Patenting the Sun: Polio and the Salk Vaccine
Jane S. Smith
1990
Anchor Books, Doubleday
$14.00
On April 12, 1955, the day the field trials for Jonas Salk's killed-polio
virus vaccine were heralded as a success, Salk was interviewed on See
It Now by Edward R. Murrow, who wanted to know who owned the new vaccine's
patent. "Well, the people, I would say," Salk replied. "There
is no patent. Could you patent the sun?" His question suggested the
title for this extremely readable book by Jane S. Smith, herself one of
the two million "Polio Pioneers" who participated in the 1954
field trials.
Current discussions about health care -- particularly but not exclusively
in respect to the AIDS crisis -- have underscored the importance of vaccines
and immunizations programs. This book is the story of the development of
one of the most successful, the killed-polio virus vaccine, and of the subsequent
field trials, told in the context of the personalities involved. It chronicles
the enormous complications involving research and politics as well as the
sheer dedication of those scientific workers to a goal they all shared.
Patenting the Sun is also the story of the founding of the National
Foundation for Infantile Paralysis, of Franklin Delano Roosevelt's obsession
with finding a treatment for paralytic polio, and of the efforts of both
the Foundation and of Roosevelt to provide help to others. The book, based
on a wide range of interviews and personal papers, is thoroughly researched
yet often graced with a sense of humor.
Although earlier cases had been reported, the first major paralytic polio
epidemic that caught the attention of the public occurred in 1916 when 27,000
persons were left paralyzed and 6,000 died. Ironically, the increase in
the incidence of epidemics was correlated with improvements in modern sanitary
conditions. Polio virus is transmitted primarily by the fecal-oral route.
In the earlier part of this century in the U.S. (and in developing countries
today) young children would develop antibodies after mild or asymptomatic
disease, providing them with lifelong immunity. Heightened sanitation interrupted
this process, indirectly producing, in time, the gruesome sight of children
lined up in iron lungs after the virus had attacked the motor neurons controlling
their breathing. Pictures of such polio wards were powerful agents of fear,
serving, only later, in appeals for donations to the National Foundation.
In August, 1921, the Roosevelts were at Campobello Island, off the coast
of northern Maine, where for each of the previous summers since the 1916
epidemic the Roosevelt children had avoided the outbreaks in New York. But
that summer F.D.R., a rising star in the Democratic Party, became sick himself
with the dreaded virus. The fears of the people around him, the secrecy
and the manipulation of the press to ensure his political career and the
eventual use of polio as a political strength -- all these are a story in
themselves. Louis Howe, F.D.R.'s closest political advisor, and Eleanor
Roosevelt "worked to convince the party powers that Franklin Roosevelt
was still a force to be considered." According to Smith, "...his
paralysis, while denied as a physical handicap, was at the same time glorified
as a source of wisdom and political maturity." Roosevelt's very appearance
at the 1924 Democratic National Convention "was a triumph that passed
immediately into legend. Instead of being brought down by polio, it seemed,
he had been elevated, rising above the shallow concerns of lesser politicians
whose souls had not been purified in the crucible of suffering."
F.D.R., while publicly presenting an image of strength through suffering,
spent much time in what became "the little White House" in Warm
Springs, Georgia, in an attempt to reverse the paralysis. An acquaintance,
George Peabody, had heard of a "miraculous cure" and suggested
that Roosevelt visit Warm Springs in 1924. Two years later Roosevelt used
one third of his inheritance to acquire the property. Roosevelt's ambitious
and flamboyant law partner, Basil O'Connor, took over the financial management
and created the Georgia Warm Springs Foundation.
In turning over the management to O'Connor, "Roosevelt unwittingly
started one of the century's most original careers in philanthropy."
Until he died in 1972, Basil O'Connor was directly and actively involved
in almost every aspect of the National Foundation for Infantile Paralysis,
including raising funds through Presidential Balls and the March of Dimes
and hiring advisors to oversee the progress of Foundation-funded research,
of which polio research was a large recipient. In Patenting the Sun
Jane Smith captures the essence of this colorful personality.
