How was the polio vaccine developed?

Daniel and Kelly talk about the development of the polio vaccine.

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Episode Transcript

Speaker 1 (00:03):
Daniel Here. Before we jump into today's episode, I want
to remind you of my new book Do Aliens Speak Physics?
Comes out very soon. It's all about what it might
be like to try to talk to aliens about physics.
Sean Carroll said the book quote is lighthearted and fun,
but also shows a way to think truly deeply about
what physics is and how we come to learn about it.
So go check out the book at www dot Aliensspeakphysics

(00:26):
dot com. Okay, on to the show.

Speaker 2 (00:32):
Quick disclaimer here this episode is about polio and touches
on issues related to death and suicide. In a past episode,
we talked about what I consider to be one of
humanity's most incredible achievements, the eradication of smallpox. Let's keep

(00:56):
the good vibes going and talk about another massive win
for hu hmanity. How science eradicated wild polio in the
United States and many other nations around the world towards
the middle of the twentieth century. For reasons we don't
totally understand, cases of severe polio in the United States
started to rise. In nineteen forty eight, over twenty seven

(01:18):
thousand kids got polio, which was three times more than
the prior year. In nineteen forty nine, there were forty
two thousand cases, and by nineteen fifty two there were
fifty seven thousand cases, which included twenty one thousand cases
of paralysis and three thousand deaths. Initially, poliosymptoms are pretty
similar to cold symptoms, so for thousands of parents, every

(01:41):
time their child came down with cold like symptoms, they
had to wonder is this polio? But today no parent
in the United States goes to bed wondering if cold
like symptoms are actually polio. Two polio vaccines developed in
the United States paved the way to eradicating wild polio
from most of the world. Today, we're going to talk

(02:02):
about the development of these amazing vaccines. We'll also talk
about how polio vaccine testing played a role in the
current high standards we set for things like informed consent
vaccine trials and industry standards for vaccine manufacturing and testing.
And now feels like a great time to remind everyone
to get their yearly flu vaccine. If you have questions

(02:24):
about vaccines, please ask your doctor. Welcome to Daniel and
Kelly's Extraordinary Universe.

Speaker 1 (02:43):
Hi, I'm Daniel, I'm a particle physicist, and I'm very
grateful to biologists and to doctors.

Speaker 2 (02:48):
Hello, I'm Kelly Wiener Smith. I study parasites and space,
and I am so excited that I knew pretty much
nothing about polio because I haven't had to worry about it.

Speaker 1 (02:57):
Yeah, exactly, blissful ignores beautiful thing. So, Kelly, my question
for you today has to do with vaccines, and my
question is are you afraid of shots or can you
take like a big honkin needle in the arm without flinching.

Speaker 2 (03:11):
So when I am going to answer your question, just
it's going to be a tortuous path to get there.

Speaker 1 (03:16):
Are we going to start with fish guts?

Speaker 2 (03:18):
No, we're going to start with organic chemistry.

Speaker 1 (03:20):
Okay, that's the other place Kelly's stories start.

Speaker 2 (03:22):
Yeah, I'd say it's way worse than fish guts, But
give me a dump truck full of fish guts before
an OKEM class any day.

Speaker 1 (03:30):
But wow, that's fire, all right. So you're in OAKM.

Speaker 2 (03:34):
So I'm in OKAM. I took it over the summer,
and I was taking it with my friends. We were
the Benzene Ring. There were six of us, the six
Garbons and a Benzene ring. And at the end of
each week there'd be an exam and we would stay
up all night staying for the exam. But every exam
that I passed, I would reward myself by getting a piercing. Oh,
and I was pretty well pierced by the end of

(03:55):
that summer. And so the lesson I'm trying to convey here,
or the point I'm trying to convey here, is I'm
not super worried about needles, and so I can handle shots.
It's not a big deal. In my opinion. I've had
bigger needles passed through my face, so it's not so bad.
What about you?

Speaker 1 (04:13):
Will you anticipate in my next question, because I was
going to say, you don't look like you have a
lot of piercings, and so is that just a phase
and you let them close or are they piercings of
a less visible nature?

Speaker 2 (04:23):
I let them close. I think at some point I
was trying to get a job where I thought they
wouldn't be appreciated, and some of them were just kind
of like you know. I decided I didn't actually look
as good with the nose ring as I thought. And
then I had the tragus, which is like the spot
right underneath your lip. Oh man, the metal back kept
rubbing my teeth and I was like, oh, I don't
like that feeling. But you know, I kept my eyebrow

(04:44):
ring for a while, but mostly it was a lot
of piercings in my ear. But my ear is weird.
This is way more information than anyone needs. My ear
is weird and would grow around my piercings.

Speaker 1 (04:52):
Oh my gosh.

Speaker 2 (04:53):
And so that was that was like less attractive and
hard to get them out at some point. So I
was like, all right, maybe this phase of my life
is done, but it might come back. Who knows.

Speaker 1 (05:02):
Well, I'm not afraid of shots. It's just not a
big deal to me. I mean, obviously they hurt, but
I don't flinch or whatever. But my daughter is terrified
of shots. I mean, she understands the concept obviously, and
she's into it, but she like sometimes faints when she
gets a shot. But she's also really interested in piercing,
and so I've been with her multiple times when she

(05:24):
has passed out after getting a piercing.

Speaker 2 (05:25):
Oh wow.

Speaker 1 (05:26):
And so just you know something you have to know,
make sure she's sitting down.

Speaker 2 (05:30):
Yeah, I think the weirdest piercing I ever got was
the eyebrow piercing, because they like pinch your eyebrow. And
then this this person went up from the bottom up
with the needle before they put the ring in, so
you could see the like needle like going up and
you could like see it was right in front of
your eye, and I was like, Oh, that's that's maybe
a little disconcerting.

Speaker 1 (05:52):
All right, Well, we're not here to talk about Kelly
punching holes in her body. We're here to talk about
saving lives with vaccines. Kelly, tell us why you decided
to talk about the polio vaccine.

Speaker 2 (06:03):
So I'm kind of interested in stories about people who
infect themselves with parasites on purpose. This is just sort
of like a weird thing that I'm interested in learning about.
And I had heard that everyone who made a polio
vaccine tested it on themselves first, and so I bought
an audiobook Polio, An American Story by David Oshinski, and

(06:23):
the story about the development of the vaccine was so fascinating.
I was like, you know what, I'm going to read
this book again. I'm going to take forty four pages
of notes, and I'm going to share the highlights with
the dKu audience, and just to make sure that I
was getting the story right. I also read Splendid Solution
Jonas Sock in The Quest of Polio by Jeffrey Krueger,
So both great stories about how polio was developed.

Speaker 1 (06:44):
I love reading stories about how science happens or how
progress is made, because it's hard for us to put
ourselves in the minds of people who didn't understand the
early universe, or didn't have a solution, or didn't know
if there was a solution to vaccinations for polio, and
I think it's so important to bring us back to
those moments and understand what they were fighting against the

(07:05):
challenges there. Remember when Sean Carroll was on the podcast
and he said it's so important to read the original
papers because they didn't know the answers and you can
see them trying to work it out. And I think
that process is so important to illuminate and so fun
and so inspiring, right because it shows you how to
make discoveries. Well.

Speaker 2 (07:21):
Yeah, and another lesson that the Polio story is going
to teach us that we're going to return to at
the end of the episode is that none of our
listeners are going to be surprised to learn that scientists
are humans and we make mistakes. Yeah, and there is
also some unethical decisions along the way. And so we're
going to get to one of my pet peeves, which
is when people act like because a scientist said so,
you don't have any right to ask follow up questions.

