The Race for the Polio Vaccine – Salk vs. Sabin

Dr. Jonas Salk on the cover of Time magazine 1955
Dr. Jonas Salk on the cover of Time magazine 1955

Long before COVID-19, during the early 1900’s, summer was not a welcomed season for both parents and children, but rather a feared one.  For back then, summer was also ‘Polio Season.’ Children were susceptible to poliomyelitis, an incurable disease that affects the central nervous system resulting in paralysis.  Polio is a highly contagious virus that spreads from contact with water or food tainted with fecal contamination. ‘Polio Panic’ was a surpassed only by fear of nuclear war.

That the disease crippled so many children was alarming enough. But the shock wave that followed a local outbreak was devastating. Communities resorted to measures used to combat the spread of influenza or even small pox. Neighborhoods were quarantined, schools and movie theaters closed, windows were shut in the summer heat, and public pools abandoned.

Worse still, most hospitals refused to admit children with polio.  Families were forced to rely on house calls by doctors who could do little more than fit tiny children with heavy metal braces. Polio paralyzed some patients’ chest muscles removing their ability to breathe.  If they were fortunate, they would be placed in one of the dreaded IRON LUNGS, huge cylindrical respirators which pulled air in and out of their small chests.

In 1921, the war on polio recruited an unlikely ally.

Although polio mainly struck children, 39-year-old Franklin Roosevelt became ill after attending a summer Boy Scout rally. Within days, he was paralyzed from the waist down. Although as President he hid his disability from the public, he became a champion of its medical research. In 1937, he announced the formation of the National Foundation for Infantile Paralysis, also known as The March of Dimes. Citizens donated dimes to support polio research. In the first year alone, it raised almost 2 million.

Two heroes emerged in the 1950s, waging war against polio. The 1st, Dr. Jonas Salk of the Univ. of Pittsburgh developed a method to kill the virus with formalin. When injected into monkeys, his vaccine protected the animals against polio!  In 1952, Salk began testing in humans, starting with children already infected with the virus, often at institutions for the disabled or mentally ill. Strongly believing in his vaccine, Salk went so far as to inject himself, his wife, Donna, and their three sons in the family’s kitchen.

Controversy arose when a 2nd competing researcher, Dr. Albert Sabin of the Univ. of Cincinnati, claimed Salk’s inactivation method failed to kill ALL the polio virus. Sabin was almost a decade older and considered the more experienced researcher.  Testifying before Congress, he attacked Dr. Salk’s killed-virus vaccine. There was no proof the vaccine conferred long-lasting immunity.

Sabin predicted that any live virus remaining in the vaccine would doom innocent children.

Despite these doubts, Salk’s method was validated and he published his results in 1953. The March of Dimes decided to finance a massive Field Trial of Salk’s vaccine on 2 million American children between 6 and 9.  The large-scale trial was made possible by major pharmaceutical companies like Eli Lilly, Wyeth Labs, and Parke Davis, producing his vaccine on a large scale.

In 1954, half of these “Polio Pioneer” children received a vaccine injection, while the other half received a placebo.  Significant risks exist when administering any untried vaccine. As Salk told a journalist:

When you inoculate children with a polio vaccine for the first time, you don’t sleep well for two weeks.”

Dr. Jonas Salk

On April 12, 1955, on the 10th anniversary of FDR’s death, Dr. Thomas Francis, Salk’s mentor and the trial director, called a press conference at the University of Michigan to report the results.  Salk was still in the dark as to the conclusion, and had little idea what Francis would say. The conference was broadcast to 54,000 physicians; millions of Americans tuned in by radio. The pronouncement was stunning.

The vaccine was safe, potent, and 90% effective in protecting against polio!

The audience of over a thousand gave Salk a standing ovation as he took the stage.  A pleased, yet overwhelmed Salk looked at the crowd.  “The objective here was not merely a reduction in crippling cases of polio, but rather the elimination of fear.” He thanked the many people who had made this success possible, but failed to mention his closest colleagues by name. This caused a rift between Salk and some of his research associates that persisted for decades.

There were over a hundred reporters at the event. Word got out around the globe overnight. The polio scourge had been whipped! Every front page and newscast proclaimed the victory. Polio panic would soon be over as pharmaceutical companies would create millions of doses of the new vaccine. Church bells and fire sirens sounded across the US. People gathered in churches to pray thanks. Many openly wept.

Salk immediately became a national hero and celebrity. That evening, he appeared on Edward R. Murrow’s television show See It Now. “Young man, a great tragedy has befallen you,” Murrow said, “you have lost your anonymity.” When asked who held the patent on the vaccine, Salk’s response became legendary:

Well, the people, I would say. There is no patent. Could you patent the sun?

