Fifty Years of Miracles: H.R. Shepherd and Peter J. Hotez Recall The Legacy of Vaccine Advances
NEW CANAAN, Conn., April 27 — Fifty years ago, six-year-old Randy Kerr from McLean, Virginia, was officially designated the nation's first child to be vaccinated with an experimental polio vaccine developed by Jonas Salk in his University of Pittsburgh laboratory. Over the next several months thousands of children who became known as "Polio Pioneers" stepped up to receive their polio injections as part of an enormous vaccine field trial. Within a year, the data from this extraordinary trial were collected and it was announced to the world that the polio vaccine was a success. Parents all over the world started to breathe a sigh of relief that their children would not die or become permanently paralyzed from annual summer polio epidemics.
The Salk vaccine was just the first in a string of new vaccines against the great virus infections of humankind that were developed over the next two decades. These new vaccines came about largely because of earlier efforts by John Enders and his colleagues at Harvard Medical School who had discovered a way to culture disease-causing viruses in the laboratory. The legacy of these viral vaccines is a story of epic proportions.
For instance, widespread use of the measles vaccine, first developed by Enders, Tom Peebles and Sam Katz in the 1960s, began with the start of the World Health Organization's Expanded Program on Immunization (EPI) in 1974 when measles was the planet's single greatest childhood killer responsible for 7 million deaths annually. Through the EPI the number of annual measles deaths has now been reduced ten-fold to less than 800,000 deaths annually. The number of lives saved through the EPI's measles vaccination program was recently estimated to be equivalent to the number of lives lost in all wars during the 20th century. In so doing, measles vaccine became our first weapon of mass peace!
Another extraordinary achievement was a second generation polio vaccine developed by Dr. Albert Sabin. Employing live-attenuated virus strains that could be administered orally, rather than using killed virus administered by the Salk injections, the Sabin vaccine gained favor worldwide. Few of us realize that the Sabin vaccine was licensed in the U.S. only after it was first tested in tens of millions of Soviet schoolchildren during the late 1950s shortly after the launch of Sputnik. This came about through a little-known but remarkable piece of back-channel diplomacy between the Eisenhower Administration and the Communists.
Today, through widespread use of the Sabin vaccine, polio has been eradicated in all but six nations. They are Nigeria, India, Pakistan, Niger, Afghanistan, and Botswana. However, almost all of the cases occur in just six states or provinces of these nations. The Global Polio Eradication Initiative, spearheaded by national governments, the WHO, Rotary International, the CDC, and UNICEF has the ambition to interrupt transmission by wild poliovirus by the end of this year. Tremendous progress has been made in the global fight against polio since 1988, when the World Health Assembly resolved to eradicate the disease. From 1988 to today, the number of worldwide polio cases has decreased from 350,000 to just a few hundred. The WHO and its Director of the Eradication Initiative, Dr. David Heymann, have argued persuasively that we have "a historic, one-time only opportunity" to stop polio transmission forever.
Provided we act immediately, no parent has to witness their child suffering from polio's crippling effects. Practically speaking this means that every child under five who lives in the world's remaining polio-endemic regions must receive the Sabin vaccine. Through the same type of global cooperation and "vaccine diplomacy" that resulted in the taming of measles and the development of the polio vaccine, we are on the verge of an equally extraordinary global health goal that would wrap up fifty of the most exciting years of human achievement, which brought science and politics together for a common and noble purpose.
Peter Hotez, M.D., Ph.D. is the Chief Scientist, Sabin Vaccine Institute, and Chair of Microbiology and Tropical Medicine, The George Washington University. H.R. Shepherd, D.Sc., is Chairman of the Board of the Sabin Vaccine Institute in New Canaan, CT and Washington, DC.