Polio vaccine
In the early 1930s, John A. Kolmer began grinding spinal cords from infected monkeys to create a live polio vaccine. He soaked these tissues in salt solutions and filtered them through mesh before treating the mixture with ricinolate. This process produced what critics later called a veritable witches brew of biological material. By April 1935, Kolmer had tested his experimental vaccine on 100 children without reporting any immediate ill effects. He distributed 12,000 doses to approximately 700 physicians across the United States and Canada without providing instructions on how to administer it or report side effects.
Kolmer's approach led to tragic consequences when ten cases of paralytic polio appeared following vaccination, six of which were fatal. These deaths occurred in towns where no natural polio outbreak was happening at the time. The scientific community reacted with fury during an October 1935 meeting in Milwaukee, Wisconsin. James Leake of the U.S. Public Health Service stood up and accused Kolmer of being a murderer while describing clinical evidence of multiple deaths caused by the vaccine. Kolmer simply stated that he wished the floor would open up and swallow him.
Maurice Brodie worked simultaneously on an inactivated version using formaldehyde to kill the virus. His team published their first article on the 1st of June 1934, showing successful immunity induction in three monkeys. Brodie conducted field trials involving over 1,500 doses administered in Kern County, California between November 1934 and May 1935. Despite promising initial results, poor protocol design left his work vulnerable to criticism. Three children fell ill with paralytic polio after receiving the vaccine, leading the Warm Springs Foundation to withdraw funding in December 1935.
The aftermath saw Brodie fired from his position within three months of the symposium's publication. He died of a heart attack just three years later at age 36. Kolmer returned to Temple University as a professor and continued publishing papers until his retirement in 1957. The moratorium on human poliomyelitis vaccine development resumed following these failures, delaying progress for nearly two decades.
Jonas Salk developed the first effective polio vaccine in 1952 while working at the University of Pittsburgh. His team included Julius Youngner, Byron Bennett, L. James Lewis, and Lorraine Friedman. Salk announced a successful test on adults and children via CBS radio on the 26th of March 1953. Two days later, the results appeared in JAMA medical journal. Leone N. Farrell invented a key laboratory technique that enabled mass production of the vaccine through her team in Toronto.
The Francis Field Trial began on the 23rd of February 1954, involving about 4,000 children at Franklin Sherman Elementary School in McLean, Virginia. This massive experiment eventually enrolled 1.8 million children across 44 states from Maine to California. Roughly 440,000 received one or more injections of the vaccine while 210,000 received a placebo consisting of harmless culture media. Another 1.2 million children served as an unvaccinated control group.
Results announced on the 12th of April 1955 showed the Salk vaccine was 60-70% effective against PV1, over 90% effective against PV2 and PV3, and 94% effective against bulbar polio development. The date marked the tenth anniversary of President Franklin D. Roosevelt's death, whose paralytic illness was believed caused by polio. Following licensing in 1955, vaccination campaigns launched immediately across the United States.
Annual polio cases dropped dramatically from 35,000 in 1953 to 5,600 by 1957. By 1961 only 161 cases were recorded nationwide. A week before the Francis Field Trial results announcement, Pierre Lépine at the Pasteur Institute in Paris declared his own effective polio vaccine would soon be produced in large quantities. The Times of London reported this development on the 4th of April 1955.
Albert Sabin developed a live attenuated oral polio vaccine that came into commercial use in 1961. His trivalent vaccine containing all three types of poliovirus strains was created in 1957. During a November 1955 meeting in Stockholm, Sabin presented results obtained on 80 volunteers while Koprowski read findings from a trial enrolling 150 people. Because America committed to the Salk vaccine, both men conducted their testing outside the United States.
Sabin worked extensively in Mexico and the Soviet Union where ten million children received his oral vaccine in 1959. For this work he received the medal of the Order of Friendship of Peoples, described as the Soviet Union's highest civilian honor. Mikhail Chumakov led large-scale clinical trials in the Soviet Union between the late 1950s and early 1960s demonstrating safety and high efficacy of the vaccine.
Japan Broadcasting Corporation journalist Tetsu Ueda played a pivotal role raising public awareness about polio outbreaks in Japan during the early 1960s. NHK began broadcasting daily reports from regional bureaus on new cases which significantly heightened national anxiety. This surge prompted the Minister of Health and Welfare to urgently import the Soviet live attenuated vaccine leading to rapid disease containment.
Once widely available, Sabin's oral vaccine supplanted Salk's injected version which had been tarnished by the Cutter incident of 1955. The oral form eliminated need for sterile syringes making it more suitable for mass vaccination campaigns worldwide. OPV also provided longer-lasting immunity than the Salk vaccine while producing excellent protection in the intestine.
