I seemed to have hit a stall in this series when I tried to determine what was in a rabies vaccine due to the many formulations, so I decided to dig into the history of rabies and of rabies vaccination. SARS CoV2 rabies is not, meaning that it is far from a supposedly novel disease possibly made worse by some mad scientists tinkering in a lab with something. A quick Google search indicates that rabies was first mentioned in the fifth century as being something to guard against from excessively salivating dogs. Long before anyone was peering into a microscope at brain tissue there was a encephalitic disease that appeared in some people after being bitten by certain animals.
As a precursor for the not a virus types out there reading this, that disease could have been misattributed. Infections are common from all kinds of untreated wounds, and an infection and inflammation of the brain tissue could certainly happen in some cases which leads to neurodegenerative destruction. I am not claiming that there is nothing there rather I am trying to understand what that something is.
In researching the history of the rabies vaccine I quickly discovered that a lot of it is a story. The winners write the history and in this case the winner was Frenchman Louis Pasteur. A Google search (This search engine is being used intentionally as it will give me the most reliably accepted dogma) reveals that Louis Pasteur is considered the father of the rabies vaccine, following on from experiments conducted in the 1880’s. Pasteur was the first to experiment on people with the vaccine, which had only been tested in dogs, sheep and rabbits before that.
There’s some common themes that I see in the evolution of this medical treatment, which mirror those of other vaccines:
In spite of not because of thinking seemed to become dominant. The disease always killed you and never the intervention. If somebody died following rabies vaccination, it was often due to the disease rabies which, despite their best efforts, they were unable to stop. It was never because of the interventions (aka the vaccines). I noticed evidence of this when I asked google if the rabies vaccine was 100% effective at stopping rabies. The top search result was a recent Times of India account of a woman who died of rabies despite being vaccinated, three days after being bitten by a (suspected) rabid dog and immediately going to receive treatment. The disease usually takes weeks and sometimes up to one year to manifest (also according to Google) so how did she die of rabies three days after the bite? Wouldn’t it make more sense to attribute her death as likely from the vaccine?
Cherry picking; burying the failures while celebrating and widely publicizing the successes. When I asked google who was first vaccinated against rabies I got this feel good story of Joseph Meister, a boy who was bitten 14 times by a rabid dog in 1886,but who survived after vaccination and lived to a healthy old age. He was celebrated as the poster child for successful rabies vaccination 50 years later. It sounds great, right? Except he wasn’t the first person vaccinated, just the first success story.
Treatment bias; how many of these people would have developed rabies without the intervention? Obviously many of these animals were not even available for autopsy, but if you redefine it so that 100% of animals of certain classes are suspected rabies carriers, even if only a fraction of a percent of them actually are, then you’ve radically redefined the risk parameters. In short if 100% of vaccinated subjects do not get rabies you can claim a 100% success rate, even if in reality 0% of them would have contracted the disease with or without intervention. Similar mathematical shenanigans were employed in arriving at the Pfizer Covid vaccines intial 95% claimed risk reduction.
There seems to be a lot of intellectual thievery of prior work and sometimes steering it in more unsavory directions by those who were better able to sell fear and promise miracles. In this case Louis Pasteur took the work of Galtier on dogs and sheep and refined it.
There are some wild stories in from Louis Pasteur: Between Myth and Reality. But the first experiments on inoculations against rabies appear to have begun in the 1880’s:
On 1 August 1881, Galtier reported to the Academy of Sciences the success of his rabies vaccination [80]: “I injected rabies saliva into the chinstrap of the sheep seven times, without ever getting rabies; one of my test subjects has since been inoculated with rabid dog slime, and for over four months after this inoculation, the animal has always been well; it seems to have acquired immunity. I inoculated it again two weeks ago by injecting it eight cubic centimeters of rabies saliva into the peritoneum, it is still doing well”. In total, he injected the rabies virus into the blood stream of nine sheep and one goat. He then injected the deadly virus into these animals and ten control animals. The ten vaccinated animals survived, and the ten control animals perished. In 1886, Galtier published a work entitled: “Rabies considered in animals and in humans from the point of view of its characteristics and its prophylaxis”.