(07:44):
And I saw a lot of this during COVID, a
lot of you know, people posting on their Facebook page like.

Speaker 1 (07:48):
The science is settled.

Speaker 2 (07:49):
Yeah, the science is settled. The good thing about science
is you don't have to believe in it. It's just
true or whatever. And I'm like, oh man, but like
there's different levels of evidence to support claims, and I
think you should be very willing to answer questions about
what you did and how confident you are. And the
polio story has a lot of ups and downs, and
all right, reveal some errors made along the way.

Speaker 1 (08:11):
Well, before we share that whole story, we were wondering
what people already knew about the polio vaccine. So Kelly
went out there and asked folks what did they know
about the development of the polio vaccine? So think about
it for a moment. What is your understanding of the
development of the polio vaccine. Here's what's in the minds
of our listeners.

Speaker 3 (08:28):
Medically, I don't know the development of the polio vaccine,
only that it worked and then it was a big deal.
I mean, millions suffered from a debilitating disease and it
essentially ended that. I mean, think about the advantages that
you've just created for society. I don't know. Vaccines are incredible.

Speaker 4 (08:46):
Yes, I remember a vaccination day in kindergarten nineteen seventy nine.
I'm older than you, excepting now you claim your hundred
I'm still twenty eight. Lies.

Speaker 1 (08:59):
I'm in my fifties.

Speaker 5 (09:00):
Well, I know that was very welcome and the ginas
sulk and I seemed to saw as to whatever you
call it, and that he gave war any roots to
it so that people can get it chaply. So well
in all a good story.

Speaker 1 (09:15):
My mother's from England.

Speaker 6 (09:16):
When my grandfather was diagnosed with polio, my grandparents were
told it would likely kill him, but we're given the
option to try an experimental vaccine. He took it and
lived with just a slight limp to show for it.

Speaker 2 (09:27):
I think it was developed in the late nineteen forties
it worked, and all to there in the US were
and still are, required to get the polio vaccine to
attend school.

Speaker 7 (09:36):
I know the polio vaccine helped the world tremendously.

Speaker 1 (09:39):
I think. That's all I know.

Speaker 6 (09:40):
I was so knowledgeable about the polio vaccine, especially considering
that it probably saved my life and a whole lot
of other people's lives.

Speaker 8 (09:48):
I know that the most commonly used polio vaccine is
an inactivated polio vaccine, which means it contains dead poliovirus.
There's all so an oral vaccine which contains weakened polio virus,
but you still have the risk of catching polio from it.

Speaker 1 (10:09):
As far as I know.

Speaker 7 (10:10):
So it's a vaccine against polio. Boom, that's it, podcast done.
I know there was a huge campaign in Brazil to
eradicate polio and it was a great success. The most
memorable thing I remember about this campaign was a mascot
called Zego China, something like Joseph Droplet, which is famous

(10:34):
up to this day.

Speaker 5 (10:35):
Well, all I know is that I got it when
I was a little kid, and since then I've never
owned a.

Speaker 6 (10:42):
Polo shirt at all, so it must have worked pretty well.

Speaker 5 (10:47):
The idea for the vaccine came about when Louis Pasteur
was hanging out with those milkmaids.

Speaker 3 (10:53):
I know that smart people get the polio vaccine, Kelly.

Speaker 1 (10:56):
So you heard these answers after you did your deep
research dive, like fifty pages of notes here.

Speaker 2 (11:02):
Episode I'll talk fast.

Speaker 1 (11:06):
Did the listeners have sort of the same impression you
did before you did all your research.

Speaker 2 (11:10):
Well, some of them knew a lot more, to be honest.
So one of the listeners mentioned that there's a killed
virus version of the vaccine and a live virus version
of the vaccine. I didn't realize there were multiple versions
of the vaccine. I was excited to hear the story
about Brazil. But I think the only thing I knew
about this vaccine was that it worked, and I didn't
have to know about polio because it worked so well.

(11:32):
And I think I had heard that Jonassack gave his
vaccine away for free and he has been sort of
lionized for that. Had you heard that.

Speaker 1 (11:41):
Too, Yeah, I have heard that story. Yeah, I hope
that's true.

Speaker 2 (11:44):
Yeah, it's more complicated. Uh oh no, we're going to
get to it.

Speaker 1 (11:49):
And so that reveals that this podcast secretly is actually
just a project to give me and Kelly excuses to
do deep dives in research and stuff we always wanted
to know about.

Speaker 2 (11:57):
Yeah, I don't think that should be a secret, you know.
I think our excitement about the universe is. You know,
that's part of why I love researching for this this podcast.

Speaker 1 (12:07):
There is so much really cool stuff to learn. But
today we're talking about not the whole universe, just polios.
To tell us what is polio? How does it work?
It's not a preon, It's not a bacteria. Is it
a virus?

Speaker 2 (12:17):
It is a virus, and it's a virus that you
can get either through droplets in the air, like if
someone sneezes or coughs, or through the We've talked about
the fecal oral route before the butt to mouth routes.

Speaker 1 (12:28):
I don't like talking about the round.

Speaker 2 (12:31):
That is a very delicate opinion for someone who lives
with a microbiologist who studies poop. I know.

Speaker 1 (12:36):
And we just did a freezer clean out last weekend,
and boy, there was a corner of that freezer I
did not want to touch. Yeah, were in the corner.
I didn't get a definitive answer. I got to like
you don't really want to open that bag kind of
an answer anyway. So polio's a virus and it lives

(12:58):
in fluid bodily fluids, Does that mean that, like it
can't live outside of water if it like landed on
our surface and it dried up the polio and break
apart or something, it needs those droplets.

Speaker 2 (13:07):
Well, So, because it's fecal oral, that means that, Like
you know, so if you wipe your rear end and
then you touch a surface, the virus can stay alive
on that surface for a while. And then if somebody
else comes by and they touch the same surface and
then they put their fingers in their mouth, then they
can get it that way, so it can survive in
the environment.

Speaker 1 (13:25):
I like the way you made that indirect fecal table oral,
Like that's a nice intermediary there. I appreciate it.

Speaker 2 (13:31):
It is nice if there's a step in between.

Speaker 1 (13:36):
All right, So it can come in through the mouth
of the nose, and then where does it go in the.

Speaker 2 (13:41):
Body, So it can go to your gut and start
replicating in your gut, it can go to your lymph
nodes and start replicating in your lymph nodes. And for
a lot of people, actually they get pretty lucky and
this replication sort of stops there, your immune system gets
it under control. Some people don't even realize they have polio, really,
and that's actually the majority of people don't realize they

(14:01):
have polio, like they don't have bad symptoms.

Speaker 1 (14:03):
So it might be that a lot of people have
had polio and didn't know.

Speaker 2 (14:06):
It eighty years ago. Yes, yeah, but yeah in the past, yeah,
but not now.

Speaker 1 (14:10):
Wow. Fascinating.

Speaker 2 (14:11):
And so for that small subset of people who are
super unlucky, the virus keeps replicating and gets into the bloodstream.
And then once it gets into the blood stream, it
moves to the nerves and it can kill some nerves.
And so a lot of times it will kill nerves
that go to your legs or your arms, And so
you'll wake up and discover you can't use an appendage,
or sometimes you'll wake up and discover you can't use

(14:33):
multiple appendages.

Speaker 1 (14:34):
It's that sudden that you just like go to sleep
being able to walk, and you wake up paralyzed.

