Mint noted that enough of them should be produced to cover the polio drive. The March of Dimes took in just shy of two million dollars in its first year.
The money was well spent. And there were of course the researchers to support. NFIP grants to Salk alone from to totaled nearly a million dollars. In democratic countries the science of association is the mother science; the progress of all the others depends on the progress of that one. He expected the extravagant funding for this tedious undertaking would help to pay for his true cherished ambition: the universal flu vaccine.
The detour into polio was just a means to this end. The prerequisite to the campaign against polio was virus typing. The numerous strains that researchers had isolated from patients over the years needed to be sorted according to type. When various strains belonged to a particular type, this meant they were similar enough that they would be susceptible to the same vaccine. But the number of polio types was then virtually unknown.
Figuring out how many types there were would be grunt work. As Jane S. Its main attributes were constant repetition of the same small procedure, endless waiting for results, painstaking attention to detail and method — and a clear certainty that no glory lay at the end of all the effort. He was expected to be a dutiful follower, and that he appeared so courteous and agreeable in his work came as a very pleasant surprise to Weaver.
Using a method known as serum neutralization, Salk would inoculate monkeys with type 1 virus, then after six weeks collect their blood serum, with its antibodies against type 1. He would combine this serum with virus of an unknown type, then inject it into the brains of uninfected monkeys. Then he would see whether the serum with its antibodies against type 1 protected the monkeys against infection from the unknown virus.
If the monkeys stayed healthy, that meant the unknown virus was type 1; if they sickened, the unknown virus was type 2 or 3. The procedure was unwieldy, time-consuming, and hard on the lab monkey population. There had to be a better way. Salk turned his mind to improving on the method, which had been developed by Albert Sabin of the University of Cincinnati, one of the eminences of the typing project. Trying the mineral-oil adjuvant he had successfully used in the influenza vaccine, he found that it also enhanced the immunizing force of polio virus, multiplying a hundredfold the ability of the injection to produce antibody response.
However, when Salk disclosed his discoveries in January and suggested procedural changes, the Committee on Typing rejected his plan.
The committee required additional convincing on another, more significant innovation that Salk proposed. Salk would tell biographer Richard Carter of the opposition he encountered from the committee:.
They were again discussing the problem of viruses of low infectivity or, as we call it, low infectious titer. Some infectivity experiment or other was being analyzed. Salk, you should know better than to ask a question like that.
Salk handled the hostile crowd with conciliatory circumspection but pressed his point. To type each strain under the current regimen required some forty monkeys, while to do so under his proposal would take only fifteen. The researchers could save invaluable time, avoid some of the endless bother, and spare a wilderness of monkeys. The committee voted him down. Salk told Carter of his trials at the hands of his colleagues:. The typing program was to take three years, but our laboratory had the whole thing solved before the end of the first year.
Everything that happened during the last two years was merely confirmatory. What could I do? Even if I could have, I would not have wanted to. They had their way of looking at things and I had mine and it was incumbent on me to try to win them over.
He would petition Weaver graciously but insistently until Weaver gave in and granted permission to try the innovative procedure on several strains. He now seized the chance to prove his point. They found that type 1 was the most common, accounting for over eighty percent of cases, while types 2 and 3 made up about ten percent each.
Type 1 accounted for the familiar epidemics of paralysis associated with the disease, while type 2 was a milder virus that often caused no symptoms at all. Type 3, the rarest form, was also the most deadly, as it was the most likely to cause dangerous infections of the medulla oblongata that could paralyze the diaphragm, leaving patients unable to breathe.
The implication: Polio might be susceptible to a single vaccine that would work against all three types of virus. Salk was instrumental also to overcoming the other chief impediment to success: the difficulty of safely cultivating enough virus to mass-produce a vaccine.
Oshinsky provides perhaps the clearest and most succinct account. Virus grows only in living cells, and in Sabin and Peter Olitsky of the Rockefeller Institute had grown polio virus for the first time in tissue culture , which is to say in vitr o — in a flask, as opposed to in vivo , in a living organism.
They had used tissue from two human fetuses, three to four months old, obtained from Caesarean sections in a nearby hospital. The original paper leaves unclear the circumstances of the C-sections and how the researchers obtained the fetuses. Vaccines made with virus grown in nervous tissue were thus quite dangerous. However, contrary to the prevalent belief among researchers at the time, nervous tissue was not the sole viable culture medium for polio.
