Polio Vaccines: Then and Now

  • Posted 09.05.14
  • NOVA

In the first half of the twentieth century, polio killed thousands of people each year. The invention of the first polio vaccine was a major milestone for public health. But the history of the vaccine is a complicated one.

Running Time: 13:47


Polio Vaccines: Then and Now

Posted: September 5, 2014

Narrator: David Salamone's childhood story is also extremely rare, and his changed the course of vaccination history.

David Salamone: 
I contracted polio from the vaccination. It affected my right leg, my muscles atrophied, I wear a leg brace, my right foot's smaller than my left foot.

Narrator: At 22, this is first time David has spoken publicly of his family's epic journey.

David Salamone:
 You know, I'm one in the million in the sense that I contracted polio from the vaccination, but I'm also one in the million that I was born into the family that I was born into.

Narrator: When he was six months old his parents, John and Kathy, took him for his routine vaccinations, including the oral polio vaccine. Within 24 hours, David had a fever and a rash.

John Salamone:
 So we took him to the pediatrician and he basically said, "Oh, it's nothing, probably a little reaction, but don't worry about it."

Kathy Salamone: High fever.

John Salamone:
 Yeah, it just seemed to get worse. 
And then, suddenly we noticed that he wasn't even able to move his extremities—lower extremities. We gave up on the pediatrician and immediately took him to Children's Hospital. And after a week, they basically said, "You know, we're sorry, but your son has some kind of paralysis and—"

Kathy Salamone: "We don't know why."

John Salamone: "We don't know why. We just simply don't know why." We went home and cried our eyes out and, not knowing really at that point that there was a direct relationship with the vaccine, because we had been assured that, "Oh no, nothing to do with the vaccine."

Narrator: For the first few years David needed ongoing physical therapy. He was sick a great deal.

Kathy Salamone:
 It was strange because he would get sick and then the doctors would give him antibiotics, and then he'd seemed to be better, and then he'd get sick again. I didn't know what to think.

Narrator: By age three, after endless tests, one doctor connected the dots.

John Salamone:
 He came back to us and he basically said, "Well, your son has a genetic disorder—he was born without half of his immune system," which by the way, in retrospect, could explain why he kept getting sick and the doctor kept putting him on antibiotics.

Narrator: David was diagnosed with an immune disorder known as Bruton's disease, which means his body can't produce antibodies. So when a germ enters his system, he has no way to mount a defense.

John Salamone:
 No one knew at the time that he had a compromised immune system. So when he was given the live polio vaccine, we effectively gave him polio that day that we took him into the doctor's office for his vaccination.

Narrator: To understand how this could happen, we need to revisit the extraordinary but troubled history of the polio vaccine. This unusual looking contraption is an iron lung, a relic from the 1950s polio epidemic in the United States. In 1952 alone, 58,000 Americans were affected.

Dr. Paul Offit:
 In the 1940s and 1950s, when polio was king, there would be tens of thousands of children who would be paralyzed every year. There'd be as many as 1500 children who would die every year, and what made polio so particularly heinous was you never knew who it was going to be. You didn't really understand why it was happening, you didn't understand why some children were paralyzed and others weren't, and so parents became enormously fearful. It was a silent stalker of children.

Ok, it's called an iron lung. Have you ever heard that term iron lung before?

Boy #1: How does the machine help your lungs expand?

Offit: So it creates a negative pressure. A negative pressure actually causes it to expand. It was a vacuum, that's exactly right. It would create a vacuum. It would create a vacuum, and then no vacuum, vacuum, no vacuum. The way that polio would work is it would travel to the spinal cord, and it would damage the spinal cord so you couldn't use your muscles to breathe. And if the nerves don't work, you can't breathe.

Boy #2: How long do you have to stay in there?

Offit: Sometimes it would just be a few days. Sometimes it would be a few weeks. Sometimes children would go into that as children, and they would stay in that for the rest of their lives. Until they were adults, even elderly adults.

Woman: This was my worst nightmare. Worst, when I was a kid. I was scared to death that I would be in one.

Narrator: In the 1950s, millions of Americans donated a dime to help fund the quest to develop a polio vaccine.

Voiceover: In the all out fight against polio led by the National Foundation for Infantile Paralysis, there were many years of struggle and heartbreak.

Narrator: It was an extraordinary alliance of scientists and volunteers, moving step by step closer to a viable vaccine. Then, in 1955, came the announcement that changed history.

Voiceover: A major medical hurdle was crossed with the discovery by Dr. Jonas Salk of the anti-polio vaccine, which was to spread a mantle of protection over millions of American children.

Jonas Salk: This gigantic task, for which there was no precedent, seemed impossible of achievement. But it was possible. It was carried through.

Narrator: They had developed a vaccine that could prevent polio.