Speaker 2 (14:38):
Yeah. So when Franklin delan Or Roosevelt got it, he
went to bed feeling kind of like he had the
cold or like a flu. And then the next morning
his legs started to feel kind of numbed and like
he couldn't really use it, and then on the way
to the bathroom he fell over and was paralyzed. So
it's pretty quick.

Speaker 1 (14:54):
Oh my god, that is terrifying.

Speaker 2 (14:56):
I know, I don't But even more terrifying is that
it can go after a part of your brain stem
that controls the muscles that are important for breathing. And
so the way you breathe is, you know, you have
a diaphragm that goes up and down, and as it
goes up and down, it changes the pressure in your
lungs and pulls air into your lungs and pushes the
air out of your lungs. So when your diaphragm isn't working,

(15:18):
you can't breathe.

Speaker 1 (15:19):
Breathing's kind of important, right.

Speaker 2 (15:20):
Yeah, this is a major cause of death from the disease.
Oh no, And if you caught it fast enough, you
could get put in an iron lung, and the iron
lung it has a change in pressure inside that sort
of does the job of the diaphragm, and so it
breathes for you. But it means you have no control
over your breathing, which makes it hard to talk, it
makes it hard to eat because you're just on the

(15:41):
timer of the iron lung. And some people could stay
in the iron lung for a little while and they
got better and they'd get.

Speaker 1 (15:46):
Out they got better, meaning you can recover control of
your nerves.

Speaker 2 (15:49):
Yeah. So I think in some cases your nerves will
like grow back, or you know, your body will sort
of rewire things, but that's not always the case. Plenty
of people were pair for their entire lives, and some
people stayed in an iron lung for their entire life,
for their entire life.

Speaker 1 (16:05):
Wow, yeah, yeah, I mean I've seen pictures of these things.
It's basically like a head sticking out of a wall, right,
and the rest of your body's just like inside this tube. Yes,
and that's you.

Speaker 2 (16:15):
Just live like that, yeah, right, and if like you know,
if your nose is itchy, you can't scratch it. Like
Mary Roach had this story where she in her most
recent book, Irreplaceable You, which highly recommend and you should
check out our episode with Mary Roach. Anyway, she got
in an iron lung to see what it was like,
and she said, like the second you get in there,

(16:36):
you want to scratch your face, but you can't because
you can't get your hands out of the tube that
you're in. And she said that she was in there
for like five minutes and it felt like hours, and
it was like a very very uncomfortable experience, and she
wanted to get out like right away.

Speaker 1 (16:48):
But there are people who spent like decades in those things. Yes,
oh my gosh, wow.

Speaker 2 (16:53):
Yeah, And so, as we've discussed, this happened pretty quickly
and so and a lot of times the symptoms started
as sort of like a cold or a flu, and
often it would hit kids. So can you imagine like
when your kids in first grade, all the times that
they came home with cold or flu like symptoms, and
every time that happened, having to worry like, oh my gosh,
is this polio? Like my kids were constantly snotty for

(17:17):
like kindergarten, first grade, second grade. I'd like just never
would have slept for those years me either.

Speaker 1 (17:23):
I mean, I'm a worrier, So anything that goes wrong,
I'm like, oh, is this the end? Is it all
coming crashing down?

Speaker 4 (17:29):
Yep?

Speaker 1 (17:29):
And so to have a real reason to worry every
time your kid gets a cold, yeah, I would be
like checking on them in the middle of the night
every hour. Though. I guess there's nothing you can do, right,
I mean, is there something you can do if they
catch it? Can they Is there an intervention or something?

Speaker 2 (17:43):
No, there wasn't like a medication or anything like that.
You know, the best you can do is make sure
that you're at the hospital if your kiddo is going
to need the iron lung so you can get them
in there right away.

Speaker 1 (17:52):
Oh my god.

Speaker 2 (17:53):
Yeah, it was. And one of the weird things about
this illness is that, you know, we know that this
illness has been running through the human pop for a
really long time, but most of the time it didn't
produce really bad symptoms. But then in the nineteen forties
and into the nineteen fifties, suddenly a lot more cases
of paralytic polio started happening. Wow, And we kind of

(18:15):
stopped studying polio after we got a vaccine, so we
don't really understand why this is the case. But in
nineteen forty eight there were almost twenty eight thousand kids
who got polio, which was three times more than the
prior year, And in nineteen forty nine it was forty
two thousand cases, and in nineteen fifty two it was
fifty seven thousand cases. Twenty one thousand of those kids

(18:37):
got paralyzed and three thousand of them died. So we're
I mean, to be fair, we're not talking millions of deaths.
But still, like you know, twenty one thousand kids being
paralyzed is nothing to sneeze at if it's happening for
one year in the United States.

Speaker 1 (18:52):
Yeah, and it made a big impact on that generation.
I think anybody who knows people that from that generation
has met somebody impacted by polio. My teacher in fifth
grade walked with crutches and didn't have complete use of
his legs because he had polio as a kid.

Speaker 2 (19:06):
Now, I have never met anyone who has shared a
polio's story with me. I think we're moving far enough
away from when the vaccine was developed that it's rarer
and rarer to hear those stories. But certainly it was
common in the fifties.

Speaker 1 (19:18):
Didn't Mitch McConnell have polio? I mean, I think he's
like five hundred years old. Yeah, Yeah, Mitch McConnell is
a polio survivor. Wow, his upper left leg was paralyzed.

Speaker 2 (19:26):
Huh, Well, he was one of the lucky ones who
made it through.

Speaker 1 (19:30):
So do we understand now why this started to ramp up?
Was there some like mutation in the virus or a
change in the environmental situation or.

Speaker 2 (19:37):
As far as I know, we don't know. We kinda
we felt like we licked polio and so we moved
on to other things, which makes sense. But it would,
you know, still be interesting to know and interesting to
understand because you know, there could be other viruses that
might mutate that we should be like keeping an eye
on if we understood why this happened.

Speaker 1 (19:53):
Are there silly conspiracies based on like random correlations, like
that's when rock and roll started to spread across the
country or something.

Speaker 2 (20:02):
There were a lot of crazy conspiracy theories about how
polio was transmitted. For example, a lot of people thought
it had to do with cats, so thousands of cats
in New York City got killed. I oh, so there.
You know, there were plenty of conspiracy theories. But to
be honest, I didn't look too much into why I
didn't look for conspiracy theories. They're so easy to find

(20:23):
most of the time, all.

Speaker 1 (20:24):
Right, And so at this point we have vaccines already
for other diseases, right, So it must have been like
on the radar, like, let's get a vaccine for polio.

Speaker 2 (20:31):
Yeah, And so our early research into polio unfortunately set
us on kind of the wrong track. So there was
a guy named Simon Flexner at the Rockefeller Institute and
he was trying to infect Reesis monkeys to understand how
the virus is transmitted. But one of the hard things
about studying human diseases in other animals is that sometimes
it works different in those animals, and so in the

(20:53):
Reesis monkeys, the way you got them infected was you
swabbed their nasal passage and essentially you were sending the
virus like really close to the nervous system. And so
the Reesis monkey's got polio, but if you put it
in their mouth and had them swallow it, they didn't.
And so there was this idea that the only way
polio could get to people is if it went directly

(21:14):
into the nervous system, and that you couldn't get it
by ingesting it. And that's bad for a couple of reasons.
So one it's throwing off your understanding of how the
disease is actually transmitted, which means public health measures are
harder to create. And the other thing is it suggests
that the virus is never passing through the bloodstream and
that is your best chance at hitting it with your

(21:35):
immune system. So if you're going to have a vaccine,
it's probably going to create antibodies that will be in
your bloodstream. And if the virus is never in the bloodstream,
how's your body gonna attack it?

