Comparing the polio and COVID-19 vaccine rollouts

Children in Vancouver receive the Salk vaccine - April 1955.
B.C. Marching Mother's Appeal for the Polio Fund campaign at Vancouver City Hall, January 24, 1961.
Ramesh Ferris with a polio survivor in India.
Ramesh Ferris in Ottawa.
Ramesh Ferris with world leaders.
Ramesh Ferris provides the polio vaccine to a child in India.

Ramesh Ferris, 42, is a polio survivor. A Rotarian, he has previously come to the Sea to Sky to spread polio awareness and promote its vaccination program.

When he was born, his mom did not have access to the polio vaccine, and because of this, Ferris contracted the disease when he was six months old. 

It left his legs paralyzed for life.

When he was a toddler, his mom could no longer care for him, so she turned him over to a Canadian orphanage located just outside of Coimbatore, India. 

A family in the Yukon adopted him. 

He recently told The Chief that he is reminded every day about the effects polio can have on one's life.

He relies on leg braces and crutches to get around. 

The disease is "100% completely preventable through life-saving vaccines," he told The Chief in an email. 

According to the Canadian Public Health Association, polio cases in Canada peaked in 1953 when there were about 9,000 cases and 500 deaths — making it the most serious national epidemic since the 1918 influenza pandemic. 

Many folks in Squamish got polio, and some died from it.

"I contracted polio 25 years after the release of Dr. Jonas Salk's polio vaccine while living in India in 1980," Ferris said. "My birth mother never heard of the polio vaccine or didn't have access to it because she lived in poverty."

Back to the future on vaccines

The Salk vaccine was introduced in 1955.

The inactivated polio vaccine (IPV) shot was given in multiple doses, as the currently available COVID vaccines are.

Oral polio vaccine (OPV) was given as liquid drops via the mouth — in a sugar cube for some local kids — after 1961.

Salk created the original vaccine at the University of Pittsburgh School of Medicine. The National Foundation for Infantile Paralysis, now the March of Dimes, hired him to participate in the charity's polio research program.

Polio vs. COVID vaccines

Ferris said what scares him the most about COVID-19 is watching history repeating itself. 

"As a global community, we have utilized our advancements in science and technology, we have established partnerships with civil society, private sector business, philanthropists, and governments, and invested billions of dollars into our modern-day miracle — the COVID-19 vaccines," he said. "Once citizens from developed countries like Canada, U.S., U.K., Australia, etcetera are vaccinated, will we shut the door and turn our backs to the poorer countries? I certainly hope we won't be hearing about people being hospitalized from new cases of COVID-19 in the year 2045 —25 years after the release of the COVID-19 vaccine," he said. 

"A case of polio anywhere in the world is a threat to people everywhere in the world. COVID-19 is no different. We will not successfully recover from COVID-19 until every person, everywhere in the world has equal access to the COVID-19 vaccine, and every country in the world has recovered."

University of Victoria history professor Mitchell Hammond, who specializes in epidemics, told The Chief the differences in the vaccine rollouts between when Salk's vaccine was rolled out and now are more pronounced than the similarities. 

"It is going to be arguably an even bigger and more concentrated rollout than they did with polio," he said. 

One of the big differences is that in 1955 there was just the Salk vaccine, whereas today, there are several to address the coronavirus. 

Another difference is the current vaccines have been developed by for-profit companies with the support of government or government-owned companies, depending on the part of the world where the COVID-19 vaccines are being made. 

"There's a much different mix of public and private sector interests," Hammond said. 

The speed at which the COVID-19 vaccines have become available is much faster than the Salk vaccine. 

"They worked on the polio vaccine for ages, on and off," he said. "Even the last really concentrated push in the 1950s took several years."

According to Hammond, just figuring out how many types of polioviruses there were was a "tremendous undertaking," according to Hammond. 

About the kids

With COVID-19, though the drug companies have recently started trials on kids, children weren't part of the first trials — given the disease was not impacting them the way it was older people — but for polio, kids were central to the trials. 

"There were a couple of really small trials with small groups of children, but after that, there was a large clinical field trial." 

Children across the U.S. were part of the testing in 1954. 