That restriction happened to be true for the particular strain that Sabin and Olitsky had used, but not for most other strains. In his lab grew all three types of polio virus on skin, muscle, and kidney tissues from human fetuses. Mass production of vaccine would now be possible. The indispensable preliminaries were over. He was an adept popularizer, a natural go-between who made the complex science not only intelligible but even fascinating to a public eager and anxious for the latest word on polio.
When Weaver wanted someone to talk to a reporter from Good Housekeeping , or allow a Foundation photographer in his lab for a day, or address a nationwide audience on the radio, Salk was the man for the job.
He even responded courteously to letters from the public telling him that polio was caused by anxiety or cats. Jonas is in touch with the world. But he is a human scientist, or call him humane or humanitarian or humanistic. He is aware of the world and concerned about it. He sees beyond the microscope….
These were the reasons, along with his friendly, modest ways and his unmistakable sense of honor and rectitude, that I liked Jonas. Before that ship landed I knew that he was a young man to keep an eye on. The work at hand consumed Salk. He abandoned his influenza research in order to focus all his energies on polio prevention. The production of antibodies — proteins that emerge in the blood in response to intruders, fending off infection — was the keystone.
There were two known methods to provide antibodies, which Jacobs describes:. People could be actively immunized to produce their own through inoculation with either weakened live or killed virus. He even considered immunizing cows and hens so the public could acquire antipolio antibodies from milk and eggs. Gamma globulin, which provided immunity only for a few weeks, might be used to stem an outbreak but had no promise as a universal, long-term preventive.
With a handsome grant that restricted Salk to vaccine development, Weaver convinced him to forget passive immunization and to concentrate on beating polio once and for all. Salk began by selecting a virus strain of each type that was capable of raising antibody levels high and keeping them there for a long time. For type 1, he chose a strain that had been isolated by Thomas Francis from a patient in Ohio; for type 2, a strain isolated by Rockefeller Institute researchers from the spinal cord of a British soldier in the Middle East Forces who had been killed by polio; and for type 3, a strain isolated by Salk himself from the stool of a paralyzed ten-year-old boy at Municipal Hospital.
He used formalin, a type of formaldehyde, to inactivate the virus. Sometimes blind chance determines the speed and direction of scientific or medical advance. Salk feared that an experiment had gone hopelessly awry when the electricity shut off in the cold room and ice began to melt, but he discovered serendipitously that 1 degree Celsius, the temperature of melting ice, was highly effective for inactivating virus using formalin.
The killed virus, in theory, would not run the risk of live vaccine — reverting to virulence, thus causing the disease that the vaccine was intended to prevent. By June , during the largest polio epidemic the United States had seen, Salk was ready for the first human trial for his vaccine, on polio victims at the D. Watson Home for Crippled Children outside of Pittsburgh. Salk had picked this particular place for his first trial because it was sufficiently isolated from colleagues and reporters; he wanted to keep the trial from the eyes of the public until it was over.
The children would of course not derive any medical benefit from these trials. Salk was testing for side effects first and foremost, as well as for antibody production, and so polio victims seemed like the ideal first subjects, since there was presumably no risk of their accidentally contracting the disease. As Oshinsky explains, Salk first determined which type of polio the children had suffered from by checking which antibodies were present in their blood, and then injected them with a killed-virus vaccine derived only from that type, to ensure that they would not be put at risk of infection by a different type of polio.
None of the subjects showed adverse effects, and all showed elevated antibody levels. But these subjects already had antibodies against the particular type of polio they had contracted.
So Salk had to test again, this time in a riskier trial with children who had not had polio — and thus had no acquired immunity — but had already been crippled by other causes. This way the safety of the vaccine could be tested again on children — the population who was most susceptible to contracting the disease and who would need to receive vaccination — while not risking the paralytic effects of polio, should any of the children accidentally get the disease from the vaccine.
Of course, if they did, their existing paralysis would do nothing to prevent the other possible effects of polio, including fever and acute illness, winding up on an iron lung, or death. In the event, none of the twenty-seven came down with polio from the vaccine.
And the vaccine worked. Then he inoculated cultures of monkey kidney cells with the mixtures. Instead of dying from infection, the kidney cells thrived. Compared to the feeling I got seeing these results under the microscope, everything that followed was anticlimactic.
