A letter from Catherine the Great – dated April 20, 1787 – sold for $1.3 million dollars at a London auction on Wednesday. The Russian empress supported mass immunization against smallpox in the letter, a nod to how the country's longest-ruling female leader (1762-1796) could've seen vaccinations in a pandemic era.
In the letter, which sold at MacDougall’s auction house in London, Catherine the Great instructs a governor-general of Ukraine to make immunization of the public a priority.
"Count Piotr Aleksandrovich, among the other duties of the Welfare Boards in the Provinces entrusted to you, one of the most important should be the introduction of inoculation against smallpox, which, as we know, causes great harm, especially among the ordinary people," Catherine wrote, according to a translation.
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"Such inoculation should be common everywhere, and it is now all the more convenient, since there are doctors or medical attendants in nearly all districts, and it does not call for huge expenditure."
The letter was also sold with a painting by Dmitry Levitsky. MacDougall stated that the letter showed the "statecraft and foresight shown by the great monarch."
Catherine the Great, who was immunized nearly 20 years before the letter she wrote, was one of the first people in Russia to be immunized against smallpox. However, millions of Russians still feared the procedure in the late 1700s.
According to a 1984 article in what was then the Bristol Medico-Chirurgical Journal, at the time the smallpox immunization was called variolation proliferated, a process in which pus or scabs from a person with smallpox were introduced into the bloodstream of a patient. A person who underwent variolation would then develop a milder form of the disease and subsequently become immune after recovery. The process had a 2% death rate, as compared to the minimal risk modern smallpox vaccine.
Supporters of a similar method of immunization was backed in the U.S. by Benjamin Franklin, John Adams and George Washington.
This article originally appeared on USA TODAY: Immunization letter by Catherine the Great sells for over $1 million