How the United States successfully eradicated polio, a midcentury scourge - Vox Creative

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How the United States successfully eradicated polio, a midcentury scourge

This feature was produced in collaboration between Vox Creative and America’s Health Rankings. Vox Media editorial staff was not involved in the creation or production of this content.

By Anita Manning

For children growing up during the 1940s and early 1950s, summers often meant closed swimming pools, darkened movie theaters, and worried parents.

Polio, also called infantile paralysis, stalked the country. The disease struck people seemingly at random — hitting rural areas, cities, and suburbs; the poor and the rich; the well-fed and the malnourished. It circulated mainly in late summer and early fall and, while adults were vulnerable to it — most famously, President Franklin Roosevelt was struck at age 39, in 1921 — most victims were children.

America's Health Rankings Public Health Legacy campaign explores the history of the disease. The first polio epidemic in the U.S. occurred in Vermont in 1894, with 132 cases. The virus continued to cause sporadic epidemics in the U.S. and grew in size and frequency through the 1950s. In 1952, polio infected nearly 60,000 children, paralyzing thousands and killing more than 3,000.

It was a fearsome disease, but its worst effects were not common. The virus is highly contagious, but 72 percent of those infected displayed no symptoms and another 24 percent had mild symptoms that cleared up in about a week. But for an unlucky less than 1 percent, paralysis set in. Of those, up to 10 percent died when their respiratory muscles became paralyzed.

Infected children were placed in iron lungs, a tank that acted as a respirator and which became, along with leg braces, an iconic image of the polio era in the U.S.

Defeating the disease became a rare national effort that united politicians, scientists, celebrities, and parents in an effort to advance research toward a vaccine that would prevent infection — and ultimately eradicate polio in the U.S.

President Roosevelt, with the help of music and film stars who held charity balls and created publicity, raised money for research and founded the National Foundation for Infantile Paralysis, later known as the March of Dimes. The foundation, thanks to the work of legions of volunteers and donors, funded most of the work of Jonas Salk, creator of the first polio vaccine. Salk's vaccine was tested in a field trial involving 1.8 million school children, known as "pioneers," and when news of the trial's success was announced in a press conference in Ann Arbor, Michigan, on April 12, 1955, it made national headlines, with church bells ringing in cities around the country.

Among the first to receive Salk's vaccine was his son, Peter, when he was 11. Peter Salk is now a medical doctor and president of the Jonas Salk Legacy Foundation in La Jolla, California. "I recall the experience of being in our kitchen when the three of us children received the vaccine," he says. "Father brought home needles from the lab, boiled them on the stove, and gave us the injection. I hated needles."

Nobody liked needles, but children lined up by the thousands at schools and gymnasiums to get the shot. The vaccine was dramatically successful. By 1961, Salk says, polio cases had dropped 97 percent. The following year, a second polio vaccine, created by Albert Sabin, was licensed and quickly became the vaccine of choice because it could be given as a liquid, instead of an injection, and was cheaper.

After 1979, there were no "wild" cases of polio in the U.S., and it was declared eradicated. But there continued to be eight to 10 cases of polio per year, caused by the re-activation of the virus in the Sabin vaccine. In 2000, the oral vaccine was discontinued in the U.S., and is being phased out worldwide, as the effort for global eradication continues.

"By 2012, there were only 223 cases of polio reported to be caused by wild polio virus," in the world, Salk says, and "this year is shaping up to be the best on record." The Global Polio Eradication Initiative reported that as of October 7, 2015, this year there had been 48 cases of wild polio virus counted in the world—36 in Pakistan and 12 in Afghanistan—and 13 cases of circulating vaccine-derived polio.

In the U.S., immunization for polio and other recommended vaccines varies by state, according to United Health Foundation's America's Health Rankings, which compiles health data each year. In the most recent 2014 report, immunization coverage ranges from a high of 82.1 percent in Rhode Island to a low of 57.1 percent in Arkansas, with an overall rate of 70.4 percent for children ages 19 to 35 months, up from 68.4 percent the previous year. Even though there is no polio in this country, "it is crucial to maintain the success rate of U.S. vaccination efforts since the disease still exists in some parts of the world," says the U.S. Centers for Disease Control and Prevention.

Salk says his work continues, "to continue and extend the legacy of my father." The Jonas Salk Legacy Foundation is involved in preserving historic papers and documents and plans to work on project that were important to the elder Salk, including developing a curriculum for high school students to educate the next generation about immunization.

He remembers father showing him where the polio ward was in the old Municipal Hospital in Pittsburgh, where Salk's lab was. "The kids were in iron lungs," Peter Salk says, but he never saw them. "My father didn't open the door."

This feature was produced in collaboration between Vox Creative and America’s Health Rankings. Vox Media editorial staff was not involved in the creation or production of this content.

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