Perspectives From the Introduction of the Polio Vaccine

B. Dale Magee, MD, Curator

The physICIans Of the WOrCester DIstrICt shOWeD remarkable insight in dealing with the emotion surrounding the polio epidemic of the 1950’s and the development of a vaccine.

In 1955, shortly after release of the vaccine, the “Cutter Incident” occurred in which, due to defective manufacturing, live virus was included in the inactivated virus vaccine. Over 40,000 cases of polio resulted, including cases of paralysis and death. The inoculations were in April, 1955.

In response Worcester Medical News published the following in May,1955:

“To one who has watched the development of immunization against contagious diseases during the last 55 years, certain definite conclusions have been formulated which he wishes to put on record.

The writer remembers the antagonism that was still alive in the early 1900s against smallpox vaccination. This was continued into the late 1920s by uninformed and regular practitioners of medicine. He was also active in organizing the campaign for the prevention of diphtheria in the city. With all similar immunizing procedures, successful and unsuccessful, there were many bugs which only trial could correct. This happened in the toxin-antitoxin that was first used to immunize against Diphtheria which was so prevalent before the 1920s. The adoption of this wonderful procedure was slow and many imperfections were gradually removed so that today we have a safe method which has nearly banished that dread disease from the community. It has gone into history as one of the great victories of medical science over disease. Immunization against Scarlet Fever had its problems also, but they were overcome by experience. Happily, with the advent of antibiotics, Scarlet Fever ceased to be a problem.

And now we have the Salk vaccine which is destined to be a wonderful addition to the physicians’ armamentarium against that frightening disease, poliomyelitis, and which has been received with greater acclaim after only a few months trial. There will be many bugs in its development. Who is to blame for the hysteria which demanded that mass production of this vaccine before all safeguards could be established? Here is one man’s opinion:

1st: The Polio Foundation for the value of publicity and its beneficial effect on their campaign for funds grabbed the opportunity with great fanfare.

2nd: The great bacteriological laboratories that were eager to be the first to present their vaccine to the public.

3rd: The public press who overplayed the value of the vaccine before it was properly safeguarded.

4th: The pharmaceutical house which gave free close circuit TV report of the evaluation of the test last summer.

5th: The medical profession who were so easily stampeded into getting the first release of the vaccine.”

Yet, after what was felt to be adequate proof of safety, the WDMS not only supported the vaccine, but worked to immunize as many as possible in the community (funds from this project provided the seed money for the WDMS Scholarship Fund.

The challenges of building trust and meeting the needs of Public Health were illustrated in this editorial from Worcester Medical News from October, 1959:

“Local newspaper reports that the board of health of a nearby town was taken to task and sort of slapped on the wrist by the district chapter of the National Foundation because four children in one family who had not received the Salk vaccine came down with polio.

Rather than be overly critical, it would be well for this chapter to intensify its efforts in the discussion of education, urging more and more people, over and over again, to take advantage of these inoculations. In this particular case, it is known that the mother was urged to take advantage of these inoculations not only through ordinary channels of publicity, but also by private physicians. Furthermore, according to available records, this particular town has done an outstanding job of immunizing the population.

We should not use slapdown methods to get these people to take inoculations. Because of ignorance, indolence, misdirection or misinterpretation of information, or “fear of the needle“ there will always be an irreducible minimum who will refuse these injections, unless we can have a law which will compel Salk injection similar to that for a smallpox vaccination. Even then, there would be a few individuals who would deviously circumventive law.

At this rating, Worcester has not had a single case of polio in 1959. Perhaps that may be due to good fortune, but more likely to our immunization program. Through the efforts of our medical society, private physicians, and the department of public health, 92% of all school children, 90+ percent of preschool children, 60+ percent of all adults under 40 years have received three or more polio inoculations. Furthermore, additional clinics are set up to take care of the stragglers so that the maximum number of people will be immunized. Worcester can indeed be proud of this record.”

Wisdom from our forefathers. Human nature, it seems, has not changed. +