May 3, 20219:00 AM ET SUSAN BRINK
The
mass inoculation of millions of American children against polio in 1955, like
the vaccinations of millions of American adults against COVID-19 in 2021, was a
triumph of science.
But the
polio vaccine had overwhelming public acceptance, while stubborn pockets of
vaccine hesitancy persist across the U.S. for the COVID-19 vaccine. Why the
difference? One reason, historians say, is that in 1955, many Americans had an
especially deep respect for science.
"If
you had to pick a moment as the high point of respect for scientific discovery,
it would have been then," says David M. Oshinsky, a
medical historian at New York University and the author of Polio: An American Story. "After World War
II, you had antibiotics rolling off the production line for the first time.
People believed infectious disease was [being] conquered. And then this amazing
vaccine is announced. People couldn't get it fast enough."
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Today,
the unprecedented speed of the COVID-19 vaccines' development, along with
a flood of disinformation on
the internet about all vaccines, has led to a lingering hesitancy among some
Americans to receive the increasingly available COVID-19 shots.
"In
hindsight, Operation Warp Speed wasn't the best name," says Oshinsky.
"It sounds like the project prioritized speed over everything else. They
did roll it out quickly, but the FDA and CDC have done an amazing job of
testing the vaccines and ensuring their safety and efficacy."
During
the late 1940s and early '50s, according to statistics from the Centers for
Disease Control and Prevention, polio disabled an average of 35,000 people a
year in the U.S., most of them children. As outbreaks popped up
across the country in the hot summer months, people were terrified and
voluntarily isolated. Many parents kept their children close to home and away
from community gathering spots like movie theaters, roller rinks and beaches.
In hindsight, Operation Warp Speed wasn't the best name. It
sounds like the project prioritized speed over everything else. David M.
Oshinsky, medical historian, New York University
"Back
then, it affected business and travel," says Stacey D. Stewart,
current president and CEO of the March of Dimes. "People didn't know how
the virus was transmitted. They lived in a state of fear. Pools were closed.
Businesses were affected because people didn't want to be out in public."
President
Franklin D. Roosevelt, who had himself essentially lost the use of his legs
after a polio infection in 1921, when
he was 39, launched the National Foundation
for Infantile Paralysis, a charitable organization, in the late
1930s. Later renamed the March of Dimes, the foundation took the lead in
efforts to fund research at a time when the National Institutes of Health was
in its infancy.
"Roosevelt's
passion for finding a solution — a cure, a vaccine — made polio a priority
coming from the very top leader of this country," says Stewart. "People
across the country felt like they were called to duty. It was a call to action,
like the war effort."
An army
of volunteers for the March of Dimes, largely mothers, went door to door,
distributing the latest information about polio and the effort to stop it; they
also asked for donations. As little as a dime would help, they said. And the
dimes and dollars poured in, Oshinsky says, handed to the volunteers, or
inserted into cardboard displays at store checkout counters or placed in
envelopes sent directly to the White House.
Cases
of polio may have peaked in the U.S. in 1952 with nearly 60,000 children
infected. More than 3,000 died. (By comparison, roughly a year's worth of
comparable statistics for the
COVID-19 pandemic reveal more than 32 million reported cases in
the U.S. so far and more than 573,000 deaths.)
People across the country felt like they were called to duty. It
was a call to action, like the war effort. Stacey D. Stewart, CEO, March of
Dimes
The
years-long campaign of information and donations to the polio eradication
effort made anxious Americans feel they were invested in a solution, Stewart
says. So confident was the public in the research leading up to the polio
vaccine that by the time the Salk vaccine was ready for experimental testing in
1954, the parents of 600,000 children volunteered their own offspring as
research subjects.
When
the results of those studies showed the vaccine to be safe and effective in
1955, church bells rang. Loudspeakers in stores, offices and factories blared
the news. People crowded around radios. "There was jubilation," says
Stewart. People couldn't wait to sign their kids up for a shot.
Then
tragedy struck. One of the six labs manufacturing the vaccine, Cutter
Laboratories in Berkeley, Calif., made a terrible
mistake. The correct list of ingredients for the Salk vaccine called
for polio virus that had been
inactivated, but in the Cutter facility, the process of killing the
virus proved defective. As a result, batches of the company's vaccine went out
that mistakenly contained active polio
virus. Of the 200,000 children who received the defective vaccine, 40,000 got
polio from it; 200 were left with varying degrees of paralysis, and 10 died.
