John Enders, Jonas Salk, and the eradication of polio

Perhaps you've heard the claims: Were it not for Jewish genius, we would find ourselves in a world still afflicted by polio epidemics (continue reading).

A comment at feministx features an excerpt from the Wikipedia page of John Enders:

In 1954, while working at Children's Hospital Boston, Enders, Thomas Huckle Weller, and Frederick Chapman Robbins were awarded the Nobel Prize in Physiology or Medicine "for their discovery of the ability of poliomyelitis viruses to grow in cultures of various types of tissue". This work was the first to show that viruses of this type could be grown and manipulated outside of the body.[1] It was this technique dubbed the Enders-Weller-Robbins method that Jonas Salk used to develop the polio vaccine in 1952. After a large-scale test of the vaccine proved successful in 1954, Salk appeared on a radio show and announced his success to the world.[2] Although he never claimed the credit for himself, he also did not offer up any credit to any of his colleagues, including Enders, Weller, and Robbins, whose technique made his success possible. Salk became a hero to the public, but was somewhat shunned by the scientific community.[3] Despite this misappropriated credit many professionals in the field still regard Enders', Weller's and Robbins' work as substantial have given Enders the title of "The Father of Modern Vaccines".

As it turns out, in addition to overseeing the work for which he and his colleagues were awarded a Nobel Prize, Enders directly laid the groundwork for both killed virus and attenuated live polio vaccines with his work on mumps:

It was the best of vaccines, it was the worst of vaccines. The vaccine eradicated polio in the U.S., but everything that could go wrong in a vaccine did go wrong. The polio vaccine story emerges from a tangle of ignorance, great science, medical practice, politics, luck, and intensely personal rivalries and jealousy. And, of course, money and power.

The bare story can be quickly told. In 1955, Jonas Salk's killed virus vaccine was licensed. It was highly effective, the number of polio cases decreased phenomenally. But multiple injections were required; these were expensive and inconvenient and resisted by portions of the population. Furthermore, some individuals did not respond to the vaccine.

Just four years later, in 1959, Sabin's live, oral polio vaccine was also approved. It largely replaced the Salk vaccine because it induced lifelong immunity, was easily administered by mouth on a sugar cube, and had the advantage of spreading to unimmunized contacts so that they too were "vaccinated."

But it was later discovered that the oral vaccine actually caused polio in a very small number of cases. That resulted in a title back to Salk's vaccine amid much and angry dispute about the relative merits of the two vaccines.

From 1966 to 1969 the official recommendation was to give both vaccines--first the Salk vaccine, then boosters with the oral vaccine. Ultimately the oral vaccine was abandoned; the killed vaccine is the only one available in the U.S.


Let us go back to the beginning and look at this in more detail. The story starts with Dr. Invar Wickman, who carefully observed a polio epidemic at the Stockholm Pediatric Clinic in 1905. He confirmed the long-held suspicion that polio is contagious. Even more important, he recognized for the first time that in many instances polio was a mild intestinal infection that did not cause paralysis but could be nonetheless transmitted to others. [. . .]

Just one year after Wickman published his paper, Karl Landsteiner, and Austrian scientist, made another leap forward. [. . .] Landsteiner and his colleagues also found that whatever was being transferred was much smaller than bacteria and in fact was invisible in the microscopes of the day. [. . .]

In 1936 there was an ultimately lethal competition between two would-be vaccine inventors, Maurice Brodie at NYU and John Kollmer at Temple University. Brodie concocted a "vaccine" from an emulsion of ground-up spinal cords of infected monkeys. He attempted to deactivate the virus by exposing the vaccine to formaldehyde, phenol, and polio antiserum. He tried the vaccine on twenty monkeys, and with that woefully inadequate experimental base conducted a human trial with three thousand children. The vaccine was of little or no value and was associated with severe side effects. His research career was destroyed, and he later killed himself.

Even worse was Kollmer's vaccine. He attempted to attenuate polio virus obtained from monkey spinal cords. He created a stew of spinal cord tissue and various chemicals and refrigerated the mixture for two weeks. He used it on a few monkeys, himself, his children, and twenty-two others. Hew as so convinced of the value of his vaccine that the distributed thousands of doses to physicians around the country. This vaccine caused many cases of polio, some fatal. It probably had no value as a vaccine. At a medical society meeting in 1935 he said, "I wish the floor would open up and swallow me."

What both these disasters did accomplish was to delay the development of a safe and effective vaccine. But the door was reopened by John Enders, a fighter pilot, realtor, language scholar, and ultimately virologist. In 1941, working on the mumps virus, the demonstrated two things. A killed virus could immunize an animal, and it was possible to attenuate the virus so that it was not virulent but could still elicit an immune response. The application of these two principles to the polio virus is the basis of the polio vaccines. Enders also accomplished what no one else had: He learned how to grow the polio virus in the lab. [. . .] He made it possible to grow large quantities of virus in the lab, thus solving the monkey problem.

