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Polio as the People's Disease David Oshinsky, PhD Speaker biography | Summary | Transcript | Q&A Audio Transcript
D.A. Henderson: Monica, we have time for some questions, do we? How much? Ten minutes for questions, and then there will be a break for fifteen minutes where you may go out and look for the book. So questions now. David Oshinsky: Any Questions? Yes, sir. Joe: Joe Dudley, EAI Corporation. It's Interesting to have Dr. Henderson here, because this question crosses both lines. We saw a situation a couple years ago where we thought that polio was isolated to a small area in one country on the African continent, and on the horizon was the possibility that polio could be dealt with as small pox had been dealt with. And we've now seen polio go from Nigeria westward across West Africa, eastward to India and Indonesia. And the interesting thing for this conference is that this was tied to a lack of communication with a cultural community that had a great fear of outside intervention and a propaganda campaign that snowballed into a popular resistance. Originally the popular resistance was seen as a local phenomenon, until some people went to the Hajj, and polio is halfway around the world once again. Number one, do you think we can get the genie back in the bottle again? And number two, do you think we can make this lesson learned, so that these same contradictions don't interfere with other future epidemics. I think one thing we forget is that many people in many parts of the world don't believe in the pathogen–disease–illness syndrome. D.A. Henderson:I think we want to leave time for other questions. David Oshinsky: I'll let D.A. answer the latter part. I would say to the gentleman: you're quite right. The World Health Organization thought that by 2004 there would be no more polio in the world, and in the Muslim areas of Nigeria, when polio did begin to spread again there was cultural resistance to it. As you said there were rumors, as you noted, that the vaccine would cause infertility in women and AIDS and the like, and it has begun to spread outward again. The World Health Organization now has, I think, 2010 as its latest goal; but I'll let D.A. talk briefly about his views on whether in fact that goal can be reached. D.A. Henderson: Well there was an article in Science just last week, which I think summarizes it, and there are differences of opinion as to some who still think it can be reached and there are some who, at this point, feel the obstacles are too great. I am quoted as thinking it is not possible to eradicate it and what we need to do is have a long term control program. Joe: Thank you. David Oshinsky: Yes? Sarah: Sarah Landry from GlaxoSmithKline. I was wondering-- the Cutter incident--how that was handled? And what I perceive from what I have read to be a fairly–what's the word I'm looking for–the public did not seem to have lost confidence in vaccines as a result of that. I'm wondering what lessons we can draw from that experience now, what do you attribute that to, and is there anything we can do as we try to reinforce the public confidence in vaccines in this country? Dr. Henderson: OK, as some of you may know, in 1954 after the vaccine was determined to be successful, the March of Dimes had already paid a number of drug companies to produce large amounts of the vaccine and the government immediately agreed to this and these companies began producing it. One of the companies, Cutter Labs of Berkeley California, was not following protocols carefully, and even though it was a killed-virus vaccine they were not killing the virus as well as the protocols demanded. There was live polio virus in their vaccine and a number of kids came down with polio and died. And so right after the Jonas Salk vaccine is declared successful and there's a victory, suddenly there's vaccine out there that is very dangerous. What the government does–and if there is a message, it was: what the government did very quickly with the Public Health Service was to take all of the vaccine off the market temporarily. All Cutter vaccine was recalled, and Cutter never made polio vaccine again. What they did was send epidemiologists into the field and found out very quickly what the problem was, it was Cutter vaccine, they allowed other companies who were producing safe vaccine back on the market and what was interesting was that if there is a message here, the government was so honest with the people, both in taking the vaccine off the market very quickly, finding the problem, and dealing with the problem, that when the vaccine went back on the market, people began putting their kids forward to use it again. So it seems to me that the message there is sunshine and openness. It is one of the great stories, and it's in my book, of sort of how quickly the Public Health Service really honed in on Cutter and found out what the problem was. So, I think that is the answer. There is an interesting book out by Paul Offit, who is a very well known virologist, on the Cutter incident, just came out. Paul is also, as a doctor, very interested in the litigation aspects of what came out of Cutter as well, which are quite controversial. Dr Henderson: Yes? Woman 1: When we look at the Avian Bird Flu, and there just seems to be a lot of hysteria already in the media for something that might not happen. I was a little girl in 1959 and I still remember the hysteria about polio, places we couldn't swim because we'd get it. I didn't even know what it was, but literally terrified I would fall into the marsh. Did the March of Dimes help the hysteria, did it, in some ways, make it worse, and are there some public relations lessons we can learn from that, for any pandemic flu we might face? Dr. Henderson: That's a hard question to answer. The March of Dimes' role, I'm a big supporter of the March of Dimes, and of Rotary international, which has taken on the fight against polio as you know. I think what the March of Dimes did was, on the one hand, it did scare people, I think, beyond the scope of polio. In other words, given the numbers, what you could say is that they were doing this as a way of raising money and that is true. On the other hand, they let people know what the precautions were, you know, if there were symptoms, go to a doctor. If the child does have polio they set up regional centers to deal with it. On that level, I think they were extremely professional: The difference with Avian Flu is that, if it comes, you're talking about a pandemic that will be much greater and wider than anything related to polio. I mean the worst case scenario could be the flu of 1918-1919. My sense is that the lesson here would be, certainly, to educate people, and to make certain that the government is actually following procedures that will try to minimize it when it comes and have effective ways of dealing with it. The March of Dimes was a very different kind of operation. I mean, their operation was to protect people against polio, but it was also in raising awareness to raise money as well. Those went hand in hand. David Oshinsky: Any other questions? Well, thank you very much I really appreciated being here. D.A. Henderson: We are grateful indeed. Now let me just say a word about the book. This is a page-turner. There's no question about it. There're more interesting stories in that book than you could possibly imagine and in fact there's one for the Canadians, which most people don't know, and that is when they're trying to make the vaccine for the big field trials, the only company that really knew how to do this and had worked it out was the Knott laboratories in Canada. And so they made all of the vaccine in bulk in Canada, and the March of Dimes was so concerned that it had to be a hush-hush operation. They wouldn't let it be publicized that this was a Canadian-produced product. But it was Canadian-Produced, shipped over, bottled in the United States, and it wasn't until very much later that anyone found out that the Canadians had played a very important role in the vaccine. [Applause] Dr. Henderson: The one other story that I thought would be revealing and I'll mention very briefly was that Jonas Salk, as a young man in the 1930's coming from New York city, was involved in sort of Left Wing causes, which was very common in the 1930's. In the 1940's, Jonas Salk needed a security clearance, an FBI check, to work for various parts of the government and to get his research money, and they did two full-field FBI investigations on Salk that are hundreds of pages long. And had it been up to J. Edgar Hoover and the FBI, that would have been the end of this anonymous researcher, who was not known at all at this time. Amazingly, and just looking at the FBI file you cannot be sure, he was cleared by the surgeon general. Had he not been cleared, there would have been a vaccine, but Jonas Salk would not have played a role in it. What is extraordinary is that in 1955, when Salk is invited to the White House with his family, everybody is cheering. Eisenhower thinks this is the best thing for American foreign policy; we're going to give the vaccine to the world. A letter arrives from J. Edgar Hoover: "I wouldn't allow this Lefty in the White House." It's an interesting story. Dr Henderson: So, as I say, it is a page turner, and you will love it. So, you can get the books outside, I think we've got fifteen minutes to 1:30 and David is prepared to sign at that point. Thank you all very much, thank you David. [Applause] |
