One morning in the spring of 1955, a pair of press officers greeted a crowd of journalists in a majestic hall at the University of Michigan.. Press officials had important news: A clinical trial of the highly anticipated polio vaccine had proven it to be safe and effective. Journalists almost ran over each other in their careers for spreading the news. After they did, church bells rang and people took to the streets to celebrate.
In our current pandemic, the collective hope of finding a vaccine is just as palpable and reinforced just as regularly, as was this week's news of the promising results of a small test of a coronavirus vaccine. The federal government's expert leader in infectious diseases, Anthony Fauci, stated that "here, the final turning point will be a vaccine". President Trump assured us that creating a vaccine is not far off. Presenters and television experts say this goal is within reach because we have already defeated infectious killers in the past with vaccines, such as polio.
However, America's experience with polio should not give us hope, but should make us reflect. The first effective polio vaccine emerged after decades of research and testing. Once all the exams were completed, it was passed at record speed. Then there were life-threatening manufacturing problems. This was followed by difficulties in distribution. Political struggles broke out. After several years, enough Americans finally received the vaccine to reduce the number of cases significantly, but the disease persisted in poor communities for more than a decade. The full history of polio should make us mistrust promises that we will soon have the coronavirus under control with a vaccine.
The first polio epidemic in the United States hit Vermont in 1894: 18 people died and 58 others were permanently paralyzed. That was just the beginning.. Over the course of the following decades, outbreaks in places with hot climates became common. Those outbreaks hit communities one year and forgave them the next, although they sometimes returned later with greater force. An outbreak in New York City killed more than 100 people in 1907. In 1916, polio returned and killed 6,000 people. The disease mainly attacked children. It killed 25 percent of those affected. Furthermore, he left many paralyzed, and confined some to living in an iron lung.
Scientists knew that polio was caused by a virus, but they did not know how it spread. (Today we know that it was spread by consuming water or food contaminated with the virus present in fecal matter). At that time, as now, the only way to be safe was not to get infected. Villages that had cases closed movie theaters, swimming pools, amusement parks, and summer camps. They canceled fairs and festivals planned long before. Parents kept their children close to their homes. Those with the resources fled to the field. However, the cases increased. Of the three preliminary polio vaccines developed in the 1930s, two were found to be ineffective and the other fatal.
Finally, in April 1954, a promising vaccine developed by Jonas Salk's laboratory in the University of Pittsburgh underwent a large one-year clinical trial. In 1955, the day press officers met journalists in Ann Arbor, they shared the results: The vaccine, which contained inactive poliovirus, was safe. Plus, it was 80 to 90 percent effective.
The federal government licensed the vaccine in a matter of hours. Manufacturers quickly started production. A foundation promised to buy the first $ 9 million in vaccines to apply to the country's first and second grade children. A national campaign was started.
But less than a month later, the initiative came to a complete halt. Authorities reported six cases of polio linked to a vaccine made by Cutter Laboratories in Berkeley, California. The country's surgeon general asked Cutter to recall his vaccine lots. The National Institutes of Health asked all manufacturers to suspend production until new safety standards were established. Federal investigators discovered that Cutter had failed to completely kill the virus in some batches of the vaccine. The faulty vaccines caused more than 200 cases of polio and 11 deaths.
The vaccination program was partially resumed two months later, but the chaos continued. Due to a short supply of the vaccine, rumors began to spread about the existence of black markets and unscrupulous doctors who charged exorbitant fees. A manufacturing company planned to vaccinate its employees' children first, and then sent a letter to shareholders also promising priority access to their children and grandchildren..
States asked the federal government to implement a program that would guarantee equitable distribution. A Senate bill proposed that the vaccine be free for all minors. A House bill proposed that vaccines be free only for needy children; According to various accounts in the newspapers of the time, the discussion of the bill triggered an "angry fight" that forced the president of the Lower House to ask for a recess "to calm down.". The $ 30 million Polio Vaccination Assistance Act signed by President Dwight Eisenhower that August was a midpoint that, in essence, left states to decide for themselves.
Polio cases fell dramatically over the following years. Then, in 1958, when national attention began to wane, cases increased again among the unvaccinated. Polio cases accumulated in urban areas, mostly among the poor population of color with little access to medical care. The "polio patterns" of the states had become "something very different from those generally seen in the past," in the words of government epidemiologists.
Three years later, the federal government approved an oral polio vaccine developed by Albert Sabin's laboratory in Cincinnati, which contained weakened, non-inactive virus.. By the end of that year, polio infections had been reduced by 90 percent compared to 1955 levels. In 1979, the country recorded its last case of community transmission.
Today, decades after the start of a global vaccination campaign, polio persists in only three countries. The battle against disease has been a century-long effort. In addition, it has required a continued commitment to continue polio vaccination, a commitment that is currently in jeopardy as global polio vaccination initiatives have been suspended to curb the spread of the coronavirus.
There are certainly many, many differences between the fight against coronavirus and the historic battle against polio. Today's global vaccine research and development capacity is vastly greater than it was in the 1950s. Drug authorizations and manufacturing safety protocols have also been refined since then. Within a few months of the start of this pandemic, there are already many more vaccines against the coronavirus in development than there were against polio.
However, the regulatory barriers that we have spent decades setting are being pushed aside to accelerate that development, and some of the coronavirus vaccines that are currently in "ultra-fast" development - developed by new biotech companies, university laboratories, and large pharmaceutical companies. recognized — they are as unprecedented and novel as the first polio vaccine was in 1955.
If any vaccine proves to be safe and effective, we will face the same challenges of the past: manufacturing enough to protect the population without causing harm, and distributing them without exacerbating existing inequalities in our society.
* c. 2020 The New York Times Company