Approximately 650,000 children received the vaccine. There were over one million children who received injections as a control group.

Thus, there were on the order of 1.8 million participants in the clinical trial. 

"It was the largest trial of its kind," Hammond said. 

The National Foundation sponsored the vaccine trials for infantile paralysis, not the government, Hammond noted. 

"It was a nationwide effort, and this was just to test it. This wasn't the vaccine already proven to be safe; this was the field trial," he said. 

"It is difficult to contemplate the kind of social solidarity that was possible in order to pull this off," Hammond said, adding that were such a trial to be suggested today, there would likely be demonstrations in the streets.

Trust in science and leaders

Hammond noted at the time of the polio vaccine there was a great degree of trust and enthusiasm in North America that science could improve people's lives. 

"This had been a disease that had been dogging North America, among other places, for decades, and I think because it was kids, I think that was another thing that made it much easier to rally behind. The effects were so devastating for the kids that did get severe cases of polio — even though many children did not.... — they were the center and people wanted to protect them," said Hammond.

Moving past Cutter

With the so-called Cutter Incident, there was one laboratory, Cutter Laboratories in California, that created a bad batch.

Salk had provided instructions for manufacturing the vaccine, but they weren't precisely step-by-step instructions, Hammond said. 

"He provided people with the basic recipe, like 'Here's how you bake this cake, but you adapt it to your kitchen,'" Hammond said.

As a result, the bad batch caused 40,000 cases of polio, leaving 200 children with varying degrees of paralysis and 10 children dead.

The Cutter incident stopped vaccine production in the U.S. in the summer of 1955. 

"One of the things that helped it ramp back up again was that Canada did not stop... producing the vaccine and distributing it," Hammond said. 

The vaccine was manufactured at Connaught Laboratories in Toronto. 

The father of former Canadian prime minister Paul Martin was health minister in 1955, and he had suffered polio, as had Paul Jr., though the younger man had a milder case. 

"Paul Martin Sr. consulted with experts at Connaught labs... and basically, in a nutshell, the biologists at Connaught were confident that their procedures were going to avoid the problems that had happened at Berkeley. Paul Martin [Sr.] was persuaded, and Canada continued on." 

There were no harmful effects, so that is one of the things that led to the resumption of vaccinations in the U.S. 

The American government stepped in more forcefully after the Cutter incident, Hammond noted. 

The Food and Drug Administration tightened its requirements for vaccine production. 

"That is why FDA approval, at least until very recent times, was considered a very high standard that had to be met," he said. 

Ferris, who still lives with the impact of not having access to the polio vaccine, is concerned about the opposition to the COVID-19 vaccines. 

"The longer people stay opposed to vaccines, think COVID-19 is hoax, or is just like the flu, the longer it will take the world to recover, and will have to endure the daily disruptions to their daily life — if you are still alive and haven't died of COVID-19," he said.

Give and take

While the Canadian government recently purchased 1.5 million doses of the Oxford-AstraZeneca vaccine from the U.S., in the late 1950s, Canada was part of a form of vaccine diplomacy that benefited the U.S. 

Connaught Laboratories exported millions of doses of polio vaccine to other countries. 

Canada also had a hand in developing the vaccine. 

Some of the chemists developed a liquid formula that was used in mass production.

Like with the COVID-19 vaccines, initially, there were shortages, but eventually, manufacturers were able to make enough, Hammond said.

Leadership factor

Former U.S. president Franklin D. Roosevelt, who had polio when he was 39 years old, founded a polio rehabilitation centre and the National Foundation for Infantile Paralysis, later called the March of Dimes, the organization ultimately responsible for the Salk vaccine.

There has since been some question if Roosevelt actually had polio, but at the time, it was thought he did.

"The U.S. dime has Roosevelt on it. That is because after he died, [they put him on there] for the March of Dimes," said Hammond.

The March of Dimes was a fundraising campaign that asked the public to give a dime to fight polio. 

It was inspired by the song, "Brother Can You Spare A Dime?"

In his time, Roosevelt was known as the most famous polio survivor, Hammond said. 

Most believed he had recovered fully, but later it was realized he had concealed that he was paralyzed from the waist down and never recovered.

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