This trial also succeeded. Whether the polio trials were ethical remains a live question. A fine line separated heroic boldness from moral deformity. First, there was the problem of consent. In the case of the mentally disabled children housed at the Polk school, many had no family members to speak for them.
However careful that process, we might expect that distant state bureaucrats would not advocate for the children as aggressively as family members would have. Moreover, although there is no tangible indication that any of the overseers saw the children as disposable, the trials took place in an era when vulnerable people were often the first choice for medical experimentation.
Given that Salk had earlier infected adult mental patients with the flu, we might wonder whether the prevailing attitude toward institutionalized people affected the polio trials.
Then there were the risks of administering an untried vaccine. On the one hand, Salk took extensive precautions, doing all that he could to minimize potential harm — which was more than could be said of many of his contemporaries and indeed of his own earlier experiments. On the other hand, these precautions might not have been enough. Any number of things might still have gone wrong.
All medicine, experimental or otherwise, involves some risk of harm. The essential question is whether test subjects also stand to benefit medically from an experiment. This was clearly the case for the children who had not yet had polio, who would potentially gain protection from the disease.
Somewhat paradoxically, the children who had already had polio constitute the more morally ambiguous case. Salk was specifically testing them for the risk of side effects, while they would not be able to receive any benefit from the trials — meaning that they were treated as experimental subjects rather than as patients.
As Jonas Salk has often remarked, it would be impossible to repeat his polio work today, when such ventures need to be passed by human-subject review boards and peer review boards and various other qualifying agencies.
In you got the permission of the people involved and went out and did it, and then wrote up your results in a scientific journal. If something terrible happened, the blame would be on your head and the blood on your hands, and of course your career would be over — but in the planning stages, at least, life was a great deal easier for the medical experimenter than it has since become. Medical trials, particularly with children and mentally disabled individuals, require the most careful ethical considerations, including assessments of the risks and potential benefits to the subjects.
What is indeed impossible today is to make these assessments single-handedly. It is also worth noting that Salk did what he could to get the vaccine right before the trials because the patients in these studies mattered to him. It was an era of harrowing epidemics, and Salk had to think of the fate of unknown thousands as well as to feel for the dozens of children in his immediate care.
Not everyone involved in the eventual production of the Salk vaccine would be so scrupulous as he, and the consequences were tragic. Carelessness amounting to recklessness on the part of pharmaceutical manufacturers, as we shall see, marred and threatened to undo his triumph.
Pediatrics, Nov ; - Bennett, And J. Salk, J. Younger, L. James Lewis, And Byron L. Preparation Of Antiserum Pools.
Salk, Byron L. James Lewis, And J. James Lewis, J. Youngner, And Byron L. Salk, Angela M. Laurent, and Mary Lynch Bailey. Am J Public Health, Jun ; - Youngner, Elsie N. Ward, And Jonas E. Youngner, L. Youngner, And Elsie N. Youngner And Jonas E. The virus of poliomyelitis.
From discovery to extinction. JAMA, Aug ; Landmark article Aug 6, Considerations in the preparation and use of poliomyelitis virus vaccine. By Jonas E.
JAMA, May ; Salk And Angela M. Byron L. Bennett and Jonas E. Salk and Byron L. Control of influenza and poliomyelitis with killed virus vaccines. J Salk and D Salk. Science, Mar ; - Vaccinology Of Poliomyelitis. Darrel Salk and Jonas Salk. Volume 2, Issue 1, March , Pages Jonas Salk. Vaccine, Volume 8, Issue 5, October , Pages Salk, Jonas Salk and Dominique Dormont..
Vaccine, Volume 12, Issue 12, , Pages Creativity As A Distributed Function. Bruce J. West and Jonas Salk. Complexity, Organization And Uncertainty. Immunology Today, Volume 8, Issue 1, , Pages Darrell Salk, AntonL. Van Wezel and Jonas Salk. Merging Intuition And Reason. Technological Forecasting and Social Change. Volume 26, Issue 2, September , Pages Jeffrey Kluger.
New York:G. Don McLeese. Juvenile audience, Internet Resource. Deanne Durrett. Elementary and Junior High School. Marjorie Curson. Juvenile audience. Englewood Cliffs, N. Jonas Salk : Conquering Polio. Jonas Salk : Polio Pioneer. Corinne J Naden; Rose Blue. Primary school. Brookfield, CT:Millbrook Press, James Barter. Richard Hantula. Milwaukee, WI: World Almanac, Debbie Bookchin; Jim Schumacher. New York : St.