Jonas Salk became involved with the polio virus and with the National Foundation
in 1948 when he agreed to participate in the Foundation's virus-typing project,
necessary to show that there were no more than the three separate strains
of virus that had been identified. To protect against polio, all three strains
would have to be included in any vaccine. Although Salk had been primarily
interested in developing an influenza vaccine and had worked in the lab
of Dr. Thomas Francis at the University of Michigan, he realized that money
received from the Foundation for the project could be used to expand his
lab facilities at the University of Pittsburgh. (Dr. Francis later became
director of the Polio Vaccine Evaluation Center at Ann Arbor -- and announced
the successful results of the vaccine's field trials.) Salk's "laboratory
life" is detailed in Smith's books (sometimes in humorous fashion),
including his involvement in the minutest details, such as designing the
lab and injecting the vaccine to pre-field trials subjects himself.
Smith also describes the long hours Salk put in, the long letters he wrote
to defend his ideas and work, and the inevitable problems that came his
way.
One problem involved the great number of Rhesus monkeys required for the
virus-typing project. The polio virus attacked not only humans, but also
monkeys and chimpanzees. Sacred to the Hindu religion, monkeys were caught
in the wild in India, but only by non-Hindus during certain seasons. The
Indian government could block shipment to the U.S. if it thought the monkeys
were being mistreated. Monkeys were prone to many other diseases and often
arrived sick. Basil O'Connor dealt with the problem of acquiring sufficient
numbers of healthy primates by establishing Okatie Farms, what Smith refers
to as a "Warm Springs for monkeys." No one had tried to breed
monkeys for research purposes before. (Okatie also sold "scientifically
developed dry monkey food . . . consistency of friable putty .... recommended
three times a day so the animals would not have quite so much to fling around
and mash in each other's hair.")
The field trials on humans began on April 26, 1954, with each Polio Pioneer
receiving three shots of vaccine over a two month interval. Thousands of
volunteers participated in the administration of the vaccine to children
at 217 sites around the country. The details of the numbers of people involved,
the record-keeping, the excitement to be the first to receive this "honor,"
as well as the enormous task of gathering the data -- which fell to Thomas
Francis -- are awesome. The publicity surrounding the field trials and the
subsequent acceptable results was at times overwhelming for all involved,
particularly Salk and Francis. The vaccine was licensed by Oveta Culp Hobby,
Secretary of Health, Education, and Welfare on the same day the results
were announced; because the National Foundation had gambled nine million
dollars to subsidize the production of vaccine by four different drug companies,
the vaccine was ready to be shipped out for use that same night. Unfortunately,
a bad batch of vaccine from one of the companies resulted in 150 vaccine-related
cases of paralytic polio, eleven of the victims subsequently dying.
The negative publicity resulted in a temporary lack of enthusiasm for vaccinations,
and several polio outbreaks occurred in the summer of 1955, including 4,000
cases in Boston. But the incidence of paralytic polio dropped dramatically
after that. Since then, the federal government has become more involved
in monitoring and regulating vaccine development and testing. There was
very little government involvement in polio research at the time of these
trials.
Unbelievably, particularly for the lay person, Salk did not win the Nobel
Prize. (Neither did Albert Sabin, who had been extremely critical of Salk's
vaccine and whose live virus vaccine is used in the U.S. today. Sabin's
vaccine can be taken orally and provides longer lasting immunity.) Many
felt that although his accomplishments were Herculean, Salk's work was not
"new." Of course, most scientific research is not "new."
Salk's contributions, like many another's efforts that build upon previous
research, represented volumes of work and exemplified numerous virtues:
the ability to make careful decisions as well as take risks, the willingness
to defend one's work under often harsh criticism, political astuteness,
and a general ability to get along with people to accomplish a goal. Smith's
book brings such research to life. In the end, Patenting the Sun
is a story about people, the idiosyncrasies, their vulnerabilities and their
courage.
Jan Lycette, a Lab Instructor in the Biology Department at Salem State College, holds degrees in bacteriology and biology from the University of Massachusetts - Amherst and from Purdue.