Anniversary of Polio Vaccine Approval, Remembering Microbiologist Hilleman
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SUSAN DENTZER: “The shot heard ’round the world.” That was commentators’ description of the impact of the famed Salk vaccine for poliomyelitis, or polio. Fifty years ago today, U.S. scientists announced the desperately awaited news about the vaccine developed by the University of Pittsburgh’s Jonas Salk.
SPOKESPERSON: The vaccine could be considered 80 to 90 percent effective against paralytic poliomyelitis.
SUSAN DENTZER: That was the beginning of the end for the global plague of polio. Epidemics of the disease, caused by a virus, had hit with a vengeance in 20th century America. Thousands, most of them children, were left disabled or paralyzed. The history of the Salk vaccine and America’s epic battle against polio is told in a new book “Polio, an American Story.”
We sat down recently with the author, David Oshinsky, a historian at the University of Texas at Austin. David Oshinsky, welcome. We see these pictures today of little kids in braces and on crutches, of people in iron lungs because their chest muscles were paralyzed by polio, and we can hardly fathom the impact that polio had on American society in the 20th century.
DAVID OSHINSKY: Well, polio was the most feared disease of the middle part of the 20th century. It was a children’s disease. There was no prevention. There was no cure. Every child everywhere was at risk. And what this really meant was that parents were absolutely frantic.
And what they tried to do was to protect their children the best way they could. And the best way they could was to try to keep them out of swimming pools, to keep them out of the movie theaters, to make sure they didn’t make new friends, so that germs weren’t shared among children.
But in reality, none of that worked, and really what parents began to think about was what the March of Dimes, the National Foundation for Infantile Paralysis, which had been formed in the 1930s, began to tell them, which was there really is only one solution, and that is a vaccine, and you must get behind the vaccine.
SUSAN DENTZER: The typical polio victim was a child under 15, but perhaps the most famous one was Franklin Delano Roosevelt.
DAVID OSHINSKY: Franklin Roosevelt got polio in 1921 at the age of 39. He was a very atypical victim. Yet in one sense, he wasn’t. He had spent that summer in Washington under great stress. He had gone to a Boy Scout camp surrounded by children. He had gone to his summer home in Campobello Island, engaged in frenetic activity, actually falling off his yacht into the Bay of Fundy. All of this made it more likely for him to get polio.
More important, he spent his life as an advocate of the fight against polio. He’s the founder of the Warm Springs Foundation, where the little White House was, where people went to be rehabilitated from polio. He was the founder of the National Foundation for Infantile Paralysis, known to Americans as the March of Dimes. And when he died in 1945, his portrait was put on the dime.
SUSAN DENTZER: You wrote in your book that Americans were primed to see polio in a typical American fashion, and to attack it through “a combination of ingenuity, volunteerism, determination, and money.”
DAVID OSHINSKY: Yes, that is absolutely right. In this era, the federal government was not much involved in medical research. It had to be done privately. And what the March of Dimes did was to involve everybody. Everybody could give something.
And what they did with this money was to put together research teams of really the best virologists and scientists in the country, trying to get a vaccine at Hopkins, at Yale, at Pittsburgh, at Cincinnati. And what they did when they thought they had a vaccine ready was to begin the largest public health experiment in American history.
They lined up two million kids and basically gave them a vaccine that no one was certain was safe, that the government hadn’t tested, that might not work. And what this really seemed to show was the enormous fear that people had of polio.
SUSAN DENTZER: Much of what came about during the battle against polio transformed American public health, and we see the remnants to this day, starting with our very notion of a poster child.
DAVID OSHINSKY: Yes, we do. The first poster child was Donald Anderson, and he came to the March of Dimes in the mid-1940s. What the March of Dimes did, as a way of trying to enhance polio and turn it into America’s national disease, was to use poster children, was to have mothers marching against polio, was to use celebrities who loved to get involved in any charity involving children– Mickey Rooney, Grace Kelly, Elvis Presley.
I have a picture in my book of Richard Nixon pumping gas for polio. It simply was using public relations, razzle-dazzle, Madison Avenue, the latest fundraising techniques to get Americans interested in a disease that was horrific.
SUSAN DENTZER: There were some dark episodes during this whole experience that set the stage for later reforms. What happened?
DAVID OSHINSKY: There were. The early polio trials in the 1930s and in the 1940s, and leading up to the major trials, were often done without any kind of really volunteerism or informed consent. You would go into a mental institution. You would go into what was called a home for the feeble-minded. You would take children who really had no parents and were wards of the state, and you would test on these children.
And they, in a sense, were perfect for testing because they weren’t going anywhere, they couldn’t object, their medical records could be kept very, very carefully. And we’ve moved to an era now, certainly I think in some degree in response to what happened, where there must be informed consent, where the government would never allow the kind of very loose handling of particularly using children, and using children who had problems.
SUSAN DENTZER: We have eradicated polio now, as you say, in most of the world. But just in the past year we’ve had new outbreaks in Nigeria, in part because the Muslim clerics there have warned the population against getting vaccinated.
