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Post-war immigration to Australia
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Mr Arthur Calwell with the Kalnins family - the 50,000th New Australian - August 1949
In 1954, 50,000 Dutch migrants arrived; Maria Scholte is to the right of the picture
Post-war immigration to Australia deals with migration to Australia since the end of World War II. In the immediate aftermath of World War II, Ben Chifley, Prime Minister of Australia (1945-1949), established the federal Department of Immigration to administer a large-scale immigration program. Chifley commissioned a report on the subject which found that Australia was in urgent need of a larger population for the purposes of defence and development and it recommended a 1% annual increase in population through increased immigration.[1]
The first Minister for Immigration, Arthur Calwell, promoted mass immigration with the slogan "populate or perish".[2] Calwell coined the term "New Australians" in an effort to supplant such terms as pommy (Englishman) and wog.
The 1% target remained a part of government policy until the Whitlam Government (1972-1975), when immigration numbers were substantially cut back, only to be restored by the Fraser Government (1975-1982).[1]
Some 4.2 million immigrants arrived between 1945 and 1985, about 40 per cent of whom came from Britain and Ireland.[3] By 2007, some 6.5 million people have migrated to Australia since 1945.[4] This total comprises 3.35 million males and 3.15 million females. This represents a significant proportion of the overall population increase experienced by Australia in that time, having gone from 7 million in 1945 to the present total of over 23 million.[4] 182,159 people were sponsored by the International Refugee Organisation (IRO) from the end of World War II up to the end of 1954 to resettle in Australia from Europe—more than the number of convicts transported to Australia in the first 80 years after European settlement.[5]
Contents
[hide]
1 "Populate or perish" policy
1.1 The Chifley years
1.2 Menzies years
2 End to the White Australia policy
3 International agreements
4 Timeline
5 Settler arrivals by top 10 countries of birth
6 Migrant reception and training centres
6.1 Queensland
6.2 New South Wales
6.3 Victoria
6.4 South Australia
6.5 Western Australia
7 Breakdown of arrivals by decade
8 Demography as at 2006 for non-English speaking ethnic groups
9 See also
10 References
11 External links
"Populate or perish" policy[edit]
The Chifley years[edit]
Australian Government poster displayed between 1949 and 1951 in reception rooms and dining halls at various migrant reception centres in Australia. (Image courtesy of the NAA).
Following the attacks on Darwin and the associated fear of Imperial Japanese invasion in World War II, the Chifley Government commissioned a report on the subject which found that Australia was in urgent need of a larger population for the purposes of defence and development and it recommended a 1% annual increase in population through increased immigration.[1] In 1945, the government established the federal Department of Immigration to administer the new immigration program. The first Minister for Immigration was Arthur Calwell. An Assisted Passage Migration Scheme was also established in 1945 to encourage Britons to migrate to Australia. The government's objective was summarised in the slogan "populate or perish". Calwell stated in 1947, to critics of mass immigration from non-British Europe: "We have 25 years at most to populate this country before the yellow races are down on us."
The post-war immigration program of the Chifley Government gave them preference to migrants from Great Britain, and initially an ambitious target was set of nine British out of ten immigrants.[1] However, it was soon apparent that even with assisted passage the government target would be impossible to achieve given that Britain's shipping capacity was quite diminished from pre-war levels. As a consequence, Calwell looked further afield to maintain overall immigration numbers, and this meant relying on the IRO refugees from Eastern Europe, with the USA providing the necessary shipping.[1] Many Eastern Europeans were refugees from the Red Army and thus mostly anti-Communist and so politically acceptable.[6]
Menzies years[edit]
The 1% target survived a change of government in 1949, when the Menzies Government succeeded Chifley's. The new Minister of Immigration was Harold Holt (1949–56).
The British component remained the largest component of the migrant intake until 1953.[1] Between 1953 and late 1956, migrants from Southern Europe outnumbered the British, and this caused some alarm in the Australian government, causing it to place restrictions on Southern Europeans sponsoring newcomers and to commence the "Bring out a Briton" campaign. With the increase in financial assistance to British settlers provided during the 1960s, the British component was able to return to the top position in the overall number of new settlers.[7]
Hundreds of thousands of displaced Europeans migrated to Australia and over 1,000,000 Britons immigrated with financial assistance.[8] The migration assistance scheme initially targeted citizens of Commonwealth countries; but it was gradually extended to other countries such as the Netherlands and Italy. The qualifications were straightforward: migrants needed to be in sound health and under the age of 45 years. There were initially no skill requirements, although under the White Australia policy, people from mixed-race backgrounds found it very difficult to take advantage of the scheme.[9]
Migration brought large numbers of southern and central Europeans to Australia for the first time. A 1958 government leaflet assured voters that unskilled non-British migrants were needed for "labour on rugged projects ...work which is not generally acceptable to Australians or British workers."[10] The Australian economy stood in sharp contrast to war-ravaged Europe, and newly arrived migrants found employment in a booming manufacturing industry and government assisted programmes such as the Snowy Mountains Scheme. This hydroelectricity and irrigation complex in south-east Australia consisted of sixteen major dams and seven power stations constructed between 1949 and 1974. It remains the largest engineering project undertaken in Australia. Necessitating the employment of 100,000 people from over 30 countries, to many it denotes the birth of multicultural Australia.[11]
In 1955 the one-millionth post-war immigrant arrived in Australia. Australia's population reached 10 million in 1959, up from 7 million in 1945.
