Saturday, April 12, 2014

APRIL 12 = Salk's Polio Vaccine Works

ANN ARBOR: The vaccine works. It is safe, effective, and potent."
(Above, Dr. Francis and Dr. Salk review his report)

"Dr. Thomas Francis, Jr., UM Director of the Poliomyelitis Vaccine Evaluation Center, told an anxious world of parents that the Salk vaccine has been proved to be up to 80-90 percent effective in preventing paralytic polio.
At a meeting of over 500 scientists and physicians and before the penetrating eyes of cameras and powerful spotlights, Dr. Francis spoke on the effectiveness of the Salk vaccine. 
Dr. Francis declared the vaccine had produced 'an extremely successful effect' among bulbar-patients in the areas where vaccine and an inert substance had been tried interchangeably."

This was the news that greeted the world on today's date, April 12 in 1955.  In effect Polio, the scourge of generations of children since the turn of the century, had been beaten.  And Dr. Jonas Salk of the University of Pittsburgh was the man of the hour. It had been a long haul to develop this vaccine.  And that haul of professional bickering, and jealousy was not over yet.  But polio was at last on the run, and would never come back.

Polio/ Infantile Paralysis - An Elusive Plague

"He sat on the side of the bed and pulled his bibbed overall legs over his. And was up like a flash.   And down like a flash. He crumpled onto the floor like a limp dishrag. 'What's wrong, Kid?' Aunt Naomi wanted to know. 'Nothing.' he responded as he pushed off the floor to crumple again. 'I can't wwwwalk.' he stammered.  'I'll help.' she said as she rose quickly from her chair.  She pulled the kid into a standing position then relaxed her hold for a moment to see if he could stand now.  He would have fallen if she hadn't caught him.  'Sam get in here. Something's wrong with the Kid.' By the time Sam got there, the Kid could hardly sit.  His muscles were deserting him.  All at once."

This was the moment in November of 1950 when Polio invaded the life of Frank Lee (above) a small boy living in rural Tennessee.  This moment would change the life of "the Kid" as he was called just as it would change the life of so many others.  It was recorded in his delightful book "Nekkid", but more about Frank and his memoir later.  Polio myelitis could strike any person in any walk of life regardless of their age or their social station.

Since the turn of the century polio myelitis, also called infantile paralysis,  had in regular seasons hit mostly young people in America.  Occurring usually during the summer months it appeared to be highly contagious and seemed to strike those who were not only young, but active. The symptoms could range from a mild headache and nausea, to muscle weakness, paralysis or death. Weakened chest muscles would often leave it's victims unable to breathe. At a time when America was becoming ever cleaner and more antiseptic polio seemed to pray on just such cleanliness. Eventually scientists would discover that the polio virus entered the body through the mouth passing from person to person via contaminated water, food or physical contact. And the increased cleanliness actually helped the virus as children in clean environments were unlikely to be exposed to the virus and thus develop life-long immunity

F.D.R., Basil O'Connor, and the March of Dimes

One very well known American who was taken by polio was Franklin D. Roosevelt who was struck in 1921 at the comparatively older age of 39.  F.D.R. was able to rally with his indomitable spirit, and run for Governor of New York and win in 1928. But his legs would be paralyzed and he would be in a wheelchair for the rest of his life (below). F.D.R. bought a resort with warm healing mineral waters in Georgia wherein he would go regularly to rest and invigorate his withered legs. To keep this resort which he
called "Warm Springs" financially viable he got his banking/ law partner, Basil O'Connor to take over its running. Basil O'Connor was a self-made man, a tough, blunt and very hard-working Irishman, who knew nothing of polio, but was an extremely skilled organizer and financier.  America was in the grip of the Great Depression by the time Roosevelt became President, and donations from the rich were drying up.  So O'Connor revolutionized charitable donations in America by asking every citizen to send one dime to the president in the White House. This "March of Dimes," backed by celebrity endorsements by the likes of Eddie Cantor and Mickey Rooney brought in tons of money from ordinary Americans who now felt that they had a personal stake in the fight against polio, with volunteers organizing fund raising drives all over America.

Killed -vs- Live Virus Vaccine; Salk -vs- Sabin

Far from merely organizing fund drives, O'Connor set up the "National Foundation for Infantile Paralysis" (the "NFIP") to collect all the funds and arrange grants for scientists to study the polio virus and maybe develop a vaccine to stop its spread.  But through many years of research a vaccine remained elusive. The standard approach used against such diseases as yellow fever and small pox was to use a greatly weakened live version of the virus itself to trick the body into producing natural antibodies to fight the virus and thus bring about life-long immunity.  But this was a time consuming process which left years for more young people to be afflicted. O'Connor wanted progress right now! And in 1949, he met a brash and ambitious young scientist who followed a different drummer. This young man, Jonas Salk, 39 believed that an effective safer vaccine could be produced using a form of the actual virus which had been killed and introduced directly into the blood stream. This was an idea which really appealed to O'Connor
who formed a fast friendship with Salk, and backed his study with NFIP funds.

