Can't Help Falling In Love With A Vaccine: How Polio Campaign Beat Vaccine Hesitancy
Susan Brink
Elvis Presley got his polio vaccination from Dr. Harold
Fuerst and Dr. Leona Baumgartner at CBS' Studio 50 in New York City on
Oct. 28, 1956. The chart-topping singer took part in a March of Dimes
campaign to convince teens to get vaccinated.
Seymour Wally/NY Daily News Archive via Getty Images
The mass inoculation of millions of American children against
polio in 1955, like the vaccinations of millions of American adults
against COVID-19 in 2021, was a triumph of science.
But the
polio vaccine had overwhelming public acceptance, while stubborn pockets
of vaccine hesitancy persist across the U.S. for the COVID-19 vaccine.
Why the difference? One reason, historians say, is that in 1955, many
Americans had an especially deep respect for science.
"If you had to pick a moment as the high point of respect for scientific discovery, it would have been then," says David M. Oshinsky, a medical historian at New York University and the author of Polio: An American Story.
"After World War II, you had antibiotics rolling off the production
line for the first time. People believed infectious disease was [being]
conquered. And then this amazing vaccine is announced. People couldn't
get it fast enough."
Today, the unprecedented speed of the COVID-19 vaccines' development, along with a flood of disinformation
on the internet about all vaccines, has led to a lingering hesitancy
among some Americans to receive the increasingly available COVID-19
shots.
"In hindsight, Operation Warp Speed wasn't the best
name," says Oshinsky. "It sounds like the project prioritized speed over
everything else. They did roll it out quickly, but the FDA and CDC have
done an amazing job of testing the vaccines and ensuring their safety
and efficacy."
During the late 1940s and early '50s, according to
statistics from the Centers for Disease Control and Prevention, polio
disabled an average of 35,000 people a year in the U.S.,
most of them children. As outbreaks popped up across the country in the
hot summer months, people were terrified and voluntarily isolated. Many
parents kept their children close to home and away from community
gathering spots like movie theaters, roller rinks and beaches.
"Back then, it affected business and travel," says Stacey D. Stewart,
current president and CEO of the March of Dimes. "People didn't know
how the virus was transmitted. They lived in a state of fear. Pools were
closed. Businesses were affected because people didn't want to be out
in public."
President Franklin D. Roosevelt, who had himself essentially lost the use of his legs after a polio infection in 1921, when he was 39, launched the National Foundation for Infantile Paralysis,
a charitable organization, in the late 1930s. Later renamed the March
of Dimes, the foundation took the lead in efforts to fund research at a
time when the National Institutes of Health was in its infancy.
"Roosevelt's
passion for finding a solution — a cure, a vaccine — made polio a
priority coming from the very top leader of this country," says Stewart.
"People across the country felt like they were called to duty. It was a
call to action, like the war effort."
An army of volunteers for the March of Dimes, largely
mothers, went door to door, distributing the latest information about
polio and the effort to stop it; they also asked for donations. As
little as a dime would help, they said. And the dimes and dollars poured
in, Oshinsky says, handed to the volunteers, or inserted into cardboard
displays at store checkout counters or placed in envelopes sent
directly to the White House.
Cases of polio may have peaked in
the U.S. in 1952 with nearly 60,000 children infected. More than 3,000
died. (By comparison, roughly a year's worth of comparable statistics for the COVID-19 pandemic reveal more than 32 million reported cases in the U.S. so far and more than 573,000 deaths.)
The years-long campaign of information and donations to the polio
eradication effort made anxious Americans feel they were invested in a
solution, Stewart says. So confident was the public in the research
leading up to the polio vaccine that by the time the Salk vaccine was
ready for experimental testing in 1954, the parents of 600,000 children
volunteered their own offspring as research subjects.
When the
results of those studies showed the vaccine to be safe and effective in
1955, church bells rang. Loudspeakers in stores, offices and factories
blared the news. People crowded around radios. "There was jubilation,"
says Stewart. People couldn't wait to sign their kids up for a shot.
