It cannot be overstated the extent to which vaccination changed the world as we know it, making one of the deadliest diseases in human history nonexistent thanks to a coordinated campaign of immunisation and pharmacy intervention.
Beyond its effect on eradicating one of humanity’s deadliest diseases and keeping us safe from countless others both at home and abroad, vaccination campaigns have also managed to change the course of history.
An example of this was the introduction of vaccination into Japan during a period when the country was so wary of Western medicine that it was technically illegal.
What happened next not only saved lives but, in some respects, changed history.
Masamune’s Curse
As with a lot of other countries, Japan has an exceedingly long history of smallpox outbreaks. One of the country’s most famous historical figures, Date Masamune, lost the use of his right eye as a result of it.
Prior to Edward Jenner’s development of a smallpox vaccine, there were earlier attempts at variolation based on Chinese and later Turkish techniques.
Neither was fully adopted, in part because variolation, a technique where someone is deliberately infected with smallpox either by inhaling dried scabs or having infected matter surgically inserted under the skin, is still somewhat dangerous and could risk an epidemic.
Beyond the risks of variolation, another complexity was the rather contentious and strained attitude to what was described as “Dutch” or “Western” medicine in Japan (rangaku).
Depending on the whims of the Shogunate, the attitude would vary from grudgingly tolerated to outright suppression, not helped by a policy of shooting foreign ships and executing foreigners on site.
The only exception to this was the Dutch who lived on the trading post of Dejima, as there was an agreement to allow them to remain as long as they provided yearly updates on world events and trinkets by way of tribute to the shogun.
Rangaku And The Rise Of Vaccination
Ultimately, this pursuit of rangaku and specifically the medical developments that came as a result would begin to erode away at centuries of sakoku and turn a reluctant exception into the norm.
The main reason for this was that Holland was a particularly central part of medical and scientific developments in Europe, traditionally seen as more liberal and less liable to suppress ideas based on religious reformation.
Once they established a permanent surgeon’s clinic, high-ranking members of the shogunate would occasionally ask for Western medicine as a last resort. This was led by pioneering figures such as Caspar Schamberger, whose treatment of noblemen inspired an interest in so-called “Caspar-styled surgery”.
By the 19th century, this development had reached a point that not only were Dutch people tolerated to varying legal degrees, but any bans on “Western-style” medicine were openly flouted in the pursuit of saving lives.
One of the biggest contributors to this was Ito Genboku, a highly influential surgeon who was also well-versed in rangaku due in part to his service remit in the Kyushu domain of Saga, which prioritised western studies.
Mr Ito, alongside several rangaku physicians, was aware of Edward Jenner’s vaccination and its superiority over previous variolation practices, but aside from bans and restrictions, a major issue was logistics.
At the time, smallpox vaccination was derived from cowpox infections laced onto sugar cubes, but there was no way that the infection could be safely shipped from the Netherlands to Japan by way of Dejima. It had been attempted once, but went so poorly that it was not tried again.
However, a German doctor working for the Dutch military in Nagasaki, Otto Mohnike, had a much better plan; rather than ship it all the way from Rotterdam, where it would lose its effectiveness, it could potentially be shipped from Batavia (now Jakarta in Indonesia).
This plan, and Mr Ito’s influence in high places, helped to get the cowpox vaccine imported in 1849, and within four months it had spread throughout Japan, establishing vaccination centres despite the law banning them never being repealed before the shogunate itself folded with the Meiji Restoration.
How Did It Change History?
Whilst the official end of Japanese isolationism (sa’koku) was the Perry Expedition that essentially forced open the doors, what led to such a rapid transformation for the country was the existing receptiveness to advanced medical techniques and Western technologies.
This was part of the reason why Japan radically transformed into an industrialised nation as quickly as it did, aided by the survival of countless architects of this evolution.
It also, somewhat inadvertently, exposed the weakness of the final years of the feudal shogunate system in Japan, ultimately leading to the Meiji restoration, which established an Empire of Japan that would last for nearly a century before the end of the Second World War.
Frequently Asked Questions
One of the most significant early vaccination campaigns was the global effort against smallpox. Widespread vaccination programmes throughout the 19th and 20th centuries dramatically reduced cases worldwide, eventually leading to the complete eradication of smallpox in 1980. This remains one of the greatest public health achievements in history.
Before vaccines were widely available, diseases such as smallpox, yellow fever, cholera, and typhoid could spread rapidly through ports, trade routes, and international travel. Vaccination campaigns reduced outbreaks, protected travellers, and helped countries control the importation of infectious diseases across borders.
Although many infectious diseases are now uncommon in the UK, they remain present in other parts of the world. Modern travel vaccination programmes help prevent travellers from becoming infected abroad and reduce the risk of bringing serious diseases back home. Vaccination remains one of the most effective tools in travel health.