas, annotated and expanded with various legislation, salary tables, and even the template for relevant bureaucratic forms. This obscure pamphlet, digitized from the Harvard University Library, documents a Spanish plan to create in each province or district one or two offices for vacunadores who could be dispatched to the pueblos in the archipelago with agents and assistants, “to show the caring interest that Spain has for the inhabitants of its overseas provinces (ultramar).”

In 1803, Spanish King Carlos IV, aka “El Cazador” (The Hunter), organized an expedition to counter a smallpox epidemic. The expedition was headed by Francisco Javier de Balmis, court physician, whose mission was to distribute a vaccine to the Spanish overseas territories. He traveled by sea and transported the vaccine live—through 27 boys who were vaccinated to develop antibodies that were then used to develop more of the medicine. The 27 boys, with their mothers, were said to symbolize “the paternal concern of the King for his subjects.”

Balmis arrived in Manila on April 15, 1805 on board the ship “Magallanes,” and the very next day vaccinated the children of the governor general to reassure the people that it was safe. Days later, Balmis vaccinated more children in Intramuros and the suburbs. The vaccine also reached some provinces with the assistance of parish priests, gobernadorcillos, and cabezas de barangay.

The smallpox outbreak led to the establishment of the Junta Central de Vacuna in Manila, with a governing board that included the governor general, the Archbishop of Manila, and the Father Provincials of the Augustinians, Franciscans, Dominicans, and Recollects. Vaccine farms were established in Manila, Binondo, Tondo, and Santa Cruz using healthy children. The extracted vaccines were collected and cultured in the Casa Central de Vacuna in Manila, placed in crystal tubes, and distributed elsewhere by the Cuerpo de Vacuna (Corps of Vaccinators).

One must be wary, though, of these 19th-century material and not believe that the smallpox vaccine was Spain’s greatest gift to us. Then as now, all the good intentions expressed in laws, decrees, regulations, and instructions often remained on paper and did not always correspond to actual implementation.

(Conclusion on Friday)

Comments are welcome at aocampo@ateneo.edu