In 1816, African American diplomat and activist-educator Prince Saunders introduced the world’s first vaccine to the kingdom of Haiti. At the invitation of King Henri Christophe, Saunders set up shop in the royal palace of Sans-Souci, where he vaccinated scores of children and taught the technique to local Haitian doctors. From there, Christophe established vaccination centers throughout his northern realm. Saunders had acquired the smallpox vaccine in London from none other than the renowned abolitionist William Wilberforce, who upon learning that the vaccine had yet to reach Haiti, insisted that Saunders immediately sail back and share samples of this miraculous new technology.^[1]

An English physician, Edward Jenner, had first published his observations on the vaccine, Inquiry into the Causes and Effects of the Variolae Vaccinae, in 1798, immortalizing the concept of vaccination. For much of the nineteenth century, the word “vaccine” referred not to a synthetic compound produced by scientists but the pus harvested from pustules formed on ailing livestock. When Saunders carried this new “invention” across the Atlantic, he also brought back teachers from Lancaster who helped him set up the Royal College of Haiti. Both exchanges were part of a new alliance Christophe forged with Britain to gain political recognition in the wake of revolutionary turmoil.^[2] The Haitian king hoped that academies of higher learning and institutions of preventative medicine would legitimize his right to rule. In this, he was not alone.

Throughout the Atlantic World, state leaders looked to the vaccine as a source of political power. It was a game changer that would extend life expectancy, lower infant mortality, and boost the laboring population, and with it, revenues paid to royal and state treasuries. Thomas Jefferson was a notable advocate, who wrote optimistically to Jenner in 1806 that “future nations will know by history only that the loathsome smallpox has existed.”^[3] The vaccine, too, held symbolic power. For monarchs and republicans alike, the right to govern stemmed from the paternalism of protection. As the Gazette Royale d’Hayti intoned, “Fathers and Mothers, avow your thanks for these virtuous philanthropists and for our generous monarch; you will no longer have to fear the destructive scourge of smallpox! You will no longer be anxious to see your children suffering from this disease, without being able to protect them!”^[4]

King Carlos IV of Spain promulgated the same message in 1803—a year before Haiti won independence from France—through a royal expedition intended to reclaim his empire through the vaccine. For the Spanish king, vaccination was a divine gift, one that would bind his subjects to him through a ritualized blood pact and an act of humanitarian care. Incubating the smallpox vaccine through a chain of orphaned and enslaved children, Spanish authorities transported the it from the Iberian Peninsula to the Caribbean, offering vaccination in exchange for colonial loyalty. In doing so, they embedded the vaccine not only in the bodies of children, but the political, social, and economic currents of the Atlantic World.

Indeed, the Peruvian doctor Don José Hipólito Unánue explicitly contrasted the royal benevolence of this campaign with the Haitian Revolution, lamenting in an 1806 speech that while European monarchs sought to end human suffering through smallpox prevention, enslaved insurgents remained indifferent to humanity, slaying their masters with little thought or care. For Unánue and others, Haiti became a land where “colonial blood runs in torrents, spilled by implacable barbarous hands.”^[5] Though the royal expedition notably wound its way through four continents, reaching as far as Macau—and though Carlos IV proclaimed his paternal love for all this subjects—Spain never once extended the gift of the vaccine to those in Hispaniola. Instead, islanders there would have to wait on the interventions of English abolitionists to establish these public health measures and incorporate medical technology that other nations had swapped and shared for well over a decade.

Despite the global reach of viral threats like smallpox, then, as now, geopolitical rivalries determined which states would have exclusive access to epidemic prevention and which would remain at risk.^[6]

We are witnessing a similar competition over a COVID-19 vaccine, a measure that public health authorities the world over agree is our best bet for stopping SARS-CoV-2 in its tracks.^[7] Last month, President Donald Trump reportedly tried to obtain exclusive access to one from the German research lab CureVac for the sum of $1 billion USD.^[8] As of now, there are 115 COVID-19 vaccine projects being conducted around the world.^[9] Last week the WHO issued a public statement calling for global collaboration between them.^[10] A day later, Trump announced that he would suspend U.S. funding to the WHO pending an investigation into the agency’s response to the pandemic. Trump alleges that this is because the WHO “covered up” news of the pandemic. However, as many have pointed out, this response is a clear attempt to shift the blame for the U.S. administration’s own failure to respond to the global crisis. This decision, as global health experts have advised, will have catastrophic effects, especially for low- and middle-income countries that rely on the WHO for health data and medical supplies.^[11]

At the same time, the U.S. government has invoked a Cold War defense act to require U,S.-based manufacturing company 3M to stop exporting respirator masks to Canada and Latin America.^[12] Similar isolationist policies have obstructed the exportation of ventilators. This month, Barbadian singer Rihanna donated $700 million to purchase machines for her home country. But as the Health Minister of Barbados Lt. Col Jeffrey Bostic reported, the U.S. intervened to block their export.^[13] This example of resource and wealth hoarding is precisely the kind of neocolonial practice that organizations like CARICOM (Caribbean Community) have railed against in their calls for economic reparations.^[14]