Katherine E Krohn; A Milgrom. Juvenile Audience. John Bankston. We saw what I call a flicker of antibody response which was real and substantial. That was the first evidence that we were able to do in humans what we could do in animals. Jonas Salk: It was nice to know that we were on the right track. It was the encouraging sign, and it sort of opened the way.
Since the success of the vaccine came when you were at a pretty young age, we might imagine that you walked into a laboratory and there it was. Jonas Salk: As I look upon the experience of an experimentalist, everything that you do is, in a sense, succeeding. This ideal, this idealized notion that discovery, so to speak, is just something falling into your lap! Or designing an experiment and finding out that it fits within certain parameters, and you see what the patterns of the response are.
Jonas Salk: The work on polio went rather smoothly, because it was following a smooth and simple path. There was one episode that occurred, after field trials, when the vaccine was licensed.
Within a matter of two weeks after it was in use, there was a report of cases of polio caused by the vaccine. Now, there was no such encounter in the field trial, and it was only as a result of the vaccine from one particular laboratory, but not the others. Well, this was a source of immediate concern, a terrible disappointment, a tragic disappointment.
When we looked into that, it became clear immediately that this manufacturer did not follow the procedures that were set forth. It was partly because of a disregard for the new principles that were introduced in order to make sure that the vaccine would be safe, as well as effective. This was an example of disbelief that it was necessary to go through the routine that was set forth. That had some adverse effects in terms of credibility, which was not attributable correctly to the work I did.
This was the exception that proved the rule that proved how right we were in the way in which we had proceeded. That was something from which it was necessary to recover. Our vaccine was suspended. Its use was suspended for a short period of time, reintroduced again after that problem was isolated and that vaccine was withdrawn.
All the others were used and things then proceeded in the normal fashion. You obviously had tremendous confidence in this vaccine.
Was it nerve-wracking when you first tested this on humans? Jonas Salk: Yes. What I had confidence in were the results that we had obtained as we went along. We had to understand how to destroy virus infectivity, so that we could do it reliably. Nevertheless, the first time that humans were inoculated it was a matter of some concern. Unknown events might have taken place, things that might have been overlooked. There was some apprehension until that phase of the experiment was over.
Before the field trial, I did a test in about 5, school children in the city of Pittsburgh which was of the nature to make sure that things did go well, before we went ahead and put this out on a much larger scale. And so, while it is true that we proceed on the basis of things that we know, about which we can have confidence, so to speak, that when you engage in human experimentation, you must proceed in a somewhat cautious manner and be prepared for the unforeseen and the unknowable.
Obviously, it was being carried out in an institution, lots of people knew about it. But we were not about to announce in the press because that was not the style in that day. The press was much less sophisticated in this regard.
I saw no reason to try to carry out laboratory experimentation under a spotlight, any more than I would want to have the press in my laboratory, recording everything that is going on. There was a good deal of human interest involved, but that was not the primary objective.
It would have been distracting, as it is now. I still preserve that attitude. We began studies in humans in July of , and what we were doing was not known, generally speaking, until the end of January. There was a leak by Earl Wilson, the columnist for one of the New York newspapers, who heard of a meeting in which I spoke — the advisory committee of the March of Dimes, to reveal to them what we had learned.
Earl Wilson called Howard Howe, of Johns Hopkins University, thinking that it was his work that was referred to, because he had been carrying out studies in monkeys and chimpanzees.
Howard Howe said no, it was not he, it was Jonas Salk. That leak revealed that we had already inoculated human subjects, and the work had not yet been prepared for publication. So I quickly got underway, and within two months we had the results of the work published. Then everyone knew what was going on. Can you describe the day that the results of the national trial were announced?
That was a pretty big deal. Jonas Salk: It was on April 12, , that the announcement was made by Dr. Francis, who had conducted the field trial. He was my mentor back at New York University and at Pittsburgh in the work on influenza. He had agreed to conduct these field trials for the March of Dimes. That was a very public event, and it was done with great fanfare.
Many people were invited, scientists and non-scientists. It was held in Ann Arbor, staged by the University of Michigan, using this occasion to draw attention to what had been done. It was then that I became looked upon as a public figure, and I had to fight and struggle to continue on with my work.
