I was still young when polio was a scourge of the world, and I well remember being terrified of getting the disease and having to spend my life in an iron lung, or walking with braces. The disease peaked in the summer, and we were always told to avoid public swimming pools, where you were supposed to be especially susceptible to the virus.
Then, Jonas Salk (1914-1995), after years of field trials, announced a successful killed-virus vaccine in 1955, when I was five. I got inoculated, as did everyone else, and within a few years polio was no longer a fearsome scourge of Americans (it took longer to tackle the rest of the world). As Wikipedia reports (and they have a nice article on Salk)
By 1962, polio had become almost extinct [in the U.S.], with only 910 cases reported that year—down from 37,476 in 1954.
The Guardian describes the field trials:
In 1954, over 300,000 doctors, nurses, schoolteachers and other volunteers across the United States, Canada and Finland took part in one of the most complex and monumental medical trials in history. The plan was to test the effectiveness of a newly-developed vaccine for a disease that was devastating the lives of children across the US: polio.
It was a mammoth task – a double-blind experiment, in which 650,000 schoolchildren were given the vaccine, 750,000 were given a placebo, and over 400,000 children acted as a control group and were given neither. For taking part, each participant was given a sweet and a certificate proclaiming their role as a ‘Polio Pioneer’. The results, announced in 1955, were just as monumental: the vaccine was safe and effective. As a direct result of the development of the vaccine, polio was completely eradicated in the US by 1979.
Here’s a “Polio Pioneer” certificated from the Gianelloni Family website:
Today would be Salk’s 100th birthday had he lived (he was born only a day after Dylan Thomas); and Google celebrates Salk’s great achievement with a Doodle. Click on the picture below to access it, and then again to see some articles about Salk.
There is now a Global Polio Initiative, with the goal of completely eliminating the disease from this planet. Since the virus cannot survive outside the human body, it is entirely within our capacities to get rid of the disease, as we have with smallpox and rinderpest. The initiative has reduced the number of cases from 350,000 in 1988 to only 416 cases last year. And, if the antivaxer Hindus, Muslims, and Western nutjobs would relent, it would drop to zero. As The World Health Organization reports, the disease is now endemic in only three nations: Pakistan, Afghanistan, and Nigeria.
Three questions:
1. Why didn’t Salk patent the vaccine? The answer is often given that he was a pure humanitarian and not interested in getting wealthy. In a famous exchange, journalist Edward R. Murrow asked Salk who had the patent on his vaccine. Salk answered, ““Well, the people, I would say. There is no patent. Could you patent the sun?”
Here’s the video of that famous exchange:
But, as BIOtechNOw reports, the story is more complicated:
As pointed out by Robert Cook-Deegan at Duke University, “When Jonas Salk asked rhetorically “Would you patent the sun?” during his famous television interview with Edward R. Murrow, he did not mention that the lawyers from the National Foundation for Infantile Paralysis had looked into patenting the Salk Vaccine and concluded that it could not be patented because of prior art – that it would not be considered a patentable invention by standards of the day. Salk implied that the decision was a moral one, but Jane Smith, in her history of the Salk Vaccine, Patenting the Sun, notes that whether or not Salk himself believed what he said to Murrow, the idea of patenting the vaccine had been directly analyzed and the decision was made not to apply for a patent mainly because it would not result in one. We will never know whether the National Foundation on Infantile Paralysis or the University of Pittsburgh would have patented the vaccine if they could, but the simple moral interpretation often applied to this case is simply wrong.”
Nevertheless, many modern patents rely on prior art, and it’s unthinkable that something like the Salk vaccine wouldn’t be used today to enrich researchers and pharmaceutical companies. And from what I know of Salk’s life (he was a real humanitarian), I don’t think he even cared about making any money off the vaccine. To me he’s still a scientific hero.
2. How much would Salk have made had he patented the vaccine? Salk’s killed-virus vaccine is now the inoculation of choice over the live-virus Sabin alternative. The riches spurned by Salk are discussed in a piece by Amar Prabhu in Forbes, who estimates that Salk would have made over two billion dollars had he patented the vaccine (Prabhu’s article is a fascinating analysis). Of course Salk made a decent salary as a physician, medical researcher, and later as head of the Salk Institute, and became about as famous as a scientist can get, but that’s still a lot of dosh to forgo!
