MOS: Polio Eradication

The world found out on April 12, 1955 that there was now a polio vaccine that was “safe, effective, and potent.” Salk’s vaccine worked, and less than a decade later Sabin’s would be added to the front lines in the march against the disease. Thanks to both vaccines, polio was a non-issue in the US by 1979, gone from the western hemisphere by 1991. 

It was on the ropes with only 22 diagnosed cases between three countries in 2017. Then everything went to hell. 

Today’s Moment of Science… Eradicating polio?

Shots started going into arms right away that April. Even with plenty of fear about the disease, minor hiccoughs in a vaccine rollout can be enough to scare off nervous parents. The Cutter incident was not minor and could have been devastating. Cutter Labs produced a batch of Salk vaccine chock full o’virus that wasn’t killed properly. Bernice Eddy, a scientist from the NIH, spotted the issue in summer of 1954 when monkeys injected with the vaccine were paralyzed. Her warnings went unheeded.

About 120,000 children received vaccines with live virus in it, leading to about 40,000 cases of polio, nearly 200 cases of paralytic polio, and there were ten fatalities. 

That was the first goddamn month of the vaccine’s availability. So how in a honey badger’s ass did they get people to vaccinate? Before you say “people were different then,” there was a lawsuit in 1920 over mandatory smallpox vaccines in schools (in Texas because fucking of course). The Supreme Court ruled that mandatory vaccines were a-okay by them, which I’m bringing up for no reason whatsoever with regard to current events. 

It was marketing, really. 

Many of us have seen the images from when Elvis got his shot live on the air, and he wasn’t the only one. Judy Garland and Marilyn Monroe also joined the March of Dimes’ outreach effort. Realizing that they’d used mainly images of white entertainers early in the campaign, Sammy Davis Jr, Louis Armstrong, and Ella Fitzgerald were all recruited for the campaign. Posters from the March of Dimes featured black children to increase awareness -and hopefully trust- in their communities.

Some folks were wary of the vaccine after the Cutter incident and wanted to wait longer before getting their kids vaccinated. This resulted in many paralyzed children and regretful parents. Some refused to vaccinate for everything, even smallpox, and likely never would have vaccinated no matter how perfectly the rollout went. But by the time the worldwide polio eradication effort began in 1988, the Cutter incident was a distant memory, and polio had been gone from the US for nearly a decade.

So now we have to talk about circulating vaccine-derived poliovirus (cVDPV). Because funny thing about polio. Well, not funny ‘haha.’

So you know how anti-vaxxers will argue with you in one breath that these diseases are harmless and then start yelling something about diseases being caused by viral shedding from vaccines, and at that point you kinda tune them out because this has to be bullshit, right? 

This is one major exception to the ‘vaccines don’t cause disease’ axiom. But it’s complicated, and quitting vaccinating is not the way out. 

Sabin’s vaccine, the oral polio vaccine (OPV) worked great for a while. It used mutated strains of polio that were ostensibly safe, conferring immunity to the three wild strains without causing disease themselves. 

But over time, this being a live virus and a highly transmissible one, it was passed from vaccinated person to unvaccinated person via orofecal transmission, spreading asymptomatically. Enough mutations in this virus that was introduced to the environment via vaccine, and it now causes an illness indistinguishable from that which it was meant to prevent. 

Wild polioviruses types 2 and 3 have been eradicated, and only type 1 remains. But that’s only causing outbreaks in two countries, Pakistan and Afghanistan. Last year when global eradication efforts were temporarily suspended, cVDPV erupted through thirty countries. 

So since throwing our hands up and saying “eh, we tried” isn’t an option, what now? The Novel Oral Polio Vaccine type 2 (nOPV2) was approved last year. With all we’ve learned about genetics since this vaccine first came out, they’ve created a more genetically stable vaccine with a drastically reduced chance of becoming virulent. If successful it will likely replace the Sabin vaccine, along with nOPV1 and nOPV3 that are in development.

For now though, if you still have questions about what to do regarding polio? You should probably vaccinate. 

This has been the conclusion of the longest goddamn moment of science, hoping to see the last case of polio in my lifetime.

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