The Salk polio vaccine story

Jonas Salk— CHJ 2010 Humanist of the year “The story behind the story” Dave Shafer, CHJ

Jonas Salk 1914-1995 Developer of polio vaccine 1976 Humanist of the Year American Humanist Association 2010 Humanist of the Year Society for Humanistic Judaism

Jonas Salk was born in NYCity in 1914

“I was the eldest of three sons and the favorite and the one who had all of her attention, certainly until my little brother was born -- I was about five years old then -- and my youngest brother when I was about twelve. I was essentially an only child in the sense of having her interest and concerns and attention. She wanted to be sure that we all were going to advance in the world. Therefore we were encouraged in our studies, and overly protected in many ways. “

Jonas Salk’s father designed women’s blouses and had an artistic tempera- ment. His mother had a lot of ambition for her son. Jonas seemed to draw up- on both traits in his own life.

Salk quotes: “As a child I was not interested in science. I was merely interested in things human, the human side of nature, if you like, and I continue to be interested in that. That's what motivates me.” “I think I was curious from the earliest age on. There was a photograph of me when I was a year old [not this one here] and there was that look of curiosity on that infant's face that is inescapable. I have the suspicion that this curiosity was very much a part of my early life: asking questions about unreasonableness. I tended to ob- serve, and reflect and wonder. That sense of wonder, I think, is built into us.” “I got along with my classmates, but I was not as sociable a child. I could spend time by myself and I still do. I would say that I spent more time alone than I did in social settings. Part of this was probably attributed to my mother's over-protectiveness, lest I hurt myself, or be injured in some way. How much of this is innate, and how much of this came about through that kind of nurturing, I can't say. “ But we can say. Salk had a largely absent father and a VERY ambitious mother.

Salk described his childhood of being a time of extended waiting, waiting to grow up and do great things. Sort of like waiting for the phone of adulthood to ring.

Left to right - Brother Herman, became a veterinarian Jonas’ 1st wife Donna, a social worker Jonas Brother Lee, became a child psychologist Bottom Father, Daniel— clothing designer Mother, Dora (Dolly) Both Russian Jews

Salk went to City College when he was 15, and then NYU medical school. In 1935 Yale medical School received 501 ap- plicants. 200 of these were Jewish. Of the 76 people accepted, Yale only took 5 Jews. Cor- nell and others were equally restricted.

For Salk to apply to a restricted Ivy League medical school would have been a career non-starter and he knew that.

Salk’s wife Donna’s father was a wealthy Manhattan den- tist and regarded Salk as so- cially inferior by several notches. He agreed to the marriage only if Salk was a doctor (to put on the wedding invitations) and took a middle name, which he did not have. They married the day after he got his M.D. degree. They had three sons.

“Being Jewish was a deeply important aspect of my father's life. I don't believe he was a member of any Jewish organizations as an adult, but there may be things of that sort that I am not aware of. He arranged for me to spend a summer in Israel (Kaitz ba Kibbutz) when I was 18, and I think supported one or even both brothers to visit Israel in their youth. I think my father's sense of being Jewish had more to do with the cultural/genetic heritage than with religion. I consider myself Jewish, but in that same way (heritage, not religion). It was important to me (for reasons I don't un- derstand) to marry a woman who was Jewish -- which I did. Our son, I believe, considers himself Jewish -- again, by heritage, not in terms of a practiced religion; though some aspects of ritual have been important to him (e.g., lighting candles during Hanukkah). Both of my brothers married gentiles. I think they both regard themselves as Jewish, but I can't speak for them. I'm not clear how their own children feel about their half-Jewish backgrounds.” Statement by Dr. Peter Salk, Jonas Salk’s oldest son

Polio has always been with us. Here is an Egyptian with a with- ered leg and deformed foot. Po- lio is caused by a virus and in some cases can result in total paralysis in a matter of hours.