This sounds promising, albeit it was done on a small number of animals and it is not clear if the two groups were treated identically. Also how many of these sheep would have gotten rabies naturally if not intentionally injected with a very large amount of it, sometimes directly into brain tissue? Louis Pasteur then began his experiments on dogs. Moving the treatment to humans, however, would prove tricky. So Pasteur first proposed testing his serum on death row inmates in Brazil. According to this NIH article:
Introduction
In 1884, Louis Pasteur (Fig. 1), from Paris, asked the Brazilian Emperor Dom Pedro II (Fig. 2) to authorize the use of anti-rabies vaccine trials in prisoners sentenced to death in the South American country. Though the disturbing fact is that the rabies vaccine had so far only been tested on dogs by Pasteur, and the request involved imprisoned, subjugated, and vulnerable subjects, not at risk of developing rabies previously the vaccination.
French scientist Louis Pasteur (1822-1895), 1878, by Paul Nadar (1856-1939). Source: Wikimedia Commons [4, 32, 33].
Retrato de D. Pedro II of Brazil, 1885, by Marc Ferrez, Rio de Janeiro, RJ/Acervo IMS [34].
At Pasteur’s time, he had to face opposition regarding the anti-rabies vaccine development, as he was not a physician, as well as, he suffered the resistance of the antivivisectionists because of the animal experimentation, but also of the antivaccinationists.
Some people were opposed to animal experimentation and to vaccination even back then, which echoes what A Midwestern Doctor has written regarding smallpox.
Pasteur urged to follow a next delicate step “when Guinea pigs are human” [23]: But even though I have multiplied the examples of rabies prophylaxis in dogs, it seems to me that my hand will tremble when I have to move to the human species.”
It is clearly shown that scientific research in the biomedical field has been developed with experiments. However, at Pasteur’s time, there was already an ethical limit for human experimentations, at least from the theoretical point of view. Simonds, in his book on medical deontology (1845) [2], recommends that the experiment would be allowed on limited occasions in desperate cases. Still, physicians would have to avert inhuman procedures or anything which might reduce the patient’s life or impede even simple palliative resources. Besides, it is well known that there was not always a distinction between human and animal subjects. If certain classes of people were not considered socially relevant according to the moral appreciation of the time, against individual autonomy, they would be used in research…
It seems that the late 1800’s was a good time for developing a formula for dehumanizing and othering others to a point where scientific experimentation could be peformed.
As Pasteur proposed: … If I were king or Emperor or even president of the republic, here is how I would exercise the right of pardon on death row inmates. I would offer to the lawyer for the convicted person, the day before the execution of the latter, to choose between imminent death and an experiment which would consist of preventive inoculations of rabies to cause the constitution of the subject to be refractory to rabies . Employing these trials, the life of the condemned man would be saved. If it were, and I have the persuasion that it would indeed be, – as a guarantee vis-à-vis the society which condemned the criminal, it would be subjected to surveillance for life.
All the condemned would accept. The death row inmate only apprehends death.”
This is probably true, but how could these death row inmates be veritably “cured” of a disease which they didn’t have? Would this also involve intentional exposure to the otherwise quite rare disease?
Louis Pasteur wrote the first of his papers on rabies, in 1881 [26], with the collaboration of Chamberland, Roux, and Thuillier: We have started studying rabies.
It is not clear from that article if Pasteur’s vaccine was used in Brazil during the 1885-1886 timeframe, with the first success story then being reported as Joseph Meister in 1886 in France. So I jumped back to the Pasteur life and Myth article:
In his book and after examining Pasteur’s notebooks, Geison makes a damning observation [3]. Before the first attempts on humans, between August 1884 and May 1885, experiments involved 26 dogs bitten by rabid dogs with three different vaccine approaches. The overall success rate was 62%. However, none of them correspond to the one used on Joseph Meister (the supposed first human inoculated against rabies).
This makes me wonder what formulation was used on Meister, or if there was anything toxic used at all. I’ll get to that next time.
This is undoubtedly one of the reasons why his most loyal collaborator, Dr Roux, refused to test the vaccine in humans on which he himself had been working, and it was Joseph Grancher who performed the injections. As a source of attenuated viruses, it was Roux’s idea to dry out the spinal cords of rabbits that had succumbed to rabies, hung in vials, while Pasteur had the idea to add potash to accelerate the drying. Pasteur’s laboratory notebooks reveal that Joseph Meister was not the first human to be treated with Pasteur’s rabies vaccine.
I wonder why Louis Pasteur didn’t mention earlier subjects?
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