NOTE: This Message was originally addressed to Tom Mckeever
      from Bh265@freenet.toronto.on.ca and was forwarded to you by Tom 
Mckeever
                           --------------------
Date:         Sun, 9 Apr 1995 22:04:16 -0400
From:         Chris Rutty 
Subject:      Re: POLIO Digest - 7 Apr 1995 to 8 Apr 1995
To:           Multiple recipients of list POLIO 
Dear LFox:
I'm afraid you have some of your facts confused.  During the early 1950s
it was Salk's ideas that were seen as radical by viologists and
immunologists.  The idea of an inactivated vaccine had only been tried
before with the influenza vaccine, which was Salk's earlier work. By
1951-52 when it was clear the poliovirus was present in the bloodstream in
the early stages of the disease, and that the poliovirus could be easily
grown in non-nervous tissue cultures, Salk and others were confident that
an injected inactivated vaccine could work on humans.  It was here that
Connaught supplied the necessary synthetic medium which Salk was able to
use to make the first inactivated polio vaccine for human use in late
1952.  These developments, and Connaught's development of methods to grow
the poliovirus in bulk, was what gave the NFIP/ March of Dimes the
confidence to go ahead with the 1954 field trial.
At this time Sabin was nowhere near ready with a live vaccine.  He and a
few others had been working on cultivating a few possible strains, but
were not ready for any field trials until well after the Salk vaccine had
been licensed in 1955.  The first Sabin, and other live vaccine trials
did not begin until 1958-59, and not in a standardized manner on a
broad scale until 1960-61. The first mass Russian trial occured in 1959.
By June 1960 Sabin's vaccine had been given to over 50 million in the
USSR, China, Czechlosovakia, and in Europe, the U.S., Mexico, Africa and
the UK.  Rival vaccines developed by Koprowski, as well as Cox at Lederle
Labs were also used widely by 1960:  7 million received Koprowski's in
Africa, Poland and the US, while 2 million were given the Cox-Lederle
type in Latin America, Europe and the US.  Connaught began working with
Sabin's strains in 1959 and were the first to license a trivalent live
polio vaccine in March 1962.
There has never been a problem with the bloodstream immunity generated by
the Salk vaccine.  You are right about the Cutter vaccine problem where a
number of incompletely inactivated batches of Salk vaccine were
released.  All Salk vaccine produced for the 1955 polio season by US
manufacturers was not double tested by the US government and Cutter was
quite inexperienced with making the vaccine, especially under the
pressures placed on it from the NFIP and the public to have the vaccine
ready immediately upon licensing.
The Salk vaccine is by no mean forgotten today.  It is used almost
exclusively in Ontario and some other Canadian provinces, as well as in
parts of Europe.  Connaught, until recently has been the sole producer of
it in the world.  Indeed, in order to carry out the World Health
Organization's international polio eradication program both types of
vaccine are necessary as the Sabin vaccine had its limits in terms of
safety, shelf life, and is ineffective in immunosuppressant people.  The
Salk vaccine is more expensive, but its safety record is unblemished and
is effective for all.  In recent years its potency has been improved
considerably and its price reduced through the use of continuous cell line
virus cultivation.  Another important advantage of the Salk vaccine is
that it can be easily combined with other antigens, such as diphtheria
toxoid, pertussis vaccine, tetanus vaccine, and a few others, thus
minimizing administration costs and increasing its use.
I don't doubt your experience with polio, but I'm afraid some of your
facts have become confused over the years.  I have been studying the
history of polio for some time now, and have been immersed in the primary
medical, government and scientific literature to an extensive degree.  My
chronology is very well documented.  If you would like some precise
references, I'd be happy to furnish them.
Thank you for your response to my short paper and for your comments.
On Sun, 9 Apr 1995 LFox@AOL.COM wrote:
> I don't know if this is the correct way to respond to a Polio Digest. I
> wanted to comment on the dissertation by Mr. Rutty on the polio vaccine in
> Canada. There are elements which fall into conventional wisdom that I don't
> believe are correct. There was a lot of concern in the 50's over the 
adical
> ideas put forth by Sabin for a live, attenuated vaccine. Salk had developed 
a
> "killed" vaccine and the politics of the day won out. A frequently quoted
> comment was that the Sabin approach was untried. In fact, over 6 million
> Russian children had already been immunized with it by the time that the 
U.S.
> trials started. The then shoddy manufacturing procedures of Cutter (it was
> subsequently purchased by the German company Bayer and operated under the
> Miles name until last week, during which it had to clean up its act) led to
> virus not being killed and infection of American children with some deaths.
> However, anyone familiar with immunology is aware that exposure to "dead"
> viruses leads to limited immunity. An attenuated virus such as advocated by
> Sabin (one has to remember that Sabin was an abrasive personality, not 
smooth
> like Salk) infects a region of the intestine know as the "patch" and thus
> affords ongoing challenge to the body's immune system. In fact, today, the
> Salk vaccine is basically forgotten and almost all immunization occurs via
> the Sabin vaccine.
>
> I probably have tried to cram too much into too small a space, but I wanted
> to share some of these observations (I have been a practicing Ph.D. 
biologist
> for over 30 years and a survivor of paralytic polio in the 40's).
>
Christopher J. Rutty
Department of History, University of Toronto
Toronto Freenet: bh265@torfree.net
U. of T.: crutty@epas.utoronto.ca
289 Guelph Line, Burlington, Ont., L7R-3L1
(905) 639-3603
 * WCE 2.01á4/2037 * I shook my family tree and a bunch of nuts fell out.
--- WILDMAIL!/WC v4.11 
1:374/22.0)
---------------