Roosevelt was probably the most famous vic- tim of polio. The news media went out of their way to not show him in a photo like this and the public’s image of him, at the time, was not this one. How times have changed!

The Roosevelt memorial has been criticized for showing him with a large cape that obscures his condition.

Andrew Wyeth’s “Christina’s World” shows his neighbor, who had polio.

Today our image of polio is of adults who had it back then. Back then the public image was of stricken children.

Cause was unknown No treatment Mostly children Public hysteria, fueled by fund raising ads and im- ages Small chance of getting compared to other ill- nesses, accidents, etc.

Although there was no treatment for polio that would cure it, there was something that would somewhat help the symptoms. Sister She got enormous resistance Kenny was an iron-willed self-taught Aus- from the medical establish- trailian WWI nurse, shown at right. She basi- ment. Their approach — cally invented the whole field of physical braces and crutches, turned out therapy and that was her way of helping polio to do more harm than good. victims. Body manipulation and exercise.

Although adults could get polio, the fund appeal was based on emotional pitches about children. The money raised was eventually channeled towards Salk’s research labs. Sabin also was supported in his quest for a vaccine.

Entertainer Eddie Cantor coined the phrase “March of Dimes” on his radio show. People were encouraged to send a dime to help fight polio. The response was absolutely overwhelming. Posters were everywhere.

Some Inconvenient Facts Polio occurs quite rarely compared to other serious diseases or accidents. Public hysteria was not based on facts. Its media visibility was very much out of proportion to its actual occurrence Polio mainly hits children under age of 3 (50% of all cases). Roosevelt was not a typical case. Of people who get polio only 1 in 200 experience paralysis, usually in the legs. Very few ended up in an iron lung. 90% have no symptoms at all.

Recent US data During the 1952 US polio epidemic (worst year ever), about 3,000 people died from it. A tiny blip on a chart like this, if it were for 1952. Today 40,000 people a year die in car crashes, 65,000 from poison and about 80,000 from infectious diseases (not polio)

A Bizarre Situation Polio becomes much more common when primitive sanitation is replaced by improved hygiene. Constant exposure to the virus in primitive environments results in natural immunity. With better hygiene, exposure is delayed and infrequent, and immunity is lost. Much better hygiene still is then need- ed to turn this around, so that exposure becomes very rare.

Polio Hysteria An interesting digression - what was behind this exaggerated fear?

After the horrific war the country wanted to live a safe, quiet, peace- ful life with no strife.

In the early 1950’s the country felt that there were scary threats to the hard-won post-war stability and prosperity. UFOs were sighted. Russia got the H-bomb, due to spies here in our midst. Commies were hiding under every bed. You did not know who could be trusted anymore.

Disturbing elements were emerging in young people

Marlon Brando was in “The Wild One” 1953 movie. The media was full of fringe elements breaking the “rules” of conventional society.

Your neighbor could be a secret commie. Or, as in this TV show and movie, could be a double agent— an undercover commie for the FBI. These communist threats to society were scary because of being so hidden.

Questioning someone’s patriotism could ruin a career, as Nixon sleazily did.

The iconic 1952 movie “High Noon” was a veiled reference to the idea that a truly courageous individual would stand up to the paranoid “Red Scare” hysteria, and Joe McCarthy’s House Un- American Activities Committee. Several people associated with the movie were then blacklisted. This time—1952—when “High Noon” was released coincided with the peak of the polio fear hysteria.

During the war many women had left home to help with the war effort (Rosie the Riveter). They also ran the household in the ab- sence of men. After the war society (i.e. men) tried to stuff women back into the home and into confining roles where happiness was supposed to come from cooking and appliances.

Rosie the Riveter did not like being stuffed back into the lim- ited possibilities of the home.

Women had helped win the war and now did not want to lose that independence and sense of achievement outside of the home.

The 1956 book “The Organization Man” docu- mented the rigid conformity that was stifling tensions within the home and within society. The pressure cooker being held here can be viewed as a metaphor for problems ahead.

