Jonas Salk and the polio vaccination

Today, 12 April 2015 marks the sixtieth anniversary of the announcement that Jonas Salk’s vaccine could prevent poliomyelitis. We asked Charlotte Jacobs, author of Jonas Salk: A Life, a few questions about this event.

What is the significance of this date?

Ever since 1916, when poliomyelitis struck 27,000, mostly children, in America’s first large epidemic, parents had feared the onset of summer. As the number of victims increased yearly, pictures of children on crutches and in iron lungs filled the news. Then, on 12 April 1955, a waiting world learned that Jonas Salk’s vaccine could prevent polio. Two remarkable aspects stand out with regard to that accomplishment: First, Salk and his small research group, not some large pharmaceutical company, prepared the vaccine in only three months. Secondly, the American public, through the March of Dimes, funded his work and conducted the national trial, including over a million children, which confirmed the vaccine’s effectiveness.

alk became an international hero overnight, yet he received few accolades from the scientific community. Why not?

In the wake of his achievement, Salk did receive a staggering number of awards. While heads of states around the world rushed to honor him, the scientific community—the one group whose adulation he craved—remained ominously silent. “The worst tragedy that could have befallen me was my success,” Salk later said. “I knew right away that I was through—cast out.” This young researcher, not yet a member of the scientific brotherhood, had made and initially tested the polio vaccine in secret while challenging one of their firmly held principles—that only a vaccine made of live virus could impart lifelong immunity. They accused Salk of failing to give proper credit to other researchers; senior scientist Albert Sabin promulgated the impression of Salk as a technician who borrowed others’ methodologies to concoct the vaccine, calling him a “kitchen chemist.” To make matters worse, because Salk reached out to the public in ways scientists had never done, many accused him of crossing the line of academic decorum by soliciting media attention.

What is the difference between Salk and Sabin’s vaccines?

At the time of the polio trial, most virologists believed that only live viruses could provide lifetime protection by inducing a low-grade, almost imperceptible infection. They held fast to this tenet with what one epidemiologist called “an almost religious fervor.” Salk thought that a killed virus, although it had lost its ability to cause infection, could still stimulate production of antibodies. Thus, the first successful vaccine was made from killed poliovirus. Over the next five years, it reduced the incidence of paralytic polio in the United States by ninety percent.

Most senior scientists, led by Albert Sabin, still maintained that only a vaccine made from live, weakened virus could eradicate polio. Sabin prepared and tested such a vaccine. In 1961, the US Public Health Service replaced Salk’s vaccine with Sabin’s oral vaccine, delivered in a sugar cube, citing cost and convenience. Salk warned that live virus, although weakened, could revert to its virulent form and cause polio. In his efforts to have Sabin’s vaccine de-licensed, he was overruled by the major medical decision-makers.

By 1968, US pharmaceutical companies had stopped manufacturing the Salk vaccine. Although most cases of paralyzing polio in the United States could be traced to Sabin’s vaccine, it had become entrenched. Salk set out to reverse what he called a risky, politically-driven decision—a sole warrior in a fight that lasted the rest of his life. In 1999, the US government recalled the Sabin vaccine, replacing it with a newer version of Salk’s vaccine. By then, Salk was dead.

Today a great deal of controversy surrounds vaccination of children. Did Salk face any public controversy?

In the 1950s, the paralysis and death of children was so devastating that parents pleaded for their children to be vaccinated. Yet Salk did have his detractors. Among the most vitriolic was D. H. Miller, self-proclaimed president of Polio Prevention, Inc., who circulated anti-vaccination literature nationwide. One, entitled “Little White Coffins,” began, “Only God above will know how many thousands of little white coffins will be used to bury the victims of Salk’s heinous, fraudulent vaccine.”

Just weeks before the national trial of Salk’s vaccine commenced, Walter Winchell, a popular newsman for ABC, announced on his Sunday night radio program: “Good evening, Mr. and Mrs. America and all the ships at sea! Attention, everyone! In a few moments I will report on a new polio vaccine. It may be a killer!” An estimated 150,000 children were kept from participating in the field trial by frightened parents.

In 1955, after the vaccine was released to the public, the state of Massachusetts closed its vaccination program because of a manufacturing misstep leading to contaminated vaccine. Even though this was quickly corrected, Massachusetts didn’t reopen its program upon the advice of several Nobel-Prize laureates. That summer the state suffered an epidemic of polio. Four thousand contracted the disease, 1700 were paralyzed.

What would have happened if Jonas Salk set out to accomplish the same feat today?

Today development of a vaccine is a much more complex undertaking and can take ten to fifteen years from concept to public availability. Salk made his vaccine in a time of dire need, completely funded through the March of Dimes, and with almost no government regulations. Given Salk’s legendary perseverance, however, I have no doubt he would accomplish the same today.

Feature Image: Bundesarchiv B 145 Bild-F025952-0018, Bonn, Gesundheitsamt, Schutzimpfung. Photo by Jens Gathmann. CC BY-SA 3.0 via Wikimedia Commons