Then tragedy struck. One of the six labs manufacturing the vaccine, Cutter Laboratories in Berkeley, Calif., made a terrible mistake. The correct list of ingredients for the Salk vaccine called for polio virus that had been inactivated,
but in the Cutter facility, the process of killing the virus proved
defective. As a result, batches of the company's vaccine went out that
mistakenly contained active polio virus. Of the 200,000
children who received the defective vaccine, 40,000 got polio from it;
200 were left with varying degrees of paralysis, and 10 died.
In
April, the U.S. campaign against COVID-19 suffered a blow too. Reports
that an extremely rare but serious blood-clotting disorder might have
resulted from Johnson & Johnson's vaccine — one of the three
authorized for use against COVID-19 in the U.S. — once again raised the
question of whether possible harms caused by a vaccine might derail
people's confidence in a public health campaign at a crucial time.
On April 13, the CDC and the Food and Drug Administration jointly announced
that among the 6.8 million doses of the Johnson & Johnson vaccine
administered to date, six cases of a serious blood-clotting issue had
been recorded, and one had woman died.
Polio
vaccinations were temporarily halted in 1955 following the Cutter error
as well. In both incidents, health officials followed the science.
After Cutter's manufacturing error was pinpointed as the problem,
vaccinations restarted within weeks, with renewed quality control
efforts and minus any involvement from Cutter Laboratories.
In
1955, mothers and fathers jumped right back in following the Cutter
tragedy, once again signing permission slips and lining their kids up to
get their polio shot. It was widely understood and accepted that the
risks of polio were a much greater threat than the risks of the vaccine.
"I
think back then, people were so personally invested in the vaccine,"
Stewart says. "They listened to what happened in the Cutter case, and
they understood. They continued to trust."
Because of that trust, the campaign to prevent polio with vaccines — first Jonas Salk's and then also Albert Sabin's
— was successful, eventually nearly eliminating the disease from the
planet. But that also means, says Oshinsky, that people born after the
mass vaccination effort don't have memories of how bad the disease could
be.
"Vaccines have been a job ... done so well they have obliterated
evidence of what the disease can cause: kids on crutches, in
wheelchairs, in iron lungs," Oshinsky says. "I remember seeing the
occasional empty desk in school because a child had died. People had
seen polio every summer, and they wanted kids vaccinated as soon as
possible."
The polio vaccine effort offers some lessons for
today, says Stewart. First, volunteers from local communities are
trusted and invaluable in providing education on disease, research and
vaccines. To get people's attention, add to that numerous high-profile
advocates — individuals recognized and esteemed by various parts of the
population. The March of Dimes recruited Judy Garland, Mickey Rooney and Marilyn Monroe to join the fundraising effort to educate people about polio and the value of the vaccine. And in 1956, Elvis Presley was vaccinated backstage at The Ed Sullivan Show.
Vaccine efforts at the time did have to contend with racism.
Oshinsky writes, for example, about some areas in the Jim Crow South
where Black children lined up for shots on the front lawns of white
schools, while white children got their shots indoors. The Black
children, he notes, weren't allowed inside those white schools, even to
use the bathrooms. Very aware of the prejudices of the times, Stewart
says, the March of Dimes knew it would also need to recruit prominent
and popular Black performers to promote the polio vaccine.
Sammy Davis Jr., Louis Armstrong and Ella Fitzgerald
joined the campaign. "There was a very early recognition that you
couldn't just have white people talking about the vaccine," Stewart
says. In addition to beloved Black celebrities, she says, "the March of
Dimes had Black children on the posters to raise awareness in Black
communities."
"That's
the low-hanging fruit," says Oshinsky. "After you vaccinate all the
people champing at the bit to get it, that's when you have to think of
strong marketing strategies for those who are hesitant."
The
strong, consistent message during the polio years was "We're all in this
together." The same message, says Stewart, must come across loud and
clear today.
Susan Brink is a freelance writer who covers health and medicine. She is the author of The Fourth Trimester and co-author of Change of Heart.
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