What the COVID-19 vaccine owes to Dr. Jonas Salk and the end of 'polio season'

WHITE PLAINS, N.Y. — Roberta O'Shaughnessy remembers the day she rolled up her little school-uniform sleeve and became a "Polio Pioneer," among the first to get Dr. Jonas Salk's polio vaccine trial.

It was June 1954 and O'Shaughnessy — then known as Roberta Van Tassell — was a 7-year-old about to finish the second grade in Mount Kisco, New York.

Now 74 and living in New Hartford, New York, O'Shaughnessy's strongest memory from that day isn't how she felt about being a pioneer or if she was nervous about the shot — or even whether her parents had been living in constant fear of her contracting polio. Back then, polio was a constant cloud hanging over summer months, the dreaded "polio season" that could mean paralysis and leg braces or life in an iron lung.

"If they were nervous, they never said anything to us children," she said.

As the coronavirus vaccine rolls out and goes into the arms of Americans — starting with medical teams and senior citizens — it's worth pausing to consider the trailblazing trial that made it possible.

The Salk vaccine lifted decades of fear, created the bedrock process for determining if a vaccine works, and gave rise to now-universal grassroots fundraising efforts employed in the fight against disease.

The vaccine also worked; it all but wiped out polio.

More:Police, firefighters, teachers will be next in line for COVID-19 vaccine

Don't cut in line for the COVID vaccine. Elites who do will be named and shamed.

A dime at a time

The coronavirus vaccine stands on the shoulders of Salk's work, said Dr. Rahul Gupta, senior vice president and chief medical and health officer at The March of Dimes, which began as a campaign by the National Foundation for Infantile Paralysis, founded by President Franklin D. Roosevelt.

Roosevelt contracted polio at 39, in 1921, and lost the use of his legs. He became a champion for finding a vaccine to prevent other outbreaks.

Between 1938 and 1955, when Salk's vaccine was approved, the March of Dimes raised $230 million and gave direct aid to more than 335,000 people with polio to pay hospital, medical and rehabilitation expenses, said March of Dimes spokeswoman Christine Sanchez. 

Much of that was raised a dime at a time, and mailed to Roosevelt at the White House — slipped into envelopes that were exempt from postage.

Roosevelt did not live to see Salk's vaccine. He died on April 12, 1945, at Warm Springs, Georgia, site of his little White House and a rehabilitation hospital where he welcomed polio victims to play and spend time with others who shared their experiences.

A gripping fear

From the first major American outbreak, in the summer of 1916, until the vaccine was approved, on April 12, 1955, polio was a terrifying reality every summer. Those stricken by the virus could lose the use of their arms and legs.

If their lungs were affected, it meant life in an “iron lung,” a pressurized tube whose “whoosh” became a fact of life, the breath of life. Archival photos show wards filled with rows of children in iron lungs.

Historian Geoffrey C. Ward remembers living under the terror as a boy in Hyde Park, on the south side of Chicago. The eldest of three children, he remembers newspapers printing the addresses of homes where polio cases were confirmed. 

“July to September was polio season. And everybody, the way people look up baseball scores, during that period, they looked every morning to see how bad it was. Parents did. Certainly my mother did.”

Ward, the author of many books, including four on Franklin Roosevelt, has teamed with filmmaker Ken Burns — writing award-winning documentaries including “The Civil War” to “Baseball” to “The Roosevelts: An Intimate History,” to name a few. He has won five Emmy Awards.

He describes his mother as a take-charge, but anxious woman who lived in fear of polio and laid down a long list of things that were off limits each summer.

"We couldn't go to the zoo. We couldn't go to the beach, for the most part. You didn't know where you would encounter it and she was absolutely terrified all the time," Ward said.

Ward's mother's worst fears were realized in the late summer of 1950, when her eldest son contracted polio at the age of 9.

"[My best friend and I] got it the same morning," Ward remembered. "I went to the hospital for three months. He had no symptoms at all and had no effect. He is still my best friend."

"The word 'capricious' is really useful. It was a capricious disease. It could crush your lungs or have no effect at all.  It just depended entirely on chance."

Ward's mother lived to be 100 and never forgave herself, Ward said, trying to identify her lapse, "the one hole in the wall that allowed it to happen."

'How can you patent the sun?'

When the vaccine was unveiled, Ward was living with his family in India — his father was an executive with the Ford Foundation. 

