Most people are aware of the big historic dates and events related to vaccines.
For example, they might now when Edward Jenner first tested his smallpox vaccine (1798), when the first polio vaccine was licensed by Jonas Salk (1955), or that we just got a Meningococcal B vaccine (2014).
“It is hard to fully appreciate how vaccines have revolutionized modern medicine. The long schedule of vaccines may seem like a hassle, and rumors about harmful effects unnerve parents. But, the fact is, vaccines have helped save millions and millions of lives. Just a few generations ago, people lived under the constant threat of deadly infectious diseases, like smallpox, polio, and hepatitis.
Let’s look at the greatest infectious scourges of the past 1,000 years and how vaccines have mitigated or even eradicated the danger.”
Public Health Understanding Vaccines
From historical safety concerns, like the Cutter Incident in 1955 or the withdrawal of the first rotavirus vaccine in 1999, to improvements in vaccine safety and the control, elimination, and eradication of vaccine-preventable diseases, understanding the history of vaccines can help you get educated and understand that vaccines work and that they are safe and necessary.
Early History of Vaccination
In the early history of vaccination we had the the smallpox vaccine and the beginning of the pre-vaccine era – the first vaccines.
- Lady Mary Wortley Montagu brings variolation to England to prevent smallpox
- George Washington mandated that every soldier in the Continental Army had to be inoculated against smallpox
- Edward Jenner conducts experiments in 1796 that led to the creation of the first smallpox vaccine a few years later and replaces variolation as a preventative for smallpox
- *Dr. Luigi Sacco becomes the Jenner of Italy
- James Madison, one of the Founding Fathers, signed the Vaccine Act of 1813 – An Act to encourage Vaccination.
- a vaccine for rabies is developed by Louis Pasteur in 1885
- vaccines for cholera and typhoid were developed in 1896 and a plague vaccine in 1887
- the first diphtheria vaccine is developed in about 1913 through the work of Emil Adolf Behring, William Hallock Park, and others
- the first whole-cell pertussis vaccines is developed in 1914, although it will take several decades before they are more widely used
- a tetanus vaccine is developed in 1927
- 12 children die when a multi-use bottle of diphtheria vaccine that didn’t contain a preservative became contaminated with bacteria in the Queensland Disaster in 1928
- Max Theiler develops the first yellow fever vaccine in 1936
- the AAP formally approves the use of a pertussis vaccine created by Pearl Kendrick and Grace Eldering in 1943
- the first flu vaccine is licensed for use in the US in 1945
End of the Pre-Vaccine Era
In the mid-20th century, we started to get vaccines to control diseases that many of us have never seen, like polio, measles, and rubella.
- the individual diphtheria, tetanus, and pertussis vaccines become combined in a single DTP vaccine in 1948
- the last smallpox outbreak in the United States kills one person, Lillian Barber, in the Rio Grande Valley of South Texas in 1949
- the Salk inactivated polio vaccine (IPV) is introduced in 1955
- President Dwight D Eisenhower signed the Polio Vaccination Assistance Act in 1955, which gave $30 million in federal grants to states to cover the costs of planning and conducting polio vaccination programs, including purchasing polio vaccine
- about 200 children develop polio in 1955 from contaminated polio vaccines in what becomes known as the Cutter Incident
- the live, oral Sabin polio vaccine (OPV) replaces the Salk polio vaccine in 1962
- President John F Kennedy signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act), which started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, but it has been continuously reauthorized ever since
- the first live and inactivated measles vaccines were licensed in 1963 but weer replaced with a further attenuated measles virus that was more effective and caused fewer side effects in 1968
- President Lyndon B Johnson established a legacy of US leadership in global immunization by funding the CDC Smallpox Eradication program in 1965
- the MMR vaccine becomes available in 1971, combined the vaccines for measles, mumps (licensed in 1967), and rubella (1969), and was routinely given when toddlers were about 15 months old
- routine vaccination with smallpox vaccines end in the US in 1972
The Vaccination Era
The end of the 20th century brought more vaccines and protection against even more now vaccine preventable diseases.