The real threat to the “American way of life” was not secret communist cells, the Russian H-bomb, UFOs, or juvenile delinquents or beatniks. It was the unex- ploded bomb that was brew- ing of women’s lib (and also black civil rights). The deeper tensions in society, and within the home, over that may have fueled the Red Scare and the polio hysteria of 1952, as psychological displacements.

And now back to our story Sabin and Salk didn’t see eye to eye about how to best make a Sabin developed good polio vaccine. Salk’s vaccine used a vaccine that dead polio virus. contains live, but weakened polio virus.

Developing a new vaccine was kind of like alchemy - lots of trial and error instead of systematic science. American slaves in colonial times knew about a type of vaccination that was used by witch doctors in Africa.

It is remarkable that some ancient witch doctor practices are actually good medi- cine and not just mumbo-jumbo. They would scratch one’s skin or make some small cuts and rub into it smallpox oozings from a sick person.

Puritan preacher Cotton Mather (1663-1728), famous for his role in the Salem witch trials, had a theory of why this smallpox treatment worked. He thought that if you breathe in the “humors” surrounding a person sick with smallpox it would go directly to your lungs and middle of your body. But if introduced through a scratch in your skin it gave your body time to marshal its defenses. Quite a clever man, ahead of his time.

There was intense rivalry between Sabin, shown here, and Salk over who would first develop a vaccine. Sabin dismissively called Salk “A kitchen chemist”. Sabin’s oral vaccine with live weakened virus eventually won out over Salk’s shot with dead polio virus. Sabin too was Jewish.

One person involved in this race to produce the first polio vaccine said that the choice would be between the “young Jew” (Salk) and the “smart Jew” (Rabin). Of the two Salk was far and away more media savvy. Any time photogra- phers came to his labs he would put on a lab coat even though he was not involved at all in the day to day lab work. Salk also bypassed medical journals to announce results directly to the press. These and other grand- standing actions made Salk quite unpopular with his scientific colleagues.

I hope that no Jonas Salk fans get too bent out of shape over this, but facts are facts. Salk initially failed to acknowledge the major contributions to his vaccine by his close lab asso- ciates, who did most of the work and development. This did not endear him to other scientists, who place a high value on proper credit-giving.

Sometimes life presents some re- ally tough choices. Because of intense public fears the polio founda- tions decided to go with Salk’s vaccine instead of Sabin’s because Salk’s was already ready. A huge field trial was begun.

Salk’s vaccine was the first success but was not quite as effective as Sabin’s. On the other hand Sabin’s vaccine had live polio virus and there were a few tragic mistakes now and then, with both vaccines, like the Cutter Labs screwup, where some people got polio or died from a bad batch of vaccine. Today the few US polio cases each year are almost all caused by the polio vaccine itself. There were other risks with both vaccines — about which more later.

Despite these problems the verdict was in—polio vaccine was judged safe for use

Soon everyone was lining up to receive the Salk vaccination shot. Later the Sabin vaccine turned out to be easier to adminis- ter in 3rd world countries, since it is taken orally.

Salk became an instant mega-celebrity and he was given the (figurative) keys to the city everywhere he went. He said that he did not like this publicity and just wanted to work in his lab.

On April 12, 1955, Dr. Thomas Francis, Jr., of the University of Michigan, the monitor of the test results, "declared the vaccine to be safe and effective. By the time Thomas Francis stepped down from the podium, church bells were ringing across the country, factories were observing moments of silence, synagogues and churches were holding prayer meetings, and parents and teachers were weeping. 'It was as if a war had ended', one observer recalled. Within minutes of Francis's declaration that the vaccine was safe and effective, the news of the event was carried coast to coast by wire services and radio and television newscasts. Ac- cording to Debbie Bookchin, "across the nation there were spontaneous celebrations, . . business came to a halt as the news spread. The mayor of New York City interrupted a city coun- cil meeting to announce the news, adding, 'I think we are all quite proud that Dr. Salk is a graduate of City College.'"[4]: April 12th had almost become a national holiday: people observed moments of silence, rang bells, honked horns, blew factory whistles, fired sa- lutes, kept their red lights red in brief periods of tribute, took the rest of the day off, closed their schools or convoked fervid assemblies therein, drank toasts, hugged children, at- tended church, smiled at strangers, and forgave enemies. Salk would not accept the ticker tape parade that NYCity was urging on him, nor would he patent his discovery.