“I remember seeing Ed Murrow interview Salk and asking him if he was going to patent the vaccine and Salk said something like: ‘How can you patent the sun?’" Ward said. "I find Jonas Salk an incredibly impressive man."

Salk's polio vaccine wasn't a cure for polio, Ward pointed out. It could not reverse the debilitating damage it had done. But it could, and did, stop polio in its tracks.

"He didn't invent anything, he made it work. And somehow among snarky scientists, that means he's a lesser person. But he figured out how to make that stuff. And my brother and sister didn't get polio, so I'm grateful to him."

Deliver a safe, effective COVID-19 vaccine in less than a year? Impossible. Meet Moncef Slaoui. 

Where’s the COVID-19 vaccine? Who’s been vaccinated? Here's how we'll know.

A vaccine doesn't stop a virus. A vaccination does. People have to take the vaccine to make it effective. For polio, taking the vaccine was a national priority and a dream realized. There was no question that children would take the vaccine.

And there was no question it worked. 

The year Ward contracted polio, 1950, there were 33,000 cases. Two years later, the virus hit its all-time high: 52,000 cases. Then came the vaccine in 1955. By 1962, there were just 886 cases.

Setting the standard

Salk's science is now how vaccines are developed, said Gupta.

"The Salk field trial included the largest trial in U.S. history, with 1.8 million children," Gupta said.

"And Salk created the standardized double-blind placebo process, that has become the bread and butter of every clinical trial. That's where it began. There was a placebo population and a vaccine population. It hadn't been that way prior to that."

When she took part in the trail, little Roberta Van Tassell received, for her troubles, a "Polio Pioneer" card that bore the name of Basil O'Connor, the head of The National Foundation for Infantile Paralysis. She still has the card.

O'Connor, a Wall Street lawyer, was an unlikely candidate to champion the cause — except that he was a loyal friend, and former law partner, of Roosevelt.

Also ground-breaking was O'Connor's March of Dimes grassroots campaign — not asking government to fund the research and care for those affected by infantile paralysis.

There were giant Roosevelt birthday galas held, as many as 6,000 one year, in cities and towns across the country. It was not a celebration of the president, but a way of helping others and boosting a cause that he championed.

Hollywood joined the fight, with magazine and newspaper ads and newsreels. Everyone from Mickey Rooney and Judy Garland to Eddie Cantor got involved. It was Cantor who coined the term "March of Dimes," a nod to a newsreel called "The March of Time." 

Movies were paused to pass a pail for pocket change, anything patrons could spare.

'No corners were cut'

O'Shaughnessy said she has spent her life being inoculated against one disease or another, from all the regular childhood immunizations to the Salk trials to typhoid and typhus shots required when she traveled to Germany in the '60s.

She gets the flu shot every year, and has gotten shots for pneumonia and the old and new shingles vaccines.

It's surprising, then, to hear the polio pioneer say will wait before getting the COVID vaccine.

"I know this vaccine has probably been tested, but I guess the title 'Warp Speed' has thrown off a bunch of people," she said. "I thought it really did not go through enough scientific testing like the others have, but maybe it did. I will probably get it in the summer after it has been tested on more people."

Gupta, with the March of Dimes, said he realizes that our nation is divided, that there are some who question the speed with which the vaccine reached the market. 

Yes, the vaccines were created quickly, he said, but "there is every indication at this point, despite a lot of scrutiny, that no corners were cut."

Still, he said, he fully expects setbacks and issues with the roll-out.

"Science is always messy," he said. "If you could get from point A to point B directly in science, we could do it easy, but the fact of the matter is, it's often a zigzag path. We're going to see issues of allocation. We're going to see issues of distribution. We're going to see some side effects. These things are expected. These are not unexpected issues."

When the polio vaccine was rolled out, it was administered to a united country, a community that came together, he said.

"We have to be able to unite around this particular success that we've had as a nation. This is nothing less than a success that we've had as a nation in having vaccines in less than a year."

Vaccinations shouldn't be politicized, he said.

"It's not a Republican vaccine. This is not a Democrat vaccine. This is a vaccine to save lives, lives that we cannot afford to lose. We're losing thousands a day."

Ward shows not a moment's hesitation when asked if he'll get the shot.

"You bet. I can hardly wait," he said. "When 80-year-olds come up on the thing, I'm there. We can't live like this. I've been to the dentist twice. That's the extent of my travel since March."

Follow Peter D. Kramer on Twitter at @PeterKramer.