For these accomplishments, he along with his youthful associates Frederick Robins and Thomas Weller received a Nobel Prize. Enders's Nobel lecture is a study in modesty and clarity; he respected and acknowledged the work of his peers, including Salk and Sabin, both of whom stood on Enders's shoulders. Now all the pieces were in place. The frantic race to produce a vaccine was on again.

Salk won. He won the race, thanks in part to Basil O'Connor. Salk met O'Connor while returning from the 1950 Second International Poliomyelitis Conference in Copenhagen. Salk and O'Connor, the multimillionaire law partner of FDR and director of the March of Dimes, became close friends. O'Connor provided Salk with massive financial aid and, when necessary, political support. [. . .]

Salk was ready for large clinical trials, but the idea was opposed by much of the scientific community, including Albert Sabin, who was working on a live vaccine. He testified that the Salk vaccine, known also IPV (inactivated polio virus), was dangerous and should not be used. [. . .]

The feud between the two grew bitter. Sabin, who was generally recognized as the superior scientist, called Salk a "kitchen chemist who never had an original idea in his life." But Salk had on his side the March of Dimes, the press, and intense public pressure to field a vaccine as soon as possible. The decision was made to proceed with IPV.

The director of the trial was Dr. Thomas Francis Jr. of the University of Michigan School of Public Health. The trial, the largest of its kind ever to be conducted, included 1,829, 916 children. The results were unequivocal. The vaccine was safe and effective. Efficacy was better than 70 percent, enough to prevent epidemics.

On April 12, 1955, the success was announced at a press conference. The celebrations that followed rivaled those at the end of World War II. Salk, the son of Orthodox Jewish Russian immigrants, was a hero, if not actually a savior. The many scientists in the field were not happy to learn of the trial results from the newspaper instead of professional medical journals. Salk's failure to acknowledge the work of so many others further increased a growing resentment. Enders noted that scientists always build on the work of others even though "the one who places the last stone and steps across the terra firma of accomplished discovery gets all the credit."

[Kurt Link. The vaccine controversy: the history, use, and safety of vaccinations. Greenwood Publishing Group, 2005.]

Without question, Jews are and were overrepresented in medical research; but I see no evidence in this story that Jewish talent was essential or irreplaceable. One can try to argue the presence of Jewish researchers sped up vaccine research, but even this much is unclear.

There was no real reason for John Enders to keep poliovirus in his freezer. He certainly didn't plan to do any work with it and might not even have remembered that he had it at all. One day, however, someone reminded him it was there. When that happened, Enders changed the world. [. . .]

Poliovirus, as everyone knew, not only couldn't grow outside the body, it couldn't even grow outside of nerve tissue within the body. Polio cultivated in the laboratory could grow only in tissue taken from the spines of monkeys, humans, and occasionally rats. In 1935, no less a pair of researchers than Peter Olitsky and Albert Sabin of Rockefeller University had proven this point. [. . .] Sabin and Olitsky's conclusion [. . .] became on of the unshakable bits of polio dictum.

[Jeffrey Kluger. Splendid solution: Jonas Salk and the conquest of polio. Penguin Group, 2006.]

The University of Pittsburgh team that produced the IPV vaccine include many researchers besides Salk:

The announcement of the coming trials had fired up the already overheated newspapermen, who continued to publish equally overheated reports on the progress of what they now universally referred to as the "Salk vaccine." The growing use of that label did not please either the NFIP or Salk. [. . .]

"Polio Fighter Salk," the legend under the picture read. "Is this the year?"

Salk was horrified. As of this moment, his vaccine research had accomplished exactly nothing beyond burning through nearly $3 million of the NFIP's money and possibly protecting a flyspeck population of early volunteers. If there must be covers, save them for later, for the time the magazines could actually declare This is the year, tossing their cautionary question makr aside.

Salk bought a copy of the magazine, carried it to his office, and opened it with dread. The story, he found, was a different beast entirely.

No matter how objectionable some of Gil Cant's questions might have been, he had placed Salk's work in precisely the right perspective. The text was shot through with the names of the polio researchers who had gone before as well as the other men directing the research today. There were pictures of John Enders, Tommy Francis, Basil O'Connor, and even Albert Sabin. Enders's work particularly was featured, described as nothing short of virology's equivalent of the relativeity equation--which was no exaggeration. If you saw nothing but the cover of Time magazine on the newsstand, you would have thought Jonas Salk a solitary visionary doing battle with polio entirely on his own. If you took the time to read the story, you saw him for who he was--the point man, perhaps, in a larger war, but just one soldier nonetheless. [. . .]

Somewhere in the middle of the auditorium, the small delegation from the Pittsburgh Virus Lab sat shocked and silent. There had been not a word, not a nod of acknowledgment from the man with whom they'd worked so hard for so many years. Each time in his speech that Salk seemed ready to recognize his team--"There is a group," he'd say, "that gave so much more than they received, that I cannot find analogies to say what I mean"--they'd sit forward expectantly, only to slump back when he directed his thanks toward someone else. He'd found room in his remarks to acknowledge strangers; he'd found room to acknowledge a corporation; he'd found room for 1.8 million boys and girls whose names he didn't know. But he hadn't found room for eleven other people with whom he'd worked and lived as if in a crucible for nearly eight years.

