Philip Roth’s lovely, short novel “Nemesis,” set in “equatorial Newark,” in wartime, is probably the best portrait of the dread that enveloped American communities confronting polio, an illness that had no cure—a time, as Roth wrote, when parents were urged to call a doctor if their children showed any signs of “headache, sore throat, nausea, stiff neck, joint pain, or fever.” Panic came naturally. And, although polio tended to strike children, Roth’s generation knew that no one was immune. When Franklin D. Roosevelt suffered partial paralysis, in 1921, he was thirty-nine.
Dwight D. Eisenhower was in the White House in April, 1955, when Jonas E. Salk’s new polio vaccine was pronounced safe, effective, and potent. Eisenhower never doubted it; he never said, “I’m not a scientist, and so …” Rather, he was someone who talked with scientists, understood what they were saying, and supported those who wanted to bring sense and order to a nationwide inoculation program that was greeted with enormous relief, but also, quite naturally, some apprehension. At a press conference that month (Ike met with the press almost every week), he was asked what role the federal government should play.
“I believe very greatly in the power that can be developed by the humanitarian agencies of this country when they work together in coöperation,” the President replied. “And if they have the direction which is to be given them through the Advisory Committee set up in [the Department of Health, Education, and Welfare], I believe that we will get the most rapid possible distribution of this vaccine.”
Sixty years ago, the idea that the federal government might launch a giant program to vaccinate millions of people—for their own protection, and not least to protect others from infection—seemed the height of rationality, an understanding that the best medicine is preventive medicine. This view prevailed despite a truly ghastly mistake in the early days of the program, during the Salk vaccine’s first trial, with 1.8 million children. Licenses to produce the vaccine had been granted with great speed to five pharmaceutical firms, but one of them, Cutter Laboratories, of Berkeley, California, had been careless. Cutter produced a vaccine that contained live polio virus, an error that directly led to five deaths and fifty-one cases of permanent paralysis, and that in turn led to a small epidemic: the Cutter group’s infection spread to friends and neighbors; five more died and more than a hundred family members or neighbors were paralyzed. Recounting this in the New England Journal of Medicine, in 2005, Dr. Paul A. Offit, who later wrote a book about the Cutter incident and its aftermath, described how, despite what he rightly called “one of the worst pharmaceutical disasters in U.S. history,” the program continued, first with the Salk vaccine and then with an effective oral vaccine developed by a medical rival, Albert Sabin.
But there was very little posturing from the Democratic Congress about the Cutter incident. A House of Representatives committee said that it would look into the Administration’s handling of the program and safety; there were calls for Oveta Culp Hobby, the H.E.W. secretary, to resign. Eisenhower, whose temperament was the opposite of panicky, held a press conference in early May and said that he expected to see a report “covering every single detail, factual and planning detail, of the whole matter. As quickly as I get it, I will make it available to the public.” But the program was in no danger of stopping, and money wasn’t going to get in the way. “I want to emphasize again that the matter of inability to pay is never going to have the slightest thing to do with this, and that it is going to be distributed equitably to every state in the union,” the President said.
Still, no one could guarantee that the vaccine was absolutely safe; Offit pointed out that the licensing procedure took just two and a half hours. (The process today is, needless to say, far more extensive.) But if anyone doubted what Salk and Sabin and all who came before them had achieved, the statistics were persuasive: the number of polio cases dropped from thirty-eight thousand, in 1954, to twenty-nine thousand, in 1955—and, a year later, to fifteen thousand. Since then, polio has pretty much been wiped out in the United States and most of the world. So have what were once fairly common “childhood diseases”—measles, mumps, and rubella, among others. Or so it was thought.
Measles and the rest, although they can cause death and misery, never did the damage that polio did, which may be why it’s so easy for some public figures to dilate so irresponsibly on the subject. Chris Christie, the governor of New Jersey and world traveller, visited a vaccine laboratory in Cambridge, England, the other day and said that there should be some “some measure of choice” as to whether shots for measles and other diseases should be mandatory—in other words, let your infectious children roam at will. Rand Paul, the Kentucky senator and a doctor, went on a couple of television programs and said that most vaccines should be voluntary, to help avoid the risk of “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.”
Christie and Paul, perhaps because they want to be taken seriously as Presidential candidates, are already backing off, if only a little. (Paul said that he was not asserting causality, just a “temporal association.”) They may have realized that they were sounding a bit like the former Minnesota Representative Michele Bachmann, who, after a 2012 Republican debate, expressed her view of the HPV vaccine, which offers protection against cervical cancer, when she said, “There’s a woman who came up crying to me. … She said her daughter was given that vaccine. She told me her daughter suffered mental retardation as a result. There are very dangerous consequences.” This view remains dangerously persistent.
It was, therefore, something of a relief to hear a party leader like the Senate Majority Leader, Mitch McConnell, emphatically reject any sort of Bachmannism. As a two-year-old, in the nineteen-forties, McConnell had polio, and was unable to walk until he was five. As he grew older, he saw the disease disappear. “As a victim of polio myself, I’m a big fan of vaccinations, and if I were a parent who had a child … being subject to getting any particular disease, I would come down on the side of vaccinations,” he said. There, that wasn’t so hard! Like any injection, even an injection of reality, it will just hurt for a second.