3. Finally, why didn’t Salk (or his rival Sabin) win the Nobel Prize? Salk was festooned with honors, degrees, and awards in his life, but one prize always eluded him: the Nobel. The common explanation, as implied in question #1 above, is that Salk’s vaccine wasn’t innovative in a technical sense, since it combined elements of previous research, such as using material from a dead microbe to induce immunity. But still, as Wikipedia notes, that isn’t really a sufficient answer:
Because Salk was the first to prove that a killed-virus could prevent polio, medical historian Paul Offit wrote in 2007 that “for this observation alone, Salk should have been awarded the Nobel Prize.” Virologist Isabel Morgan had earlier shown and published that a killed-virus could prevent polio, although she did not test her vaccines on humans. Morgan’s work, nonetheless, was a key link in the chain of progress toward the killed-virus polio vaccine for humans later developed and tested by Salk.
Yes, but many discoveries that got a Nobel built on the work of others. One thinks of Watson and Crick using Rosalind’s Franklin’s X-rays (sadly, she couldn’t have gotten the Prize anyway, as she died of cancer before it was awarded), or of Erwin Chargaff’s observation that, in DNA, the proportion of G bases equalled that of C bases, and the proportion of A bases equalled that of T bases, implying G-C and A-T pairing. (A historical note: Watson’s stint in Cambridge, where he worked with Crick, was funded by the March of Dimes Foundation, originally created by Franklin D. Rooosevelt to fund the elimination of polio.)
One could also argue that Salk’s innovation was mainly technical. But so what? Lots of prizes have been given for technical advances deriving from prior research, especially in physics. The fact that Salk actually used a killed virus to virtually wipe out a disease, and did so in the face of formidable odds, in both research and epidemiology, make him, in my book, eminently Nobel-worthy.
***
Finally, two fun facts about Salk. Wikipedia notes that he and his first wife “had three children: Peter, Darrell, and Jonathan Salk. In 1968, they divorced, and in 1970, Salk married Françoise Gilot, the former mistress of Pablo Picasso.” It’s a bit strange that the same woman slept with both Salk and Picasso! Also, a personal fact: I once went to a Pittsburgh Pirates baseball game with one of Salk’s sons (I can’t remember which one), as he was part of a group of Jewish kids who had a connection with my uncle (both my uncle and Salk were Jews who lived in Pittsburgh). That’s my brush with fame.
If you want to read a fascinating book on Salk and the polio story (including the March of Dimes campaign and Salk’s famous and rancorous rivalry with Albert Sabin), I highly recommend Polio: An American Story by David Oshinsky. It won the Pulitzer Prize for History in 2006, and is a page-turner.
And here’s an early film clip extolling the announcment of Salk’s successful vaccine:
I cannot imagine us doing such a thing today. In part because I think we have gotten a lot more stringent about human trials (and their ethics). But also in part because I can’t imagine the public supporting such a thing. If some disease started killing 40,000/year, IMO the vast majority of the public would demand the trial vaccine and very few would agree to participate in a blinded study.
Absolutely right. Politicians would be climbing over the bodies of their kids trying to get control of the process.
I was a child in Pittsburgh when his vaccine was distributed. Of course, it was BIG news for the city, and for the U of Pittsburgh (where I later got my BS in chemistry.) I remember the fear of polio, even as a 4 year old, and the relief his vaccine gave to everyone. I’ve always wondered why he never won the Nobel.
I, too, remember the polio days. Several of my cousins were stricken by it.
If a modern discoverer like Salk posed the question “Would you patent the Sun?” in response to a question to a Fox News interviewer today, the answer would be “Of course! … ’cause that would make me a job creator!” If the Koch brothers could patent the Sun, the climate “skepticism” industry would be gone by tomorrow.
Despite the rumoured materialism of Americans, as discussed in the section above on how much Salk potentially could have made if he’d patented his vaccine, I couldn’t find any ‘Polio Pioneer’ certificates on ebaY. Which is slightly surprising. I’d have expected there to be some, even if only being sold from house-clearing, but descendants, whatever.
Oh, hang on, found a “pin” or “button”, titled “Polio Pioneer 1954” and “The National Foundation for Infantile Paralysis” (with some other similar vintage stuff).
I remember lining up in 3rd grade to get the vaccine (my guess is that it wasn’t a trial, but the first widespread inoculation campaign). I still remember the relief when told that swimming and riding my bike were now OK. It likely contributed to my becoming a scientist.
Thank you Dr. Salk.
I recall mom dragging us to the doctor’s office to get shots but at 4 or 5 years old, who knows why. We just had to do it. I think there was a total of 3 or 4 times you had to get the shot.