Speaker 1 (21:46):
All Right? So now you've questioned your immune system is
only in the blood or is that where most of
it is?

Speaker 2 (21:52):
Or what your immune system is in lots of places.
But my understanding is that the strongest part of the
immune system, and the part of the immune system that
gets act devated by vaccines, tends to be in the blood.

Speaker 1 (22:02):
Yeah, And since we're doing an immune system primer, what
is an antibody exactly? Is it one of these crazy
white blood cells that you see on those videos like
searching around and killing bacteria?

Speaker 2 (22:12):
Ah? No, not quite. So your immune system makes an
antibody when it encounters a pathogen for the first time.
And what the antibody does, it's like a protein and
it binds to the pathogen. And one of the things
that it does is it keeps the pathogen from, for example,
getting into a cell. So this could keep polio from
getting into a nervous system cell because it's essentially like

(22:32):
blocking it from doing anything that it wants. Another thing
that it does is it flags the pathogens so that
those white blood cells can then find it. So it
essentially is like white blood cells over here, I've got something.
And so you make antibodies that are specific to different
kinds of pathogens. So if your body encounters the poliovirus,
it will create antibodies that remember the poliovirus. And so

(22:55):
the next time you encounter polio, your immune system is
ready to attack it right off of the bat.

Speaker 1 (23:01):
And you say, remember, And that makes me think of like,
you know, I remember somebody's face, and I have no
idea how that works inside the brain. How does it
work for the immune system. Is it like it builds
some protein which latches onto the something on the surface
of that thing. I'm totally guessing here. How does it work?

Speaker 2 (23:17):
Yes, So I think you are the amount of antibodies
that you have for a specific pathogen does kind of
go down over time. And like you may have had
the experience where you go to get a booster vaccine.
And so sometimes your body does seem to sort of
forget if it hasn't seen something for a while, and
so you're essentially just reminding your immune system like, hey,
this is a bad thing. You should be prepared. And

(23:38):
it's not like it always has loads of antibodies for
all pathogens that could possibly encounter, but there's some of
them in there, and then the number of them can
be rapidly increased if the pathogen is encountered.

Speaker 1 (23:50):
Again, I see, And so you're saying remember and forget.
It's sort of like anthropomorphizing our immune system. Really, it's
like do you have a bunch of antibodies for this
or do you not?

Speaker 2 (23:58):
Absolutely?

Speaker 1 (23:59):
Yeah, that's right, all right. And so it's a big
challenge to develop a vaccine for something if it doesn't
go through the blood I, which just like bypasses our
major defense system. So what does that mean about developing
a vaccine? What else can we do?

Speaker 2 (24:12):
Well? So it turns out that Simon Flexner, because he
had studied Reesei's monkeys, he thought it never went through
the blood. But he was wrong.

Speaker 1 (24:21):
He was wrong.

Speaker 2 (24:22):
He was wrong, and he was wrong because he was
studying monkeys and polio is different in riesis monkeys than
it is in humans. In those monkeys, it can only
get in through the nose if you put it really
close to the nervous system. But in humans, we can
get it through our mouth and then it goes into
our stomach and into our lymph nodes, and then it
goes into our blood before it goes to the nerves.
So you do have a shot. But for a long

(24:43):
time we were all sort of thrown off track by
this research that didn't quite get it right because the
animal model set us on the wrong track.

Speaker 1 (24:50):
All right, So bad news for the recis monkeys, but
good news for humans.

Speaker 2 (24:54):
So eventually good news when we figure it out.

Speaker 1 (24:57):
Where we figure it out. Yeah, all right, so let's
take a break. Can we come back. We'll hear more
of the saga of how we developed a polio vaccines,
the twists that turns the ups the downs. Get your
popcorn and get some tissues because it's gonna get emotional.

(25:29):
All right, we're back, and we're telling a story of
how we developed the polio vaccine. Kelly, what is the
next step in this story?

Speaker 2 (25:36):
Well, you know, like so many scientific endeavors. The next
step is get the money, because it's expensive to do science.
And the story for how the vaccine got funded starts
with Franklin Delano Roosevelt, who in nineteen twenty one, at
the age of thirty nine, got polio himself and his
legs were paralyzed. In nineteen twenty four, he hears that

(25:57):
this person went to these nice warm springs, and by
going in the warm springs and moving his body around
in the springs, he was able to walk again. Oh,
and FDR was like, Wow, what that's great, I'm gonna go.
And so he goes, and he falls in love with
the place. He feels like, actually he can move a
little bit better in the warm strings. That might have
been a placebo effect, but also it's just sort of

(26:18):
nice to have a lot of your body supported by
the water, and the warm water probably felt pretty good.

Speaker 1 (26:23):
Hot tubs are fun, they sure.

Speaker 2 (26:24):
Are, yes, And so he decides, you know what, I
love this place. I'm gonna buy it.

Speaker 1 (26:29):
Wait, I'm gonna buy it.

Speaker 2 (26:31):
I'm gonna buy it. Yeah. He came from a rich family,
so he was like, I'm gonna buy it.

Speaker 1 (26:35):
I'm not just enjoying the hot tubs. I'm in the
hot tub business now, Wow cool.

Speaker 2 (26:39):
Yeah, And so he buys it, but he buys it
and tries to make it a place where lots of
polio folks can go oka. And so he will sometimes
even charge people less if they have polio and they
want to come to the warm springs but they can't
afford to. And that's great, but he's having trouble making money,
one because he's giving people all these discounts, and two
because it turns out people who don't have polio are

(27:00):
worried about getting into the water with people who do
have polio because we don't know how it's transmitted. And
so this place is financially going down the tubes.

Speaker 1 (27:09):
Comes soak in hot disease water doesn't really work.

Speaker 2 (27:11):
It turns out, yeah, well right, yes, that's right. You know,
for these patients, the polio had passed through their body.
They were still paralyzed, but they almost certainly weren't shedding
virus anymore. So it probably was safe. But you know,
stigma being what it is, people were staying away.

Speaker 1 (27:25):
Nobody wants to slip into polio soup anyway.

Speaker 2 (27:28):
Yeah, yeah, that's right. So in nineteen twenty eight, FDR
becomes New York Governor, and in nineteen thirty two he
becomes pregnant. Pregnant, oh my god. In nineteen thirty two.

Speaker 1 (27:41):
He becomes accomplishment.

Speaker 2 (27:42):
Yeah, that's right, that's right. Who knew polio was the
cue anyway? All right, So in nineteen thirty two he
becomes president and he no longer has time to run
warm Springs, and so his work colleague, Basil O'Connor, takes
over and he's trying to figure out how he's going
to take this financial disaster and turn it around, and

(28:03):
he essentially starts a campaign that's sort of focused on
FDR where he says, hey, let's start to raise money
for polio by having like big gala balls, And eventually
he brings in famous actors and actresses to try to
raise money, and this becomes the National Foundation for Infantile Paralysis,
which ultimately becomes the March of Dimes, which I think

(28:24):
a lot of people have heard of. Ye, And this
is why FDR's face is on the dime. Oh because this, yeah,
this became like a super popular thing. Okay, well, they've
raised loads of money. A lot of their money was
spent on helping to care for people who were paralyzed,
and so they offered a lot of support for polio victims,
but they also saved a bunch of money for research,

(28:46):
and so this is how the research is going to
get funded.

