Would the polio vaccine have been considered "rushed" back when it was first used on the masses?

by BelgoCanadian
theytookthemall

I can only speak for American history, and the answer is...no, but also yes a little bit.

By and large, the Salk polio vaccine, which was approved for widespread use in 1955, was seen as a godsend. Researchers had been working towards an effective polio vaccine since at least the 1930s, when there were two disastrous trials that caused the deaths of a number of children in Philadelphia and New York. The incidence of polio generally rose every year throughout the 40s and early 50s, and wherever it struck, it inevitably left devastation. Adults were affected, of course, but children were most affected. Newspapers talked about -- and then newsreels and even TV showed -- hospital wards with row after row of young children reliant on iron lungs to breathe.

FDR, while always a bit cagey about revealing the true extent of his physical disability in public, was a powerful advocate for polio research. In 1944, during a national radio address, he compared the fight against polio to the ongoing fight in WWII: that's how serious of a threat it was. In fact, America's involvement in the war arguably helped increase the desire for an effective vaccine and/or cure for polio: the need for healthy young men to fight for the cause was a driver for a large number of public health initiatives, including nutrition and anti-venereal disease campaigns. A sickly young man couldn't fight Nazis, regardless of whether he'd been stricken by paralytic polio or syphilis. Essentially, poliovirus was a lurking menace, which inevitably popped up in even otherwise "perfect" communities, robbing parents of their children and destroying lives.

There had been a record number of polio cases in 1952, and the same year, Salk had begun early human tests. By 1953, Jonas Salk was becoming a household name for his promising research on a polio vaccine and expanding trials.

I'm obligated to add here that, while Salk was absolutely a heroic figure, he and his research were a product of their time, and medical ethics were shockingly different back in 1952. Salk's earliest human trials were performed on children and adult residents of institutions for people with developmental disabilities. While the "Nuremberg Code" of 1947 spelled out a code of ethics for medical experimentation, it was not seen as particularly important until decades later. The term "informed consent" as it is used today as a cornerstone of medical ethics did not yet exist in 1953. Fortunately, Salk's early human trials were successful, with few adverse effects and positive outcomes, and were not seen as problematic at the time, they were [i]not[/i] acceptable by today's modern medical ethics.

Regardless of modern ethics, Salk's trials were extremely promising. By mid-1953, he publicly gave himself, his wife, and his three children the vaccine, which certainly helped to boost confidence. The results of his large-scale trial was announced in April of 1955, the vaccine was approved for widespread use that day, and Jonas Salk was widely hailed as a hero. On April 13,1955, the day after the Salk vaccine was approved, there were five stories on the front page of the New York Times about it. One of the headlines, in fact, was "Supply to be low for time, but output to be rushed". Manufacturers knew it would take time to ramp up production and they would struggle to meet demand.

Within the month, a batch of vaccine shipped to western states resulted in at least 250 cases of polio infection. The virus in the vaccine was not adequately deactivated and caused several smaller outbreaks within populations that had received the vaccine. Vaccines were immediately stopped across the country, and the ensuing investigation took months. Several prominent people resigned, including the director of NIH. Ultimately, it was found that there was no inherent flaw in Cutter's process; all of the labs producing the vaccine had found it difficult to ensure that the vaccine was fully deactivated. Cutter was found liable in court and paid out financial damages, and vaccination resumed.

Despite the 'Cutter Incident', the polio vaccine remained in high demand. In 1955 there were 17.6 cases per 100,000 Americans. In 1956, there were 9.0 cases per 100,000. IN 1957, there were 3.2 cases per 100,000. The CDC has an old surveillance report [url=https://stacks.cdc.gov/view/cdc/48110/cdc_48110_DS1.pdf?]here[/url] where you can see the numbers plummet as more and more people got vaccinated.

This was the first new, effective vaccine that anyone alive had seen. Smallpox still existed but was a routine vaccination; it was officially eliminated in the United States in 1952, and most people would have never seen a case. Everyone had seen polio, though, and to be able to watch it disappear was remarkable.

Sources: Stern, A. M., & Markel, H. (2005). The History Of Vaccines And Immunization: Familiar Patterns, New Challenges. Health Affairs, 24(3), 611–621. doi:10.1377/hlthaff.24.3.611

Davenport R, Schwarz L, Boulton J. The decline of adult smallpox in eighteenth-century London. Econ Hist Rev. 2011;64(4):1289-1314. doi:10.1111/j.1468-0289.2011.00599.x

Smith, J. D., & Mitchell, A. L. (2001). Sacrifices for the Miracle: The Polio Vaccine Research and Children With Mental Retardation. Mental Retardation, 39(5), 405–409. doi:10.1352/0047-6765(2001)039<0405:sftmtp>2.0.co;2

NATHANSON, N., & LANGMUIR, A. D. (1963). THE CUTTER INCIDENT POLIOMYELITIS FOLLOWING FORMALDEHYDE-INACTIVATED POLIOVIRUS VACCINATION IN THE UNITED STATES DURING THE SPRING OF 1955. American Journal of Epidemiology, 78(1), 29–60. doi:10.1093/oxfordjournals.aje.a120328