Vaccine expedition in early 1800s

In 1824, the city and people of Manila erected a statue to Spanish King Carlos IV in front of the Manila Cathedral in Intramuros, adding a fountain to it in 1886, in gratitude for the enlightened Bourbon monarch’s gift of smallpox vaccine that saved many lives. This statue and a seldom-read historical marker in the Research Institute of Tropical Medicine in Alabang become relevant again due to the swirling controversy over dengue vaccine acquired and administered by the Department of Health that might have caused more harm than good. Let’s leave our politicians to use the issue for grandstanding and while we wait for expert medical opinion to clear the hot air, let’s look back on the Royal Philantrophic Expedition of Vaccination better known as the Balmis Expedition (1803-1806) or the Balmis-Salvany Expedition for its leader Francisco Javier de Balmis and his assistant Jose Salvany who distributed smallpox vaccine through Spanish America all the way to the Philippines.

In March 1803, Carlos IV convened the Council of the Indies to look into an epidemic of smallpox in South America and study a way to introduce a vaccine throughout the empire. Having lost some relatives to the disease, Carlos had his children inoculated during an outbreak of smallpox in Spain in 1798. Balmis was commissioned and the expedition sailed from La Coruña in November 1803 arriving in Puerto Rico in February 1804 via the Canarias. Since the vaccine did not travel well, Balmis used live carriers: 22 children, between 8-10 years old, sourced from the charity hospital and orphanage of La Coruña. Only boys who had not been infected with the smallpox virus nor vaccinated were chosen. During the voyage, Balmis transmitted the vaccine in sequence, from child to child, arm to arm along the way to their destination. By March the expedition was in Venezuela where they split in two, with Balmis going to Cuba, Mexico and the Philippines; his assistant Salvany took the vaccine to: Colombia, Ecuador, Peru, Bolivia, and Chilean Patagonia. Travel time took so long Salvany had not even reached Buenos Aires in 1809.

Of interest to us is the swing through the Philippines and Macau. Balmis had sailed from Spain to Mexico originally with 22 orphans from La Coruña who were left in Mexico in the care of the Bishop of Puebla for eventual return to Spain. For the trip to the Philippines, Balmis calculated the voyage from Acapulco to Manila at two months requiring at least 24 Mexican boys plus two to serve as spare tires. They were from 4-6 years old; some were Spaniards, others mestizo-Indian. Mexican carriers had known parents or at least a mother to return to afterwards unlike the orphans who carried the virus from Spain. Before leaving Mexico for the Philippines, Balmis had vaccinated about 100,000 children and established vaccination centers.

After an uncomfortable sea passage with cabin conditions not what he bargained for before departure, Balmis arrived in Manila on April 15, 1805. His initial problem was that the Archbishop of Manila was not keen on vaccination. Fortunately, governor-general Rafael Aguilar had his five children vaccinated providing an example that won the support of the archbishop and the trust of the people resulting in over 20,000 vaccinated. Balmis’ assistants, with 12 children, took the vaccine to the Visayas and Mindanao to stop smallpox outbreaks in Misamis and Zamboanga.

Balmis was beset with stomach trouble and was irritable in Manila, so he left his assistants in Manila to complete the vaccinations and to establish vaccination centers before returning to Mexico in 1807 with the Mexican boys. Balmis took a different return route passing through Macau and Canton then onward to Lisbon and Madrid where he was received at court in San Ildefonso by Carlos IV in September 1807. A footnote to the story is that Balmis attempted to bring the vaccine to China. On his trip to Macau, Balmis took three Filipino boys as vaccine carriers all provided by the parish priest of Santa Cruz. The boys returned to Manila after their mission and it is unfortunate that history did not record their names like the Spanish and Mexican boys who joined the expedition. I hope to find their names some day.

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