Speaker 1 (28:48):
So if you're out there and you're a disease and
you're listening, it's a bad idea to infect a white
guy who becomes really important, because those are the diseases
that get attention.

Speaker 2 (28:58):
I wish that that were otherwise, but no, you're right,
And in fact, there's a pretty good argument that you
could make that polio in particular was getting a lot
of attention because it tended to hit the middle class,
and so there was this idea that maybe because the
middle class were living in like super sanitary environments, they
were more susceptible to polio. But this was a disease

(29:18):
of like upper middle class white people, and that is
probably part of why it got so much attention.

Speaker 1 (29:25):
Yeah, Unfortunately, folks in government need like a personal connection
to some kind of experience before they take action. Sometimes
it's too bad. Yeah, Anyway, it's good news that there
was a lot of research money towards developing a vaccine.
It's a bummer that FDR had to get polio for
that to happen. But then how did that research effort
kick off?

Speaker 8 (29:42):
All?

Speaker 3 (29:42):
Right?

Speaker 2 (29:42):
Well, so first they had to decide what kind of
vaccines they wanted to fund, and it turned out there
were two competing camps that both felt very strongly and
the competing camps were live attenuated virus. So you essentially
get a wimpy version of the virus and inject that
into peace people, or a killed virus where you kill

(30:03):
the virus before you inject it into people, but you
make sure that you haven't like totally destroyed it. You
need your immune system to still recognize it.

Speaker 1 (30:11):
Okay, And did we have working examples of both in
other diseases.

Speaker 2 (30:15):
Yes, The live attenuated virus was pretty common at the time,
and it was thought that that was the best way
to make vaccines. But Jonassock, early in his career, is
going to get experience working on a killed version of
the influenza virus. Oh, and he's one of the people
who helps develop the first flu virus, and that kind
of convinces him that killed viruses are the way to go.

(30:38):
But there's a couple problems. So the live virus people
argue that a killed virus will never stimulate the immune
system as well, and so you might get weaker immunity
or immunity that fails more quickly. And they're concerned that
it's going to be really hard to be sure you've
always killed all of the virus, Like if you know,

(30:59):
you've got a batch of virus that is alive, and
then usually what happened is they put formulin a formaldehyde
in there. How can you be sure that it got
to every single virus particle. How can you be sure
you're not going to give people polio?

Speaker 1 (31:10):
Oh my god, imagine injecting polio into some kid. That'd
be terrible.

Speaker 2 (31:15):
Yeah, hang on, we're going to get there. And so, yeah,
I know, it's it's a sad story. And so the
problem with the live attenuated virus is that viruses mutate,
and so a virus that has been made sort of
wimpy over time can mutate and go back to being
really bad. And when you make a live attenuated virus,

(31:37):
people shed that virus and it gets into the environment,
and so anywhere people are defecating, you've now got this
polio virus in the environment, and you can't really control
where it goes and what it does.

Speaker 1 (31:47):
Yeahs, both of these seem like bad ideas. Now, Kelly,
you've got me almost over the.

Speaker 2 (31:53):
Okay. The lesson at the end is going to be
that we have really good protocols for killing viruses now,
and it's been going well for like fifty or sixty years.
There have been no mistakes as far as I know.

Speaker 1 (32:05):
All Right, So what were some of the early tests?
How did they go?

Speaker 2 (32:07):
Okay? So, one of the early trials is called the
Park Brodie vaccine, and this is named after the two
scientists who worked on it, and this was around nineteen
thirty four, and they essentially infect monkeys with polio, grind
up their nervous tissue, and add a little bit of formalin,
hoping the formulin will kill the virus. And they first
give it to twenty monkeys, and the monkeys make antibodies

(32:29):
to polio, which suggests it works. And then they try
the vaccine on themselves and it goes pretty well.

Speaker 1 (32:35):
They gave the vaccine to themselves.

Speaker 2 (32:37):
They did give the vaccine to themselves. They were pretty confident.

Speaker 1 (32:40):
Wow, okay.

Speaker 2 (32:41):
And then they give it to twelve kids and it
goes okay. Okay, and so they say, hey, we've got
a safe polio vaccine, and they start scaling things up
really quickly, because everybody really wants a polio vaccine, right
and so as soon as there's like evidence that you've
got something that works, people start scaling up. But the
problem is it wasn't really safe and it might not

(33:02):
have been protecting against polio.

Speaker 1 (33:04):
So but before they scaled up, they must have had
some evidence that it was working. That was the evidence,
just that it was creating antibodies in the humans, and
that doesn't mean necessarily that it's protecting against polio. Having
antibodies isn't enough.

Speaker 2 (33:17):
One of the lessons we're going to learn from this
is that there hadn't been enough basic research before they
started making the vaccine. And it turns out there's three
types of polio, not just one, and so you can
protect against one type, but someone can still die or
get paralyzed by some of the other types I see,
and so they didn't have complete protection. And then the
other problem was we didn't know at the time that

(33:38):
there's a lot of people who will have very strong
immune system reactions to monkey nervous tissue, and so some
of the nervous system cells were still in the vaccine,
and people had like massive abscesses and their whole body
would be inflamed. And kids were getting super sick from
this vaccine and it was because of the monkey cells.

(33:59):
At the same time, this guy Comer is making another vaccine,
but this one is a live virus vaccine with the
wimpy version of the virus. This was in nineteen thirty five.
He also vaccinates himself. He vaccinates his two kids. Oh
my gosh, and so he must have been confident. And
then he vaccinates twenty three other kids whose kids are
these kids? Right?

Speaker 1 (34:20):
So sometimes treat jab jab.

Speaker 7 (34:24):
Oh.

Speaker 2 (34:24):
You know, I if somebody confidently told me I can
protect your kid from polio, there's some chance I'd be like, like,
I wouldn't want my kid to be the first one
in line. Yeah, but I can imagine why he was
able to find twenty three kids.

Speaker 1 (34:37):
Well, it's a terrible decision to make, like do you
maybe take this vaccine that protects your kids or do
you not take it? And then they're still risking their lives, right,
this risks either way.

Speaker 2 (34:45):
Yeah, there absolutely are. But he then goes on to
vaccinate ten thousand kids. Wow, so a pretty big trial.
And at least a dozen kids get paralytic polio from
his vaccine and nine of them die.

Speaker 1 (34:58):
Oh my gosh.

Speaker 2 (34:59):
Yeah, And so they're there's a scientific conference where the
Park Brody vaccine and the Comer vaccine are discussed, and
it's a bunch of polio scientists and at the end,
essentially Colmer gets accused of murder by one of the
other scientists and he says, gentlemen, this is one time
I wish the floor would open up and swallow me.

Speaker 1 (35:17):
Oh my god. He must have felt terrible.

Speaker 2 (35:19):
He felt horrible. And Brody dies at age thirty six
or something of a heart attack. There's some argument that
maybe it was he brought the heart attack on, you know, purposefully.
But anyway, really horrible episode for everyone involved. And the
lesson they end up taking away from this is that
we need a lot more basic research.

Speaker 1 (35:38):
And these guys were all acting in good faith.

Speaker 6 (35:40):
Right.

Speaker 1 (35:40):
Maybe they rushed a little bit, maybe they got unlucky,
but they were trying to.

Speaker 2 (35:44):
Do good Yeah. Yeah, And you know, I think that
Comer who tested the vaccine on his kids, he must
have thought he had the solution, or he didn't like
his kids.