- Pneumovax, the first pneumococcal vaccine that protects kids and adults from certain types of Streptococcus pneumoniae bacteria is approved in 1971 and is given to high-risk kids
- President Jimmy Carter’s National Childhood Immunization Initiative in 1977 reached its goal of immunizing 90% of children
- the Thirty-Third World Health Assembly declares that smallpox is eradicated in 1979
- Menomune, the first meningococcal vaccine is licensed in 1981 and is recommended for high-risk kids until it is later replaced by Menactra
- a plasma-derived hepatitis B vaccine is licensed in 1981
- Vaccine Roulette, a controversial news segment, airs in 1982 and attempts to associate the DPT vaccine with permanent brain damage, downplays the risks of pertussis disease and helps start much of the modern American anti-vaccine movement
- a Haemophilus b capsular polysaccharide vaccine is licensed in 1985, but unfortunately does not provide good protection in kids younger than 18 to 24 months, who are most at risk for Haemophilus influenzae Type b disease
- a recombinant hepatitis B vaccine (Recombivax HB) is approved in 1986 but is only recommended to be used in those at high risk for infection
- another hepatitis B vaccine, Engerix-B, is approved in 1989
- the first Haemophilus b conjugate vaccine (PRP-D) is approved in 1988 to provide protection against Haemophilus influenzae type b disease in all kids at least 18 months old, but in 1990, they are replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that can be given to infants as young as two months old
- a booster dose of MMR is first recommended in 1989, but only for kids who live in counties that have at least 5 cases of measles. The routine 2 dose MMR schedule wasn’t put into use for all kids until 1994.
- the Vaccine Adverse Events Reporting System (VAERS) is established in 1990
- the hepatitis B and Hib vaccines are recommended for all infants in 1991
- after year’s of neglect under President Reagan, President George HW Bush’s immunization action plan in 1991 once again raised immunization rates following three years of measles outbreaks
- the DTaP vaccine, which is supposed to have fewer side effects than DTP is licensed, and by 1997 replaces DTP for all required doses, although DTP is never actually shown to have caused seizures or brain damage, as was once claimed in Vaccine Roulette
- President Bill Clinton’s Childhood Immunization Initiative in 1993 includes signing the Vaccines for Children (VFC) Act, providing free vaccines to many children
- the WHO declares that polio has been eliminated from the Western Hemisphere in 1994
- a vaccine to protect kids against chicken pox (Varivax) is licensed in 1995
- VAQTA, the first hepatitis A vaccine is approved by the FDA in 1996 for kids who are at least two years old, but is mainly given to kids at high risk to get hepatitis A
- the Salk inactivated polio vaccine (IPV) is once again recommended for kids and replaces the oral polio vaccine (OPV) in 1996 because of a small risk of vaccine-associated paralytic poliomyelitis (VAPP), beginning with a sequential IPV-OPV vaccine schedule and then going to an all IPV schedule in 2000
- RotaShield, the first rotavirus vaccine is licensed in 1998 but is soon withdrawn from the market in 1999 after it is associated with an increased risk of intussusception, a form of bowel obstruction
- LYMErix, a Lyme disease vaccine, is licensed in 1998
- Dr. Andrew Wakefield publishes a report in the journal Lancet and attempts to link the MMR vaccine to autism
- thimerosal is removed from the vast majority of vaccines in the childhood immunization schedule in 1999 and 2000
- endemic measles is declared eliminated in the United States in 2000
- Prevnar, a newer pneumococcal vaccine is licensed in 2000 and is added to the immunization schedule the next year
- LYMErix goes off the market because of insufficient sales in 2002
- Flumist, a live, intranasal flu vaccine, is approved in 2004
- endemic rubella is declared eliminated in the United States in 2004
- a flu shot for all healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season.
- beginning in the 2004-05 flu season, a flu shot is recommended for women who will be pregnant during flu season, in any trimester, which is different than previous recommendations for a flu vaccine if a women was going to be beyond the first trimester of pregnancy during flu season. Unfortunately, even though they are in a high-risk category, only about only 13% of pregnant women received a flu vaccine in 2003.
- Havrix, another hepatitis A vaccine, is approved in 2005 and the age indication for both hepatitis A vaccines is lowered to 12 months.
