Shots that shaped India: A history of the country's vaccine journey

A quiet revolution has unfolded in India over the last two centuries — not on battlefields or in parliaments, but in laboratories, village camps, and crowded clinics. It is the story of vaccination, a saga both intimate and epic, where the needle and vial have shaped the destiny of millions.

This tryst with vaccines is a tale of resilience — of loss and recovery, suspicion and persuasion, dependency and leadership.

It all began with a ‘precious cargo’ arriving from Constantinople (Istanbul, Turkey), travelling thousands of miles by land and sea, in the early years of the 19th century. By then, Edward Jenner’s smallpox vaccine had already redrawn Europe’s public health map; he would pass away in 1823, but his discovery had set the stage for a revolution in medicine. A generation later, Louis Pasteur would add rabies and anthrax to the pantheon of preventable diseases, cementing immunology as the bedrock of modern science.

India’s initiation into this revolution was rather dramatic. In 1802, a ‘precious cargo’ — the first smallpox vaccines — arrived in India, not in glass vials but in human arms. Freshly inoculated with cowpox, a chain of children carried the live virus across 3,000 kilometres from Constantinople to Basra, and then onward by ship to India. Along the way, pustules would heal, chains would break, and entire expeditions would fail.

Eventually, it landed in Bombay, and soon, Anna Dusthall, a three-year-old girl of European descent, became the living source from which the Indian vaccination story began. From Anna’s arm, five more children were inoculated. From them, the benign cousin of smallpox spread, first to barracks and British settlements, and later, more hesitantly, to the Indian population.

It was the beginning of a precarious journey — one that revealed as much about empire and politics as about science.

Vaccine ad, courtesy Mysore queen!

By 1805, the vaccine reached the royal palace of Mysore, where politics and medicine converged in an extraordinary tableau.

Twelve-year-old Devajammani, newly married to Krishnaraja Wodeyar III, became the face of what was likely the world’s first vaccine advertisement. An Irish painter, Thomas Hickey, depicted lifting her arm to reveal the faint scar of vaccination.

Smallpox was more than a disease in India then; it was divine punishment from goddesses Mariyamma or Shitala. Variolation, deliberately inducing a mild infection with smallpox scabs, was common, and yet Jenner’s much weaker cowpox vaccine was distrusted as profane, alien and suspect.

The East India Company, struggling to popularise Jenner’s innovation, needed a shot of creativity. By showing a queen inoculated, the British sought to dispel suspicion through royal endorsement.

The strategy worked. Palace court records from 1806 show that Mysoreans stepped forward in greater numbers, persuaded by the scar of their queen. In that scar lay a new kind of political symbolism: medicine as spectacle, monarchy as endorsement, science as persuasion.

British historian Dr Nigel Chancellor, who identified the portrait recently, notes that her sari, which would normally have concealed her arm, was deliberately arranged to expose the vaccination site. This detail, he argues, offered “a minimum loss of dignity” while making a persuasive public point: if the queen herself accepted the vaccine, why shouldn’t her subjects.

Haffkine: From hero to haunted

By the 1890s, epidemics of cholera and plague had crippled India. Into this despair stepped Waldemar Haffkine, a Russian émigré and Pasteur’s protégé, with vaccines against both killers.

He tested his cholera vaccine in Bengal, pioneering what we now recognise as one of the world’s first controlled human clinical trials. A few years later, as plague engulfed Bombay, he developed an anti-plague vaccine working from makeshift labs at Grant Medical College, and by 1902, nearly half a million doses had been administered.

Haffkine was, for a time, celebrated as a saviour. But medicine under empires was always precarious. Trust was fragile, suspicion rampant, and one accident could wreak havoc on decades of work.

That accident occurred in October 1902, in the village of Mulkowal in Punjab. A vaccination camp was held under the open sky. Protocol was strict: each vial dipped in carbolic solution, forceps sterilised. But one misstep — a dropped forceps inadequately disinfected — seeded a disaster.

Within days, vaccinated villagers developed lockjaw (tetanus). Nineteen died in agony. Fear spread faster than the plague itself. For Haffkine, it was the beginning of his downfall. From being one of the most celebrated bacteriologists of his time, he became haunted and hounded. Colonial officials withdrew support, and he left India in disgrace. In his defence stood only Ronald Ross, the Nobel laureate who discovered the malaria parasite in a Hyderabad lab and was himself born in India.

The Mulkowal tragedy was the world’s first recorded ‘adverse event’ of vaccination — an early reminder that trust in medicine, once lost, is slow to return. Yet decades later, the World Health Organisation (WHO) would credit Haffkine as the first to define controlled field trials, acknowledging him as a pioneer who laid the very grammar of modern vaccinology.

A Republic’s gamble

By the time India gained independence in 1947, it inherited not only poverty and epidemics but also a patchwork of colonial laboratories — the Haffkine Institute in Bombay, the Central Research Institute in Kasauli, the Pasteur Institute in Coonoor and a few more. They were valuable but limited, serving mostly colonial needs until then.

The leaders of the new republic grasped something essential: vaccines could be instruments of equity. In 1948, India launched BCG vaccine trials against tuberculosis in the village of Madanapalle, 140 km from Bengaluru — almost three years before the WHO’s global programme.