End to the White Australia policy[edit]
In 1972, Whitlam Government (1972-1975) adopted a completely non-discriminatory immigration policy, effectively putting an end to the White Australia policy. However, the change occurred in the context of a substantial reduction in the overall migrant intake. During the Fraser Government (1975-1982) there was a final end to the White Australia policy but there was an increasing intake of Vietnamese refugees in the aftermath of the end of the Vietnam War, and Australia experienced the largest intake of Asian immigrants since the arrival of the Chinese gold miners during the gold rush of the 1850s and 60s. In 1983, the level of British immigration was below the level of Asian immigration for the first time in Australian history.[1]
International agreements[edit]
Financial assistance was an important element of the post war immigration program and as such there were a number of agreements in place between the Australian government and various governments and international organisations.[12]
United Kingdom - free or assisted passages.[12] Immigrants under this scheme became known as Ten Pound Poms.
assisted passages for ex-servicemen of the British Empire and the United States.[12] This scheme later covered ex-servicemen or resistance fighters from the Netherlands, Norway, France, Belgium and Denmark.[12]
an agreement with the International Refugee Organization (IRO) to settle at least 12,000 displaced people a year from camps in Europe.[12] Australia accepted a disproportionate share of refugees sponsored by IRO in the late 1940s and early 1950s.[13]
formal migration agreements, often involving the grant of assisted passage, with the United Kingdom, Malta, the Netherlands, Italy, West Germany, Turkey and Yugoslavia.[12]
there were also informal migration agreements with a number of other countries including Austria, Greece, Spain, and Belgium.[12]
Timeline[edit]
Period
Events
1947 Australia's first migrant reception centre opened at Bonegilla, Victoria - the first assistant migrants were received there in 1951.[14]
1948 Australia signed Peace treaties with Italy, Romania, Bulgaria and Hungary and accepted immigrants from these countries.[2]
1949 In 1949 assisted arrivals reached more than 118,800, four times the 1948 figure[2]
In August Australia welcomed its 50,000th "New Australian" — or rather, the 50,000th displaced person sponsored by the IRO and to be resettled in Australia. The child was from Riga, Latvia.[13][15]
Work began on the Snowy Mountains Scheme - a substantial employer of migrants: 100,000 people were employed from at least 30 different nationalities. Seventy percent of all the workers were migrants.[16]
1950 Net Overseas Migration was 153,685, the third highest figure of the twentieth century.[2][17]
1951 The first assisted migrants received at the Bonegilla Migrant Reception and Training Centre.[14] By 1951, the government had established three migrant reception centres for non-English speaking displaced persons from Europe, and twenty holding centres, principally to house non-working dependants, when the pressure of arrival numbers on the reception centres was too great to keep families together.[14]
1952 The IRO was abolished and from then most refugees who resettled in Australia during the 1950s were brought here under the auspices of the Intergovernmental Committee for European Migration (ICEM).[13]
1954, The 50,000th Dutch migrant arrived.[18]
1955 Australia’s millionth post-war immigrant arrived.[2] She was a 21-year-old from the United Kingdom and newly married.[19][20]
1971 Migrant camp at Bonegilla, Victoria closed - some 300,000 migrants had spent time there.[14]
Settler arrivals by top 10 countries of birth[edit]
Birthplace
No. of arrivals
July 1949 - June 2000[21]
July 1949 - June 1959[22]
July 1959 - June 1970[23]
July 1970 - June 1980
1 United Kingdom & Ireland 1,787,449 (31.6%) 419,946 (33.5%) 654,640 (45.3%) 342,373 (35.8%)
2 Italy 390,810 (6.9%) 201,428 (16.1%) 150,669 (10.4%) 28,800 (3.0%)
3 New Zealand 371,683 (6.6%) 29,649 (2.4%) 30,341 (2.1%) 58,163 (6.1%)
4 Germany 255,930 (4.5%) 162,756 (13.0%) 50,452 (3.5%) not in top 10
5 Greece 220,603 (3.9%) 55,326 (4.4%) 124,324 (8.6%) 30,907 (3.2%)
6 Yugoslavia
(Yugoslavia recorded until 1994 –95 inclusive) 206,554 (3.7%) not in top 10 94,555 (6.5%) 61,283 (6.4%)
7 Vietnam 170,990 (3.0%) not in top 10 not in top 10 30,633 (3.2%)
8 Netherlands 161,298 (2.9%) 100,970 (8.1%) 36,533 (2.5%) not in top 10
9 Hong Kong 108,181 (1.9%) not in top 10 not in top 10 not in top 10
10 Philippines 103,310 (1.8%) not in top 10 not in top 10 not in top 10
Malta not in top 10 38,113 (3.0%) 28,916 (2.0%) not in top 10
Austria not in top 10 33,730 (2.7%) not in top 10 not in top 10
USA not in top 10 16,982 (1.4%) 20,467 (1.4%) 27,769 (2.9%)
Egypt not in top 10 13,430 (1.1%) not in top 10 not in top 10
Spain not in top 10 not in top 10 17,611 (1.2%) not in top 10
Lebanon not in top 10 not in top 10 not in top 10 32,207 (3.4%)
Turkey not in top 10 not in top 10 not in top 10 18,444 (1.9%)
India not in top 10 not in top 10 not in top 10 17,910 (1.9%)
Top Ten Total 3,770,348 (66.8%) 1,072,330 (85.6%) 1,208,508 (83.6%) 648,489 (67.8%)
Other 1,870,290 (33.2%) 180,753 (14.4%) 236,848 (16.4%) 308,280 (32.2%)
Total Settler Arrivals 5,640,638 (100.0%) 1,253,083 1,445,356 956,769
Migrant reception and training centres[edit]
Bonegilla Migrant Reception and Training Centre, 1954
On arrival in Australia, many migrants went to migrant reception and training centres where they learned some English while they looked for a job. The Department of Immigration was responsible for the camps and kept records on camp administration and residents.[24] The migrant reception and training centres were also known as Commonwealth Immigration Camps, migrant hostels, immigration dependants' holding centres, migrant accommodation, or migrant workers' hostels.[25][26]
Australia's first migrant reception centre opened at Bonegilla, Victoria near Wodonga in December 1947. When the camp closed in 1971, some 300,000 migrants had spent time there.[14]
By 1951, the government had established three migrant reception centres for non-English speaking displaced persons from Europe, and twenty holding centres, principally to house non-working dependants, when the pressure of arrival numbers on the reception centres was too great to keep families together.[14] The purpose of reception and training centres was to:
provide for general medical examination and x-ray of migrants, issue of necessary clothing, payment of social service benefits, interview to determine employment potential, instruction in English and the Australian way of life generally.[14]
The centres were located throughout Australia: (dates are those of post office opening and closing [27])
Queensland[edit]
Stuart[24]
Wacol[24]
Yungaba Immigration Centre (known today as Yungaba House)
New South Wales[edit]
Bathurst (1948 to 1952)[28]
Bradfield Park, now Lindfield[25]
Chullora, a suburb of Sydney (1 August 1949 to 31 October 1967)
Greta, near Newcastle (1 June 1949 to 15 January 1960)
Uranquinty (1 December 1948 to 31 March 1959)
Other hostels in New South Wales included Adamstown, Balgownie, Bankstown, Berkeley, Bunnerong, Burwood, Cabramatta, Cronulla, Dundas, East Hills, Ermington, Goulburn, Katoomba, Kingsgrove, Kyeemagh, Leeton, Lithgow, Mascot, Matraville, Mayfield, Meadowbank, Nelson Bay, North Head, Orange, Parkes, Port Stephens, Randwick, St Marys, Scheyville, Schofields, Unanderra, Villawood, Wallerawang and Wallgrove.[26]
Victoria[edit]
Bonegilla (December 1947 to 17 March 1971)
Benalla (9 June 1949 to 30 May 1952)
Mildura (1950 to 17 July 1953)
Rushworth (1 June 1949 to 15 June 1953)
Sale West (1950 to 30 November 1953)
Somers (18 August 1949 to 14 February 1957)
Fishermen's Bend, Victoria 1952.