There are probably some older people today who can remember where they were and what they were doing when they first heard this exciting news. The long awaited break- through had finally arrived.

With the country ecstatic over this emotional catharsis, Jonas Salk was treated as some sort of god.

Salk had hit a scientific home run and the nation was cheering. Only later would it become clear that there were a few Frankenstein aspects to what he had created.

Now it’s time to pop some illusions about the polio vaccine.

We are all mature adults here, right? As hu- manists we should be immune to hagiography. We can handle the truth here, I hope. The much touted success of the Salk and Sabin vaccines is not what it seems. 1952 was the peak of polio incidence in the US. Salk’s vaccine did not come out until 1955. By then polio incidence was way down, before the vaccine was introduced. Greater emphasis on public hygiene awareness plus perhaps a natural evolution of the epidemic had polio incidence rates only 1/3 or less by 1955, when the vaccine came out, than at the peak in 1952. Furthermore, around 1955 the medical definition of polio was changed to a more restrictive class, so that there was a sudden drop in “polio” cases around the time the Salk vaccine was introduced—just due to this medical redefinition of what polio was. The vaccine worked but was not by any stretch the miracle the country believed.

Big polio incidence dropoff before Salk vaccine was introduced

In 1998, after 18 years of the use of the Sabin vaccine, the federal govern- ment advised that only the Salk vaccine be used from that point on. The Sabin vaccine is now no longer avail- able in the United States. One prob- lem was that the Sabin vaccine is developed by weakening the polio virus by passing it through many genera- tions of monkey kidneys. It turns out that in the process it picked up a monkey virus—Simian Virus 40—that can cause cancer in humans. This was not known about until long after the vaccine was being used.

Having monkey virus attached to the polio vaccine turns out to be a very bad idea. Simian Virus 40 was first discovered in both the Sabin vaccine and the Salk vaccine in 1961. The more general controversy today about other vaccines is not completely without merit. 98 million Americans were given polio vaccine containing this carcinogenic monkey virus from 1955 to 1963. There are real hazards with vaccinations produced using non-human tissue cultures.

In 1994 studies showed that tissue samples from victims of mesothelioma (previously thought to be caused by asbes- tos exposure) were loaded with Simian V-40 monkey virus. It has definitely been es- tablished now, by labs around the world, as a causer of some types of cancer in humans. 98 million Americans were given polio vaccine containing that same monkey virus. Mesothelioma samples from Finland and Turkey show no SV40 virus and those countries never used polio vaccine contaminated with SV40 virus. Recent research suggests that SV40 is also liked to some bone and brain cancers.

Inter-species contact is best left to the jungle and not deliberately fostered in the laboratory, while inad- vertently producing monkey virus contaminated vaccines. Fortunately, this led to much greater awareness of vaccine risks and tighter standards and quality control.

Mistakes still happen. In March, 2010 a team of re- searchers found that a children’s diarrhea vaccine con- tained pieces of pig virus. The F.D.A. was alerted. They had no idea what the effect of this might be. Af- ter studying the situation for 2 months the F.D.A. decided that it was O.K. to continue using this vaccine. Who knows on what scientific basis that decision was made? Any long term effects of the pig virus would take much more than 2 months to show up. This kind of story is not that uncommon.