- Menactra, a vaccine to protect against certain types of meningococcal disease is licensed in 2005 and is added to the immunization schedule in 2006, being recommended for all at 11 to 12 years of age or when they enter high school
- the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria
- RotaTeq, another rotavirus vaccine, is licensed in 2006, and is added to the immunization schedule in 2007
- the hepatitis A vaccine is added to the routine childhood immunization schedule in 2006
- Gardasil, the first HPV vaccine, is approved in 2006
- a shingles vaccine, Zostavax, is approved for adults in 2006
- a 2nd booster dose of the chicken pox vaccine is added to the immunization schedule in 2007 to help prevent breakthrough infections
The Post Vaccination Era
Why call it the post-vaccination era?
It has been some time since a vaccine for a new disease has been added to the routine vaccination schedule, but we are also starting to see more and more outbreaks of old diseases, especially pertussis, mumps, and measles.
- another rotavirus vaccine, RotaRix, is approved in 2008
- another HPV vaccine, Cervarix, is approved in 2009
- Gardasil is approved for use in males in 2009
- another meningococcal vaccine, Menveo, is approved in 2010
- Prevnar 13, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010
- Fluzone Intradermal and Fluzone High-Dose are two new flu vaccine options that became available in 2011
- a combination vaccine that protects against both Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y was approved by the FDA in 2013. MenHibrix is recommended for infants at high risk for meningococcal disease.
- Quadrivalent flu vaccines, which protect against four strains of flu, become available for the 2013-14 flu season
- Trumenba, the first vaccine to protect against serogroup B Meningococcal disease is approved by the FDA (October 2014). Previously, Bexsero, a MenB vaccine that is approved in some other countries, was given to some college students during outbreaks under the FDA’s expanded access program for investigational products. Both are now recommended by the ACIP for those at increased risk for meningococcal serogroup B infections.
- Gardasil 9 is approved by the FDA (December 2014) to provide protection against five additional types of HPV.
- Cervarix is discontinued in the US in 2016 because of poor sales
- Vaxchora is approved to in 2016 for adults traveling to cholera-affected areas
- MenHibrix is discontinued in the US in 2016 because of low demand
- Menomune is discontinued in the US in 2017 as it was long ago replaced by the new meningococcal vaccines Menactra and Menveo
- Shingrix, a new shingles vaccine for adults who are at least 50 years old is approved in 2017
- Heplisav-B, an adjuvanted hepatitis B vaccine for adults is approved in 2017
- Vaxelis, a hexavalent combination of the DTaP-IPV-Hib-HepB vaccines, is approved in 2018
- Ervebo, an Ebola Zaire vaccine is approved in the US in 2019
- MenQuadfi, another MenACWY vaccine is approved in 2020 for kids who are at least 2 years old
- the first COVID-19 vaccines get EUA in the United States in 2020
Surprisingly, there haven’t been all that many changes to the childhood immunization schedule in the past 20 years!
What changes will we see in the next twenty years?
More Information About Vaccine Timelines
- Did the National Childhood Vaccine Injury Act of 1986 Cause the Immunization Schedule to Triple?
- Historical Immunization Schedules
- History of Vaccine Manufacturers
- The History of Flu Vaccine Recommendations
- Do Kids Really Get 72 Doses of Vaccines?
- Vaccine Schedules from the 1940s to 2019
- The History of Vaccine Exemptions
- Why Are Vaccine Schedules Different in Each Country?
- Why Didn’t Everyone Die with Our 1980s Level of Vaccination Rates
- Milestones Towards the Eradication of Polio
- Remembering Measles
- IAC – Historic Dates and Events Related to Vaccines and Immunization
- History of Vaccines Timeline
- Timeline – A history of vaccine development
- NOVA – A History of Vaccination
- The Vaccine Timeline
- CDC – Timeline: Thimerosal in Vaccines
- CDC – Historical Vaccine Safety Concerns
- CDC – History of Vaccine Safety
- Canada Immunization Timeline
- UK Vaccination Timeline
- History of Vaccination in Australia
- A brief history of vaccines & vaccination in India
- Polio Timeline
- History of Polio
- Wakefield Controversy Timeline
- Remembering The Pre-Vaccine Era: The Diseases of Childhood