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The End of Polio?
The headline in the Montpelier Evening Argus on April 12, 1955, was the one they’d all been waiting for: “Dr. Salk Wins Great Victory Over Polio.” It must have felt like the end of a war. Salk, a University of Pittsburgh scientist, now knew that the vaccine he developed was 90% effective in preventing paralysis and had been licensed for public use by the National Institutes for Health. By the following day, newspapers all over the world hailed the American success. It couldn’t have come at a better time. Polio may have been an ancient disease, but it was not until the 1800s that epidemics began to be documented. In June of 1894, the first recorded epidemic in the United States struck Otter Creek Valley, Vermont. At first, the victims seemed to have summer colds. But in some cases, the sick lost the ability to move their legs. Dr. Charles Caverly, Vermont State Board of Health president, studied the outbreak, noting that the disease targeted young children and boys more often than girls. Ultimately he diagnosed this as infantile poliomyelitis or polio. Subsequent American epidemics followed, beginning in the northeast then spreading throughout the country. One of the worst hit was New York City in 1916, leaving 8,900 children and some young adults with paralysis. The Montpelier epidemic of 1917 resulted in 117 cases. In 1949, there were close to 40,000 cases reported in the United States. By the 1950s, many cities closed swimming pools and delayed school openings. Patients often had mild cases but in others the paralysis was severe. If the lungs were affected, the only alternative at the time was the iron lung. In a 1952 survey, Americans indicated that they feared polio second only to nuclear annihilation.Scientists had been competing fiercely in the race to find a vaccine, including Salk and his chief rival, Albert Sabin. The conventional route was to create a vaccine using live virus. Salk thought the “killed virus” version could also be used to stimulate the production of antibodies, which would then protect the individual from infection. In 1954 Salk completed work on his vaccine and the country readied itself for the largest medical experiment ever attempted. Some 1,800,000 elementary-school-age children would be the subjects in a trial of the vaccine’s effectiveness. They would come to be known as the ”polio pioneers.” Rebecca Sheppard of Montpelier remembers lining up on the school playground almost 70 years ago to receive the first of the three polio shots, which would be administered over the course of the year, and she remembers the lollipops that were handed out afterwards. When the trial was completed, Sheppard, like the other pioneers, was presented with a medal, a prize she’s kept to this day. Once it was declared effective, batches of the vaccine were sent out from pharmaceutical houses to public health officials and to doctor’s offices. Sabin came out with his own vaccine by 1962. This could be given orally and made use of live virus. Both of the vaccines are considered to be effective, however, since the year 2000, only the Salk vaccine has been used in the U.S. The United States believed that polio had been eliminated in this country when the last case was diagnosed in 1979. In 1993, the CDC announced that no cases of polio had been reported anywhere in the Western Hemisphere since 1991. Then in July of 2022, one documented case of polio was reported in New York. On August 3, evidence of polio was found in New York City wastewater. On September 13, 2022, the World Health Organization added the United States to their list of countries in which polio was circulating, the only country in the Americas to appear on that list. Vaccines may have become the victim of success. When a disease is no longer visible, it becomes easier to question the vaccine. Vaccination rates have been going down, and diseases are beginning to return. Measles was believed to be eradicated in the U.S in 2000. By 2019, there were 695 cases reported in the U.S., the largest outbreak since 1992. Now polio is “circulating” again. The U.S. uses only the Salk vaccine, but the Sabin is used in some other countries. While this form of the vaccine is effective and easy to administer, there’s a remote chance of getting polio. It would be a very weakened form of the virus, one which cannot lead to paralysis. The individual may even be asymptomatic. Now imagine that this infected person travels to New York carrying the infection and coming into contact with New Yorkers who aren’t vaccinated at all. They can pick up the disease and give it to others. Eventually the virus is circulating through a community. As it circulates, it mutates and becomes stronger. The infections become more severe. American families are faced with a dilemma. How can we keep our children safe when we’re overwhelmed with clashing theories about vaccines and almost everything else? The test of time may be our best guide. In 1955, the NIH declared the Salk vaccine to be “safe, effective, and potent.” After almost seven decades, that still seems to be true.