South Australia[edit]
Main article: Migrant hostels of South Australia
Elder Park
Gepps Cross
Glenelg
Pennington/Finsbury
Rosewater
Smithfield
Willaston
Woodside[29]
Western Australia[edit]
Northam Holden (15 August 1949 to 30 June 1957)
Graylands[24]
Cunderdin[24]
Breakdown of arrivals by decade[edit]
Immigrants who arrived in Australia (by decade of arrival) as a percentage of the total population, subdivided geographically by statistical local area, as of the 2011 census
1941-1950
1951-1960
1961-1970
1971-1980
1981-1990
1991-2000
Since 1950 Australia has experienced average arrivals of around one million per decade, with the totals in the earlier decades being slightly above the totals in the more recent decades. Current statistics suggest that one million will be reached again in the current decade.[4] The breakdown by decade is as follows:
1.6 million between October 1945 and 30 June 1960;
about 1.3 million in the 1960s;
about 960.000 in the 1970s;
about 1.1 million in the 1980s; and
over 900,000 in the 1990s.[4]
The highest number of arrivals in any one year since World War II was 185,099 in 1969-70 and the lowest was 52,752 in 1975-76.[4]
Period
Migration Programme [30]
2002–03 108,070
2003-2004 114,360
2004-2005 120,060
2005 142,933
2006 148,200
2007 158,630
2008 171,318
2011 185,000
2012 190,000
Demography as at 2006 for non-English speaking ethnic groups[edit]
In the 2006 census, birthplace was enumerated as was date of arrival in Australia for those not born in Australia. For the major immigrant groups enlarged by the arrival of immigrants to Australia after World War II, they are still major demographic groups in Australia:
Ethnic group
Persons born overseas[31]
Arrived 1979 or earlier[31]
Aged 60 years and over[31]
This compares with 18% of Australian residents
who were aged 60 or over at the time of the census[32]
Australian citizens[31]
Italian Australian 199,124 176,536 or 89% 63% 157,209 or 79%
Greek Australian 109,990 94,766 or 86% 60% 104,950 or 95%
German Australian 106,524 74,128 or 79% 46% 75,623 or 71%
Dutch Australian 78,924 62,495 or 79% 52% 59,502 or 75%
Croatian Australian 50,996 35,598 or 70% 43% 48,271 or 95%
Not all of those enumerated would have arrived as post-war migrants, specific statistics as at 2006 are not available.
See also[edit]
Immigration history of Australia
Demographics of Australia
References[edit]
^ Jump up to: a b c d e f g Price, CA (September 1998). "POST-WAR IMMIGRATION: 1945-1998". Journal of the Australian Population Association. 15 (2): 17.
^ Jump up to: a b c d e "Immigration to Australia During the 20th Century – Historical Impacts on Immigration Intake, Population Size and Population Composition – A Timeline" (pdf of 7 pages). Department of Immigration and Citizenship (Australia). 2001. Retrieved 2008-07-18.
Jump up ^ Jan Bassett (1986) pp. 138–39
^ Jump up to: a b c d e "Fact Sheet 2 - Key Facts in Immigration". Department of Immigration and Citizenship (Australia). 2008. Retrieved 2008-07-21.
Jump up ^ Tündern-Smith, Ann (2008-05-23). "What is the Fifth Fleet?". Fifth Fleet Press. Retrieved 2008-07-21.
Jump up ^ J. Franklin, 'Calwell, Catholicism and the origins of multicultural Australia', 2009.
Jump up ^ "Look at Life - Immigration to Australia 1950s 1960s" on YouTube
Jump up ^ "Ten Pound Poms". ABC Television (Australia). 1 November 2007.
Jump up ^ "Ten Pound Poms". Museum Victoria. 10 May 2009.
Jump up ^ cited in Michael Dugan and Josef Swarc (1984) p. 139
Jump up ^ "The Snowy Mountains Scheme". Cultureandrecreation.gov.au. 20 March 2008. Retrieved 14 July 2011.
^ Jump up to: a b c d e f g "Fact Sheet 4 - More than 60 Years of Post-war Migration". Department of Immigration and Citizenship (Australia). 2007. Retrieved 2008-07-18.
^ Jump up to: a b c Neumann, Klaus (2003). "Providing a 'home for the oppressed'? Historical perspectives on Australian responses to refugees". Australian Journal of Human Rights. Australian Human Rights Centre: Faculty of Law at the University of New South Wales. 9 (2). ISSN 1323-238X. Retrieved 2008-07-19.
^ Jump up to: a b c d e f g "Bonegilla Migrant Centre - Camp Block 19". Australian Heritage list. Aussie Heritage. 2007. Retrieved 2008-07-20.
Jump up ^ "Photograph of Mr Arthur Calwell with the Kalnins family - the 50,000th New Australian - CU914/1 (1949)". National Archives of Australia. Retrieved 2008-07-20.
Jump up ^ "The Snowy Mountains Scheme". Culture and recreation portal. Department of the Environment, Water, Heritage and the Arts (Australia). 2008. Retrieved 2008-07-20.
Jump up ^ 1950 = Third highest figure per Department of Immigration timeline: In 1919 Net Overseas Migration was 166,303 when troops returned from World War I and in 1988 it was 172,794.
