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The Balmis Expedition

Updated: Jun 28, 2020

By Anya Miksovsky


Graphic by Senching Hsia, Graphics Editor

In November of 1803, a Spanish corvette set forth from La Coruña, Spain with the intent of circumnavigating the globe. For many countries in Europe, 1803 was a worrying year full of political strife. However, the Spanish Royal Philanthropic Expedition, or the Balmis Expedition, was dispatched with a worthier goal in mind: to spread the newly-minted smallpox vaccine around the world, saving hundreds of thousands of lives.


Today the topic of vaccination has become a point of contention, but the first vaccines were invented centuries ago, and the precursor to vaccination — variolation — has been around for thousands of years. In 1796, English physician Edward Jenner observed that previous sufferers of cowpox showed signs of immunity to smallpox, a related disease. Hypothesizing cowpox could be used as a preventative measure, Jenner inoculated an 8-year-old boy with cowpox. Six weeks later, when inoculated with smallpox, the boy was unaffected. This groundbreaking discovery, which Jenner termed “vaccination,” made him a celebrity in England, and he was awarded with honorary degrees and millions of dollars from Oxford and Cambridge.


The importance of Jenner’s invention shouldn’t be underestimated. Smallpox is an infectious disease that has plagued humanity for millenia, with its earliest appearance dating back to 10,000 B.C.E. Smallpox was introduced to the Americas by Spaniards in the 16th century, where it eliminated 90% of native populations. By 1796, the disease had caused millions upon millions of deaths worldwide, with 400,000 Europeans dying each year. But over 100,000 Europeans were vaccinated by the year 1800 thanks to Jenner’s medical breakthrough.


By this time, the news had also reached King Charles IV of Spain, sitting atop the powerful but crumbling Spanish Empire. Charles IV may well have never accomplished anything of importance if his own daughter, the Infanta Maria Teresa, had not succumbed to smallpox. Even in 1800, smallpox was largely incurable, and the disease claimed the lives of poor men and princesses alike. Charles IV was strongly affected by his daughter’s death, and began researching the condition to prevent others from living his pain. Charles IV ordered the remaining members of the royal family, and eventually the entire population of Spain, to be variolated. But while the preventative method of variolation — inoculation with a less dangerous form of smallpox — was well known, variolation usually led to heavy scarring and sometimes fatalities.


Charles IV’s research eventually led him to hearing of vaccination in 1799, still a relatively new technique. Charles IV conducted a council meeting in 1800, in which a plan to vaccinate every person in the Spanish Empire was proposed. A Spanish corvette would be dispatched, carrying the vaccine to countries and colonies all around the world.


But there was one significant issue: by 1800, the concept of refrigeration was still undeveloped. Even today’s vaccines must be preserved at an exact temperature. In conditions too hot or too cold, they become worthless. At the time, there was no way to ensure a vaccine would survive a transatlantic journey. Thus, a solution considered somewhat morally and medically questionable by today’s standards was proposed: the use of human carriers. Accompanying Francisco Xavier de Balmis, the appointed leader of the expedition, would be 22 orphaned children, along with their caretaker Isabel de Zandala y Gomez. The children would act as the vaccine’s purveyors, forming a human transmission chain.


The Balmis Expedition left Spain on November 30, 1803. First stopping in the Canary Islands, the corvette made the transatlantic crossing, arriving in the West Indies. From there, the corvette journeyed around South America and onwards towards the Philippines and China. Members of the expedition also split off in order to reach more areas. In each location the expedition stopped, thousands of people were vaccinated, and a vaccination board was established in order to educate local populations, document immunizations, and establish the ongoing administration of vaccines. The expedition returned to Spain in 1806, having travelled thousands of miles and spread Jenner’s discovery to two continents.


The Balmis Expedition marks a unique turning point in the history of the Spanish Empire. Spain’s golden age began with Columbus’s arrival to the West Indies in 1492. Spain claimed the Americas as their own, launching the beginning of a new, prosperous era for the nation and rewriting itself as a global power. But the same event, so fortuitous for Spain, inadvertently released deadly diseases among the native people, which would decimate their populations. Indeed, some scholars claim that it was largely due to smallpox, rather than military genius or heroic exploits, that Spain was able to conquer so much of the Americas in such a short period of time. It was not until three hundred years later, when their empire started crumbling, that Spain finally made the effort to reduce the effects of smallpox in the New World. In this way, the story of the Spanish Empire comes full circle.


But the Balmis Expedition’s legacy lives on in more than Spain’s historical canon. A humanitarian effort, the Balmis Expedition was an organized international attempt to halt one of the deadliest and most noxious diseases in human history. In effect, this was the world’s first international healthcare campaign. In utilizing the most progressive science of its day, the Balmis Expedition demonstrates the power of medical discovery. Through the combined efforts of selfless world citizens from dozens of nations, from an English physician to a disgraced Spanish monarch, to the unnamed people who worked to receive the Balmis Expedition in their respective nations and ensure vaccination would be available to local citizens, over 100,000 lives were salvaged from a devastating illness.


Two hundred years later, we find ourselves in a confusing place, with proven science often questioned by the media, and the validity of many medical breakthroughs such as vaccines put into doubt. Yet at the time of discovery, immunization was recognized and celebrated. The Balmis Expedition shows how health campaigns can unite the world, especially in times of political strife, and bring out the noblest intentions in all of us.


References:

https://academic.oup.com/cid/article/41/9/1285/278013

https://www.futilitycloset.com/2015/01/19/podcast-episode-42-the-balmis-expedition-using-orphans-to-combat-smallpox/

https://www.history.com/news/the-rise-and-fall-of-smallpox

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.3.611

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994746/

https://www.biography.com/people/charles-iv-of-spain-21389243

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