Of his four years at the University, April 12th, 1955 remains particularly vivid for David Livingstone. That morning, he and the entire country waited with held breath to learn of the results of a massive study undertaken to determine the efficacy of the polio vaccine developed by Jonas Salk and his colleagues at the University of Pittsburgh.
The results were to be announced at Rackham Auditorium by Salk, who spent the early 40s as an assistant professor at the University, and Dr. Thomas Francis, the man who led the study and the head of epidemiology at the University
If proven successful, the vaccine would mark the beginning of the end of this virus which had terrified America since the early part of the century; if not, it would be yet another setback in the long battle against polio.
“The atmosphere was electric,” said Livingstone, a sportswriter for The Michigan Daily, at the time, who was in the newsroom at the time the success of the vaccine was announced. “We all realized that we were witnessing a truly momentous event.”
Down the road, the Rackham Building was swarming with people anxious to hear the results of the study. The third floor had been converted into a newsroom packed with 50 buzzing telephones and half a dozen clacking teletype machines. They were there to accommodate the nearly 100 reporters invited to the event and who were to file the reports that would splash the front pages of every newspaper in the country the next day.
“News coverage of the report will probably be the greatest ever accorded a medical meeting,” wrote the Daily.
Inside the packed auditorium, reporter Hanley McGurwin bumped elbows with high-level government officials and big name reporters as he covered the event for the Daily.
“Every seat in the place was filled. Everyone was extremely excited — it was the topic of conversation wherever you turned,” he recalled.
Having been left completely in the dark about the study’s results, rumors and speculation abounded among those in attendance.
“Since the University was making such a big deal, we assumed that it would be favorable news,” McGurwin said.
The crowd was expecting big news, and at 10:20 a.m. Francis fulfilled this expectation: “Safe, effective and potent” was how Francis described Salk’s vaccine. The vaccine had been 80 percent effective and had prevented hundreds of cases of polio among the test subjects who received it. Salk took the stage and quickly promised that the next generation could be nearly infallible.
The end of polio was now in sight, and the crowd greeted the announcement with a standing ovation. The next day’s papers and newsreels were filled with what one New York Herald Tribune cartoon triumphantly dubbed “The News From Ann Arbor.”
“People just went nuts,” said Howard Markel, the George E. Wantz Professor of the History of Medicine at the University. “This achievement was considered by many to be a godsend.”
RELIVING THE PAST
The vaccine was a godsend, because the virus it promised to eradicate seemed to many Americans to be sent straight from hell.
Polio attacks the central nervous system, destroying nerve cells and can lead to paralysis or death. Most of its victims are younger children, though polio’s effects can last a lifetime.
From the 1920s to the early 1950s, polio was at the front of every parents’ mind, and fear of the disease sometimes bordered on panic — especially in the summer when the number of cases skyrocketed. Newspapers printed weekly tallies of polio cases, while public beaches and pools were closed in areas that experienced outbreaks.
Richard Lichtenstein, the Associate Dean for Academic Affairs at the University’s School of Public Health remembers how this fear paralyzed more than just polio’s victims during his childhood.
“It was pretty common for parents, and especially my mother to tell you that you can’t go swimming in the summer. ‘You can’t go in the pool, you might catch polio,’ she told me. I didn’t know what that meant at the time, but it was very strictly enforced,” Lichtenstein said. “(As a child), every day someone was worried that I was going to get polio.
From 1916 to 1955, there were an average of 13,000 cases per year. At the height of the polio epidemic in 1952, more than 57,000 Americans — mostly young children —became infected with polio. A number that, while significant, is “not nearly as many as the kids who got diphtheria or pneumonia or tuberculosis,” Markel said. These diseases, however, did not receive nearly as much media attention or instill as much fear in the public as polio did.
One reason for this singling out of polio was because of the visibility and the general “creepiness” of the disease’s most serious symptom, paralysis, Markel said.
While the majority of those infected exhibit no symptoms, the virus occasionally leaves its victim paralyzed from the waist down, unable to walk. Even more rarely, victims of the disease are paralyzed from the neck down, unable to breath without mechanical aid.
