Sunday, April 13, 2014

Sixty years ago, parents prayed for vaccines...


Iron lung, International Museum of Surgical Science, Chicago

    This started as a column about the 60th anniversary of the Salk vaccine trial — I figured, a chance to tell a gripping medical story that the average reader would know nothing about. Then the city desk asked if I could make it newsier, to run as a Sunday news feature, and, agreeable fellow that I am, I said, "Sure." Doing my due diligence, I phoned the city, county and state boards of health, plus the state and city school boards. And while I was at it, I thought I would invite Jenny McCarthy to re-think her stand on vaccines, since it has been a number of years since she came out strongly against them, and we work for the same place. Collegiality. She decided, since she had so much to say, that rather than give a comment to me, she would write her own column explaining her position. That column, last time I looked, had almost a thousand "likes," while this story, which prompted it, had about 40. There's the public for you. 

    The sickness came in the spring, with the warm weather. It struck children, who would flock outside and catch it from each other’s unwashed hands. There was no known prevention beyond washing those dirty hands and avoiding public places, especially swimming pools. There was no cure.
     Most who got sick got better. Others were left with a limp, a withered leg, or unable to walk altogether, or paralyzed or unable to breathe on their own. The disease came on very quickly: A child could wake up with a headache and be dead by supper. Or consigned to a life of braces. Or trapped in an iron lung.
     The sickness was poliomyelitis, polio for short; 1952 was the worst year ever: 57,000 cases in the United States. In one week in July, 11 of the 14 Thiel children of Mapleton, Iowa, got sick. That September, four of six children in a family in Milwaukee caught a particularly virulent strain of polio and quickly died, one after another.
     That year Chicago saw 1,200 cases.
     “It was just so scary,” said Kurt Sipolski, 67, who contracted polio as a 2-year-old in Streator in 1948, and wore a brace for years, remembering how his mother struggled to help him recover. Parents rang doorbells for the March of Dimes to fund its private search for a cure — the government, worried about socialized medicine, kept its hands off medical research.
     But medical science already had the answer. Dr. Jonas Salk, a researcher at the University of Pittsburgh, and his team found a vaccine. But first they had to prove it worked, through tests, trying to ignore a public demanding it now.
     As opposed to the public view today. With the horrors vanquished by vaccines — not only polio, but scarlet fever, whooping cough, measles, mumps, smallpox, a catalog of plagues — now consigned to history or distant corners of the globe, parents are free to obsess instead on the infinitesimal risks that have always been associated with vaccines, or imagine larger ones, such as autism, which has no link to vaccines other than a single bogus, repudiated English study. Based on hearsay, these parents spurn the greatest engine ever devised for avoiding disease.
     "I don't vaccinate 'em," said Julio DiVito, 47, of Elmwood Park, referring to his two children, 11 and 9. "Because they're unproven. A lot of this is unproven. It proves nothing. I don't worry that anything will happen."
     Sixty years ago, in April 1954, thousands of doctors, nurses, principals, teachers, mothers and other volunteers banded together in what is still the largest medical experiment in U.S. history: to test the Salk vaccine. The parents of 1,349,135 children offered them up in a blind trial. Half got the cherry-red vaccine, the rest a placebo or nothing.
    There were 244 test areas around the country, two near Chicago. In DuPage County, most first-, second- and third-graders participated, as did thousands of children in Peoria.
     The test was almost scuttled. Then, as now, some viewed vaccines with suspicion. Just before the test began, Walter Winchell, an incendiary radio broadcaster, went on the air and hinted that the vaccine "may be a killer" and that authorities were stockpiling "little white coffins;" the next week, 150,000 children dropped out of the test.
     Salk, who had tested the drug on himself, his wife and his three sons, pushed ahead.
     On April 26, 1954, 6-year-old Randy Kerr of McLean, Va., offered his left arm for the first injection. "I could hardly feel it," he said later.
     The trial continued through the spring and summer. Hundreds of the children in the study died— from accidents, cancer and polio. The question was, were the kids dying of polio the same ones who got the vaccine? Did it work?
     The Illinois Department of Health reports that 97 percent of schoolchildren in the state receive their vaccinations, which means about 70,000 out of 2.3 million students don't.
     "We'd like to do better," said Dr. LaMar Hasbrouck, director of the Illinois Department of Public Health, noting that we are at a "critical balance" when it comes to immunization.
     He blamed schools that are supposed to bar unvaccinated students without religious or medical exemptions but instead wave them in so as not to lose federal funds.
     "From a public health standpoint, we really want to see schools enforce this," he said. "One unvaccinated kid puts everybody at risk."
     There are indications we aren't keeping track of how low vaccination rates are.
     In 2012, Illinois had its worst year for whooping cough in 62 years: more than 2,000 cases.
     In Canada, medical authorities estimate as many as 20 percent of new parents delay or skip vaccinations.
     "What we're seeing is outbreaks of disease, a lot of disease among people who have not been vaccinated," said Dr. Julie Morita, medical director of immunization programs for Chicago. She called vaccines "a victim of their own success."
     "We've gotten rid of so many of these diseases, we don't remember how bad they were or how serious," she said. "There is a lot of misconception."
     Crunching the numbers from the 1954 test took months, tabulated by hand at the University of Michigan and using another new technology, a "decimal, drum memory machine" that IBM had built in Detroit.
     Pressed to offer a date for an announcement, the Michigan team chose April 12, 1955, the 10th anniversary of the death of the most famous polio patient of all, Franklin D. Roosevelt.
     The meeting room was packed. University officials had to stand on a table and throw handfuls of the press release into the scrum of newsmen who went at them "like hungry dogs." It began, "The vaccine works. It is safe, effective and potent."
     People compared the resulting hoopla to V-J Day — the news was read in factories and schools. Church bells rang.
     "SALK POLIO VACCINE PROVED A SUCCESS!" the Sun-Times trumpeted across its front page.
     Still, the path was not smooth. A California pharmaceutical company, Cutter, produced a spoiled vaccine, which instead of preventing polio caused it in several cities, including Chicago, in the summer of 1955. Even when prepared properly, the vaccine wasn't universally taken and didn't always work — it didn't protect everyone who took it — and Chicago had another outbreak in 1956 with hundreds of cases and a dozen deaths.
     But the overall success was undeniable. There were 38,476 new U.S. polio cases in 1954. In 1961, there were 1,312. It kept dwindling. The U.S. has been polio free since 1979, according to the Centers for Disease Control and Prevention. Last month India announced that, having not found a case in the past three years, polio is now eradicated there.
     More good news: The anti-vaccine movement is on the wane.
     "The pendulum has swung," Morita said. "Parents are having a better understanding of the safety and benefits. The vast majority of people see the efficacy of vaccine."
     Dr. Anita Chandra-Puri, a pediatrician with Northwestern Memorial Hospital, won't accept children as patients if their parents don't have them vaccinated.
     "It's amazing, the disconnect," she said. "When their child has a fever, they trust me. Why not trust me here? A lot of these parents [who spurn vaccines] are very educated folks, passionate about what they believe. So are we. We're trying to do everything safe and right for these children.
     "Vaccines have done an amazing job, been proven safe, effective, cost-effective," she said. "People have become complacent with what vaccines have done. They don't think illness exists anymore."
     Hasbrouck said, "They don't see the consequences of not being vaccinated, the bad things that happen. The paralyzed limbs from polio. The memory of it all is faded. Now folks see it almost as an inconvenience."
     "That's why it's so terribly important for people to remember these anniversaries," said Kurt Sipolski, who eventually recovered from his polio. "Because they have no idea what it was like."

