“Who saves one human life, it is as if he has saved all mankind” (Q 5:32)
Contagious diseases have existed since ancient times. Smallpox, for which the first vaccine was developed, is believed to have infected humans since the time of the earliest agricultural settlements some 12,000 years ago although not much evidence exists until the New Kingdom of Egypt (1570 to 1085 BCE). Skin lesions resembling those of smallpox were found on mummies including Ramses V (r.1150–1145 BCE), who seems to have had raised spots on his face and body for which smallpox is named (derived from the Latin word for “spotted”).
Smallpox was described as early as 1122 BCE in China. Historians speculate that smallpox brought about the devastating Plague of Athens in 430 BCE and the Antoine Plague of 165 -180 CE; it spread around the world in the sixth century by colonials and merchants travelling along trade routes.
Smallpox was first identified as a disease distinct from measles by the Persian physician Abu Bakr Muhammad Zakariyya Razi (d. ca. 925), known in the West as Rhazes. In his book titled On Smallpox and Measles (al-Judari wa al-Hasbah) he describes the two diseases as being unique from each other.
This text was translated into Latin as De variolis et morbillis and became “a landmark in the development of the concept of specific disease entities and the value of diagnostic precision” (The Medical Influence of Rhazes, Encyclopedia.com).
The practice of immunisation (from the Latin immuitas, meaning ‘exemption from taxes’) has had a long history: Buddhist monks drank snake venom for immunity to snake bites, and variolation was practised to treat smallpox in ancient China, Turkey, parts of Africa, and popularised in Europe around 1721. This form of immunisation involved inserting powdered smallpox scabs or fluids from the pustules of an infected person into a cut made in the skin of the person being immunised. This led to a mild infection of the disease, but induced immunity to the virus. Some historians date this practice to 200 BCE (History of Vaccines).
In 1796, English doctor Edward Jenner (d. 1823) performed an experiment, inserting pus from a milkmaid who had contracted cowpox (an eruptive bovine disease which spread to humans and devastated humankind for many centuries) into the arms of a healthy eight-year-old boy. Jenner concluded that a person could be protected from smallpox without having to be directly exposed to it. This was the world’s first successful vaccine, a term that Jenner himself coined – vaccinia from the Latin vacca, meaning ‘cow.’
Jenner’s innovation, to create immunity to smallpox, quickly made the practice widespread, undergoing medical and technological changes over the next 200 years, eventually resulting in the eradication of smallpox in the late 1970s. Several vaccines were developed over the centuries for numerous diseases such as by Louis Pasteur for chicken cholera (1879) and rabies (1885), and by other scientists for diphtheria, tetanus, cholera, anthrax, among others.
Russian doctor Waldemar Haffkine was working in British India developing a vaccine for cholera when the region was struck by the bubonic plague beginning in 1896. He advised the British government in Bombay that the best measure to stop the spread of the virus would be innoculation. In his Memoirs (Cassell, 1954), Mawlana Sultan Muhammad Shah describes the situation:
“It was a grim period. The plague had its ugly, traditional effect on public morals. Respect for law and order slipped ominously. There were outbreaks of looting and violence. Drunkenness and immorality increased; and there was a great deal of bitter feeling against the Government for the haphazard and inefficient way in which they were tackling the crisis…” (p 37).
Dr Haffkine “was convinced that inoculation offered a method of combating bubonic plague. He pressed his views on official quarters in Bombay without success… Meanwhile people were dying like flies – among them my own followers” (p 37-38).
Imam offered one of his residences to Dr Haffkine to conduct research to develop a vaccine. He stayed at Imam’s residence for two years, conducting his research until eventually the government of India, “convinced of the success of his methods, took over the whole research project and put it on a proper, adequate, and official footing” (Ibid).
When the vaccine was available, there was large-scale mistrust of the colonials in British India, hence vaccine hesitancy was rampant. Imam said:
“It was in my power to set an example. I had myself publicly inoculated, and I took care to see that the news of what I had done was spread as far as possible as quickly as possible. My followers could see for themselves that I, their Imam, having in full view of many witnesses submitted myself to this mysterious and dreaded process, had not thereby suffered. The immunity, of which my continued health and my activities were obvious evidence, impressed itself on their consciousness and conquered their fear (Ibid).” Mawlana Sultan Muhammad Shah was twenty years old.
(More at Nimirasblog)
Due to the highly contagious nature of the viruses, travellers were required to provide a proof of immunisation in order to enter various ports (hence, ‘pass-ports’) or before boarding trains and ships. During the smallpox pandemic, the scars on the arms were the first ‘passports.’ Subsequently, travellers carried a yellow card that had a record of their immunisation.
A health pass issued by officials of Montecchio in Italy in 1722 promises that since their land “is, by the grace of God, free and safe from any suspicion of the plague,” the bearer may depart from Reggio.
In an interview with NPR, Dr Sanjoy Bhattacharya, professor in the History of Medicine at the University of York, England, states that confirmation of having taken the vaccine for smallpox was a pre-requisite for pilgrims entering towns such as Pandharpur in British India or going to Mecca for the Hajj. At that time, vaccinations were given at government centers, which handed out a certificate to those who got the vaccine (Mira Patel, The Indian Express).
Before smallpox was eradicated, international travellers carried the World Health Organization’s “yellow card,” a small, stapled booklet presented along with a passport when crossing borders. The card’s initial focus was smallpox, but it remained in use to confirm vaccination for yellow fever and other infectious diseases. Mass inoculation also eradicated polio in most regions of the world by 1988 (WHO).
Vaccine certification checks are codified under international law with the first protocols defined under the International Sanitary Regulations Act, adopted by WHO member countries in 1951. It was re-named the International Health Regulations (IHR) in 1969; this Act allowed member states to demand proof of vaccination as a condition of entry.
Over the centuries, public health measures have been an essential way to reduce contact between people sick with an infectious disease and those susceptible to it, thereby reducing its spread. Such measures, in the absence of pharmaceutical interventions, helped contain infection, delay the spread of disease, avert death.
In Islam there is a moral imperative to protect lives as per ayat 5:32. Mawlana Hazar Imam, who notified publicly that he has been vaccinated, has instructed that all his murids be vaccinated:
“… all my murids should accept to be vaccinated in accordance with the directives of their respective health authorities as soon as the vaccines are offered — as indeed I have done already. It is also my wish that my Jamat should avoid any complacency, and that every murid should continue exercising personal responsibility to ensure protection from the virus.
In particular, my Jamat should not give credence to any misinformation regarding the vaccination process… I have requested the AKDN health care facilities to extend maximum support and assistance to the government authorities in the effective roll-out of the vaccination programme…” (The.Ismaili).
Nimira is an invited writer at Ismailimail, although she has contributed several articles in the past (view previous articles). She also has her own blog – Nimirasblog – where she writes short articles on Ismaili history and Muslim civilisations. When not researching and writing, Nimira volunteers at a shelter for those experiencing homelessness, and at a women’s shelter.