During the polio epidemic of the first half of the century, this meant being confined for months in the dreaded “iron lung” — a giant metal machine that surrounds a patient and helps them breath. Although rare, the pictures of the tiny heads of children sticking out of these giant metal coffins left an indelible mark on the American public.
“It was very nightmarish,” Markel said. “There were these horrific images. You see pictures of kids not being able to walk (and having) iron leg braces. Then there were kids who couldn’t breath and were trapped in iron lungs.”
And the virus comes seemingly without warning, preceded by symptoms that could indicate anything from the common cold to polio, Markel said.
“Your kid complains of a sore throat or has a low fever and goes to bed; the next morning that kid wakes up and can’t move his legs,” he said. “That’s pretty scary stuff.”
MAKING THE VACCINE
In response to this crushing fear, the medical community launched an all-out campaign to eradicate the disease. The effort was spearheaded by the National Foundation for Infantile Paralysis, an organization originally founded by Franklin D. Roosevelt — a polio victim. The Foundation’s media-heavy approach later became the model for the campaigns against cancer and AIDS, said Markel.
“ (The Foundation) pioneered things like the telethon, celebrity endorsements. They invented the poster child,” Markel said.
In 1948, the Foundation funded Jonas Salk who was working in Pittsburgh at the time. Six years and a number of smaller studies later, Salk believed his vaccine to be ready for a larger trial in 1954.
Using recent advances in technology, Salk developed a vaccine based on a technique he used years earlier when working on influenza. It relied on injecting dead, harmless polio virus into the body, thus allowing its immune system to adapt to the disease and defend against attack from the dangerous, live virus.
But Salk had to proceed with caution: Two earlier vaccines had notoriously failed, including one that actually infected recipients with polio rather than granting immunity to the virus. In order to avoid a similar fiasco, an enormous trial would need to be conducted to determine with certainty the efficacy and safety of the vaccine.
To conduct the study, the Foundation turned in 1954 to Salk’s former colleague and mentor from his days at the University, Dr. Thomas Francis.
“The Foundation needed a first rate epidemiologist who had experience doing these types of trials,” Markel said. “In the roster of epidemiologists at the time, Thomas Francis was in the top five. He was very well regarded with a sterling reputation and had experience. He also had the right temperament — he didn’t get ruffled.”
In organizing and running such a high profile and highly scrutinized study, Francis couldn’t afford to get ruffled.
“Francis was on a tightrope in the big top. Everyone was watching him,” Markel said.
And Francis’ act included juggling the 1.8 million children, hundreds of schools and thousands of volunteers involved in the study. At the time, the study was the largest of its kind in history, Markel said.
Vaccine administration sites were set up in schools across the country, and children, volunteered for the study by their parents, filed in to be injected with either the Salk vaccine or a placebo.
Francis insisted that a large number of children receive a placebo to ensure the validity of the trial; in the end, more than 1.1 million did. Francis also stipulated that the trial must be double-blind, that is, both the doctors and nurses giving the injection and the child receiving it have no idea as to whether it is the vaccine or a placebo.
Barbara Kolecamp was one of those children who participate in the trial— the Polio Pioneers — and she remembers with pride her role in the eradication of Polio.
“It was a big deal among us (at school). I was a Polio Pioneer and my older sister was not — it was something I had on her,” Kolecamp said while wearing the “Polio Pioneer” pin that she received as a young needle-pricked girl, proof of her contribution to science.
The study was a success, “Francis came through beautifully.” Markel said. But more importantly, it had shown concretely that Salk’s vaccine was indeed “safe, effective and potent,” as announced to the restless Rackham audience.
Today, a small plaque in the carpeted hall outside Rackham honors the announcement, and polio is little more than a bad memory for most Americans — if that.
But according to the World Health Organization, polio is still a threat in a number of third-world countries; Nigeria reported over 700 cases last year. 50 years after the first polio vaccine, Markel said there is no excuse for a single person to contract polio.
“It’s beyond tragic, it’s a terrible waste,” he said. “It takes money and it takes effort and we have these things.”