Jump up ^ "Photograph of MMigrant Arrivals in Australia - 50,000th Dutch migrant, arrives in Australia aboard the SIBAJAK. Miss Scholte presents Australia's Minister for Immigration, Mr. H. E. Holt, with inscribed Delft plates, which she brought as goodwill gifts from Netherlands Government (1954)". National Archives of Australia. Retrieved 2008-07-20.
Jump up ^ "Marketing Migrants". Horizons (exhibition): The peopling of Australia since 1788. National Museum of Australia. Retrieved 2008-07-21.
Jump up ^ "Their Country's Good". Time. 21 November 1955. Retrieved 2008-07-21. Only in the decade since World War II has Australia, by means of a vast and wisely planned immigration scheme, banished the last vestiges of the emigration stigma. Last week the drums were beating as, with much eclat, bright and chirpy Barbara Porritt stepped ashore at Melbourne. She was Australia's millionth immigrant since 1945.
Jump up ^ "Immigration: Federation to Century's End 1901–2000" (pdf (64 pages)). Department of Immigration and Multicultural Affairs. October 2001. p. 25. Retrieved 2008-07-21.
Jump up ^ Department of Immigration and Multicultural Affairs: Settler arrivals by birthplace data not available prior to 1959. For the period July 1949 to June 1959, Permanent and Long Term Arrivals by Country of Last Residence have been included as a proxy for this data. When interpreting this data for some countries, it should be noted that in the period immediately after World War II, there were large numbers of displaced persons whose country of last residence was not necessarily the same as their birthplace.
Jump up ^ Note this period covers 11 years rather than a decade.
^ Jump up to: a b c d e Migrant accommodation
^ Jump up to: a b "Migrant Hostels in Australia". Retrieved December 22, 2012.
^ Jump up to: a b "Migrant hostels in New South Wales, 1946–78 – Fact sheet 170". Retrieved 2013-05-28.
Jump up ^ Premier Postal History. "Post Office List". Retrieved 2008-04-11.
Jump up ^ Bathurst Migrant Camp at the http://www.migrationheritage.nsw.gov.au site
Jump up ^ Hostel Stories, a site by the Migration Museum of South Australia
Jump up ^ https://www.border.gov.au/about/corporate/information/fact-sheets/02key
^ Jump up to: a b c d "2914.0.55.002 2006 Census Ethnic Media Package" (Excel download). Census Dictionary, 2006 (cat.no 2901.0). Australian Bureau of Statistics. 2007-06-27. Retrieved 2008-07-14.
Jump up ^ 3,602,573 Australian residents were aged 60 or over as a proportion of 19,855,288 from : "Cat. No. 2068.0 - 2006 Census Tables: Age (Full Classification List) by sex - Count of persons (excludes overseas visitors)". 2006 Census of Population and Housing Australia (Australia). Australian Bureau of Statistics. 2007-06-27. Retrieved 2008-07-21.
External links[edit]
Chinese Museum Chinese Immigration to Australia
NSW Migration Heritage Centre
fifthfleet.net - list of ships which brought Displaced Persons to Australia between 1947 and 1951. Accessed 19 October 2010
Ten Pound Pom Social Museum
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2-digit postcode areas Israel(defined through the first two postcode digits)
Postal codes in Israel (Hebrew: מיקוד, Mikud) are numeric and consist of seven digits. They are assigned from north to south, thus, Metula in the north has 1029200 as its postal code, and Eilat in the south was assigned 88xxxxx. Jerusalem postal codes start with the digit 9, although this does not correspond with its geographical location. Each postal code corresponds to a mail carrier route or RR, thus, when the letters are sorted by the postal code, they are assigned to a specific carrier.
Army unit postal codes start with a 0 and are not changed even if a unit is roaming.
Until February 2013, Israel postcodes were 5-digit. The change to 7-digit postcodes was first announced by the Israel Post service in March 2012, though implementation was postponed from 5 December 2012 to 1 February 2013.[1][2] Officially the 5-Digit codes remained valid until 31 January 2013, though they continue to be used widely.
References[edit]
Jump up ^ "איתור מיקוד". Israel Post, 05/03/2012. Retrieved 2012-10-31.
Jump up ^ "איתור כתובת לפי מיקוד - דואר ישראל". Israelpost.co.il. 2014-02-16. Retrieved 2016-02-14.
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Smallpox vaccine
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Smallpox vaccine being administered. Note the bifurcated needle.[1]
Smallpox vaccine, the first successful vaccine to be developed, was introduced by Edward Jenner in 1796. He followed up his observation that milkmaids who had previously caught cowpox did not later catch smallpox by showing that inoculated cowpox protected against inoculated smallpox. The word "vaccine" is derived from Variolae vaccinae (i.e. smallpox of the cow), the term devised by Jenner to denote cowpox and used in the long title of his An enquiry into the causes and effects of Variolae vaccinae, known by the name of cow pox.[2] Vaccination, the term which soon replaced cowpox inoculation and vaccine inoculation, was first used in print by Jenner's friend, Richard Dunning in 1800.[3] Initially, the terms vaccine/vaccination referred only to smallpox, but in 1881 Louis Pasteur proposed that to honour Jenner the terms be widened to cover the new protective inoculations being introduced.