We just had know idea what a big deal it was at the time.
As far as I know, there are few to no anti-vaxxer Hindus. India just managed to be polio free for a few years in a row.
http://www.theguardian.com/society/2014/mar/28/india-10-other-asian-countries-declared-polio-free
I think there are Hindu anti-vaxers. There’s a lot of Ayurvedic woo in India and it gets expressed, in part, in anti-vax attitudes. This article alludes to it…
“The department has roped in the support of religious and spiritual leaders in the district for the immunisation campaign, in an attempt to counter the anti-vaccination lobby’s propaganda against immunisation.”
Well, there are anti-vaxxers everywhere and of all stripes, but the article seemed to imply that Polio eradication in India is hampered by Hindu anti-vaxxers, whereas that is simply not the case.
One thinks of Watson and Crick using Rosalind’s Franklin’s X-rays (sadly, she couldn’t have gotten the Prize anyway, as she died of cancer before it was awarded)
Even if she had been alive at the time, there would have been a problem because, in order for her to share the prize, either Watson, Crick, or Wilkins would have had to have been denied as the roolz limit the award to not more then three individuals. Of course, they could have awarded her the prize in chemistry (Watkins, Crick, and Wilkins won in medicine/physiology)for AFAIK, there is no rule against awarding the prize in one category if the prize in another category has been awarded for collaboration in the same contribution.
Yes, it could have gone to Franklin and Wilkins in chemistry, and Watson and Crick in Medicine and Physiology, and one could argue that that would have been an equitable solution.
Yes, that would have been -if Franklin had still been alive- the perfect solution, fully agree. At any rate, the discovery of the structure of DNA, and what it entails, should merit easily more than one Nobel prize, IMHO.
In view of the latter, another possibility would have been to award the prizes in consecutive years.
I agree. Furthermore, elucidation of the structure of DNA by use of X-ray diffraction is more appropriately an achievement in chemistry – just as much as Max Perutz’s determination of the stucture of hemoglobin was an achievement in chemistry.
…although, to be fair, I don’t think Franklin’s use of X-ray diffraction data was done in the same way the conventional crystallographers would consider to be a full “structure determination” in the sence that one does a quantitiative comparison of diffration intensities with intensities predicted by the structural model.
Which doesn’t alter the point that it was an achievement in chemistry.
What an inspiration. Few people like him have walked this planet.
I agree! But few people have ever heard of him…
I first heard of him from Muhammad Ali in ’73 or ’74, on a TV ad where the former Cassius Clay was promising that Salk would go on to knock out MS (which I’d also never heard of). I’d had my shots already – lining up for the spoonful of Sabin syrup is one of the few memories I can place before I was four years old, and I believe the Salk injections were given at the same time.
Talking about Nobel prizes, I think Salk should have been awarded it together with Sabin.
The dead and injected Salk vaccine gives better individual protection, while the oral and live Sabin vaccine also stops transmission. The latter is better from an epidemiological pov., I should think. It even somewhat protects anti-vaxxers.
Was the relation between Salk and Sabin really that bad? Is there some more on that? They both are heroes in my personal pantheon.
Those who are young never had to experience the despair of parents when the child next door came down with polio.
I think that is the major reason why anti-vaxxers are so blithely indifferent to what vaccines can do: they are blithely ignorant of the damage done by the diseases having grown up in a world where such suffering was non-existent.
As the song says: When will they ever learn?
I fear the answer is never. Even if new outbreaks cause the pendulum to swing back towards vaccine acceptance, it will take only a decade or three before the next generation in their ignorant bliss declare they don’t need vaccines.
A victim of their own success. Alas.
Ballet people of a certain age remember the story of Tanaquil LeClercq, a brilliant dancer (and wife of George Balanchine) whose career was ended by polio in 1956, the year after the Salk vaccine was announced.
My oldest sib was born in 1957 and 4 more of us came along pretty quickly. I have no memories as a child of knowing anyone who had polio. But I do remember my parents, Mom in particular, being terrified that we would catch something. If there were vaccinations for something, we were first in line. A lesson I’ve tried to convey to my kids.
As a kid (I was born in 1955) I had a friend a few years older than me who had polio.
If not the Nobel Prize in Medicine, why not the Nobel Peace Prize?
Finally, even if Salk had made the $2 billion or any fraction thereof, he’d STILL be a “scientific hero” since he did not appear to be motivated by money when he undertook the research, and even if he was, the billions of people his research saved from poliomyelitis would still be saved and be eternally grateful.