8 comments:

  1. Good piece in today's "Slate" by someone called Philip Plait taking apart Ms. McCarthy's claim that she's not and never has been "anti-vaccine."

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    1. Mr. Plait sums it up nicely with this comment: "Despite McCarthy’s well-meaning intentions and sincerity, her claims are still very, very wrong. So let me be clear: Don’t heed the advice of anti-vaxxers. Instead, go to your board-certified doctor and ask about vaccines. And if the doctor recommends you go ahead and get the shots, do it. The life you save may be your own child’s, as well of those of children all around you."

      Honestly, I just can't understand why people would give any credence to Ms. McCarthy on a medical issue. It would be like listening to Matthew McConaughey telling us to never refrigerate milk.

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  2. Neil - As I commented on my FB post today linking to Dr. Jennifer Raff's article ("Dear parents, you are being lied to."): "Here it is, clearly laid out with links to multiple scientific studies. Of course, most people that follow hysterical and ignorant nattering nabobs of negativity (e.g., Jenny McCarthy et al.) are not likely to be swayed by logic and facts. Still, one never knows..." If your article and blog cause even one parent to rethink their ridiculous position and have their children vaccinated (protecting the child, as well as the rest of us, thanks to herd immunity), you will have succeeded. Good for you!

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  3. Wonderful column. Did you read. "Patenting the Sun" great social history of polio and the vaccine.

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    1. No, I actually owned it, for years, but didn't like how it was written, and could never get into it. Then, when I went to write this, I looked for a copy and couldn't find one.

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  4. I usually don't hit "Like" on columns, but I did with this one. You're up to 166 now.

    I was diagnosed with Rheumatoid Arthritis at the age of ten and have dealt with the pain and limitations of the disease all of my life. I wish a vaccination could be developed for this destructive, though not fatal, condition.

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  5. Hi Neil,
    Words cannot express the amount of contempt and distaste I have for that woman. And yes, she is only "that woman". I know 3 boys very well (one is a cousin) who are on the spectrum and not one of their parents believes for a second it was caused by vaccinations. All of them believe that Jenny McCarthy's done a great deal more harm than good with her ignorant, ridiculous claims. All of them noticed issues with their children prior to any vaccination.

    @ Wendy C... I did my part in raising money for arthritis in the past. I've met quite a few people who's lives are severely affected by the disease, including my own sister-in-law with the same diagnosis as you and about the same time. I hope to run Chicago in 2015 for the Arthritis Foundation again.

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  6. Larry in NorthbrookApril 20, 2014 at 8:26 PM

    Well, my dad had Polio, call me crazy, but I'm guessing not one of these anti-vaccination folk did. I'd give anything for him to have had that vaccine, and not gone through his very tough life. Truly a heroic story, was never supposed to walk (he did, even golfed, shot in the 90's, with no strength at all in one leg and one arm, an athletic marvel actually); met FDR in rehab, later traded stamps with him...but people that want to risk this dreaded disease returning? Selfish, and sick.

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