Remember Polio? This COVID-19 Pandemic Is Surprisingly Similar | Orthopedics This Week - Part 2
Biologics

Remember Polio? This COVID-19 Pandemic Is Surprisingly Similar

(L to R): Gymnasium converted to iron lung ward in Los Amigos Hospital and Vanderbilt University Hospital Parking Garage Converted for COVID-19 response / Source: Smithsonian National Museum of American History and American Institute of Architects

The Desperate Search for a Vaccine

Here is where the parallels with Polio and COVID-19 appear so strong.

Resources were poured into various labs around the country to try to find a cure or preventative for polio.

The two lead laboratories were under Jonas Salk and Albert Sabin.

We know today that those two labs were both successful and the vaccines they created, tested, and widely produced led to the eradication paralytic poliomyelitis by 1979 in the U.S., and the western hemisphere by 1994. Most of the world is now polio-free.

Jonas Salk’s Vaccine and Clinical Study

Jonas Salk’s lab was backed by the National Foundation for Infantile Paralysis (NFIP), also known as the March of Dimes. He was focused on a vaccine based on dead polio virus. With the help of multiple public institutions and private corporations Salk’s team was able to produce enough virus to supply vaccine for an historic clinical trial.

The trial was designed with two arms to account for biases in the population that could throw off the results if only those who received the injection were volunteers. The first arm of the study was to inject the dead virus into second graders whose parents volunteered, while first and third graders at the same schools were simply observed.

Why this approach? The panic among parents at the time was so strong that Salk and his team worried that more affluent families would somehow buy their way into the study and bias the results against the vaccine, as affluent children were afflicted disproportionately.

The second arm was a randomized, placebo-controlled study that effectively nullified the bias. Concerns over the ethics of not providing a vaccine were aired, but the trial was carried out regardless.

Incredibly, 600,000 children were injected with vaccine or placebo, and over 1 million were observed. Results were released in 1955. It was broadcast live across the county in cinemas where as many as 50,000 doctors watched. The data showed that Salk’s vaccine, using a dead virus, was 80-90% effective. It was licensed the following day. Salk’s vaccine went on to virtually eliminate cases of polio in the following years. Unfortunately, a supplier of vaccine, Cutter Laboratories, released a batch of vaccine that was not sufficiently killed and led to multiple cases of poliomyelitis killing five children.

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