In
April, the U.S. campaign against COVID-19 suffered a blow too. Reports that an
extremely rare but serious blood-clotting disorder might have resulted from
Johnson & Johnson's vaccine — one of the three authorized for use against
COVID-19 in the U.S. — once again raised the question of whether possible harms
caused by a vaccine might derail people's confidence in a public health
campaign at a crucial time.
On
April 13, the CDC and the Food
and Drug Administration jointly announced that among the 6.8
million doses of the Johnson & Johnson vaccine administered to date, six
cases of a serious blood-clotting issue had been recorded, and one had woman
died.
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You Need To Know
Ten
days later, after a careful review of
those cases and others, the pause was lifted and
immunization with the vaccine resumed, with new guidance for recipients and
doctors about what to look for in the
way of symptoms and how to treat these extremely rare events.
Polio
vaccinations were temporarily halted in 1955 following the Cutter error as
well. In both incidents, health officials followed the science. After Cutter's
manufacturing error was pinpointed as the problem, vaccinations restarted
within weeks, with renewed quality control efforts and minus any involvement
from Cutter Laboratories.
In
1955, mothers and fathers jumped right back in following the Cutter tragedy,
once again signing permission slips and lining their kids up to get their polio
shot. It was widely understood and accepted that the risks of polio were a much
greater threat than the risks of the vaccine.
"I
think back then, people were so personally invested in the vaccine,"
Stewart says. "They listened to what happened in the Cutter case, and they
understood. They continued to trust."
Because
of that trust, the campaign to prevent polio with vaccines — first Jonas Salk's and
then also Albert Sabin's —
was successful, eventually nearly eliminating the disease from the planet. But
that also means, says Oshinsky, that people born after the mass vaccination
effort don't have memories of how bad the disease could be.
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"Vaccines
have been a job ... done so well they have obliterated evidence of what the
disease can cause: kids on crutches, in wheelchairs, in iron lungs,"
Oshinsky says. "I remember seeing the occasional empty desk in school
because a child had died. People had seen polio every summer, and they wanted
kids vaccinated as soon as possible."
The
polio vaccine effort offers some lessons for today, says Stewart. First,
volunteers from local communities are trusted and invaluable in providing
education on disease, research and vaccines. To get people's attention, add to
that numerous high-profile advocates — individuals recognized and esteemed by
various parts of the population. The March of Dimes recruited Judy Garland, Mickey Rooney and
Marilyn Monroe to join the fundraising effort to educate people about polio and
the value of the vaccine. And in 1956, Elvis Presley was vaccinated
backstage at The Ed Sullivan Show.
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Equitable
Vaccine
efforts at the time did have to contend with racism. Oshinsky writes, for
example, about some areas in the Jim Crow South where Black children lined up
for shots on the front lawns of white schools, while white children got their
shots indoors. The Black children, he notes, weren't allowed inside those white
schools, even to use the bathrooms. Very aware of the prejudices of the times,
Stewart says, the March of Dimes knew it would also need to recruit prominent
and popular Black performers to promote the polio vaccine.
Sammy
Davis Jr., Louis Armstrong and Ella Fitzgerald joined
the campaign. "There was a very early recognition that you couldn't just
have white people talking about the vaccine," Stewart says. In addition to
beloved Black celebrities, she says, "the March of Dimes had Black
children on the posters to raise awareness in Black communities."
It has
now been several months since Sandra Lindsay, a nurse
on Long Island, N.Y., became the first person in the U.S. to receive
a COVID-19 vaccination. At least 30% of the country's total residents are now
fully vaccinated, and more than 44% have
received at least one dose.
"That's
the low-hanging fruit," says Oshinsky. "After you vaccinate all the
people champing at the bit to get it, that's when you have to think of strong
marketing strategies for those who are hesitant."
The
strong, consistent message during the polio years was "We're all in this
together." The same message, says Stewart, must come across loud and clear
today.
Susan
Brink is a freelance writer who covers health and medicine. She is the author
of The Fourth Trimester and co-author of Change
of Heart.
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