Saturday, February 20, 2021

Polio Post

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Others were exposed in Africa.

"For some Americans, COVID-19 vaccine rollout brings memories of another time and place" by Emma Goldberg New York Times, December 25, 2020

Lizzo’s “Good As Hell” greeted the arrival of COVID-19 vaccines this month at Boston Medical Center, where the scene of dancing health care workers quickly spread on TikTok. Others shared triumphant selfies of their arms post-injection.

For Americans of a certain generation, the rollout evoked searing memories of an earlier era — one that rescued their childhood from fear and the sudden loss of classmates and siblings.

Lynne Seymour was 8 years old in 1955 when her mother, a nurse, let out a startling noise while listening to the radio at their home in Berkeley, Calif.

“She started jumping up and down, crying and laughing at the same time,” Seymour said. “It scared me a little because I didn’t know what was happening. So I said, ‘Mom, what is it?’ ”

Her mother explained that Dr. Jonas Salk, a medical researcher, had developed a vaccine for a dangerous virus. “It meant we wouldn’t have to worry about polio anymore, and children wouldn’t be in iron lungs, and we would go back to the swimming pool,” Seymour said. “It was like a dark cloud had lifted.”

The first polio epidemic in the United States began in Vermont in 1894, an outbreak that killed 18 people and left at least 58 paralyzed. Waves of pernicious outbreaks, targeting children, would mar the next half-century. In the country’s worst single year, 1952, nearly 60,000 children were infected, and more than 3,000 died. Many were paralyzed, notably including Franklin D. Roosevelt, who would become president and hide his disability. Others were consigned to life in an iron lung, a type of ventilator that encased a child’s body to ease breathing.

A litany of other celebrated figures also lived with the disease: songwriter Joni Mitchell, artist Frida Kahlo, Olympic sprinter Wilma Rudolph, and Senator Mitch McConnell of Kentucky.

Parents anxiously wondered how to keep their children safe from the disease, ordering them to stay away from swimming pools and movie theaters. They practiced the hand-washing routines that have become all too familiar to families this year. (It is now understood that the polio virus spread through consumption of water and food contaminated by fecal matter.)

Salk made an ambitious bet that he could develop a vaccine for polio using inactivated virus, which was killed using formalin. When his trial was successful in April 1955, church bells rang and households cheered.

American children had been taught for years to dread summer because it so often brought polio outbreaks. A vaccine promised that they could go out and play again, and swim without as much worry.

The federal government licensed the vaccine within hours of the announcement, and manufacturers began their production efforts. “An historic victory over a dreaded disease,” a newscaster’s voice declared in an April 12 reel from Metro-Goldwyn-Mayer. The announcement includes clips of men in suits rolling carts of vaccine shipments, much like this month’s images of coronavirus vaccine shipments. “Here, scientists usher in a new medical age.”

After all of the fanfare, some children remembered getting the vaccine as anticlimactic. Philip McLeod, 77, who was living in Nanton, Alberta, at the time, said he and his classmates were lined up very quickly, and then it was over. “It was hard to believe as a 12-year-old that was going to save your life, because it was so routine,” he said, but visibly, the creek and the skating rink by his home, long abandoned out of fear — similar to the scenes today at many communal playgrounds and parks — once again filled with the sounds of children playing.

Among the first children in the country to receive the vaccine were Salk’s three sons. Peter Salk, the oldest, recalled their father gathering them near the kitchen table and instructing them to roll up their sleeves and expose their triceps. Then Salk moved from the stove, where he had sterilized needles and syringes, and injected his sons.

“It was an opportunity to demonstrate my father’s confidence in the work he had done,” Peter Salk said, “and to get us kids protected.”

When the shot was later administered in a 1954 field trial at their Pittsburgh elementary school, one of the teachers asked Darrell Salk, who was only 6 at the time, to comfort a crying schoolmate and explain that his father’s vaccine was safe.

“What did I know?” Darrell Salk said. “I was a kid, but I did my best to reassure him it was helping to protect people from a very nasty disease.”

Still, much like the atmosphere surrounding the debut of this month’s coronavirus vaccines, introduction of the polio immunization was bittersweet for many families who had already lost relatives.