Contents
[hide]
1 Variolation
2 Early vaccination
3 Developments in vaccine production and inoculation
4 Eradication of smallpox
5 Post-eradication vaccination
6 Other protection
7 Vaccine stockpiles
8 See also
9 References
10 Further reading
11 External links
Variolation[edit]
The mortality of the severe form of smallpox—variola major—was very high without vaccination, up to 35% in some outbreaks.[4] A method of inducing immunity known as inoculation, insufflation or "variolation" was practiced before the development of a modern vaccine and likely occurred in Africa and China well before the practice arrived in Europe.[5] It may also have occurred in India, but this is disputed; other investigators contend the ancient Sanskrit medical texts of India do not describe these techniques.[5][6] The first clear reference to smallpox inoculation was made by the Chinese author Wan Quan (1499–1582) in his Douzhen xinfa (痘疹心法) published in 1549.[7] Inoculation for smallpox does not appear to have been widespread in China until the reign era of the Longqing Emperor (r. 1567–1572) during the Ming Dynasty.[8] In China, powdered smallpox scabs were blown up the noses of the healthy. The patients would then develop a mild case of the disease and from then on were immune to it. The technique did have a 0.5–2.0% mortality rate, but that was considerably less than the 20–30% mortality rate of the disease itself. Two reports on the Chinese practice of inoculation were received by the Royal Society in London in 1700; one by Dr. Martin Lister who received a report by an employee of the East India Company stationed in China and another by Clopton Havers.[9] According to Voltaire (1742), the Turks derived their use of inoculation to neighbouring Circassia. Voltaire does not speculate on where the Circassians derived their technique from, though he reports that the Chinese have practiced it "these hundred years".[10]
Variolation was also practiced throughout the latter half of the 17th century by physicians in Turkey, Persia, and Africa. In 1714 and 1716, two reports of the Ottoman Empire Turkish method of inoculation were made to the Royal Society in England, by Emmanuel Timoni, a doctor affiliated with the British Embassy in Constantinople,[11] and Giacomo Pylarini. Lady Mary Wortley Montagu, wife of the British ambassador to Ottoman Constantinople, is widely credited with introducing the process to Great Britain in 1721. Source material tells us on Montagu; "When Lady Mary was in the Ottoman Empire, she discovered the local practice of inoculation against smallpox called variolation."[12] In 1718 she had her son, aged five variolated. He recovered quickly. She returned to London and had her daughter variolated in 1721 by Charles Maitland, during an epidemic of smallpox. This encouraged the British Royal Family to take an interest and a trial of variolation was carried out on prisoners in Newgate Prison. This was successful and in 1722 Princess Augusta, the Princess of Wales, allowed Maitland to vaccinate her children.[13] The success of these variolations assured the British people that the procedure was safe.[11]
“ ...scarred the wrists, legs, and forehead of the patient, placed a fresh and kindly pock in each incision and bound it there for eight or ten days, after this time the patient was credibly informed. The patient would then develop a mild case [of smallpox], recover, and thereafter be immune.[14] ”
— Dr. Peter Kennedy
Stimulated by a severe epidemic, variolation was first employed in North America in 1721. The practice had been known in Boston since 1706, when Cotton Mather (of Salem witch trial fame) discovered his slave, Onesimus had been inoculated while still in Africa, and many slaves imported to Boston had also received inoculations.[15] The practice was, at first, widely criticized.[16] However, a limited trial showed six deaths occurred out of 244 who were variolated (2.5%), while 844 out of 5980 died of natural disease (14%), and the process was widely adopted throughout the colonies.[17]
The inoculation technique was documented as having a mortality rate of only one in a thousand. Two years after Kennedy's description appeared, March 1718, Dr. Charles Maitland successfully inoculated the five-year-old son of the British ambassador to the Turkish court under orders from the ambassador's wife Lady Mary Wortley Montagu, who four years later introduced the practice to England.[18]
An account from letter by Lady Mary Wortley Montagu to Sarah Chiswell, dated 1 April 1717, from the Turkish Embassy describes this treatment:
The small-pox so fatal and so general amongst us is here entirely harmless by the invention of ingrafting (which is the term they give it). There is a set of old women who make it their business to perform the operation. Every autumn in the month of September, when the great heat is abated, people send to one another to know if any of their family has a mind to have the small-pox. They make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nutshell full of the matter of the best sort of small-pox and asks what veins you please to have opened. She immediately rips open that you offer to her with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much venom as can lye upon the head of her needle, and after binds up the little wound with a hollow bit of shell, and in this manner opens four or five veins. . . . The children or young patients play together all the rest of the day and are in perfect health till the eighth. Then the fever begins to seize them and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty in their faces, which never mark, and in eight days time they are as well as before the illness. . . . There is no example of any one that has died in it, and you may believe I am very well satisfied of the safety of the experiment since I intend to try it on my dear little son. I am patriot enough to take pains to bring this useful invention into fashion in England, and I should not fail to write to some of our doctors very particularly about it if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue for the good of mankind, but that distemper is too beneficial to them not to expose to all their resentment the hardy wight that should undertake to put an end to it. Perhaps if I live to return I may, however, have courage to war with them.[19]
Early vaccination[edit]
Dr Edward Jenner performing his first vaccination on James Phipps, a boy of age 8. May 14th, 1796. Painting by Ernest Board (early 20th century).
In the early empirical days of vaccination, before Pasteur's work on establishing the germ theory and Lister's on antisepsis and asepsis, there was considerable cross-infection. William Woodville, one of the early vaccinators and director of the London Smallpox Hospital is thought to have contaminated the cowpox matter—the vaccine—with smallpox matter and this essentially produced variolation. Other vaccine material was not reliably derived from cowpox, but from other skin eruptions of cattle.[20] In modern times, an effective scientific model and controlled production were important in reducing these causes of apparent failure or iatrogenic illness.
During the earlier days of empirical experimentation in 1758, American Calvinist Jonathan Edwards died from a smallpox inoculation. Some of the earliest statistical and epidemiological studies were performed by James Jurin in 1727 and Daniel Bernoulli in 1766.[21] In 1768 Dr John Fewster reported that variolation induced no reaction in persons who had had cowpox.[22] Fewster was a contemporary and friend of Jenner. Dr. Rolph, another Gloucestershire physician, stated that all experienced physicians of the time were aware of this.[citation needed]
An 1802 caricature by James Gillray depicting the early controversy surrounding Jenner's vaccination theory
Edward Jenner was born in Berkeley, England. At the age of 13, he was apprenticed to apothecary Daniel Ludlow and later surgeon George Hardwick in nearby Sodbury. He observed that people who caught cowpox while working with cattle were known not to catch smallpox. Jenner assumed a causal connection but the idea was not taken up at that time. From 1770 to 1772 Jenner received advanced training in London at St Georges Hospital and as the private pupil of John Hunter, then returned to set up practice in Berkeley.[3] When a smallpox epidemic occurred he advised the local cattle workers to be inoculated, but they told him that their previous cowpox infection would prevent smallpox. This confirmed his childhood suspicion, and he studied cowpox further, presenting a paper on it to his local medical society.