Speaker 1 (35:53):
Oh wow, one or the other. I was trying to say,
these people are not monsters, they're not villains. But you're like,
maybe he hates it's his children.

Speaker 2 (36:01):
No, I'm just joking. They're not monsters like they really,
no doubt part of them was thinking, I will be
a really big deal if I soalve this polio thing.

Speaker 1 (36:10):
Right.

Speaker 2 (36:10):
I can't imagine that that wasn't on their minds, but
I do genuinely believe the fact that they tested it
on themselves first, they tested it on their kids, that
they really they were trying to save lives. I think
their intentions were good, but they rushed into it and
they didn't realize how little we knew.

Speaker 1 (36:25):
I think, well, it's a tragedy either way it is.
So then we did a bunch of basic research to
understand polio and the immune system better. How did that
help shape the next step in the vaccine story.

Speaker 2 (36:36):
Yeah, So the next thing that we wanted to do
was work on figuring out how many types of polio
there are. So it became clear to us that that
is a question we didn't really have a good answer to.
And this is where Jonas Sack comes in. So I
think a lot of people have heard of Sock. He's,
you know, a fairly famous scientist. His family were Jewish
immigrants from Russia who moved to New York City.

Speaker 1 (36:56):
Yay scientists immigrants, yayay.

Speaker 2 (36:59):
Oh, there's a lot of stories of scientists' immigrants here.
They're like, we have a lot of immigrants to thank
for protection against polio.

Speaker 1 (37:05):
It's almost like we should be welcoming smart, hardworking people
into our country, especially if they bring expertise and want
to help us.

Speaker 2 (37:11):
Yeah, you know, I think you and I try to
not be political on the show very often.

Speaker 1 (37:14):
I don't think that's political. I don't think that's just
common sense.

Speaker 2 (37:18):
I am one hundred percent behind you. Yes, I agree.
This is a small subset of the many immigrants who
have made our country better. So, as we mentioned, Slock
had some experience working on the flu vaccine, which was
a killed virus vaccine. He did that at the University
of Michigan with an advisor who we're going to hear
about later, Thomas Francis Junior. But then he starts his

(37:39):
own lab at the University of Pittsburgh, and when he's
at the University of Pittsburgh, he meets a representative for
the National Foundation for Infantile Paralysis. This is the funding
agency we were talking about before, and they're like, hey, look,
you're starting up a lab. You clearly need a lot
of equipment and some extra space. What if we gave
you a bunch of money to try to figure out
how many types of poliovirus there are? And he was like,

(38:01):
I need money. That's I'm in. And so he starts
typing polio and he works on this for two years,
from forty nine to fifty one, and he confirms that
there are three types. The first type is the most common,
and it's the most likely to lead to paralysis. The
second type tends to lead to asymptomatic cases, but sometimes
it can still paralyze the unlucky. And type three is

(38:23):
the most rare, but it's also the most likely to
go after your brain stem and put you in an
iron lung or kill you. Oh boy, Yeah, so you
want protection from all three of those?

Speaker 1 (38:33):
I certainly do, yes.

Speaker 2 (38:35):
Okay. So around this time there are some other really
exciting advances, one of them being that we figure out
how to grow the virus in monkey kidney cells in
dishes rather than nervous system cells. And so now we're
in a position where if we need to grow up
this virus to make vaccines, we don't have to be
doing it in monkey nervous systems anymore, and we don't

(38:56):
have to worry about that horrible reaction. The first set
of kids had key nervous system tissue.

Speaker 1 (39:01):
All right, that's good news.

Speaker 2 (39:02):
That is good news. And then a woman named Dorothy Horseman,
while doing some experiments, realizes, hey, actually polio does have
a phase where it goes through the blood. At this point,
we knew that sometimes it gets in through the stomach,
and she figures out that sometimes it goes through the
blood on the way to the nervous tissue, and she's like, hey,
that's good news. We might be able to make a vaccine.

(39:23):
This is promising. But then she stopped working on that question.
But now it's in the air that you could go
after it in the blood.

Speaker 1 (39:30):
Okay.

Speaker 2 (39:31):
So in nineteen fifty one, Stalk starts growing the virus
in the lab and he has to pick the three
strains that he wants to use. So he knows that
there's lots of different like, even if it's just type one,
there's still different kinds of strains, and some of them
are worse than the others. And so what he does
is he puts the poliovirus into kidney cells. He gently

(39:52):
rocks it in an incubator with nutrients, gently rocks it well,
not like you know, not like with a senetic. I'm
sure he had a piece of equipment that was moving
it around on a tray.

Speaker 1 (40:05):
He's whispering sweet nothings to it as it grows.

Speaker 2 (40:08):
That's a come on, babies, you got this.

Speaker 1 (40:12):
There is something kind of a cob about growing them
up just so you can kill them and then kill
all their brethren. Right, but all right, anyway, go ahead,
So you grow up all these polio vaccines in these
monkey kidney cells.

Speaker 2 (40:23):
You're growing up all these polioviruses, right, I gotta say,
I don't feel bad for them. Yeah, So then you
filtrate out as much as you can to make sure
you're just left with viruses. And viruses are really tiny,
so it's pretty easy to filter them out. But remember
some nervous system cells got through the last time, so
you got to be careful. And now he tries to
kill the viruses with formaldehyde. Formaldehyde is a super nasty

(40:45):
chemical and it's hard to do because you need to
be absolutely sure that every time you do this procedure
you kill all of the virus. Yeah, any free living
virus can really cause some trouble. Because one of the
types that he picks is a super virulent strain called
the Mahoney virus, and he picks it because it would
be really good to have resistance against this particular strain.

(41:08):
It's very common, it's very lethal. So he decides to
go with it, but you got to be sure you
kill it. And so they worked really hard on this procedure.
And one of the things you got to be worried
about is if at any point your vile sits for
too long, stuff can sort of accumulate at the bottom
and form like clumps, and virus particles in the middle
of that clump can stay alive and kill things.

Speaker 1 (41:30):
And so at this point he's using what seems like
an established procedure. You take the virus, you makes it
from aldehyde, you have a killed version of the virus.
There's no innovation yet, right, that's.

Speaker 2 (41:39):
One hundred percent right, that's a really good observation, and
that is going to continue throughout a lot of this story.
Saul didn't really do anything one hundred percent new. He
was taking procedures that other people had used, and he
was the first one to sort of put them together
and get it right. That's important. Other people had not
established a protocol that like definitely killed all the virus

(42:00):
every time, but Salk manages to do that.

Speaker 1 (42:03):
Wow.

Speaker 2 (42:03):
Interesting, Yes, And so he eventually gets something that's worth trying,
and he tries it on monkeys and it goes well.
And after the break, let's talk about how he starts
his human testing.

Speaker 1 (42:34):
Okay, we're back, and we're talking about the development of
the polio vaccine. And so far Salk has discovered there
are three kinds of poliovirus. He's grown them up whispering
sweet nothings as he incubates them in monkey kidney cells,
and that he's mixed them with from aldehyde to kill them.
And you said this was successful in monkeys, but we've
seen that before, right.