It was a big event, and it was a time when the news was good. I was not on the outside, I was on the inside. I learned what it was like on the outside later. When people meet me even now, they remember exactly the moment when this announcement was made, and the events that followed. Jonas Salk: I suppose so. There was a great rejoicing, obviously. Jonas Salk: As a child I was not interested in science. I was merely interested in things human, the human side of nature, if you like, and I continue to be interested in that.
Jonas Salk: I think I was curious from the earliest age on. I have the suspicion that this curiosity was very much a part of my early life: asking questions about unreasonableness. I tended to observe, and reflect and wonder. That sense of wonder, I think, is built into us. I kept it pretty much to myself, and when I reached that age at which I could do something about it, then I did. So it was not suppressed or destroyed. Obviously, you were doing a lot of thinking at an early age.
Did you get along with your classmates? Were you sociable? Jonas Salk: I got along with my classmates, but I was not as sociable a child. I could spend time by myself and I still do. I would say that I spent more time alone than I did in social settings. Nevertheless, I did learn in time that I could spend time alone, as I do, walking on the beach. I spend time with others, of course, but also enjoy time with myself. This change took place between leaving high school and entering college.
I entered college enrolled as a pre-law student, but I changed to pre-med after I went through some soul searching as to what I would do other than the study of the law. I was interested in science, and I began to think about the scientific aspect of medicine. My intention was to go to medical school, and then become a medical scientist. I did not intend to practice medicine, although in medical school, and in my internship, I did all the things that were necessary to qualify me in that regard.
I had opportunities along the way to drop the idea of medicine and go into science. At one point at the end of my first year of medical school, I received an opportunity to spend a year in research and teaching in biochemistry, which I did.
And at the end of that year, I was told that I could, if I wished, switch and get a Ph. And, I believe that this is all linked to my original ambition, or desire, which was to be of some help to humankind, so to speak, in a larger sense than just on a one-to-one basis. Just as I intended to study law, to make just laws, so I found myself interested now in the laws of nature, as distinct from the laws the people make. How did your parents react to your decision to go into medicine and science?
Were they encouraging? Jonas Salk: Well, my parents were more than supportive, my mother particularly. My mother had no schooling. She came to this country from Russia in She immediately, as a young girl, began to work, you know, to help support the family.
And she was very ambitious in a sense for her children. She wanted her children to have more than she had, so that she lived her life and invested her life, lived through her children. I was the eldest of three sons and the favorite and the one who had all of her attention, certainly until my little brother was born — I was about five years old then — and my youngest brother when I was about I was essentially an only child in the sense of having her interest and concerns and attention.
She wanted to be sure that we all were going to advance in the world. Therefore we were encouraged in our studies, and overly protected in many ways. He was a more artistic person. He was a designer in the garment industry, so to speak. He had not quite graduated from high school, only from elementary school. We were not brought up in a family which was already cultured. So, there was something special in the household that was very nurturing for — shall we say — advancing in the world, getting ahead.
But whether it was in business or in law or in medicine, so to speak, was not of great concern. You can accomplish great things even if you are the first in your family to go to college. Where do you think your sense of wanting to do something for humankind came from? Jonas Salk: I believe that this is part of our nature, and part of an ancestral heritage. Some people are constructive, if you like.
Others are destructive. It sounds like you felt a personal sense of duty to do something for the world. Was that something your parents instilled in you? Jonas Salk: I have the impression that people like that are born as well as made.
You are born with that instinct. I think there is something inherited. We talk about the innate versus the acquired, about nature versus nurture. Our nature is revealed in the course of our life experience, and the nurturing comes from the opportunities that are available. If I were born in some other country, for example, my life would have been quite different. Jonas Salk: As a matter of fact, I was not a great reader. I spent a good deal of time thinking, as I still do, about what went on in my life, my own observations and reflections.
I did read what was part of schooling, but I was not an avid reader. Jonas Salk: At the end of my first year of medical school, the professor of chemistry, Dr. Keith Cannon, tapped me on the shoulder and asked me to come to see him. I was quite sure that he was going to tell me that I was failing and give me some bad news.
Instead of which, he offered me an opportunity to drop out for a year and work with him in chemistry, during which time I could have my first experience in research, and also as a student teacher, so to speak.
Since my desire, from the time I entered medical school, was to enter into and to do scientific research, that was the break that I seized upon. It was a difficult decision to make, because I would have to leave my class, be alone, and in a sense be exceptional for that year, and then return to anther class.
Nevertheless, I had the courage to do so. That was an important year.
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