The Polio Vaccine, 1955

From Newsweek. 45:17 (1955). 64, 66-67.

It was a summit moment in history. None before it in the field of medicine ever received such dramatic affirmation, instant public comprehension, and official blessing. The news was attended by hubbub, but nothing could detract from the essential dignity of the central conclusion that a quiet man, standing on a platform in Ann Arbor, Mich., fished out of a welter of 144 million tabulated and evaluated points of information. The Crippler, had finally been beaten.

Salk vaccine had already taken its 40-year-old discoverer, Dr. Jonas Salk, out of the obscurity of the University of Pittsburgh laboratory in which he developed it and dropped him in the full glare of national publicity and gratitude. It also assured a tense audience at Ann Arbor last week for the whole 100 minutes it took Dr. Thomas Francis Jr. of the University of Michigan to read the results of his research squad's thoroughgoing study of last summer's vaccination of 440,000 children in 44 states. On the spot, Dr. Francis's revelation that Salk vaccine was 80 to 90 percent effective in immunizing against paralytic polio brought the 500 attending physicians and scientists to their feet in a standing ovation to Dr. Salk. Concurrently, it sent 150 press representatives racing to their chores. In that moment, Salk's name became as secure a word in the medical dictionary as those of predecessors as Jenner, Pasteur, Schick, and Lister. . . .

A 'Luxury' Disease: Polio belongs among the "luxury" diseases, one of the medical scourges that, curiously, spring up in places swept clear of maladies traceable to poverty. Americans, prodigiously doctored, scrubbed, and otherwise sanitized, have developed probably the world's highest sensitivity to the polio virus--this by the unofficial estimate of the World Health Organization. As a young Turkish doctor in Istanbul said the other day to a visitor from the U.S.: "Polio, along with hepatitis, is what we call an American disease. In countries like ours, where health and sanitary conditions are far behind yours, the people seem to build up a natural immunity to polio. With us, the big problem is still tuberculosis."

The American fear of polio, summarized in the widely seen picture of a child's withered figure, seems at times greater in adults than the dread of death itself. Last week, reaction to the smudging out of that picture was immense:

The telephone switchboards of drug companies and newspapers were flooded with calls asking for the vaccine or seeking information as to how, when, where, and for how much it could be obtained.

Only seven hours after the confirmation at Ann Arbor, officials in Washington granted licenses to six drug firms for manufacture and sale of the vaccine.

The six pharmaceutical firms had providentially gone ahead with stockpiling the vaccine in anticipation of the Ann Arbor finding. They were judged capable of putting out enough to immunize 30 million persons in the most vulnerable categories (totaling 8 million pregnant women and 54 million children aged 1 to 18) before the next polio "season" (roughly May to September). Before the 1956 season, the manufacturers said, there would be enough for everyone. . . .

A Long History: The disease that this vaccine may ultimately exterminate has probably been afflicting people for more than 5,000 years. A human skeleton that old, found in Egypt, showed evidence of polio's ravages. The oldest actual record of an epidemic goes back to England in 1835.

What might be called the trigger in the present development was the discovery by Dr. Karl Landsteiner. . . that a virus caused polio. A few years ago two Harvard men, Dr. John Enders and Dr. Thomas H. Weller and Dr. Frederick C. Robbins of West Reserve University found that the virus could be grown in a test tube on a nerve tissue. Three years ago, Dorothy Horstmann of Yale and David Bodian of John Hopkins learned that the virus resided in the blood stream before attacking the nervous system, which meant that it could be killed in the blood stream by antibodies before doing any nerve damage. Also, in 1952, Dr. William McDowell Hammon of the University of Pittsburgh demonstrated that it took relatively few antibodies to accomplish this job.

In 1953, Dr. Salk showed that he had a vaccine, made of the killed viruses, which could stimulate these antibodies into action. What he still needed, in order to determine whether the result of such action would be the prevention of polio, was a vast field trial involving human beings. In addition to the 440,000 children who received the vaccine last year, 210,000 others were given dummy shots. Blood tests were made in 27 laboratories, and Dr. Francis's final report was not completed until just four days before it was read at Ann Arbor. . . .

The Unsung Heroes

Monkeys, those tried and true laboratory hangers-on, are one of the indispensable ingredients in the manufacture of polio virus. The virus is grown in a container holding minced monkey kidneys, which are kept alive and growing. The virus attaches itself to the kidney and grows with it, multiplying in the process. (Monkeys are also used to test the vaccine, which is injected into them. After the monkeys are killed, their tissue is microscopically examined.)

The amount of vaccine one monkey can be made to produce varies with the manufacturer's own method and efficiency. One drugmaker gets 1,700 cc's of vaccine out of every monkey, or enough for a two-shot vaccination for 850 children.

Another manufacturer says he gets at least 2,500 cc's per monkey.

Most of the monkeys come from India, although some are imported from the Philippines. When India tightened its export regulations on monkeys last March, polio-vaccine production here and there was slowed. The Indians later got assurances that their monkeys were not being maltreated, and the rules were relaxed. The tide of monkey immigration is now on the rise.

It needs to be. One of the big drug houses employs (and thereby consumes) 1,000 monkeys a month, producing vaccine. Another firm plans to accommodate a monthly "several thousand." The cost of the monkeys: From $26 to $30 a piece, transportation included.