Speaker 2 (42:55):
Yep, we've seen that before. And so it's important to
note that at this stage, Sulk also injects his vaccine
into himself and his children because he's confident that it's
going to work. But then he goes on to find
a larger community that he can test it on, and
here I feel a little bit uncomfortable. So he found
the D. T. Watson Home for Crippled Children. Crippled is

(43:17):
the word they were using at the time. He also
reaches out to the person running the Pope School for
Mental Defectives. Wow, really, you know from today that is
a pretty insulting name for the facility. But it was
basically children who had some intellectual disabilities who were getting
cared for there, and there was this general feeling in

(43:38):
the community that this was a good population. So there
was a sort of condescending attitude that this is some
way they can contribute to society by essentially being these
guinea pigs, and the implication there being that they weren't
contributing in any way otherwise, which upsets me, or that.

Speaker 1 (43:55):
There's somehow less valuable because if something goes wrong, it's
not as big a deal or something exact.

Speaker 2 (44:00):
Yes, right. Also, you know they are in one place,
and we'll stay in one place for a long time,
so you can go back and test them, and you
know who they're interacting with. So there's a lot of
things you can control with this population. So for better
or worse, he gets permission to work with both of
those communities. Now the DT wants at home for crippled children.
Most of those children who are disabled are disabled because

(44:22):
of polio. And so what he does is he figures
out by looking at antibodies in their blood what kind
of polio they encountered, and then he gives them a
shot of the same type of polio that he killed
in his lab. And he thinks this should be a
pretty safe way to test things, because if I didn't
kill all the virus, it's not going to be bad
for them because their immune system is going to be

(44:43):
able to respond. And I can see if they start
making even more antibodies when I give them the vaccine,
so they shouldn't get hurt, but they'll give us some
information about whether or not we're stimulating the immune system.

Speaker 1 (44:54):
All right, So they have like natural immunity already because
they've been exposed to the disease itself.

Speaker 2 (44:58):
That's right, Okay, go that went great, actually, and it
went so great that they moved on to the other community.
And when they moved on to the other community, this
time they you know, these kids had no expected immunity
to polio. They didn't have polio. You could check that
with blood tests initially, and they are not sick after

(45:18):
they get the vaccine and they start making antibodies and
those antibody levels stay good for months. And these are
some really good results. So he's super excited.

Speaker 1 (45:26):
Do you think, by the way that they got parental
approval to test it on these kids? Do you think
the parents were like, yeah, go ahead and test it
on my kid and I put in the institution or
do you think they sort of did it without asking
the parents.

Speaker 2 (45:38):
So, in the interest of time, we skipped another vaccine
story where Hillary Kaprowski did not get good parental consents
and the Lancet even jokes about his use of the
word quote unquote volunteer.

Speaker 5 (45:53):
No.

Speaker 2 (45:53):
And so there are some questions about consent that are
raised earlier in the vaccine story, and so Sok had
this on his mind. He contacted a lawyer to make
sure he had insurance to cover him in case he
got sued, and he worked with the state to come
up with great parental consent forms that were very clear
about all this stuff. Yeah, so some lessons were learned there,

(46:15):
which is good. And so he goes to write up
his results to publish them in the Journal of the
American Medical Association. But word gets out before his article
is published that there is a polio vaccine that could
start saving kids before the next polio season.

Speaker 1 (46:29):
Oh my gosh.

Speaker 2 (46:31):
And so Salk is freaking out because everybody is like, oh,
you got to give us the vaccine, and he's like, no,
I'm not ready yet. This was like a small scale study.
This is not ready for large scale distribution.

Speaker 1 (46:40):
And we learned a lesson from earlier rapid scale ups
and that we need to be careful.

Speaker 2 (46:44):
Yes, exactly right. And so he goes on a radio
show and essentially tells the nation, Look, we don't have
a vaccine yet. We have some good results, but like,
I don't think we're going to have something for the
next polio season. So we're working on it. But now
the ball is rolling right, and the national foundation that's
paid for his research is like, we need to do
a massive national trial, and Sox sort of gets pulled along.

(47:08):
And so they give the protocol for making this vaccine
to some drug companies and they say, okay, start making
this vaccine. Wow, And now this debate starts about how
do you design this nationwide experiment that's about to happen,
and the big debate is about whether you want observed
controls or double blind injected controls. So here's the difference.

(47:29):
For the observed controls. They wanted to open enrollment to
second graders, and any second grader who wanted the shot
could get it, and then they would compare polio rates
in the second graders who got the shots to first
and third graders, so similarly aged kids who were probably
engaging in the same activities, and then compare how much

(47:49):
those two groups got polio.

Speaker 1 (47:51):
And then this is an issue there because there could
be a bias because people are selecting right, and there
would be some confounding factor with that selection.

Speaker 2 (47:58):
Yes, exactly, there's a concern that the higher income families,
whose risk is a little bit higher, might be more
likely to enroll their kids in the trial, and low
income populations were less likely to get paralytic polio, again
for reasons we don't totally understand. But those two confounding
factors made this experimental design not ideal. And so there

(48:19):
were people who were pushing for signing up a bunch
of kids who want the vaccine and giving half of
them the vaccine and half of them the placebo.

Speaker 1 (48:26):
All right, so the first plan was observed controls. But
this is the other plan, that double blind study.

Speaker 2 (48:32):
Yeah, and Salk is pretty hard against this initially because
he believes his vaccine works and it's not ethical to
randomly not vaccinate a bunch of kids whose parents want
them to get the vaccine. And in the human way
that we often find imperfect solutions to our problems, what
they ended up doing was in some places they use
observe controls and in other places they used this double

(48:55):
blind placebo situation. So you end up with both kinds
of data, and this lab at the University of Michigan
collects and analyzes all the data. It was a massive
record keeping wow fiasco because you you know, you couldn't
let the doctors or the kids know who was getting
placibo and who was getting the actual virus, because like,
if you give a doctor a vile and you say

(49:15):
this has the actual vaccine, they're going to vaccinate their
family like they're humans, you know, and maybe they're not
going to give anyone the placibo, and so you have
to actually make sure nobody knows. And then someone's job
was to track down every kid that died that was
part of the study and figure out did they die
of polio or did they could they have died of
something else? So very depressing.

Speaker 1 (49:34):
And this is before computerized records, so this is like
literally a lot of paperwork and scraps of paper and
oh my gosh.

Speaker 2 (49:41):
It was a massive, massive undertaking. So Thomas Francis Junior,
who was Socks advisor, was the one who undertook this
work and it was like, you know, years of what
his lab did was crunching these data. But right before
this vaccine trial was about to roll out and they
were about to start, you know, giving the kids the vaccines,
some of the monkeys in some of the labs where

(50:02):
they're testing the vaccine to make sure it's safe get polio.
Oh and it looks like it was just one monkey,
maybe two, that actually got polio, and the system of
checks worked right, so they did say, okay, there's some
monkeys that got polio. We need to pull those vaccine lots.
There was something wrong with them. But it gets out
and this celebrity gossip show has a host named Walter Winchell,

(50:25):
and he announces that seven out of ten tested batches
contain live virus. It's been killing monkeys. He starts a
rumor that coffins for kids are being made and distributed
around the world in advance of the release of the
Salk vaccine. Sorry, not around the world, around the United States.
But you know, a lot of what he said wasn't wrong.