Perhaps there was already an informal public understanding of some connection between disease resistance and working with cattle. The "beautiful milkmaid" seems to have been a frequent image in the art and literature of this period. But it is known for certain that in the years following 1770, at least six people in England and Germany (Sevel, Jensen, Jesty 1774, Rendall, Plett 1791) tested successfully the possibility of using the cowpox vaccine as an immunization for smallpox in humans.[23] In 1796, Sarah Nelmes, a local milkmaid, contracted cowpox and went to Jenner for treatment. Jenner took the opportunity to test his theory. He inoculated James Phipps, the eight-year-old son of his gardener, with material taken from the cowpox lesions on Sarah's hand. After a mild fever and the expected local lesion James recovered after a few days. About two months later Jenner inoculated James on both arms with material from a case of smallpox, with no effect; the boy was immune to smallpox.
The process above shows the steps taken by Edward Jenner to create vaccination. Jenner did this by inoculating James Phipps with cowpox, a similar virus to smallpox, to create immunity, unlike variolation, which used smallpox to create an immunity to itself.
Jenner sent a paper reporting his observations to the Royal Society in April 1797. Its contents are unknown. It was not submitted formally and there is no mention of it in the Society's records. Jenner had sent the paper informally to Sir Joseph Banks, the Society's president, who asked Everard Home for his views. His report, published for the first time in 1999, was sceptical and called for further vaccinations.[24] These were done and in 1798 Jenner published an analysis of 23 'cases' including several individuals who had resisted natural exposure after previous cowpox. It is not known how many Jenner vaccinated or challenged by inoculation with smallpox virus; e.g. Case 21 included 'several children and adults'. Crucially all of at least four who Jenner deliberately inoculated with smallpox virus resisted it. These included the first and last patients in a series of arm-to-arm transfers. He concluded that cowpox inoculation was a safe alternative to smallpox inoculation, but rashly claimed that the protective effect was lifelong. This last proved to be incorrect.[2] Jenner also tried to distinguish between 'True' cowpox which produced the desired result and 'Spurious' cowpox which was ineffective and/or produced severe reaction. Modern research suggests Jenner was trying to distinguish between effects caused by what would now be recognised as noninfectious vaccine, a different virus (e.g. paravaccinia/milker's nodes), or contaminating bacterial pathogens. This caused confusion at the time, but would become important criteria in vaccine development.[25] A further source of confusion was Jenner's belief that fully effective vaccine obtained from cows originated in an equine disease, which he mistakenly referred to as grease. This was criticised at the time but vaccines derived from horsepox were soon introduced and later contributed to the complicated problem of the origin of vaccinia virus, the virus in present-day vaccine.[26]:165–178
By 1800, Jenner's work had been published in all the major European languages and had reached Benjamin Waterhouse in the United States — an indication of rapid spread and deep interest.[27] The introduction of the vaccine to the New World took place in Trinity, Newfoundland, in 1798 by Dr. John Clinch, boyhood friend and medical colleague of Jenner.[28][29] Despite some concern about the safety of vaccination the mortality using carefully selected vaccine was close to zero, and it was soon in use all over Europe and the United States.[30][31]
The Balmis Expedition took the vaccine to Spanish America in 1804
In 1804 the Balmis Expedition, an official Spanish mission commanded by Francisco Javier de Balmis, sailed to spread the vaccine throughout the Spanish Empire, first to the Canary Islands and on to Spanish Central America. While his deputy, José Salvany, took vaccine to the west and east coasts of Spanish South America, Balmis sailed to Manila in the Philippines and on to Canton and Macao on the Chinese coast. He returned to Spain in 1806.[32]
The question of who first tried cowpox inoculation/vaccination cannot be answered with certainty. Most, but still limited, information is available for Benjamin Jesty, Peter Plett and John Fewster. In 1774 Jesty, a farmer of Yetminster in Dorset, observing that the two milkmaids living with his family were immune to smallpox, inoculated his family with cowpox to protect them from smallpox. He attracted a certain amount of local criticism and ridicule at the time then interest waned. Attention was later drawn to Jesty, and he was brought to London in 1802 by critics jealous of Jenner's prominence at a time when he was applying to Parliament for financial reward.[33] During 1790–92 Peter Plett, a teacher from Holstein, reported limited results of cowpox inoculation to the Medical Faculty of the University of Kiel. However, the Faculty favoured variolation and took no action.[34] John Fewster, a surgeon friend of Jenner's from nearby Thornbury, discussed the possibility of cowpox inoculation at meetings as early as 1765. He may have done some cowpox inoculations in 1796 at about the same time that Jenner vaccinated Phipps. However Fewster, who had a flourishing variolation practice, may have considered this option but used smallpox instead. He thought vaccination offered no advantage over variolation, but maintained friendly contact with Jenner and certainly made no claim of priority for vaccination when critics attacked Jenner's reputation.[35] It seems clear that the idea of using cowpox instead of smallpox for inoculation was considered, and actually tried in the late 18th century, and not just by the medical profession. Therefore, Jenner was not the first to try cowpox inoculation. However, he was the first to publish his evidence and distribute vaccine freely, provide information on selection of suitable material, and maintain it by arm-to-arm transfer. The authors of the official World Health Organization (WHO) account Smallpox and its Eradication assessing Jenner's role wrote:[36]
Publication of the Inquiry and the subsequent energetic promulgation by Jenner of the idea of vaccination with a virus other than variola virus constituted a watershed in the control of smallpox for which he, more than anyone else deserves the credit.
As vaccination spread, some European countries made it compulsory. Concern about its safety led to opposition and then repeal of legislation in some instances.[37][38] Compulsory infant vaccination was introduced in England by the 1853 Vaccination Act. By 1871, parents could be fined for non-compliance, and then imprisoned for non-payment.[39] This intensified opposition, and the 1898 Vaccination Act introduced a conscience clause. This allowed exemption on production of a certificate of conscientious objection signed by two magistrates. Such certificates were not always easily obtained and a further Act in 1907 allowed exemption by a statutory declaration which could not be refused. Although theoretically still compulsory, the 1907 Act effectively marked the end of compulsory infant vaccination in England.[40]
In the United States vaccination was regulated by individual states, the first to impose compulsory vaccination being Massachusetts in 1809. There then followed sequences of compulsion, opposition and repeal in various states. By 1930 Arizona, Utah, North Dakota and Minnesota prohibited compulsory vaccination, 35 states allowed regulation by local authorities, or had no legislation affecting vaccination, whilst in ten states, including Washington D.C. and Massachusetts, infant vaccination was compulsory.[41] Compulsory infant vaccination was regulated by only allowing access to school for those who had been vaccinated.[42] Those seeking to enforce compulsory vaccination argued that the public good overrode personal freedom, a view supported by the U.S. Supreme Court in Jacobson v. Massachusetts in 1905, a landmark ruling which set a precedent for cases dealing with personal freedom and the public good.