In the back of the hall, John Troan narrowed his eyes in confusion and made himself a note to ask Salk what he was thinking. Salk hadn't thanked John Enders, Fred Robbins, and Thomas Weller either, but that was a minor oversight. Their work had been widely recognizes--and widely celebrated--in the polio community for years, and their contribution to the success of the day went without saying. The names of the people in the virus lab were nowhere near such a given.

[Jeffrey Kluger. Splendid solution: Jonas Salk and the conquest of polio. Penguin Group, 2006.]

Here is the 1954 Time magazine article mentioned above:

Behind Salk, in turn, are 81 million of the 3 billion dimes that the US public has given to the National Foundation for Infantile Paralysis. [. . .]

Tireless work by such researchers as Dr. William McD. Hammon of gamma globulin fame (TIME, Nov. 3, 1952) and Yale's Dr. John R. Paul shows that polio is a worldwide, natural infection of man and at least as old as civilization. And the first and greatest paradox is that the more widespread the infection, the less disease there is.

Infantile paralysis was noted as uncommon but regular and widespread (and therefore endemic) by Britain's Dr. Michael Underwood in 1784. Sweden had the first reported epidemic of polio in 1887. Seven years later came the first U.S. epidemic, in Vermont's Otter Creek Valley. Around Rutland and Proctor there was no fewer than 119 paralytic cases. By brilliant horse & buggy epidemiology, Dr. Charles S. Caverly concluded that the old endemic infantile paralysis and the new epidemic polio were one and the same disease. [. . .]

The Great Breakthrough. Five years ago came the great breakthrough in the campaign to conquer polio. There had already been ill-starred attempts to make a vaccine, but in everything that they tried to do the researchers were hampered by one stubborn fact: most kinds of polio virus, it seemed, could be grown only in nerve tissues of living men or monkeys. And a vaccine prepared from such material would hold the frightful danger of causing an allergic inflammation of the brain, a malady even worse than the one it was designed to prevent.

A team of Harvard researchers headed by the brilliant virologist, John F. Enders, reported in Science in January 1949 that they had succeeded in growing polio viruses in tissue cultures of non-nervous tissues. From the obscure technical lan guage they used, only another virologist could have divined the explosive import of their work. In fact, Enders' discovery was to a polio vaccine (and to much other health-saving virus research) what Einstein's cryptic E = mc2 was to the atom bomb.

And here's a 1999 article from Time:

Fortunately, Salk had somehow found time to do basic research on the virus and write a few theoretical papers, and it was these that caught the eye of Basil O'Connor, the zealous head of the Infantile Paralysis Foundation, who decided to play a hunch and shove some dimes in Salk's direction with instructions to get going.

With that, the seeds of resentment, deep and abiding, were sown. By then, dozens of worthy researchers had been toiling far longer than Salk in the fields of polio and would have given their microscopes for such funding and freedom. Who was this hired gun who appeared from nowhere with a bankroll the size of a special prosecutor's, plus free use of all the backbreaking work that had gone before?

In fact, the key piece of research, available to all, was completed a few years earlier by the one undisputed hero of this story, Harvard's John Enders. It was his team that figured out how to grow polio in test tubes--suddenly giving vaccine hunters everywhere enough virus to work with.

Now the goal was truly in sight, and who got there first was largely a matter of speed--Salk's forte--and luck. "Salk was strictly a kitchen chemist," Sabin used to gripe. "He never had an original idea in his life." [. . .]

Within the brotherhood of researchers, however, Salk had sinned unforgivably by not saluting either Enders or, more seriously, his colleagues at the Pittsburgh lab. Everything he did after that was taken as showboating--when he opened the Salk Institute, a superlab in La Jolla, Calif., for the world's scientists to retreat to and bask in, and even when not long before his death in 1995, he started a search for an AIDS vaccine, to a flourish of trumpets and welcome new funding.

Just as some politicians are at their best when running for office, so Salk came into his own as a spokesman for vaccination. Although it is generally accepted in the field that the real man on the monument should be Enders (who in 1954 shared the only Nobel Prize given for polio research), it seems unlikely that either he or the pugnacious Sabin would have performed half so patiently as Salk the ceremonial chores expected of monuments or would have sat so politely through so many interviews and spread the gospel of disease prevention quite so far and wide and indefatigably.

John Enders' surname comes from a New York-born grandfather of German and Dutch descent, but most of the rest of Enders' ancestry appears to trace back to early New England. Robbins' ancestry seems to be half-Pennsylvania and half-New England. Two of Weller's grandparents were born in England; I found little on his American ancestry (though I would not be surprised if he has some New England ancestry).