Sarah Sundin: Historical Polio-- Part 3/3

It's been such a pleasure having Sarah Sundin back. There was a lot I didn't know about the history of polio and its occurrence that I learned from these posts. Great job, Sarah!

Polio Part 3—Vaccines

Papa had never truly forgiven Helen for catching polio, as if the doctor’s daughter should have been immune, should have been healthy and strong like Betty, should never have stooped to wearing braces. Some parents coddled their invalids, but not Papa. He’d been harder on her, required more of her. And it was never enough.

In my novel, Blue Skies Tomorrow, which takes place during World War II, Helen Carlisle deals with many repercussions of a childhood bout with polio. Thanks to vaccination, polio is quickly being forgotten, but it was a dread threat in the first half of the twentieth century. If you write fiction set in this time period, it helps to be familiar with this much-feared disease.

On August 22^nd, I discussed the disease, on August 24^th, I discussed treatment, and today the vaccines.

Immunization is the process of artificially creating immunity by deliberate infection with viral proteins, weakened viruses, or killed viruses. Vaccination results in the production of antibodies which protect the patient against infection.

 On January 3, 1938, polio survivor President Franklin D. Roosevelt established the National Foundation for Infantile Paralysis to fund polio research. Nationwide campaigns urged citizens to mail in dimes. The nickname March of Dimes stuck, a play on the popular newsreel, The March of Time. In 1946, the picture of Mercury on American dimes was replaced with the image of Roosevelt to commemorate his work.

The Salk Vaccine

The most famous recipient of those dimes was Dr. Jonas Salk, a medical researcher at the University of Pittsburgh. In 1952 he conducted small trials of a vaccine, and in 1954, a massive nationwide trial. On April 12, 1955, the tenth anniversary of Roosevelt’s death, an announcement was made that the vaccine was effective and available. Church bells rang throughout the nation.

The Salk Vaccine, now more commonly known as IPV (inactivated polio vaccine) uses a killed virus and is administered by injection. The vaccine is safe, since it does not cause the disease. On the negative side, immunized people do not shed the virus in the feces, so the desired “herd immunity” does not occur.

The Salk Vaccine was used in the United States from 1955-1962, when the Sabin Vaccine gained favor. As polio was eradicated, the dangers of the Sabin Vaccine became greater than the risk of the disease itself. In 1998, the United States returned to the use of IPV. Salk’s vaccine is currently in use in the Americas and Europe, where polio has officially been eradicated.

The Sabin Vaccine

What is science without controversy? Dr. Albert Sabin publicly disapproved of Salk’s work and did not receive funding from the National Foundation for Infantile Paralysis. Sabin conducted his clinical studies in the USSR and other countries from 1957-1960.

The Sabin Vaccine, also known as OPV (oral polio vaccine), is a weakened live virus administered orally, either by squirting into the mouth or ingested on sugar cubes. The Sabin Vaccine closely mimics wild-type virus transmission and produces long-term immunity. Virus is shed in the feces of vaccinated people, leading to immunity among contacts as well. These advantages led the United States to switch to the oral vaccine in 1962.

The vaccine is inexpensive and easily administered by volunteers with minimal training, making it ideal for administration in third-world countries, where it is still used.

However, in some cases the oral vaccine leads to actual poliomyelitis, paralysis, and death. Since the last polio case was seen in the US in 1979, the decision was made to return to the safer IPV in 1998.

Eradication

The effectiveness of the polio vaccine can’t be argued. Tens of thousands of cases were seen in the United States each year before 1955. By 1957, the rate fell 90 percent. The last case in the US was seen in 1979 among the Amish, who rejected vaccination. Polio was officially eradicated in the western hemisphere in 1994, in Australia and eastern Asia in 2000, and in Europe in 2002. Currently it remains endemic only in Nigeria, India, Pakistan, and Afghanistan, but hope remains for eventual worldwide eradication.

Resources

http://www.americanhistory.si.edu/polio (Smithsonian Institute’s display on polio)

http://www.marchofdimes.com/

Wilson, Daniel J. Living with Polio: the Epidemic and Its Survivors. Chicago: University of Chicago Press, 2005. (An excellent book describing the disease and its treatment from the patient’s point of view.)

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Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.