(50:46):
There were monkeys dying of the vaccine, but that had
been our way of catching a mistake in the vaccine process.
But the word was out, and it's estimated that one
hundred and fifty thousand children were pulled from the trial
due to this brat And in response to the monkey incident,
they now have a protocol where companies have to submit

(51:07):
eleven consecutive lots of the vaccine that they made, and
every single one needs to pass testing before any are
cleared for use. So if in a batch of eleven,
one monkey dies, then all of that has to get
thrown out and you've got to start again. Yeah, they're
trying to be extra super careful about it. So the
vaccine trial happens. It's like the biggest vaccine trial in

(51:30):
the history of the United States at the time, and
it turns out if you look at the data where
we had that placebo, like the best quality data, the
vaccine is eighty to ninety percent effective against paralytic polio.
It's sixty to seventy percent effective against type one, and
ninety percent or more effective against type two and three. Wow,

(51:51):
that is amazing. That is a yeah, that's incredible. And
so the vaccine starts getting made in massive quantities. Six
different drug commesies start making it. And this is where
we have a problem. So it was announced that like, hey, look,
we're probably not going to have enough vaccine for the
oncoming polio season. We'll have it for the year after.
But parents really wanted it right, and so companies started

(52:13):
scaling up production and some mistakes were made. And this
is where I can imagine there could be some anti
vaxxers today that remember stories that their grandparents told them.
Because there was a company called Cutter Labs from Berkeley,
California that had some batches of vaccine where not all
the virus had been killed.

Speaker 1 (52:33):
Oh no.

Speaker 2 (52:34):
And so as these cases start getting reported, Cutter vaccine
gets completely taken off the shelves. They actually stop all
vaccines for a while until they can relook at all
of the different drug companies to make sure everything is okay.
Cutter never ends up making more vaccine. The rest of
the companies are given permission to go ahead. But now
there's much stronger controls for what kind of test the

(52:58):
vaccines need to pass before they can go public. And
in the last fifty maybe even sixty or seventy years,
this problem has not happened again. So now that we've
got these appropriate controls in place, were good. And this
is when the government started stepping in. So you probably
couldn't get a vaccine trial run by a foundation that

(53:19):
isn't government run again. And so this is part of
how like the CDC and the National Institute of Health
sort of grew in response to this situation. Wow, so
let's real quick get to so Sock sort of famously
said something to the effect of you can't patent the sun.
I won't patent this vaccine. But as you pointed out, Daniel,
he actually hadn't produced any new procedures. He was very

(53:42):
clever about taking pre existing procedures and being like absolutely
anal retentive and creating a protocol that was failsafe. But
he actually probably could not have patented his vaccine anyway.
Because there were no new novel procedures, and he did
talk to patent lawyers and they were like, yeah, you're right,
this probably isn't patentable. So it's not just that he

(54:02):
was like a really great guy, although he was a
really great guy, I think, but it also was just
that like there wasn't really anything to patent there. But
at the same time, there was a competing vaccine. So
Sabin is a scientist who was born in Poland. In
nineteen oh six, he ends up at the University of Cincinnati.
He's also getting funded by the National Foundation, and he

(54:23):
makes a vaccine with virus that he has run through
animals multiple times until the virus is super weak, and
he does this with all three strains. But the National
Foundation just finished doing this national trial for the salt vaccine.
They're not going to do it again for a new
vaccine when they've got one that works. And so he
goes to Moscow and he and the Soviet Union in

(54:47):
nineteen fifty nine. They're like this, this vaccine looks good.
We like it. We're going to vaccinate ten million kids.

Speaker 1 (54:54):
Wow.

Speaker 2 (54:54):
And so they vaccinate ten million kids and they essentially
say you have to show up at the school on
this day or factory on this day, and they all
get vaccinated. They decide that actually went pretty well, and
so they now decide they're going to vaccinate everybody who's
under twenty years old. So seventy seven million people get vaccinated.

Speaker 1 (55:10):
Oh my gosh.

Speaker 2 (55:11):
And so the Saban vaccine starts making its way back
to the United States. And this is after you know,
the Cutter incident where people are like, oh, maybe the
Salk vaccine isn't safe anymore, and that starts to be
on people's mind, and Sabin sort of capitalizes on this fear.
And Saban and Sack didn't like each other at all.
They were definitely, like, not necessarily racing, but definitely competing.

(55:33):
And the Sabin vaccine ends up becoming a lot more popular,
and eventually at some point people stop getting the Salt
vaccine and they get the Sabin vaccine instead. Oh well,
both of these vaccines contributed in bringing the levels of
polio down massively. But a problem with the Sabin vaccine,
which we mentioned earlier, is that that vaccine is a
live virus, and even though it's a weak version of

(55:56):
the virus, there are parts of the world where when
people get polio, what they're getting is this version that's
in the vaccine. The Saban vaccine causes polio in one
out of a million doses. So this is the problem
with having a live vaccine. And so at some point
the United States said, look, we have so little polio,

(56:18):
but for one out of a million people who get
this polio vaccine, there's a chance they're going to get polio.
We're going to switch back to the salt vaccine. So
after doing the Saban vaccine for a while, we switch
back to SALK and now everybody gets the killed virus version,
which has been safe for sixty years. So some parts
of the world still have polio, like Pakistan, but we

(56:38):
are incredibly lucky in the United States to not have
to worry about it. As we mentioned at the beginning
of the show. You know, I get frustrated when I
hear this quote. The good thing about science is that
it's true, whether or not you believe it. And it's
like such a condescending attitude to give to people when
there have been mistakes in the past. Right, and I

(56:58):
still think we have a right to say, hey, you know,
if your kid wants to go to public school, or
if you want to be a health worker, you have
to get these vaccines. I think we have a right
to like mandate that kind of stuff. But I also
feel like we have this massive responsibility to be super
open and transparent about like what we're doing and how
we made these decisions, because we've made mistakes in the past,
and I think it's reasonable for people to like want

(57:21):
to be convinced and to you know, and for you
to need to make a good argument for it. Not
that I think all the anti vaxxers are anti vax
because they are familiar with this history, you know, the
like five G from a vaccine is kind of crazy.
But anyway, I think these things are complicated. What do
you think?

Speaker 1 (57:38):
Yeah, I think it's important that we share the process,
that people understand how scientists come to these decisions, and
also that science informs policy but doesn't dictate it. Like
the questions of how do you develop a vaccine and
the questions of should we inject this into children are
different questions. One is science and what is policy. And
I do think that's important that people out there there

(58:00):
are educated in how science works so they understand where
these decisions come from. Because Yeah, nobody wants to be
told this is the truth and that's not the truth,
and we can't explain it to you. Shut up. That's
not the way it should work. If sciences by the people,
for the people, and of the people. And that's one
reason why I think it's great we do these episodes
to show people how we learn this stuff and what

(58:20):
we know, what we don't know. We've got to be
honest about all of that, because that's what's going to
convince people. It's the process that people should trust, not
any individual answer or result. And so we've got to
include people in that process absolutely.

Speaker 2 (58:34):
Yea, amen. And also hooray I never had to worry
about my kids getting polio.

Speaker 1 (58:39):
Yeah me either, how terrifying.

Speaker 2 (58:42):
Yep.

Speaker 1 (58:42):
And so, as I said at the top of the program, like,
I am so grateful to scientists and to doctors and
to everybody who's made our lives so much better and safer.

Speaker 2 (58:52):
Agreed, thank you all right.

Speaker 1 (58:54):
And thanks to everybody out there who's interested in learning
about how the scientific process works, how peer review were,
how discoveries are made, how we develop some of these
life saving vaccines, and the things we learned along the way,
and Thanks to Kelly as always for your patented research
deep dive.

Speaker 2 (59:09):
Well, and thank you to the extraordinaries for giving me
the opportunity to read loads of stuff about topics I
find fascinated.

Speaker 1 (59:16):
And apologies to anybody who heard the phrase fecal oral
while you were having breakfast. All right, thanks everyone, Tune
in next time.

Speaker 2 (59:32):
Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio. We
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