(Above: L to R, Sabin, Salk, O'Connor)
But most of the established scientific community took an extremely dim view of this "killed virus" idea. The "live virus" vaccine, the type being sought by scientists such as Albert Sabin of Cincinnati's Children's Hospital was, in their view,  the only vaccine which could bring a lasting immunity to the polio virus. Sabin was a brilliant, and imaginative scientist from the prestigious Rockefeller Institute in New York, and really believed that he was right, that Salk was a mere "kitchen chemist" whose vaccine could never give lifetime immunity to Polio, and warned that Salk's vaccine would leave people vulnerable to the dreaded polio virus.  But to the extent that Salk was ambitious, and (perhaps) a bit of a glory seeker, Sabin was arrogant, and unyielding to anyone who disagreed with him.  And O'Connor refused to heed Sabin's warnings, To his mind, Salk alone understood that there were kids who needed a vaccine NOW, not five or ten years from now after Sabin had completed his work. Salk " aware of the world and concerned about it. He sees beyond his microscope.  He takes an overview." in O'Connor's words.

The Successful Field Trial of 1954

There was continued disagreement between these two men over the next several years, much of it very much in public. But, Salk forged ahead with his research and developed a vaccine which was ready for a trial on human patients, as most of the test work had heretofore been done on Chimpanzees. The Field Trials took place in April of 1954. In the words of Melvin Glasser one of the coordinators "This was virgin territory, the biggest medical gamble in history."  The NFIP was privately running the whole show, in this day before government got into the health care business.  But after a full year spent reviewing the results, Dr. Thomas Francis made the announcement to the deliriously happy press corps at Ann Arbor Michigan, on today's date, exactly ten years after the death of F.D.R. who had put O'Connor in charge of the whole Polio program.  The Salk vaccine had proven effective in up to 90% of the subjects who had been tested.  Salk was toasted all over as the man who had beaten Polio. But his scientific colleagues were considerably less effusive in their attitudes to Dr. Salk whom they viewed as having sold out scientific principle for fame.  There was indeed a brief suspension of the vaccinations when some of the vaccine produced by the Cutter Company caused an adverse reaction in some of the patients.  Hundreds of patients became sick.  Many became permanently paralyzed.  A few even died. Salk was haunted by the possibility that his vaccine may have caused this. But he never gave up his belief that his vaccine was both safe and effective.  And investigation proved this to be a result of the company, Cutter Laboratory not following safety protocols accurately.  This in turn resulted in much more thorough government oversight of the vaccine production process.  And after a stoppage of just eight days, the problem was identified and vaccinations resumed.

And Who Remembers Polio?

Salk's vaccine finally punched polio out of the fears of Americans for good.  Albert Sabin's live virus vaccine was licensed in 1962.  Because it was an oral vaccine (given to most children on sugar cubes), it was easier to administer than Salk's vaccine which required injections.  But today, both vaccines are widely in use.  Basil O'Connor died in 1972, at the age of  80  having lived to complete the task which his old friend, President Franklin D. Roosevelt had assigned him.  Albert Sabin died in 1993 at age 87, and Jonas Salk died in 1995 at age 81.  Neither man was ever awarded the Nobel Prize for Medicine. And Polio? It still has occasional outbreaks in the underdeveloped countries of the world, but it has nearly been eradicated from the earth.  And the great polio epidemics of 1916, the 20's, 30's 40's and the 50's are now but distant memories.


"Polio - An American Story" by David M. Oshinsky, Oxford Univ. Press, 2005

"Splendid Solution - Jonas Salk and the Conquest of Polio" by Jeffrey Kluger, G.P, Putnam's Sons, New York 2004

"Breakthrough - the Saga of Jonas Salk" by Richard Carter, Trident Press, New York, 1966

"Nekkid" by Frank M. Lee, Connie Breitbeil and Connie Lee, Co-editors, Cincinnati Book Publishing, Cincinnati, Ohio, 2013

I wish to make  special mention about this book which pretty much turned me on to this subject.  It is the story of a little boy, "the Kid" and his struggle to maintain his boyish outlook on life in spite of being poor and suffering the debilitating effects of the now forgotten scourge of Polio. Throughout this sometimes silly and sometimes touching book, "the Kid" never gives up his little boy's
view of the world.  It is truly a delightful read and I strongly recommend it to all of my  "Today in History" readers.
- B.T. Bolten

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