Louis T. Wright,[43] an African American and Harvard Medical School graduate (1915), introduced intradermal vaccination for smallpox for the soldiers while serving in the Army during World War I.[44]
Developments in vaccine production and inoculation[edit]
Until the end of the 19th Century vaccination was done either directly with vaccine produced on the skin of calves or, particularly in England, with vaccine obtained from the calf but then maintained by arm-to-arm transfer;[45] initially in both cases vaccine could be dried on ivory points for short term storage or transport but increasing use was made of glass capillary tubes for this purpose towards the end of the century.[46] During this period there were no adequate methods for assessing the safety of the vaccine and there were instances of contaminated vaccine transmitting infections such as erysipelas, tetanus, septicaemia and tuberculosis.[25] In the case of arm-to-arm transfer there was also the risk of transmitting syphilis. Although this did occur occasionally, estimated as 750 cases in 100 million vaccinations,[47] some critics of vaccination e.g. Charles Creighton believed that uncontaminated vaccine itself was a cause of syphilis.[48] Smallpox vaccine was the only vaccine available during this period, and so the determined opposition to it initiated a number of vaccine controversies that spread to other vaccines and into the 21st century.
Sydney Arthur Monckton Copeman, an English Government bacteriologist interested in smallpox vaccine investigated the effects on the bacteria in it of various treatments, including glycerine. Glycerine was sometimes used simply as a diluent by some continental vaccine producers. However, Copeman found that vaccine suspended in 50% chemically-pure glycerine and stored under controlled conditions contained very few "extraneous" bacteria and produced satisfactory vaccinations.[49] He later reported that glycerine killed the causative organisms of erysipelas and tuberculosis when they were added to the vaccine in "considerable quantity", and that his method was widely used on the continent.[45] In 1896, Copeman was asked to supply "extra good calf vaccine" to vaccinate the future Edward VIII.[50]
Vaccine produced by Copeman's method was the only type issued free to public vaccinators by the English Government Vaccine Establishment from 1899. At the same time the 1898 Vaccination Act banned arm-to-arm vaccination, thus preventing transmission of syphilis by this vaccine. However, private practitioners had to purchase vaccine from commercial producers.[51] Although proper use of glycerine reduced bacterial contamination considerably the crude starting material, scraped from the skin of infected calves, was always heavily contaminated and no vaccine was totally free from bacteria. A survey of vaccines in 1900 found wide variations in bacterial contamination. Vaccine issued by the Government Vaccine Establishment contained 5,000 bacteria per gram, while commercial vaccines contained up to 100,000 per gram.[52] The level of bacterial contamination remained unregulated until the Therapeutic Substances Act, 1925 set an upper limit of 5,000 per gram, and rejected any batch of vaccine found to contain the causative organisms of erysipelas or wound infections.[25] Unfortunately glycerolated vaccine soon lost its potency at ambient temperatures which restricted its use in tropical climates. However, it remained in use into the 1970s where a satisfactory cold chain was available. Animals continued to be widely used by vaccine producers during the Smallpox Eradication Campaign. A WHO survey of 59 producers, some of whom used more than one source of vaccine, found that 39 used calves, 12 used sheep and 6 used water buffalo, whilst only 3 made vaccine in cell culture and 3 in embryonated hens' eggs.[53] English vaccine was occasionally made in sheep during World War I but from 1946 only sheep were used.[46]
In the late 1940s and early 1950s, Leslie Collier, an English microbiologist working at the Lister Institute of Preventive Medicine, developed a method for producing a heat-stable freeze-dried vaccine in powdered form.[54][55] Collier added 0.5% phenol to the vaccine to reduce the number of bacterial contaminants but the key stage was to add 5% peptone to the liquid vaccine before it was dispensed into ampoules. This protected the virus during the freeze drying process. After drying the ampoules were sealed under nitrogen. Like other vaccines, once reconstituted it became ineffective after 1–2 days at ambient temperatures. However, the dried vaccine was 100% effective when reconstituted after 6 months storage at 37 °C (99 °F) allowing it to be transported to, and stored in, remote tropical areas. Collier's method was increasingly used and, with minor modifications, became the standard for vaccine production adopted by the WHO Smallpox Eradication Unit when it initiated its global Smallpox Eradication Campaign in 1967, at which time 23 of 59 manufacturers were using the Lister strain.[56]
In a letter about landmarks in the history of smallpox vaccine, written to and quoted from by Derrick Baxby, Donald Henderson, chief of the Smallpox Eradication Unit from 1967–77 wrote; "Copeman and Collier made an enormous contribution for which neither, in my opinion ever received due credit".[57]
Smallpox vaccine was inoculated by scratches into the superficial layers of the skin and a wide variety of instruments was used to achieve this. They ranged from simple needles to multi-pointed and multi-bladed spring-operated instruments specifically designed for the purpose.[58]
A major contribution to smallpox vaccination was made in the 1960s by Benjamin Rubin, an American microbiologist working for Wyeth Laboratories. Based on initial tests with textile needles with the eyes cut off transversely half-way he developed the bifurcated needle. This was a sharpened two-prong fork designed to hold one dose of reconstituted freeze-dried vaccine by capillarity.[1] Easy to use with minimum training, cheap to produce ($5 per 1000), using 4 times less vaccine than other methods, and repeatedly re-usable after flame sterilization, it was used globally in the WHO Smallpox Eradication Campaign from 1968.[59] Rubin estimated that it was used to do 200 million vaccinations per year during the last years of the campaign.[1] Those closely involved in the campaign were awarded the "Order of the Bifurcated Needle". This, a personal initiative by Donald Henderson, was a lapel badge, designed and made by his daughter, formed from the needle shaped to form an "O". This represented "Target Zero", the objective of the campaign.[60]
Eradication of smallpox[edit]
Smallpox eradication promotional poster
Main article: Smallpox § Eradication
