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HISTORY

How 22 Spanish orphans became ‘the vaccine’ to beat smallpox in the Americas

This is the unlikely story of how in 1803 one doctor, one ship and 22 Spanish orphans serving as human fridges helped the world beat smallpox by carrying out the first international vaccination campaign.

How 22 Spanish orphans became 'the vaccine' to beat smallpox in the Americas
British physician Edward Jenner may have administered the first vaccine but it was a Spanish doctor that helped to export the inoculation around the world. Painting: Ernest Board (1806)

We’re living through a time in history where the emergence and resurgence of viruses is becoming more prevalent, from the ongoing Covid-19 pandemic to the appearance of monkeypox, with several cases recently recorded in Spain, Portugal and the UK.

Monkeypox is a similar virus to smallpox, a devastating illness that was finally eradicated in 1980. The virus causes high fever, body aches, headaches and chills, as well as a rash of boils or sores. 

READ ALSO: Eight suspected monkeypox cases detected in Spain

While historians and scientists believe that smallpox has been around for the last 3,000 years, monkeypox was first discovered in 1958 when two outbreaks occurred in a group of monkeys kept for research. The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo.

The first vaccine

During the 18th century, smallpox was rife throughout the world and was killing millions. It was around this time that English doctor Edward Jenner saw that people who caught the milder bovine virus of cowpox never actually caught the deadlier smallpox.

So in 1796, he took the pus from a cowpox lesion on a milkmaid’s hand and inoculated an eight-year-old boy named James Phipps, rendering him immune to smallpox and creating the world’s first vaccine.

But it was in fact Spain that played a pivotal role in getting this vaccine out to the masses and helping to bring the smallpox virus under control. 

How did they transport vaccines in the 18th and 19th century?

Even today, transporting vaccines proves to be problematic, best evidenced by the specific temperature and storage requirements of some of the Covid-19 vaccines, as well the logistical delays and other distribution obstacles.

But back in the early 19th century, doctors and scientists came up against even more problems.

Health professionals at the time invented an ingenious method of taking the puss-like fluid from the sores of those with cowpox and placing it on a piece of material to dry out.

They would then travel to the next town and mix the dried puss with water, before scratching it into people’s skin to infect them with cowpox, thus protecting them from smallpox.

This method seemed to work in Europe, where distances between towns were relatively close.

The arrival of Spain’s Conquistadores in America led to the spread of viruses such as smallpox among native populations, killing millions, including the Aztecs of present-day Mexico.

However, the vaccine wouldn’t stay fresh long enough to take it further across the seas to the Americas. It wouldn’t even work for distances from one European capital to the next, only from town to town. 

Children become the vaccine carriers

This is where Spain comes in. The colonial power was desperate to send the vaccine over to its South American territories, where the virus was running rampant throughout the population, killing around half of those it infected.

In 1803, a doctor from Alicante in eastern Spain, Francisco Javier de Balmis, came up with a plan and asked Spain’s King Carlos IV, whose own daughter had died of smallpox, to fund a new mission.

His plan was to sail to the Americas with 22 Spanish orphans on board, infecting them with cowpox along the way, a plan that wouldn’t have much chance of being approved in this day and age due to human rights laws, but this was the early 18th century.

Francisco Javier de Balmis was integral in helping the first international vaccine campaign. Source: Foundling / WikiCommons

The cowpox vaccine only survived in the body for up to 12 days, so at the beginning of the journey only two of the orphans were infected with smallpox. Then, ten days later when they were sick enough and had boils all over their skin, doctors on board would lance these sores and infect two more boys. The aim was to keep this going every ten days until they reached South America.

Miraculously, the plan of using the orphans as vessels for the virus worked, and although all the children got sick, none of them died.

By the time the ship docked in Venezuela in March 1804, one boy still had fresh sores and puss which could be used to vaccinate the local population. 

Balmis and his team set about vaccinating the locals straight away and then split up, with half the team travelling through what is today Colombia, Ecuador, Peru, and Bolivia and the other half up to Mexico.

Amazingly, using this method of lancing boils and moving from town to town, they managed to vaccinate around 200,000 people, most of whom were children.

Locals who received news of their arrival would greet the heroes with all the flamboyance of a Spanish fiesta – complete with music, bullfights and fireworks. 

The mission was not yet complete

Balmis left the 22 original orphans with adoptive families in Mexico and then set out on a new voyage with a brand new set of children for the Spanish colony of the Philippines.

The ship arrived in April 1805 and again astonishingly the plan worked. Here, Blamís and his team were able to vaccinate a further 20,000. 

This vaccination plan was so successful again, that Balmis took the vaccine to China to keep inoculating the population there too. 

Thanks to the ingenious methods of one Spanish doctor and the bravery of 22 Spanish orphans, Jenner’s original vaccine was able to reach the far corners of the world, vaccinating hundreds of thousands and saving countless lives. 

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HEALTH

How many hours do I have to work to get access to public healthcare in Spain?

A common question among those wanting to move to Spain is if they will have access to the Spanish public healthcare system even if they only work part time or a few hours a week.

How many hours do I have to work to get access to public healthcare in Spain?

In order to understand the answer to this question, you need to be aware of several rules on who has the right to public healthcare in Spain. 

In Spain, you have the right to access public healthcare under the following circumstances:

  • You are an employee or self-employed and are affiliated and registered with the social security system
  • You receive Spain’s state pension
  • You are the recipient of benefits, including unemployment benefits or subsidies.
  • You have exhausted your unemployment benefit or subsidy or other benefits of a similar nature and are unemployed and residing in Spain
  • Children under the age of 15
  • Students under the age of 26

You also have the right to healthcare if your spouse pays into the social security system or if you’re pregnant.

READ ALSO: Does permanent residency in Spain equal free public healthcare?

But what happens if you are an employee, but you only work part-time, does the number of hours you work affect whether you have the right to public healthcare coverage?

Even if you work part-time (or media jornada in Spanish), you will still be paying into the social security system automatically – part of it from your salary and part of it from your employer.

Therefore you will be affiliated in the social security system as in point one above. 

According to stats from Spain’s National Statistics Institute (INE), a total of 6.6 percent of men in Spain in 2022 worked part-time and 21.6 percent of women. In September 2023, there were 2.9 million part-time employees in the country.

As far as social security is concerned, those who work part-time benefit the same as those working full-time when it comes to national healthcare, regardless of the length of their day. Part-time contributions count as one full day when it comes to paying social security.

READ ALSO: What to be aware of before accepting a part-time job in Spain

This rule, equating part-time work to full-time work was brought into force on October 1st 2023 in order to try and help reduce the gender pay gap in Spain, but was designed with the pension system in mind rather than national health coverage.

The advantage is that it also benefits those who want to work part-time and still be able to access healthcare. Even before this was brought into force, however, those working part-time and paying social security were still covered. 

All this means that there isn’t a specific number of hours you must work in order to be able to be covered under the Spanish healthcare system, and as long as you’re paying social security or fall into one of the categories above, you will be able to benefit from it.

Remember that if you’re not employed or self-employed in Spain and don’t have a spouse who is either, then you may not be covered.

To get around this you can either join a programme such as the S1 scheme for British pensioners or pay the convenio especial in order to benefit from public healthcare. For this, you will pay a monthly fee of €60 if you are under 65 and €157 if you are over 65. 

If none of these options are available to you or the requirements of your visa say so, then it’s necessary to get private health insurance instead.

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