DAVID OSHINSKY: Right.
SUSAN DENTZER: What lessons, as we work to eliminate polio and other infectious diseases like malaria, what lessons do we take away from the polio experience?
DAVID OSHINSKY: I think there are many lessons from the polio experience. In terms of what is happening in Africa, in parts of Pakistan and India, I think the great lesson is that you vaccinate your children and you do everything you can to educate the public about the need to do so. Polio is a disease that can be wiped off the face of the earth.
What we’re facing, particularly in parts of Nigeria, is really cultural resistance to that vaccination, the belief that westerners are trying to create AIDS through the vaccine, that they’re trying to make their women infertile, and because of this, we are never going to be able to vaccinate all the children we need to. The lesson really is education. Break down the resistance to vaccination, and you will end polio forever.
SUSAN DENTZER: David Oshinsky, thank you.
DAVID OSHINSKY: My pleasure.
MARGARET WARNER: Now, medical miracle worker number two: Maurice Hilleman, who died yesterday at age 85. He developed vaccines for more than 20 human diseases, including mumps, measles, chicken pox, and pneumonia. We remember him now with a friend and colleague, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. And Dr. Fauci, welcome.
DR. ANTHONY FAUCI: Good to be here.
MARGARET WARNER: You were quoted today in one of the obituaries with a remarkable statement. You said Dr. Hilleman probably saved more lives than any other scientist in the 20th century.
DR. ANTHONY FAUCI: There is no doubt in my mind. He is a legend among scientists and one of the best kept secrets among the lay-community throughout the world. He combined a phenomenal intellect with the ability to get things done.
So if you look at not only the quality of what he did, but the volume, the number of vaccines that he developed with his team, was extraordinary. Of the 14 recommended vaccines, eight of them were developed by Maurice Hilleman. He was not a person who would take credit for things so he did it in a corporate setting. But he is a man who has done what no one else has done.
MARGARET WARNER: What was it about him? He grew up on a farm in Montana. Originally he wasn’t planning to go to college. What was it about him that made him such a standout?
DR. ANTHONY FAUCI: Well, he was just a brilliant man who had the boundless energy and capability of doing things. And he put his eye on the target and went after it and nothing stood in his way. Some people are brilliant but can’t get things done. Some people can execute what you tell them but are not particularly smart. He had both of those together in unbounded energy.
MARGARET WARNER: He once said good luck and trial and error had a lot to do with it. One, do you agree with that, and do you think the mumps vaccine illustrates that?
DR. ANTHONY FAUCI: Good luck favors the person who has the prepared mind, but an example of what he did: His daughter got sick with this disease that was called mumps. And the night that she got sick and started to get symptoms, he actually took some saliva out and said,” I’m going to go to the lab and I’m going to try and isolate this virus and make a vaccine.” So as his wife was taking care of Geralynn, he went to the lab, isolated it and then we have the mumps vaccine — just as simple as that.
MARGARET WARNER: Why weren’t other people doing exactly the same thing?
DR. ANTHONY FAUCI: Well, it’s just what I said, it’s a question of the intellectual brilliance of being able to do it, conceptualize at the same time you can actually do it. And he was a man, he was a wonderful character, the kind of person, he didn’t suffer fools lightly. He was an adorable grump as we called him because he was constantly pushing and joking and asides, and things like that but he always kept his eye on the ball. When a brilliant person keeps his eye on the ball, then you’re going to get good results.
MARGARET WARNER: Is it fair to say that much of modern preventive medicine is really built on his work?
DR. ANTHONY FAUCI: Absolutely. You just mentioned diseases, just the childhood diseases, measles, mumps, rubella, Hepatitis A, Hepatitis B, meningitis, pneumococcal pneumonia, Hemafluous Influenza B. If one of those was an accomplishment of an individual’s career, they would have been considered to be a great person. He did it all.
MARGARET WARNER: You knew him personally. You said he was something grump.
DR. ANTHONY FAUCI: An adorable grump.
MARGARET WARNER: But did he strike you — if I met him, would he seem like the mad scientist, the genius?
DR. ANTHONY FAUCI: No. No. No, he was a very, very gracious person, very, very kind to people, very good with students; took the time to explain things. He just did not suffer fools or people who went on and on about things and didn’t know what they were talking about. He would cut you off in a microsecond.
MARGARET WARNER: You once told a story when you were giving a speech for his birthday that many young people in his field didn’t even know who he was.
DR. ANTHONY FAUCI: Right. Right.
MARGARET WARNER: How do you explain that?
DR. ANTHONY FAUCI: Well, I think it’s the nature of his character. He never was a person who was grandstanding or who said I did this and I did that. He gave credit to his team. When he developed it, it was the product that got the publicity, not the person who made it. That was just in his character. He had no use for self aggrandizement.
MARGARET WARNER: A remarkable man. Dr. Anthony Fauci, thank you.