It is a practice that speaks volumes about who the U.S. government deems disposable—both internationally and domestically. Even with nationalist claims to protect U.S. citizens, within the country, we are witnessing staggering health disparities across communities of color, many of whom are predisposed to contract COVID-19 due to social determinants that disproportionately put them at risk.^[15] These disparities are compounded by nativist attacks on immigrant families, who states have historically targeted to fuel xenophobic and racist policies through the language of contamination.^[16]Now, U.S. officials have co-opted the pandemic to implement unprecedented border policies that resulted in the deportation of hundreds of unaccompanied children.^[17] Meanwhile, U,S. Immigration and Customs Enforcement (ICE) has created several new outbreaks by detaining immigrants in facilities without sufficient PPE and medical care.^[18]

This phenomenon appears all the more disturbing as medical authorities in the United States turn to serum therapy as a stopgap in the race for the vaccine. Vulnerable communities like these have long been the guinea pigs of experimental medicine, and we should remain wary of who is expected to donate their blood (and who may be unaware of their donation), as Food and Drug Administration guidelines are skipped for the sake of expediency.^[19] We should also ask ourselves who will have access to these preventative technologies once they are remade into pharmaceuticals that are marketed and marked up. The current competition over vaccine development forewarns privatization and future high costs, a practice that would continue to delineate who can afford to stay alive. Viruses may cut through political borders and social hierarchies, but vaccines and differential access to them have historically helped those in power maintain these divisions. When this technology first reached the Americas, empires throughout the Atlantic World began to fracture into independent nations. Leaders jumped at the opportunity to wield this new power over life and death. Yet, as epidemics remind us, our individual survival depends on one another’s well-being. We should demand that this lesson inform the development and distribution of this new vaccine.

---

Endnotes

^[1] La Gazette Royale d’Hayti, Feb. 8, 1816. The original newspaper is archived at the Library of the American Philosophical Society, and digitized copies can be found online at http://lagazetteroyale.com/.

^[2] Laurent Dubois, Haiti : The Aftershocks of History, 1st ed. (New York, 2012), 73.

^[3] Thomas Jefferson to Edward Jenner, May 14, 1806, Monticello, VA.  https://jeffersonhour.com/blog/1332

^[4] La Gazette Royale d’Hayti (Feb. 8, 1816), 4.

^[5] José Hipólito Unanue, Actuaciones literarias de la vacuna en la Real Universidad de San Marcos de Lima, (Lima, 1807), 10.

^[6] When the smallpox vaccine was first introduced, the memory of past epidemics loomed large, including a series of outbreaks (1775–1782) that decimated communities from Tierra del Fuego to the Kenai Peninsula, which Elizabeth Fenn has methodically documented online: https://www.arcgis.com/apps/webappviewer/index.html?id=2c94e981a6c6485ab0e26bb680e0b063

^[7] https://www.nytimes.com/2020/03/19/us/politics/coronavirus-vaccine-competition.html

^[8] https://www.theguardian.com/world/2020/mar/16/not-for-sale-anger-in-germany-at-report-trump-seeking-exclusive-coronavirus-vaccine-deal

^[9] For more on the science of the vaccine development, see: https://www.nature.com/articles/d41573-020-00073-5

^[10] https://www.who.int/news-room/detail/13-04-2020-public-statement-for-collaboration-on-covid-19-vaccine-development The WHO will additionally update the list of active projects here: https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus-landscape-ncov.pdf

^[11] https://www.sciencemag.org/news/2020/04/trump-freezes-us-funding-who-world-fights-pandemic

^[12] https://www.bbc.com/news/world-us-canada-52161032

^[13] https://www.miamiherald.com/news/nation-world/world/americas/haiti/article241783756.html

^[14] For more on the history of CARICOM, see: https://mckinneylaw.iu.edu/instructors/Bravo/Caricom.pdf?fbclid=IwAR2qEgyTvrHHwYFTMlLxrw8COuA1WzSEF0kFmzeO-Nt9a91K84rHcNZkoBw

^[15] https://www.newyorker.com/news/our-columnists/the-black-plague?fbclid=IwAR0SEOWZSJp9QiHDJCz7lqrjS0hra43-DXzQx9gVWMVoU0MMt24qB4_MEw8

^[16] Nayan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (Berkeley, CA, 2001); Natalia Molina and Charles E Rosenberg, Fit to Be Citizens?: Public Health and Race in Los Angeles, 1879–1939 (Berkeley: University of California Press, 2006); Alexandra Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (Oakland, California: University of California Press,

2016).

^[17] https://www.reuters.com/article/us-health-coronavirus-usa-deportations/u-s-deports-400-migrant-children-under-new-coronavirus-rules-idUSKBN21P354?fbclid=IwAR2slzsfiTmN55F_l1DxYdvesRLSC5wXrypGhfXidxYwU3f1kP2vogcyszQ

^[18] https://www.theguardian.com/us-news/2020/mar/29/detainees-coronavirus-us-immigration-ice

^[19] https://www.globalhealthnow.org/2020-03/covid-19s-stop-gap-solution-until-vaccines-and-antivirals-are-ready?fbclid=IwAR1p9qDakxlGG3N4FO2afZ9gdd1KuJZfrLX2IyH3pOwW3h6oEj62X8DJ6M0