Good News after some years of rigorous science we now know that the mercury preservative that used to be used in vac- Bad News The F.D.A and Cen- cines does not cause au- ter for Disease Control had no tism. The mercury is no idea at all that the amount of longer used and yet au- mercury being given in multi- tism rates have actually ple vaccine shots to a child far increased since then. But exceeded the amount of mercury they were saying was dan- this could have just as gerous from eating fish or envi- easily turned out the oth- ronmental exposure. Then when er way. Mercury is very they did realize this they had no toxic and we are just for- idea what the effect would be tunate that this link to au- on a child. Tests had to be tism has been disproven. done.

Public belief in the safety of vaccines is vital to public acceptance of being vaccinated. Drug companies and governments therefore usually try to suppress, or deny any news of vaccine dangers. The feeling is that some casualties are unavoidable to promote the greater good, so these dangers need to be denied or suppressed. Here is an example of a bogus rumor that destroyed a whole country’s willingness to be vaccinated for polio. In 2003 rumors in Nigeria spread that western countries were usu- ing polio vaccine for geno- cide in Africa, particularly of Muslims, and that the vaccine spread AIDS and reduced fertility. Nigerians would only resume being vaccinated if the vaccine came from a Muslim country.

It doesn’t help that there are solid facts to base very speculative rumors on. A third type of polio vaccine (not due to Salk or Sabin), also contaminated with some monkey viruses, was used in a field trial in a remote part of Africa in 1958 and about 300,000 Congolese were vaccinated. Later genetic research showed that the AIDS virus (closely associated with a type of monkey virus) first emerged into the world in that same remote part of Africa just a few years later. Coincidence? Most probably, but this is how urban legends pros- per—piggyback riding on a veneer of facts. This can destroy public trust in vaccines

There are often unintended consequences of creating vaccines. It is a mistake to think that we are in good hands with the F.D.A. or the Center for Disease Control.

Of course people can look at the same data and see it in different ways. Some will think that there are unavoidable (but small) risks with vaccination. Others will see frequent incompetence and sometimes a lack of solid science. Unfortunately high quality control is often incompatible with affordable costs. Because of that and lots of law suits, many drug companies have gotten out of the vaccine business.

Let’s take a break now from our streak of exposing the hazards of vaccines and return to the life of Jonas Salk and what he did after his polio success. Godzilla on a break

Of course Salk is blameless in all of this. Nobody knew, back then, about the monkey virus. But it does illustrate the “Law of Unintended Consequences.” Salk remains a model of a humane committed searcher for ways to improve the lot of humanity.

Some advances in public health, like the invention of the Heimlich Maneuver, do not require much time or effort. Salk, however, was a work demon with very long hours for many years in his quest.

Later in life Salk founded the Salk In- stitute for medical research. He contin- ued an active research there himself in a search for other vaccines, like one for AIDS. He also spoke out on larger is- sues affecting humanity and wrote several books on ethical themes. Salk remarried. His 2nd wife was the former wife of Picasso (one of his mod- els) shown in her youth on the right here.

Salk Institute in La Jolla, California. Designed by famed architect Louis Kahn.

Books by Jonas Salk - Man Unfolding (1972) Survival of the Wisest (1973) World Population and Human Values: A new Reality (1981) Salk used his fame to promote, through many talks and interviews, discussions about humanistic approaches to world problems.

Salk wanted to put his great fame to good use. He saw it as an opportunity to have a public forum for pro- moting humanistic values. Linking success with good deeds is what is in the news these days, like with Bill Gates and his work in Africa.

Salk thought a lot about ways to promote world peace and prosperity, from his humanist perspective

Salk sought parallels between the evolution of civilization and the growth and evolution of cells and organisms in biology, seek- ing to use these parallels for in- sights into the future of population growth and other contempo- rary challenges to human values. After developing the polio vaccine, at a young age, he devoted the rest of his life to further at- tempts to improve the lot of hu- mankind.

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The Salk polio vaccine story

by Dave Shafer on Sep 27, 2010

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The Salk polio vaccine story — Presentation Transcript