"It was too quick, said medical
colleagues nationwide: Salk had gone public without first publishing everything in the
journals. He rushed out a killed-virus serum without waiting for a safe live-virus
one, which would be better. Doctors walked out of professional meetings; some quit
the foundation that funded the testing. Salk was after personal glory, they
said. Salk was after money, they said. Salk was after big prizes.
"Salk tested the serum of five thousand Pittsburgh
schoolchildren, of whom I was three, because I kept changing elementary schools. Our
parents, like ninety-five percent of all Pittsburgh parents, signed the consent forms.
Did the other mothers then bend over the desk in relief and sob? I don't
know. But I don't suppose any of them gave much of a damn what Salk had been after.
Annie Dillard, Polio Pioneer
Patenting the Sun:
Polio and the Salk Vaccine
page 1 | page 2 | page 3 | page 4
In 1954, the decision was made to conduct a wide-scale test of the
vaccine. It was not made easily. Although Salk had had nothing but positive
results, no one knew for sure that the vaccine would provide long-term immunity.
What if the effect was temporary and people relaxed their guard? What if the fluid
in which the virus was suspended could cause allergic reaction or cancer? What
if? What if? What if? But, as Basil O'Connor pointed out, what if they
did nothing, and another 30,000 children were stricken in the coming summer?1
That spring, almost two million children in forty-four states took part
two studies of the polio vaccine. One study was an observed-control study: in 33
states, every second grader who volunteered got the vaccine and they would be compared to
unvaccinated first and third graders. Another study would be double-blind: in
counties in eleven other states, half of the first-, second-, and third-grade volunteers
would get the vaccine and the other half would get a shot of pink-coloured water.2
No one would know who got which except the data analysts at the Vaccine Evaluation
Center at the University of Michigan in Ann Arbor.
Because no one knew where polio would strike that summer, children all
over the nation had to receive the vaccine. Over 650,000 children would get either a
dose of gamma globulin containing killed virus from all three polio serotypes or an
injection of pink water. The doses would be administered three times. Another
1.2 million children would be part of the observed control group. At the end of the
summer, researchers would examine the medical records of almost two million children, and,
they hoped, the children who got the vaccine would have had a much lower incidence of
polio than the unvaccinated controls.3
The subject children were called Polio Pioneers. It might seem hard
to imagine today that parents would allow their children to be in a medical experiment,
but in fact there were more volunteers than were needed. The growing threat of polio
loomed like a spectre over the nation, and the vaccine, even an unproven vaccine, offered
Children line up to take part in the vaccine trials.
The trials cost over seven million dollars. Five and a half million
dollars of that went to buy one million doses of gamma globulin from the Department of
Defense. It was the entire nation's supply. Some people were outraged at the
cost of the trials. Basil O'Connor calculated that it would cost $7000 per case of
polio it prevented, assuming the vaccine worked. He also knew that it cost the
National Foundation $40,000 to care for a single paralyzed person for the rest of his or
her life. It seemed like a reasonable return to him. Others felt the trials
were being held too soon. They said that the people Salk had already inoculated
should be studied for fifteen to twenty years before the vaccine was tested in the general
population. O'Connor did some more calculations; at fifty thousand cases per year,
twenty thousand resulting in paralysis, that was one million victims in twenty years, with
four-hundred thousand paralyzed. That was simply too much. Salk had conducted
three trials without adverse affects. They couldn't wait.5
The trials were enormous. After it was over, the PTA, which had
provided community volunteers, estimated that 300,000 volunteers had been used. The
trial required 1.2 million needles. Two sets of blood work were performed on 40,000
children (2% of the inoculated). One hundred thousand sets of teacher instructions
were prepared for the observed group and 37,500 for the inoculated areas. Hundreds
of millions of documents, along with press releases and public statements, and even a film
designed for the six years olds who would receive the shots flowed out of the headquarters
of the National Foundation.6
The trials were not without problem. In one area, the vials got
scrambled, and some children got placebo for one shot and vaccine for another. In
another, one doctor separated the vials from the control codes that would identify the
vaccine and placebo to the evaluators. In Denver, classed as the premier field-trial
city because it had the highest participation of eligible children, the registration
papers had been filled out incorrectly. The evaluators were prepared to throw out
all of the meaningless data, but teachers gave up their summer vacations to repair the
By June of 1954, all of the shots had been given and all of the paperwork
had been submitted to the Vaccine Evaluation Center. All that remained was to sit
back and wait for the summer to pass, to count the paralyzed and the dead, and crunch the
page 1 | page 2 | page 3 | page 4
1. Seavey, Nina Gilden, Jane S. Smith, & Paul
Wagner. A Paralyzing Fear: The Triumph over Polio in America. New
York, New York: TV Books. 1998. p. 171.
2. Smith, Jane S. Patenting the Sun: Polio and the
Salk Vaccine. New York, New York: William Morrow and Company, Inc.
1990. p. 229.
3. idem. pp. 177-178.
4. idem. pp. 157-158.
5. idem. pp. 174-175.
6. idem. pp. 237-238.
7. idem. pp. 270-272.