That was my first thought too, there have been many less worthy recipients of the peace prize than Salk.
All, y’all, raise your hands if you’ll be at the head of the line for an Ebola vaccine.
Were it not for Salk’s success, we wouldn’t even have the hope of a vaccine to stop Ebola. That’s his real legacy. Yes, stopping polio was monumental for the time…but he also showed just how rapidly an epidemic can be stopped cold in its tracks, and that accomplishment lives forever.
b&
Not unless I’m planning a holiday in Liberia.
Salk definitely deserved the Nobel Prize.
On the subject of anti-vaxxers, the irony is that so many of them claim they are “health crusaders” or “health nuts”, yet they are a health menace.
It’s difficult to understand their motivations. Obviously, complacency plays a big role, but another part of the problem is that “health” means something very different to them than it means to most people. It’s more like some kind of obsession with religious purity, and their religion is nature. It’s taking the naturalistic fallacy to unhealthy extremes. This is why there is significant overlap between the anti-GMO, alternative medicine, and anti-vaccine movements. In a lot of ways, they often function as one big “natural health” movement.
They’re dupes of the worst type of profiteering imaginable.
https://en.wikipedia.org/wiki/Andrew_Wakefield
Once his con took hold, garden variety cognitive dissonance has kept the fraud going amongst his victims.
b&
I wonder if someone like Wakefield could -or s should- be prosecuted: after all, he has the deaths of dozens of children on his hands.
It’s unlikely he’ll ever face criminal charges. Were he in the States, he could well face significant civil liability, but I don’t think that’s a possibility in Britain.
b&
Andrew Wakefield moved to Texas after the scandal of his “research” broke and he was struck off the medical register in the UK, and he still makes a living promoting woo. So the possibility of a civil liability case remains.
He should be prosecuted for crimes against humanity.
Salk should have won the Nobel. Norman Borlaug was awarded the Nobel Peace Prize in 1970 for saving a billion lives from starvation by creating high yield, disease-resistant wheat and exporting the seeds to the world.
If Salk’s vaccine “wasn’t innovative in a technical sense, since it combined elements of previous research, such as using material from a dead microbe to induce immunity,” then I fail to see how Borlaug’s seeds were innovative given that they are made by artificial selection. That prior art goes back millenia.
One technical thing that enabled Borlaug’s work, which probably didn’t directly count with the selection committee, was that he found ways to grow two generations of wheat in a single season. That apparently contributed greatly to his success, and so there’s a certain amount of innovation in his work beyond simple plant crossing.
I don’t think that prior art is a component against selection for the Peace prize, either – only the ones that are voted on in Stockholm.
Yeah, Borlaug, one of these other unsung heroes in my private pantheon.
He deserves his Nobel prize 10 times over, he made a *real* difference.
Although a Nobel laureate, he remains uncanningly unknown.
Penn & Teller refer to him approximately as the most famous guy nobody’s ever heard of (cf. Borlaug’s Wikipedia page).
One thing with Salk, that I never would have known had I not landed in Pittsburgh, is that there are some still-simmering feelings of resent over how he handled things after announcing success. Perhaps similar to the situation with Rosalind Franklin, others on the team were never acknowledged. The press showered him with accolades, and he simply allowed himself to accept them.
In particular, Julius Youngner, who was chair of my department at the Pitt med school in the later 80s, was apparently responsible for devising ways of culturing the cells needed to produce the vaccine, and without that ability the vaccine would have taken another couple years at least. Some of this is covered either in the Oshinsky book, or the other one that came out at the same time (I only read one, and can’t remember which one).
Perhaps even more remarkable than not winning a Nobel, Salk was apparently never inducted into the National Academy, either.
But even with all of that, you’d think there might be a historical marker either beside or the building where the work took place (now Pitt’s dental school). Last I heard (~10yrs ago) there isn’t.
Anyway, that’s the back-story, FWIW.
There is, however, a plaque outside the auditorium at Michigan where the announcement was made.
Sabin was elected to the NAS in the early 1950s, before either vaccine came out.
Another good book on the early days of polio eradication – though a bit of a bummer, rather than an inspiring tale – is Paul Offit’s The Cutter Incident.
The Salk vaccine didn’t confer long lasting immunity. I recall getting booster shots every year until the live vaccine.
When the live vaccine became available, it had the advantage of being contagious. Priority was given to immunizing infants, because everyone who handled the baby was likely to get a free dose of the vaccine.