Smallpox was eradicated by a massive international search for outbreaks, backed up with a vaccination program, starting in 1967. It was organised and co-ordinated by a World Health Organization (WHO) unit, set up and headed by Donald Henderson. The last case in the Americas occurred in 1971 (Brazil), south-east Asia (Indonesia) in 1972, and on the Indian subcontinent in 1975 (Bangladesh). After two years of intensive searches, what proved to be the last endemic case anywhere in the world occurred in Somalia, in October 1977.[61] A Global Commission for the Certification of Smallpox Eradication chaired by Frank Fenner examined the evidence from, and visited where necessary, all countries where smallpox had been endemic. In December 1979 they concluded that smallpox had been eradicated; a conclusion endorsed by the WHO General Assembly in May 1980.[62] However, even as the disease was being eradicated there still remained stocks of smallpox virus in many laboratories. Accelerated by two cases of smallpox in 1978, one fatal (Janet Parker), caused by an accidental and unexplained containment breach at a laboratory at the University of Birmingham Medical School, the WHO ensured that known stocks of smallpox virus were either destroyed or moved to safer laboratories. By 1979 only four laboratories were known to have smallpox virus. All English stocks held at St Mary's Hospital, London were transferred to more secure facilities at Porton Down and then to the US at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia in 1982, and all South African stocks were destroyed in 1983. By 1984 the only known stocks were kept at the CDC in the US and the State Research Center of Virology and Biotechnology (VECTOR) in Koltsovo, Russia.[63] These states report that their repositories are for possible antibioweaponry research and insurance if some obscure reservoir of natural smallpox is discovered in the future.
Post-eradication vaccination[edit]
Although Jenner used cowpox, the vaccine now contains a virus immunologically related to cowpox and smallpox viruses called vaccinia which causes a mild infection. The vaccine is infectious which improves its effectiveness, but causes serious complications for people with impaired immune systems (for example chemotherapy and AIDS patients, and people with eczema), and is not yet considered safe for pregnant women. A woman planning on conceiving within one month should not receive the smallpox immunization until after the pregnancy. In the event of an outbreak, the woman should delay pregnancy if possible. Vaccines that only contain attenuated vaccinia viruses (an attenuated virus is one in which the pathogenicity has been decreased through serial passage) have been proposed, but some researchers have questioned the possible effectiveness of such a vaccine. According to the Centers for Disease Control and Prevention (CDC), "vaccination within 3 days of exposure will prevent or significantly lessen the severity of smallpox symptoms in the vast majority of people. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may modify the severity of disease." This, along with vaccinations of so-called first-responders, is the current plan of action being devised by the United States Department of Homeland Security (including Federal Emergency Management Agency) in the United States.
Starting in early 2003, the United States government quietly started vaccinating 500,000 volunteer health care professionals, throughout the country. Vaccinees were healthcare workers in emergency departments, intensive care units, anesthesiologists, and health care workers in other settings who would be crucial first-line responders in the event of a bioterrorist attack using smallpox. Many healthcare workers refused, worried about vaccine side effects, but many others volunteered. It is unclear how many actually received the vaccine. In 2002, the Israeli army, in a similar attempt at mass vaccination, found many soldiers unwilling to volunteer.
In May 2007, the Vaccines and Related Biological Products Advisory Committee of the FDA voted unanimously that a new live virus vaccine produced by Acambis, ACAM2000, is both safe and effective for use in persons at high risk of exposure to smallpox virus. However, due to the high rate of serious adverse effects, the vaccine will only be made available to the CDC (a part of the United States Department of Health and Human Services) for the Strategic National Stockpile.[64]
Other protection[edit]
Recent studies suggest the smallpox vaccine provides some level of defense against HIV. Both the smallpox vaccine and HIV exploit a receptor called CCR5, which is expressed on the surface of white blood cells. Researchers theorize that one factor in the sudden spread of HIV in the early 1980s was the result of successful eradication of smallpox in the late 1970s followed by an abrupt decline in smallpox vaccinations worldwide. The smallpox vaccine appeared to have been reducing HIV replication five-fold.[65]
Studies also show that smallpox vaccine is associated with a tendency for reduced risk of asthma,[66] and significantly reduced risk of malignant melanoma [67] and infectious disease hospitalizations.[68]
In low-income countries, having a smallpox vaccine scar has been associated with non-specific reductions of more than 40% in overall mortality among adults.[69][70] However no randomized trials testing the effect of smallpox vaccine on overall mortality and morbidity have been conducted.
Vaccine stockpiles[edit]
In late 2001, the governments of the United States and the United Kingdom considered stockpiling smallpox vaccines, even while assuring the public that there was no "specific or credible" threat of bioterrorism.[71] Later, the director of State Research Center of Virology and Biotechnology VECTOR warned that terrorists could easily lure underpaid former Soviet researchers to turn over samples to be used as a weapon, saying "All you need is a sick fanatic to get to a populated place. The world health system is completely unprepared for this."[72]
In the United Kingdom, controversy occurred regarding the company which had been contracted to supply the vaccine. This was because of the political connections of its owner, Paul Drayson, and questions over the choice of vaccine strain. The strain was different from that used in the United States.[73] Plans for mass vaccinations in the United States stalled as the necessity of the inoculation came into question.[74]
See also[edit]
Kinepox
John Clinch, first doctor to test the smallpox vaccine in North America
Eczema vaccinatum
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Further reading[edit]
Metzger W, Mordmueller BG (2007). Metzger, Wolfram, ed. "Vaccines for preventing smallpox". Cochrane Database Syst Rev (3): CD004913. doi:10.1002/14651858.CD004913.pub2. PMID 17636779.
External links[edit]
Smallpox Vaccine: Contraindications, Administration, and Adverse Reactions
CDC Smallpox Home
Quick Guide to Preexposure Smallpox Vaccination
The 1911 Encyclopædia Britannica article on Vaccination
Early smallpox Vaccination Certificate Norway 1821 Norwegian and English Text
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