The following is the opinion and analysis of the writer:
In the wake of World War II, Drs. Spock, Salk and Seuss nurtured baby boomers. Benjamin Spock’s phenomenally popular Common Sense Book of Baby and Child Care offered practical advice to millions of anxious parents. Dr. Seuss’ (Theodor Geisel) zanily illustrated books like “Cat in the Hat” put a generation of children to bed and cultivated a love of reading. Dr. Jonas Salk’s vaccine banished the terror of paralytic polio (poliomyelitis) that had haunted Americans for decades.
Examining the polio-era in light of the COVID-19 pandemic reveals interesting parallels as well as differences. Both diseases terrified the nation, even though a relatively small number of people succumbed and both revealed persistent health inequities.
Between 1945 and 1955 polls reported that the only thing American parents feared more than polio was global nuclear war. Each summer since about 1900 polio afflicted somewhere between 20,000 and 60,000 (mostly) children, killing some and paralyzing others.
In futile efforts to stop the plague (later discovered to spread through drinking water contaminated by fecal matter), authorities closed municipal swimming pools, beaches and theaters.
Although many more children died from influenza and other common diseases, polio riveted public anxiety. Everyone knew or heard of someone whose child had gone to bed with a mild fever and never walked or breathed on their own again.
Harrowing photographs published in magazines such as Life and Look revealed hospital wards full of children in bulky metal breathing devices called “iron lungs,” an early version of ventilators. Despite medical advances, polio outbreaks grew more severe over time, the worst occurring in 1952. That year about 60,000 children were afflicted. Around 9,000 suffered some degree of paralysis and 3,000 died.
The polio virus attacked nerves, had existed for thousands of years and was a global affliction. Most babies were infected shortly after birth when it usually caused minor symptoms and conferred lifelong immunity. Ironically, improved sanitation in the U.S. delayed exposure to the virus whose symptoms became more virulent with age.
Babies raised by wealthier families in homes with better sanitation were more likely to avoid infant exposure, only to suffer graver complications if infected later.
Black and Hispanic children, clustered in the South and Southwest, generally had lower rates of paralysis. Although racist doctors attributed this to “primitive physiology,” it resulted from more common exposure as infants to virus-tainted water. This conferred later immunity to polio but increased the risk of other childhood diseases.
The effort to eradicate polio became a national crusade during the 1930s as infections rose and after Franklin D. Roosevelt , whose legs were crippled by an adult-onset of the disease in 1921, became president.
Roosevelt projected an image of the polio survivor as someone triumphant over the disease — even though he never walked on his own again.
In 1938, FDR and his former law partner, Basil O’Connor, created the National Foundation for Infantile Paralysis, later renamed the March of Dimes.
Although a private philanthropy, its association with the president provided a semiofficial aura. The foundation’s annual fundraising campaign, personified by a “poster child,” brought in millions of dollars that financed a rehabilitation program in Warms Springs, Georgia, and medical research.
In 1948-49, the March of Dimes began funding Dr. Jonas Salk, a research physician based at the University of Pittsburgh, also Dr. Spock’s institutional home. Salk expanded upon procedures pioneered by others to grow the polio virus, kill it and turn the product into a vaccine.
In 1953, after preliminary testing – partly on his family – he announced promising results. The March of Dimes began a massive “double blind” field trial in 1954 using both the vaccine and a placebo. Nearly 2 million children, dubbed “polio volunteers,” participated, dwarfing any vaccine trial before or since.
To ensure accuracy, children of all races had to be included and the doses administered at central school locations. Despite that year’s Brown v. Board of Education ruling by the Supreme Court, segregation remained deeply entrenched throughout the South. School authorities feared that allowing Black children to enter all-white schools, even for vaccine trials, might undermine segregation. Black children were assembled in parking lots outside white elementary schools to receive their vaccinations.
By 1955 newspapers declared: “Polio Threat Conquered by Salk Vaccine.” Although celebrated as a national hero, praise for Salk was not universal. Some questioned his patriotism (he had been a youthful leftist) when he declined to claim ownership of the vaccine. Doing so, he explained, would be like “patenting the sun.”
The American Medical Association (AMA) took a dim view of Salk’s call for a public-health vaccination campaign. Although it would cost less than $150 million to inoculate all Americans under 21, both the AMA and the Eisenhower administration resisted federal funding for mass production and distribution of the vaccine, fearing it would build support for “socialized medicine.”
Ultimately a mix of federal, state and private funds underwrote a mass-vaccination program. To calm “anti-vaxers,” pop icon Elvis Presley received his vaccination on live television in 1956.
Within a few years, the Salk vaccine and then oral vaccines virtually eliminated polio and the terror that accompanied it. The disease persists only in pockets of Afghanistan and Pakistan.
Unlike polio, COVID-19 emerged suddenly and globally. Where polio proved most dangerous to children, COVID-19 posed greater risks for the elderly. Minority communities which were less affected by polio have been disproportionately impacted by COVID.
In 2020, pharmaceutical companies parlayed years of federally funded research and large government subsidies into rapid vaccine development. But as in the 1950s, the absence of national planning hindered vaccine rollouts.
While the U.S. excelled in advanced research, it often faltered in delivering treatments. Chronically underfunded and overstretched local health authorities are typically tasked with solving complex logistical challenges.
Both epidemics revealed the need to combine robust science with enhanced public-health programs, especially since we will surely confront future pandemics.