You could, of course, go to a doctor and pay, but most doses were given by state and county health departments.
There’s also the aspect that playing outside in the dirt gave some amount of immunity, altho that wasn’t recognized at the time. One of the conundrums of polio at the time was that it wasn’t as prevalent in lower-income communities. Essentially, it was a side-effect of modern hygiene.
“3. Finally, why didn’t Salk (or his rival Sabin) win the Nobel Prize?”
Because the vaccine caused autism, silly!
Not even funny.
Because the Sabin vaccine was the one that actually worked as a public health measure. Salk protected those who had the means and the inclination to get a booster shot every year.
That pretty much excludes poor people and poor nations.
I did my Modern History thesis on the search for the Salk vaccine:
http://www.teachspace.org/personal/research/poliostory
My father contracted the poliomyelitis virus in late 1939; seven other Iowa State University students did as well causing the University to altogether close down that quarter then. There was, at that time, a University inpatient hospital; afflicted were within iron lungs, and five of the seven died. Daddy at his age of 19, went home to his 98 – pound mama, Grandma Adeline, who also had at home within the rural Iowa countryside at the time five younger children, she not knowing if he, her eldest, would live or when he would ‘get better.’
He was paralyzed from the neck down. It took Adeline two full years of her own home – therapies of physical exercises and other care. He survived and thrived enough, although 4 F – classified, to volunteer for the Army – Air Corps and did.
One day in 1960, with a silage wagon underneath him, he himself was on the outside of it astride its ladder at the very top of a silo.
Bilaterally and neuromuscularly suddenly, his arms failed him.
His life altogether that day … … changed. He managed to put his truncal thoracic area forward onto the ladder and with his legs slither down the rungs to the wagon. And climb out. He went inside to talk with my mother; and inside of a month’s time, he was re-enrolled in the next quarter’s agricultural economics curriculum ( a springtime one ) at the same University. We all moved there.
He never farmed again.
What did kill him too young ? far, far too young at only age 72 ? And the point of my post here ? This:
http://www.en.wikipedia.org/wiki/Post-polio_syndrome via the attacked muscle that is the heart.
A heart attack — mostly thanks to this virus.
Dr Jonas Salk is a hero. As was … … Daddy.
Blue
I vaguely remember the big day in elementary school when we all lined up to get vaccinated with the Salk vaccine. It came just too late for a boy whom I became friends with later in high school. He was tall and thin and loved playing basketball, but he had a crooked lower right leg and walked with a limp, and couldn’t make the team.
I was interested to see all the references to the “killed virus”. I thought there was some controversy as to whether viruses were alive – not that there is any magical distinction between alive and non-alive chemical reactions, but there is supposed to be a technical definition with a list of requirements, not all of which are fulfilled by viruses, depending on the list. Maybe some would say “killed virus” and others would say “inactive virus”.
sub
My brother suffered through a dreadful bout of polio. He was completely paralyzed for over a month; but was fortunate to have a full recovery. Well, what seemed like a full recovery.
Often, throughout his life, he would awaken unable to walk well and require crutches for a few days. Now,in his mid-sixties, he is suffering severe post-polio syndrome with a damaged heart (even his organs were beginning to paralyze) and a loss of mobility.
Anti-vaccers should meet someone who has suffered from this disease! It might teach them a thing or two.
Not taking anything away from Salk’s (or Sabin’s) remarkable achievements, it should be mentioned that the first polio vaccine was developed by the Polish scientist Hilary Koprowski, working in the US at the time. Koprowski used an attenuated virus and the vaccine was administered orally. I believe Sabin’s research on polio was the extention of that of Koprowski.
I remember receiving this vaccine as a child in Poland; it must have been the late 1950s/early 1960s, and I was in kindergarden. The nurses told us it was just a little “tea”, and ideed it tasted like sweetened, weak tea that we always had with all our meals. Strange, how such memories can linger.
Despite Poland being an impoverished country under the communist rule, with all kinds of shortages and rather rudimentary healthcare, polio (or rather Heine-Medin disease, as it was known there) was eradicated quite efficiently.
Reblogged this on christianagnostic and commented:
One of the most important medical advances in humna history!
And a perspective that I quite like, essentially from a fly on the wall, of Jonas Salk earlier on the day of the announcement.
Fascinating article.
Just below the first video there is a broken link in the quote from BIOtech Now: the right URL for Robert Cook-Deegan article is now http://archive.mises.org/5216/patent-and-penicillin/