Voiceover: Finally, the climax of production, inactivation. The power of the polio virus to infect man will be utterly destroyed. The enemy of man is now ready to become his servant.

Offit: It just tore through this country and this world that now we had a way to prevent polio. It was, I think, the single most dramatic moment of vaccine development, because people were so scared.

Narrator: Unfortunately, the euphoria didn't last. Fourteen days later, public health officials recalled the polio vaccine. One of the laboratories, the Cutter Laboratory, had made the vaccine badly. The virus that was supposed to be dead was still alive.

Offit: As a consequence, about 120,000 children were inadvertently inoculated with live deadly polio virus, 200 were permanently paralyzed, and ten were killed. It's, I think, probably the worst biological disaster in our country's history, arguably in any country's history.

Narrator: It became known as "The Cutter Incident." The Surgeon General announced that in the public interest the polio vaccine was suspended. And new testing procedures were introduced to prevent such a disaster happening again.

 But the lesson that was learned from that was that we needed to regulate vaccines far more carefully, far more tightly. And so it really was the birth of the vaccine regulation in the United States.

Narrator: Polio epidemics continued to sweep across the United States, but those who had received the correctly made vaccine were protected. And so the roll out re-started. In the 1960s, a second vaccine was introduced, called the Sabin vaccine. It was an oral vaccine—often delivered on a sugar cube. It became the vaccine of choice, as it was easy and cheap to administer. Together, the two vaccines saw polio cases plummet by more than 99%. However, the oral vaccine had one drawback. It used a weakened but live form of the virus. There was a tiny risk it could mutate, becoming dangerous again—a risk of 1 in 2.4 million doses. By the 1990s, the only cases of polio in the United States were those caused by the oral vaccine itself—cases like David Salamone.

John Salamone:
 No doctor that we saw had in their entire lives seen a case of polio. Who would ever think you'd have a child who would get polio today? You feel guilty, because you felt that you were—you and the doctor and society were all part of this collective effort that in the end gave your child polio.

Kathy Salamone:
 I felt anger when I found out that there was a safer vaccine, and definitely guilty because I took my baby to the doctor for this.

Narrator: Ironically, the safer vaccine was the original Salk vaccine, made correctly.

John Salamone:
 We failed to ask the question, does it pass the risk-benefit ratio test? And obviously, if the only cases of polio you have in a country come from the very vaccine designed to prevent it, it doesn't pass. And it shouldn't be given.
 So your anger then kind of turns into action.

Narrator: John went directly to the decision makers, from the Centers of Disease Control in Atlanta, all the way to Capitol Hill.

John Salamone: The Congress has oversight over CDC, over all the vaccine regulations, even though they're made by the CDC.

David Salamone: So this is where it started?

John Salamone: Absolutely.

Narrator: Using his skill as a journalist and a lobbyist, John wanted the weakened polio vaccine replaced with the injectable version.
 Ten other countries had already done so.

John Salamone:
 Media was a critical part of the campaign. They got comfortable, they got entrenched in a schedule that worked. They saw numbers, they didn't see faces. When we went to Atlanta, they saw faces.

Narrator: One of those faces was that of Gordon Pierson, who also acquired polio from the vaccine. Despite having spent his life in the modern day version of the iron lung, Gordon has just graduated high school. It's been over a decade since his parents, Randy and Susan, have seen the Salamones.

Susan Pierson: That's Gordon.

Randy Pierson: This is him before he got sick.

Susan Pierson: And he was never happy. He cried a lot as a newborn. He was one of those colicky babies. So we didn't take a ton of—there's a smile.

Kathy Salamone:
Yeah, that's a good smile.

Randy Pierson: And this was the day after he got sick. Gordon will never hold a job, he'll never wave goodbye to you, he'll never reach out and shake your hand or speak a word, or get married, or do any of the things we would associate with value or success. Yet his life holds incredible value, and we see that everyday.

Narrator: Despite the extraordinary damage the vaccine did to their child, they are not against vaccines.

Susan Pierson:
 If epidemics were still going on, people would be running for vaccinations, so people think we would come out anti-vaccine, but I really don't because I've seen the devastation of what a childhood disease can do.

Narrator: All up, it took nearly ten years to effect change. In late 1999, the U.S. government announced the switch. The U.K. and Australia followed suit several years later. However, in parts of the world where wild polio remains a threat, the cheaper oral vaccine is still preferred.

John Salamone:
This vaccine had a problem, and there was a better one and we fixed it. It worked—the system worked. It took a while. Too many had to suffer, but the system worked.

David Salamone:
 I'm not against vaccinations, I'm pro-vaccinations. We had thousands of people contracting polio prior to the vaccination. We came out with the vaccination, and that number decreased significantly. So less people are getting sick, less people are getting affected, and that's a good thing, regardless of anyway you look at it.


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This is an excerpt from the program "Jabbed - Love, Fear and Vaccines."

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