Three decades later, the Expanded Programme on Immunisation (EPI) committed the country to protecting children against six major diseases. It was an epic ask logistically. Cold chains had to be built in a tropical country, health workers trained to reach the remotest hamlets, and sceptical parents persuaded.

The measles vaccine was added to it in 1985 after the campaign was expanded by Prime Minister Rajiv Gandhi as the Universal Immunisation Programme (UIP). However, the boldest campaign came against polio. The image of health workers going door-to-door with polio drops and purple ink staining children’s fingers became iconic.

Against formidable odds, India was certified polio-free by WHO in 2014, a milestone hailed as one of the greatest triumphs in public health.

The law that changed everything

If public campaigns provided reach, it was the law that gave India its industrial muscle. The Patents Act of 1970 brought in process patents for drugs and vaccines, allowing Indian companies to reverse-engineer expensive Western medicine. Multinational monopolies crumbled. Indigenous firms emerged. By the 1990s, liberalisation opened doors to global markets.

Soon, Indian vaccines no longer required foreign endorsement — they became the global benchmark. UNICEF and WHO sourced heavily from Indian suppliers. From sub-Saharan Africa to Latin America, childhood immunisation rested on vaccines stamped with the ‘Made in India’ label.

A mare’s death and a giant’s birth

Revolutions often begin in the most unlikely places. In 1966, just days after Indira Gandhi took office, a mare at a Pune stud farm was bitten by a snake. The farm, founded by Soli Poonawalla, had bred champion racehorses for decades.

Retired stallions of the stud were regularly donated to Bombay’s Haffkine Institute for serum production. When Soli’s son Cyrus sought anti-venom for his unfortunate mare, the institute delayed it, waiting for government clearance. Approval took days. By the time it came, the mare was dead.

The revelation was painful but transformative. Cyrus realised he had been gifting horses to science, yet when he needed science, bureaucracy failed him. From that frustration came resolve. In a makeshift shed on the farm, he set up a new venture: the Serum Institute of India.

In time, the institute would become the world’s largest vaccine manufacturer, supplying billions of doses worldwide. A mare’s death had seeded an empire of life.

Indigenous innovations

India’s vaccine journey has been defined not only by scale, but also by originality. The rotavirus vaccine, developed indigenously through public–private partnership, cut costs dramatically and became a global success. A Hyderabad-based biotech company founded by Varaprasad Reddy in the 1990s produced India’s first recombinant Hepatitis-B vaccine at a fraction of global prices, breaking Western monopolies.

That ingenuity was also evident in India’s response to Kyasanur Forest Disease (KFD), a tick-borne viral fever first identified in the forests of Karnataka in the 1950s. Entire monkey troops perished before humans fell ill, and for decades, the disease haunted forest-fringe communities. Scientists at the Virus Research Centre in Pune (later the National Institute of Virology) developed a formalin-inactivated vaccine in the 1960s — India’s indigenous answer to the zoonotic threat.

Imperfect and requiring repeated boosters, the KFD vaccine nonetheless stood as proof that Indian science could confront diseases born of its own ecology, even as the world’s gaze remained fixed elsewhere.

Covid-19: The ultimate test

The Covid-19 pandemic tested this capacity like nothing else before. As the world scrambled for doses, rich nations hoarded supplies, and ‘vaccine nationalism’ gripped the West. India improvised at scale. The Indian Council of Medical Research partnered with Bharat Biotech to produce Covaxin, an entirely indigenous vaccine. The Serum Institute, meanwhile, mass-produced Covishield through a partnership with the Oxford-AstraZeneca team.

In two years, India vaccinated almost a billion of its citizens. Through its ‘Vaccine Maitri’ initiative, it shipped millions of doses to more than 90 countries — from neighbours such as Nepal to distant nations in Africa and the Caribbean.

The vial became a tool of diplomacy, its cold chain boxes carried across oceans as tokens of solidarity.

The country’s quiet arsenal

From less than a million doses of crude vaccines a year at the beginning of the 20th century to almost four billion powerful vials by 2025, India has come a long way. Indian vaccine companies are rapidly increasing production capacity, and soon it will exceed eight billion. That would be enough to cover the global population once over, while steadily boosting the country’s economy and exports — a long but arduous journey.

This is a journey that has been anything but linear. It has weathered suspicion, tragedy, and colonial neglect. It found redemption in the republic’s gamble, in the Patents Act’s defiance, in the rise of biotech firms, and in innovations like the CAR-T cancer immunotherapy by IIT, Mumbai. It reached apotheosis during Covid, when India emerged not only as a manufacturer but also as a global benefactor.

Vaccines, for India, are more than syringes and vials. They are instruments of sovereignty. They embody a country that turned colonial laboratories into engines of independence, transforming mistrust into trust, scarcity into abundance. In a world where billions of dollars are spent annually on weapons of mass destruction by some nations, this quiet arsenal of India is measured in lives saved.

This is not only a scientific triumph but also a moral stance. Vaccines represent resilience, dignity, and the possibility of a better future — the proof that sometimes the quietest revolutions are the most enduring.

The writer is an author, environmentalist, and public policy expert. His debut non-fiction, Heavy Metal (2023), exposed corporate negligence in Kodaikanal, winning the GreenLitFest Book of the Year award. His second book, Vaccine Nation, was recently released by Macmillan.