As the world tries to find a vaccine to fight the COVID-19 virus, I like to look back at the development of a very important vaccine almost 70 years ago. It is hard to believe, but in the 1950s, a deadly virus in the United States scared families, changed behaviors and led to some panicky behaviors, much like the current pandemic is now. By some the illness was called a “plague” and it was said that the greatest fear of Americans in the 1950s was the atomic bomb and this virus. It would kill thousands of people each year, and if it did not kill them, it could cause significant paralysis, even to the point of that person not being able to walk, lift an arm, or even breathe. And that paralysis could be permanent. Since it primarily hit young people, parents limited their children from some of their usual activities, like parties, swimming pools etc. And it had severely affected one of our presidents, Franklin Delano Roosevelt.
People with this illness were taken from their families and hospitalized, sometimes as long as a year. If they could not breathe, there were placed in long metal tubes to assist their breathing. The mortality rate was between 5% and 10%, depending on age. And in some states, as many as 1 in 100 were infected. Those of us who were around in the 1950s know this as polio, or its even scarier name, infantile paralysis.
What happened to polio is one of the great medical triumphs of the 20th century. And it centers on one man, Jonas Salk, one of my heroes. He was a painstaking and thorough scientist, and he began working on polio in 1947 and dedicated the next seven years of his life to finding a vaccine. He became involved in the polio fight thanks to the efforts of the “March of Dimes” which some of us remember as a method of saving dimes to fight the disease. Dimes were worth something then.
Salk began his work using an untried method, that of using a “killed” virus. His vaccine was first tried on animals, then in 1952, on humans. Salk wanted to assure the scientific world that this potential vaccine was safe, so he announced that his wife and three children had been among the first to be inoculated with the vaccine. Major trials ensued thereafter, and in 1954 a huge worldwide program was set up to test the vaccine. This was a “double blind” test, meaning that some children were given the true vaccine (440,000 of them) and some were given a shot with no vaccine (210,000). “Double blind” means that neither the person giving the shot nor the person receiving the shot knew if it contained the vaccine or not. This “double blind” method is being used with current vaccine trails in 2020. Obviously meticulous records of what each child received were kept so that true success could be measured. And 1,200,000 children were observed as a “control group” to see what the international polio rate would be.
The results were to be announced in a large theater at the University of Michigan by one of Salk’s mentors, Dr. Thomas Francis on April 12, 1955. There was massive worldwide interest and optimism, just like there will be soon, we hope, when the final results of testing for a potential vaccine for covid19 are announced. The place was jammed, as 500 people attended, including 150 from the press. Fifty-four thousand physicians watched via closed circuit TV in theaters across the USA. Millions listened on the radio, Europeans listened via the Voice of America. Workplaces stopped so people could listen, judges suspended trials so people could listen.
Francis reported that the vaccine was 80-90% effective in prevention of polio. By the time he stopped talking, church bells were ringing, cars were honking, factories observed moments of silence, parents and teachers were crying, churches and synagogues were holding prayer meetings. The world was ecstatic, just like we will all be if an effective vaccine is found for this pandemic. After the announcement, Salk said that the next vaccine would be 100% effective; the trial vaccine only contained two of the three known polio viruses, and the full vaccine would contain all three viruses. He was right, of course.
And this is what happened: millions of doses of the Salk vaccine were quickly made and distributed. It is possible that with modern vaccine production, many millions of doses of a covid19 vaccine could be produced even faster; let’s hope so. Mass immunization programs using the Salk vaccine were held over the next several years throughout the United States, and the results were amazing. In 1953 there had been 35,000 cases of paralytic polio in the US. In 1957, only 5,600. In 1961, only 161. By 1979 it was totally gone here, and it is gone from most of the world now. The key is that polio exists only in humans; there are no “carriers.” So once people are immunized, there is no more polio.
And here is another story about Jonas Salk that is probably under appreciated. Salk could have patented this vaccine and thus made millions of dollars from this. But he chose not to, as he wanted this vaccine to be available to as many people in the world as possible. What a remarkable man.
Here are some personal stories I can tell. I had a patient who was a practicing pediatrician in the 1950s. He told me, 40 years later, with tears in his eyes, that the most difficult diagnosis he had to tell parents was that their child had polio, as it could be fatal, or cause severe lifelong paralysis, and there was no treatment. He was very happy on April 12,1955.
A local Healdsburg icon, Milt Brandt, had polio as a youngster, and spent 10 months away from his family. He recovered enough to be ambulatory and contribute to the community, but was handicapped the rest of his life. One of the most amazing pictures I have ever seen is Milt Brandt, with crutches, shaking hands with my hero, Jonas Salk.
David Anderson, MD practiced internal medicine in Healdsburg for 38 years before retiring in 2011. Anderson also sits on the board of the North Sonoma County Health Care District.