An examination of John Fewster's role in the discovery of smallpox vaccination

Neutralization Determinants on Poxviruses

Smallpox was a highly contagious disease caused by the variola virus. The disease affected millions of people over thousands of years and variola virus ranked as one of the deadliest viruses in human history. The complete eradication of smallpox in 1980, a major triumph in medicine, was achieved through a global vaccination campaign using a less virulent poxvirus, vaccinia virus. Despite this success, the herd immunity established by this campaign has significantly waned, and concerns are rising about the potential reintroduction of variola virus as a biological weapon or the emergence of zoonotic poxviruses. These fears were further fueled in 2022 by a global outbreak of monkeypox virus (mpox), which spread to over 100 countries, thereby boosting interest in developing new vaccines using molecular approaches. However, poxviruses are complex and creating modern vaccines against them is challenging. This review focuses on the structural biology of the six major neutralization determinants on poxviruses (D8, H3, A27, L1, B5, and A33), the localization of epitopes targeted by neutralizing antibodies, and their application in the development of subunit vaccines.

Sir Matthew Tierney and the foundation of the 1804 Sussex Vaccine Institution

Irish physician Sir Matthew John Tierney (1776-1845) was a vaccine pioneer who learnt the procedure directly from Edward Jenner in Gloucestershire. In 1802 Tierney completed an MD at Glasgow on vaccination and moved to Brighton, where he was appointed physician to the Prince of Wales (the future King George IV). This paper considers Tierney's role in the foundation of the 1804 Sussex Vaccine Institution. Tierney was the first president of the Institution's Medical Council. His leadership lay in his knowledge of vaccination (including transporting cowpox material) and his close relationship with the Prince of Wales. The Institution's official name was the Royal Sussex Jennerian Society for the Extermination of the Small-pox and offered vaccination at 16 stations across the county and one in Kent. Vaccination was undertaken by local surgeons at their houses at set hours. In its first year, the Institution vaccinated 946 individuals, of whom 509 for free. Despite this, concerns were raised over uptake by poorer members of society. The Institution's Brighton station was probably absorbed into the new 1809 dispensary. Tierney's promotion of vaccination and instructions for new practitioners represent the embryonic beginnings of evidence-based medicine and modern medical education in Brighton.

Four Thousand Years of Concepts Relating to Rabies in Animals and Humans, Its Prevention and Its Cure

The epitome of the One Health paradigm-and of its shortcomings-rabies has been known to humankind for at least 4000 years. We review the evolution through history of concepts leading to our current understanding of rabies in dogs and humans and its prevention, as transmitted by accessible and surviving written texts. The tools and concepts currently available to control rabies were developed at the end of the 19th Century, including the first live, attenuated vaccine ever developed for humans and the first post-exposure prophylaxis (PEP) regimen. No progress, however, has been made in etiological treatment, leaving clinicians who provide care to animals or patients with symptomatic rabies as powerless today as their colleagues in Mesopotamia, 40 centuries ago. Rabies remains to date the most lethal infectious disease known to humans. Widespread access to timely, effective, and affordable PEP in rural areas of developing countries is urgently needed.