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Letter shows that Catherine the Great was one of the first advocates of vaccination

A letter that should go up for auction this week shows that government official Catarina the Great was one of the first defenders of vaccination against diseases.

The letter gives us a glimpse of the empress of Russia’s preoccupation with the smallpox epidemic, which was ravaging Europe at the time. In a correspondence with a Russian army officer, dated April 20, 1787, she wrote of the urgency of protecting the general population against smallpox using a technique now considered a precursor to vaccination.

“Count Piotr Aleksandrovich, among the other attributions of the Welfare Councils of the Provinces entrusted to him, one of the most important should be the introduction of inoculation against smallpox, which, as we know, causes great damage, especially among the common people”, wrote Catherine, according to a translation by the London auction house MacDougall’s.

“This inoculation should be common everywhere, and now it’s even more convenient as there are doctors or medical assistants in almost every district and it doesn’t require large expenses.”

The letter and a portrait of Catherine by Russian artist Dmitry Levitsky will go on sale on Wednesday. Together, they could range in value from £800,000 to £1.2 million, or around $1 million to $1.6 million.

Catherine is considered the first person in Russia to be vaccinated against smallpox, in a procedure that took place nearly 20 years before concerns expressed in the letter of 1787. According to a 1984 article in the then Bristol Medico-Chirurgical Journal, the monarch feared the disease long ago, and after a member of the Russian nobility succumbed to smallpox, she sought the services of an English doctor who had successfully vaccinated the British elite.

The inoculation method at the time, known as variolation, would be considered quite unsafe by today’s standards. It involved taking some of the material from the pustules of a patient infected with smallpox and inserting it into an incision in someone else’s arm – being deliberately infected with a mild form of the disease. The procedure had its risks – about 2% of people who were inoculated in this way died of the disease – but it was adopted across Europe because the mortality rate from natural smallpox was even higher.

Catherine was aware of the dangers. When physician Thomas Dimsdale was invited to St. Petersburg to have her vaccinated, there was a carriage ready so that he could escape the country without retaliation from his subjects, should the procedure fail. Still, she was determined to go ahead.

“How could I introduce smallpox vaccination without setting a personal example?” she wrote in a separate letter to Prussian King Frederick the Great. “I started to study the matter… Should I remain in real danger, along with thousands of people, throughout my life, or should I prefer a lesser, very brief danger, and thus save many people? Choosing the latter, I was selecting the best course”.

Catherine successfully recovered from the smallpox infection and soon had her son and heir to the throne vaccinated as well. The news was celebrated in November 1768.

“Now we have only two topics of conversation: the first is war (Russian-Turkish) and the second is vaccination,” wrote Catarina to an ambassador in Great Britain. “Starting with me and my son, who is also recovering, there is no noble house where there are not several people vaccinated, and many regret having naturally had smallpox and, therefore, they are not in fashion.”

But victories would be premature. Although vaccination was introduced across Russia in the years after Catarina’s procedure, it has not held up significantly – two decades later, she was still concerned that not enough people were vaccinated against the disease.

Reference: CNN Brasil

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