Vaccines from Two Different Worlds
Rabies has an interesting place in our society. It is universally feared, yet it is exceedingly rare. Between 1960 and 2018, there were only 125 cases (about 2 cases per year) in the United States. Why does rabies cause so much alarm? Aside from the severe symptoms the disease can cause—including anxiety, hallucinations, insomnia, paralysis, and difficulty swallowing—the mortality rate of rabies is nearly 100%. That is to say, there have been only 20 reported cases ever of people surviving after contracting clinical rabies, according to the CDC (Centers for Disease Control and Prevention). This is why the medical recommendations are so clear: see a doctor if you have been bitten or scratched by a wild animal. Symptoms may not appear until many days later—and at that point it is all too late.
The deadliness of rabies is probably what Joseph Meister and his mother were thinking in 1885 when they pleaded with famous French scientist Louis Pasteur to give the boy his newly made rabies vaccine. There had been no prior testing on humans, only some experiments on dogs that at the time seemed promising. Historian Gerald Geison uncovered, however, that Pasteur’s dog trials were much less clear-cut. Nevertheless, with his reputation on the line, Pasteur went ahead and vaccinated the boy, giving him 13 injections over 11 days using weakened rabies virus.
The vaccine worked. And Pasteur, along with his many other scientific and medical achievements, became one of the world’s most highly-regarded scientists. Despite the vaccine’s success, people have criticized his methods, both during Pasteur’s life and more recently.
The same ethical problems that Pasteur’s fellow scientists brought up in the late 1880s have come up again in 2020 with the COVID-19 vaccine, although the process used today to create the COVID-19 vaccine is completely different. We can be sure that the coronavirus vaccine has undergone significant testing through many stages and trials. One could argue that Pasteur got lucky, but the scientists and doctors who developed the COVID-19 vaccine did not blindly shoot an arrow at the target and shockingly hit the bullseye; instead, they conducted studies, carried out trials, and reviewed the data. And then they skillfully aimed their bow and hit the bullseye.
In my next post, I want to walk through the ethical problems of Pasteur’s rabies vaccine that Geison described in 1978. It is both an interesting and useful history to consider and compare with the various COVID-19 vaccines being developed and deployed today. It will illuminate for us just how different the processes were and how reliable the COVID-19 vaccine is.
- Geison, Gerald. “Pasteur’s Work on Rabies: Reexamining the Ethical Issues.” The Hastings Center Report, vol. 8, no. 2, 1978, pp. 26–33. https://onlinelibrary.wiley.com/doi/epdf/10.2307/3560403
- Geison, Gerald. The Private Science of Louis Pasteur. Princeton University Press, 1995.
- Pieracci EG, Pearson CM, Wallace RM, et al. Vital Signs: Trends in Human Rabies Deaths and Exposures — United States, 1938–2018. MMWR Morb Mortal Wkly Rep 2019;68:524–528. DOI: http://dx.doi.org/10.15585/mmwr.mm6823e1.
- Rabies. Centers for Disease Control and Prevention. https://www.cdc.gov/rabies/index.html.
- [Photograph of Louis Pasteur]: http://resource.nlm.nih.gov/10142597