Dr. Jonas Salk, when asked who owned the patent

Salk disagreed with owning a patent as millions of Americans had paid for the research via the March of Dimes.  Of course the vaccine wasn’t novel enough to be patentable according to US law, and Salk knew it.  Forbes once estimated that Salk could have earned over $7 billion in revenues.

President Eisenhower gave Jonas Salk a special citation at the White House.

The fame was unwanted however. Hotels offered Salk their best suites, pilots announced his presence on airplanes, he could not eat at restaurants as everyone wanted to shake his hand.  The March of Dimes lionized Salk to the point of offending his colleagues yet again. Other researchers grumbled that he hadn’t found anything new; just applied research that was already there.

Around the same time that Salk began his work, Dr. Albert Sabin began working on a weakened live-virus vaccine. Sabin felt that his oral vaccine was superior to an injection, as it would be easier to give to kids and cheaper to manufacture.  Sabin began testing his vaccine on humans, included prisoners from Ohio’s Chillicothe Penitentiary.  Volunteer inmates were paid $25 with a promise of some time off their sentences. None of the 30 prisoners developed polio, and the test trial was deemed successful.

Just 2 weeks after the victory announcement, scattered reports appeared of children developing polio after vaccination. An investigation implicated one of the manufacturers, Cutter Laboratories.  Cutter was quick to blame Salk’s inactivation method, arguing it didn’t work on large batches.  Albert Sabin chimed in calling it the “Salk Accident.”  Jonas Salk was in the spotlight again, but for the wrong reason.

It was soon discovered that Cutter failed to follow Salk’s strict protocol for inactivating the virus.  

The ‘Cutter Incident’ was heartbreaking for Salk. “I cannot escape a terrible feeling of identifying with these poor people who got polio.” Because of Cutter’s cost-cutting, 260 people contracted the disease.  Nevertheless, his vaccine proved a Godsend. By 1961 polio, was all but eradicated from the United States.

Because Salk’s vaccine was now being used in the US, Albert Sabin couldn’t get support for his large-scale field trial like that of Salk. In 1957, Sabin convinced the Soviet Union to conduct field studies on his oral vaccine. Ultimately 2 million Soviet children were vaccinated. Sabin’s Russian trials were also deemed highly successful.

Dr. Albert Sabin and his polio vaccine, 1963
Dr. Albert Sabin and his polio vaccine, 1963

Sabin quickly entered into an agreement with Pfizer pharmaceuticals to produce his ‘attenuated‘ live-virus vaccine. Sabin’s oral polio vaccine, administered to kids on a sugar cube, eventually replaced Salk’s injected vaccine in many parts of the world. By 1963, it became the gold standard, and the one used to eradicate polio globally.

Salk claimed his killed virus vaccine was safer, but his resistance was futile. The Sabin vaccine, cheaper and easier to deliver, won the race in the end.  Sabin belittled Salk’s earlier achievement as “kitchen chemist’s work,” which anyone could have done. Subsequent honors went to Albert Sabin that never came to Salk, like membership in the prestigious National Academy of Sciences. Neither Salk nor Sabin ever received the Nobel Prize in medicine. It’s been speculated this was due to their close, but necessary, ties to the pharmaceutical industry.

In 1963, The Salk Institute opened in La Jolla, California.  He got funding from the March of Dimes and recruited Nobel Prize-winning scientists to investigate cancer, diabetes, multiple sclerosis, and eventually AIDS.  So although Jonas Salk is credited with ending the scourge of polio because his killed-virus vaccine was first, Albert Sabin’s inexpensive sugar cube vaccine continues to successfully prevent the spread of polio in every corner of the world to this day.

Dozens of new successful vaccines in the decades since polio have revolutionized global immunization, most especially for childhood diseases. As the world currently rushes towards COVID vaccinations for new emerging coronavirus variants, take note of the years of careful scientific research it took to get a successful and safe polio vaccine for millions.

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LOST IN HISTORY Blog/Podcast about key forgotten history still relevant in today's world. Paul Andrews also has 5 historical adventure novels, all available on Amazon.

One thought on “The Race for the Polio Vaccine – Salk vs. Sabin

  1. I had 3 or 4 shots of polio vaccine (Salk) and drank the little cup of cherry flavored live polio virus (Sabine) in 1960 – at age 11. Mayo Clinic neurologist ( Dr. Millikan) said that I had developed polio from the oral vaccine – my right arm got polio – Salk vaccine was safe and effective – Sabins live virus gave polio to many like me

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