The Death of a Disease: A History of the Eradication of Poliomyelitis

6. Coming Along at the Right Time: Jonas Salk

44 The Death of a Disease 44 6 Coming Along at the Right Time Jonas Salk At the end of World War II, prospects for the development of a polio vaccine appeared grim. The puzzle of the poliovirus still had many missing pieces, and polio researchers were haunted by memories of polio vaccine trials where things had gone very wrong. In 1935, after experimenting with a formalin-inactivated vaccine that seemed to produce no adverse effects on twenty monkeys, Dr. Maurice Brodie, who was working at New York University under Dr. William H. Park, rashly decided to administer his vaccine to 3,000 children. At the same time, Dr. John Kolmer of Temple University in Philadelphia had concocted a live, attenuated vaccine, described by some as a “witch’s brew.” Hundreds of children were given the two vaccines before their dangers became clear. Brodie’s was ineffective and Coming Along at the Right Time 45 could cause severe allergic reactions, while Kolmer’s vaccine had caused cases of polio, some of them fatal. The disastrous outcome of these premature human trials, due to mistakes, inadequate data, and the investigators’ eagerness to outdo one another, dampened the scientific community’s willingness to attempt human trials of a polio vaccine for many years.1 As he worked out the inactivation methods for his polio vaccine, the 1935 fiascos had to be present in the mind of Jonas Salk. Fortunately, he had other scientific precedents and developments to build upon, and he seized the opportunity provided by each one. Salk had come along at just the right time. Several scientific steppingstones were in place in the 1940s when he was ready to put his ideas about a polio vaccine into practice. In 1935, the precursor to the National Foundation for Infantile Paralysis, the President’s Birthday Ball Commission , had formed a scientific advisory committee to determine how to allocate research project grants. This committee’s successor, the NFIP Committee on Scientific Research, began meeting in 1938. One of the first questions it laid on the table was: Is there more than one form of the poliovirus? Many scientists were convinced there was a single homogenous strain and had great difficulty believing in a family of polioviruses. Although the members of the committee may not have been aware of it, an important hurdle to developing a vaccine had been overcome some years earlier. In 1931, two Australian researchers, Dr. Frank M. Burnet (later Sir Macfarlane Burnet) and Dame Jean Macnamara, had demonstrated that antigenic differences exist between at least two strains of poliovirus, and that immunity against one 46 The Death of a Disease type will not confer protection against the other(s). Understanding that there were different strains of the virus was fundamental to attempts to vaccinate against the disease or develop tests to detect immunity. In 1948, the NFIP finally set up the Committee on Typing to determine and classify, once and for all, the number of serotypes of the poliovirus. The Committee on Typing included several distinguished scientists and key players in the polio vaccine story. The typing program represented a milestone in the field of cooperative research; it involved several university laboratories working together and applying their talents toward a common goal. Years later, a member of the NFIP’s General Advisory Committee said that he considered the typing project “the greatest single piece of developmental research that the NFIP was to accomplish during the years of its existence,” opening the way for all subsequent research. According to the polio researcher John Paul, “It was a major triumph for the NFIP to have engineered this cooperative endeavor among a highly individualistic group of research workers.” 2 Jonas Salk first became interested in poliomyelitis when he joined the typing program in 1948. Salk was thirty-three years old, a young and ambitious researcher and the newly appointed head of the Virus Research Lab at the University of Pittsburgh Medical School. His was one of four virustyping laboratories that received NFIP support to test samples of the virus and type them according to strain—a long and tedious chore. When he accepted the job, the influenza virus, not the poliovirus, was his primary area of interest, but Salk welcomed the project as a means to expand and equip his new laboratory. In 1949, David Bodian and his colleagues at Johns Hopkins University had described three basic immunological types of the...