In April 1955, soon after mass polio vaccination began in the US, the Surgeon General received reports of patients contracting paralytic polio about one week after receiving the Salk vaccine from Cutter Laboratories. The paralysis started specifically in the limb where the vaccine was injected into these children. The Cutter vaccine had been used to vaccinate 409,000 children across western and midwestern United States regions.
Later investigations revealed that the Cutter vaccine caused 260 cases of polio resulting in 11 deaths. In response, the Surgeon General pulled all polio vaccines made by Cutter Laboratories from the market immediately. Eli Lilly, Parke-Davis, Pitman-Moore, and Wyeth polio vaccines were also reported to have paralyzed numerous children. Some lots improperly prepared allowed live poliovirus into more than 100,000 doses of vaccine.
The National Institutes of Health established a Technical Committee on Poliomyelitis Vaccine in May 1955 to test and review all polio vaccine lots before release for public use. These incidents reduced public confidence leading to drops in vaccination rates nationwide. The tragedy demonstrated how improper inactivation could allow live virus to enter what should have been dead-virus preparations.
Contamination concerns emerged later when SV40 simian virus-40 was found present in stocks of injected form IPV between 1955 and 1963. Over 98 million Americans received one or more doses during this period with an estimated 10-30 million potentially exposed to contaminated vaccine. Later analysis suggested hundreds of millions more may have been exposed through Soviet bloc countries' vaccines used until 1980.
A global effort to eradicate polio led by World Health Organization, UNICEF, and Rotary Foundation began in 1988 relying largely on oral polio vaccine developed by Albert Sabin and Mikhail Chumakov. Polio elimination occurred in the Americas by 1994 while officially eliminated in 36 Western Pacific countries including China and Australia in 2000. Europe declared polio-free in 2002 following successful campaigns.
Since January 2011 no cases reported in India hence taken off WHO list of endemic countries in February 2012. By March 2014 India declared a polio-free country after years of intensive vaccination efforts. The number of cases reported annually dropped from an estimated 350,000 in 1988 to just 33 in 2018 according to WHO statistics.
An enhanced-potency IPV licensed in United States November 1987 became current choice there. Routine vaccination schedules now include doses given shortly after birth between one and two months age with second dose at four months. Third dose timing depends on formulation but should occur between six and eighteen months age before school entry booster at four to six years.
Polio vaccination programs face resistance in Pakistan and Afghanistan where wild polio cases remain as of 2020. Almost all Muslim religious and political leaders endorse the vaccine yet a fringe minority believes vaccines secretly used for sterilization of Muslims. This belief most common in Khyber Pakhtunkhwa province and FATA region leads some parents not vaccinating their children.
Attacks on vaccination teams have hampered international eradication efforts globally. On the 11th of September 2016, two unidentified gunmen associated with Pakistani Taliban Jamaat-ul-Ahrar shot Zakaullah Khan administering polio vaccines in Pakistan. Leader claimed responsibility stating group would continue this type of attack against health workers.
The fact that CIA organized fake vaccination program in 2011 to help find Osama bin Laden added another layer of distrust among local populations. In 2015 WHO announced deal with Taliban encouraging them distribute vaccine in areas they control though Pakistani Taliban remained unsupportive. Such skepticism has consequently slowed down eradication process within remaining endemic countries.
Novel OPV2 genetically modified to reduce likelihood of disease-causing activating mutations granted emergency licensing in 2021 then full licensure December 2023. This version has greater genetic stability than traditional oral vaccine making it less likely revert to virulent form causing outbreaks.
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Common questions
Who created the first experimental polio vaccine in the early 1930s?
John A. Kolmer created the first experimental polio vaccine by grinding spinal cords from infected monkeys and treating them with ricinolate. He distributed 12,000 doses to approximately 700 physicians across the United States and Canada without providing administration instructions.
When did Jonas Salk announce his successful polio vaccine test results on radio?
Jonas Salk announced a successful test on adults and children via CBS radio on the 26th of March 1953. Two days later the results appeared in JAMA medical journal after his team developed the effective vaccine in 1952 at the University of Pittsburgh.
What happened during the Cutter Laboratories incident in April 1955?
The Cutter vaccine caused 260 cases of polio resulting in 11 deaths because improperly prepared lots allowed live poliovirus into more than 100,000 doses. The Surgeon General pulled all polio vaccines made by Cutter Laboratories from the market immediately following these reports.
How many annual polio cases were recorded nationwide by 1961 compared to 1953?
Annual polio cases dropped dramatically from 35,000 in 1953 to 5,600 by 1957. By 1961 only 161 cases were recorded nationwide following the launch of vaccination campaigns across the United States.
Which countries declared polio-free status between 1994 and 2014?
Polio elimination occurred in the Americas by 1994 while officially eliminated in 36 Western Pacific countries including China and Australia in 2000. Europe declared polio-free in 2002 and India declared a polio-free country by March 2014 after years of intensive vaccination efforts.