Jean Norville, 72, remembered her older brother Tommy as a “saint,” so gentle-hearted that when she slammed her finger in a car door, he said he wished it were his own instead. Tommy fell sick with polio in October 1951, and his parents drove at speeds exceeding 100 miles per hour to a hospital in Louisville where he was put in an iron lung. Their mother, refusing to leave Tommy’s side, slept in the hospital bathtub.

He died soon afterward. The neighbors were so afraid of getting polio that Norville’s family held Tommy’s funeral with an empty coffin. When the vaccine arrived, Norville’s mother rushed her children to the health department to get the shot.

“Think of Tommy,” her mother said.

The initial polio vaccine rollout did not go smoothly. Within a month, six cases of polio had been linked to a vaccine manufactured by Cutter Laboratories in Berkeley, Calif. It was soon discovered that Cutter had failed to completely kill the virus in some vaccine batches, a mistake that caused more than 200 polio cases and 11 deaths. The surgeon general asked Cutter to issue a recall, and distribution ground to a halt.

Just like now with CV


They also halted injections, so can the recall be far behind?

The vaccine program restarted months later, and polio cases fell sharply. Elvis Presley agreed to be vaccinated on national television to build public confidence in the shot, but the disease did not disappear. US case counts rose again beginning in 1958, especially in urban areas. The country’s last case from community spread was recorded in 1979. Although two strains of polio have been eradicated, a third remains and still circulates in Afghanistan and Pakistan.


For those scarred by memories of the polio epidemic, a vaccine against COVID cannot arrive soon enough. Many older Americans, particularly vulnerable to the disease, have been shut in and separated from their children and grandchildren for much of this year.

Norville has not left her home since February and is eagerly waiting for a shot. “My son said, ‘If I could, I would bring you the vaccine today.’ ”

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They have forgotten the problems:

"Throughout history, mass vaccine rollouts have been beset by problems" by Dugan Arnett Globe Staff, January 10, 2021

The 1955 arrival of Jonas Salk’s polio vaccine is still hailed as one of modern medicine’s crowning achievements, a lifesaving intervention that some deemed nothing short of miraculous.

For those of a certain age, the mass distribution of a safe vaccine signaled the end of a dark and disturbing period, one of locked school buildings and swimming pools, iron lungs and lifelong paralysis. Many of those who went through the process of being inoculated still recall the sense of elation the vaccine brought, even if the reality wasn’t as smooth as memory might suggest.

“It’s sort of assumed this mythological status as a hugely successful campaign,” said James Colgrove, a public health professor at Columbia University, “but there was a lot of confusion, there was a lot of chaos, and the federal government was actually widely criticized for its failure to anticipate the public demand for the vaccine — and to make plans for rolling it out.”

If that sounds familiar, it should.

Today, as the country scrambles to distribute a pair of promising COVID-19 vaccines, the process has been hindered by many of the same issues — supply shortages, public confusion, delays — that impeded other mass vaccination rollouts throughout US history.

The federal government fell well short of its goal of giving 20 million people an initial dose of the vaccine by the end of 2020. By Dec. 31, the reported number of Americans vaccinated stood at just 2.8 million, and in the CDC’s most recent figures, from Jan. 8, only 6.68 million people had received their first dose, even as deaths and new cases climb at a record pace.

In Massachusetts, 151,430 residents — or about two percent — have so far received a first dose of the vaccine, according to the CDC. Governor Charlie Baker last week criticized Washington politicians for a lack of attention paid to the vaccine’s rollout, and some public health experts have suggested reducing recommended dosages temporarily to provide more people with some level of protection.

Public health experts are quick to note that the current vaccination effort differs significantly from previous attempts to inoculate large numbers of people. Never before has there been an attempt to produce and distribute a vaccine on such a wide scale in such a short amount of time.

Still, some of the problems with the vaccine’s distribution have clear historical precedent.

Perhaps the closest contemporary comparison to today’s effort is the administering of the polio vaccine in the 1950s and 1960s.

Much like COVID-19, the polio virus, which would infect 57,879 and kill 3,145 in 1952 alone, sent the country into a panic. Public spaces closed, and many people were afraid to leave their homes, as those who contracted the virus often ended up hospitalized or permanently paralyzed.

