Medical Mythmaking Splendid Solution:
Jonas Salk and the Conquest of Polio
By Jeffrey Kluger
Putnam, 2004, $25.95 Polio: An American Story
By David M. Oshinsky
Oxford University Press, 2005, $30.00 April 12 was the day, 50 years ago, that the U.S. Public Health Service licensed the killed-virus vaccine against poliomyelitis developed by Jonas Salk. In the decades since, a great myth has grown to dominate the popular imagination. Its name is “The Conquest of Polio,” and Salk is its hero.
On the anniversary day and minute, the Smithsonian Institution tolled the bell on its oldest building 50 times to open an exhibit at the National Museum of American History centered on Salk and the vaccine. That morning, the science correspondent for National Public Radio extolled the polio conquest and the Salk vaccine in the first part of a three-part series. Publications marked the occasion – the New York Times, the Washington Post, the Chicago Tribune, the Los Angeles Times, USA Today, Smithsonian magazine, and a dozen others. In the weeks before, two new books had appeared. Six more are now in the works.
This retelling of the history of polio, however, is largely a distortion. The full, true story is far more complex. Its hero is Albert Sabin – for if any one man conquered polio, it was Sabin, who developed the oral attenuated live-virus vaccine. While Salk’s vaccine did slow down the incidence of polio among middle-class Americans, its cost and its requirement of three injections and a booster meant that for years the disease continued to affect the poor and others lacking access to proper medical care. It was only after Sabin’s oral vaccine, which was cheap, effective, and easy to administer, was licensed for production in 1962 that polio could be fully controlled in the United States.
But it seems some prefer the myth to the fact. Jeffrey Kluger’s Splendid Solution: Jonas Salk and the Conquest of Polio pushes the myth to an extreme. Kluger is a senior writer at Time. In his version, the myth contains three assertions. First, Salk was a great scientist “with such a deep regard for scientific facts,” Kluger writes, “a tectonic force in scientific history.” Second, the Salk vaccine was effective and conquered polio in this country. If only it had been used for a few more years, it would have eradicated the disease. Third, the “temperamental” Albert Sabin, who was working on his own vaccine at the University of Cincinnati, sabotaged the killed-virus vaccine. Kluger implies that Sabin’s opposition had no basis in science but arose from jealousy.
In contrast, contends Kluger, Salk was controlled in his demeanor: “Stupidity always made him angry; malevolent stupidity made him angrier still. He wouldn’t show it; he never did. You couldn’t run the kind of lab he ran and conduct the kind of research he conducted and allow yourself the luxury of pique.” Kluger’s reconstruction of the history, and especially of the controversy between Salk and Sabin, depends heavily, painfully, on innuendo and inference.
These charges demand careful attention. In the first place, Salk’s research was altogether derivative. It arose from four crucial discoveries. In 1949, David Bodian, Isabel Mountain Morgan, and Howard Howe at the Poliomyelitis Laboratory at Johns Hopkins University first established that polio comes not in a single variety but in at least three. Then they showed that a preparation of killed virus could inoculate monkeys against the disease. In 1952, Dorothy Horstmann of Yale University School of Medicine and Bodian, independently, established that polio is a blood-borne disease. Also in 1952, Howe suggested that killed virus could produce good antibody responses in children.
D. A. Henderson – the man who organized the worldwide eradication of smallpox – was then at the U.S. Communicable Disease Center (now the Centers for Disease Control and Prevention) in Atlanta. In a recent interview, he told me, “So Jonas came in at this point with pretty much everything done except for moving on to wider-scale human trials.”
But by the early 1950s, Sabin and many other immunologists and epidemiologists were convinced that an oral attenuated live-virus vaccine would be more effective. Soon after Salk’s vaccine became available in the spring of 1955, many recognized that it had serious problems.