“People were afraid,” said Rahul Gupta, chief medical and health officer at the March of Dimes. “People were afraid to go out because of this disease.”

At the time, the March of Dimes, then known as the National Foundation for Infantile Paralysis, led a massive fund-raising charge to combat the virus. Celebrities, including Elvis Presley, rallied support for the cause. In a show of unity rarely seen during the current pandemic, Americans jumped to support the effort. Within a few weeks’ time in 1938, some 2.68 million dimes had been sent to President Franklin D. Roosevelt, who had been stricken with polio, to fund research aimed at developing a vaccine.

The effort paid off. In 1954, the March of Dimes organized and funded one of the largest clinical trials in history, which included 1.8 million children, and when it was announced the following April that a vaccine from University of Pittsburgh scientist Jonas Salk was both safe and effective at protecting against the virus, Americans were understandably elated, but the rollout of the vaccine soon proved challenging on a number of fronts. Americans who had expected a coordinated federal distribution effort were frustrated to learn that there wasn’t one. With the Centers for Disease Control and Prevention still in its infancy, the federal government turned to an array of pharmaceutical companies for help.

“What the government did was simply to hand the formula over to [six] companies, with virtually no oversight, and say, ‘Go produce it for everybody who wants it,’ ” said David Oshinsky, author of the Pulitzer Prize-winning book “Polio: An American Story,” and it turned out to be a disaster.”

Confusion over how to get the vaccine abounded, said Colgrove of Columbia University. Private physicians were unsure when they would receive doses and when they’d be able to deliver them to patients. There were rumors, too, of black-market sales.

In a particularly tragic episode, one of the companies enlisted by the federal government to manufacture the vaccine — California-based Cutter Laboratories — produced a defective batch that effectively resulted in tens of thousands being injected with the polio virus, a fiasco that led to a reported 40,000 cases, 50 children suffering paralysis, and five deaths.

The contamination temporarily halted the vaccine distribution, though it eventually returned and, along with a second vaccine from scientist Albert Sabin, resulted in a sharp decline of polio cases across the country. The disease was eventually eliminated in the United States.

The country would see its distribution system tested again just two decades later in 1976, when an influenza reminiscent of the 1918 influenza pandemic emerged.

Even with the lessons of the mass polio vaccination still relatively fresh in the national consciousness, things quickly went awry, as the government rushed out a vaccine and more than 400 people who received it went on to develop Guillain-Barré syndrome, a rare neurological disorder that can result in paralysis.

Some of the effects of the 1976 debacle still linger today, said Dr. Howard Markel, a professor and medical historian at the University of Michigan School of Public Health. They are often seized upon by the antivaccination movement as evidence of the government’s inability to safely inoculate its citizens.

There have also been occasional success stories in campaigns to vaccinate large numbers of people quickly.

In 1947, for instance, a middle-aged businessman arrived in New York City feeling under the weather. The man had previously received the smallpox vaccine, which had first been developed in the late 1700s, but when he died days later, and smallpox was determined to be the cause, it led to a successful campaign to vaccinate — or re-vaccinate — a vast majority of the city’s population.

Once again, it LOOKS LIKE the SHOT is what INFECTED YOU!

“In the span of less than two months, they vaccinated close to 5 million people,” Oshinsky said, who noted that the city’s compact area aided in the campaign’s effectiveness.

In some ways, too, the country has learned from its failures. Soon after the coronavirus arrived, for instance, the federal government invested billions into the development of a vaccine, no doubt speeding up development. The safety breaches that plagued previous rollouts also resulted in an increasingly regulated process, with the Food and Drug Administration adopting much stronger oversight in the development and licensing of vaccines, and despite the current distribution “hiccups,” the tremendous strides made over the past year should not be ignored, Gupta said.

Far from it! 

They are repeating them!

The only thing they have learned is how to better deceive the public with the terror campaign.

“We’ve had a number of vaccines developed within a year, remarkable work by the global community to come together and serve the most vulnerable people across the world,” he said. “In so many ways, I think it’s a remarkable success.”

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The CV rollout has been no different, with deaths approaching one-thousand and adverse reaction nearing 20,000 -- and those are only the cases that have been reported.