Shots, No Chaser

Michael Leddy's misreading the cookie post made me remember some of my recent ruminations about my personal vaccination history.

I had the measles while we lived on Long Island. (My mother always called them the "hard measles.") It was in early 1963, I think. That's the year a vaccine became commercially available in the U.S., nine years after the virus was identified. Daughter Number One had brought the illness home from school and all three of us younger ones caught it, of course. DN4 and I, who were ages 1 and 3 at the time, were really sick and my mom was afraid at least one of us would die, she always said. I know my mother's own family had similar scares back in the 1930s with it, too.

Daughter Number Two just recently reminded me that all four of us also had German measles (Rubella) and chicken pox the same year. My poor mother. 

A year and a half later, we moved to the small town where we all spent most of our childhoods, just before I started kindergarten in 1964. I'm not sure when I got the polio and smallpox vaccines exactly, but I remember them both, vaguely. We were given the live, oral Sabin vaccine for polio — the one that was in a sugar cube — and for smallpox, we got the shot that was done with a gun-like device that was actually several needles scratching your arm. It left that tell-tale scar of the Baby Boom generation. (DN2 has the keloid version.)

Reading through the Wikipedia history of the vaccines for these three diseases made me aware of the work (not all of it ethical) that went into developing the methods that brought them reality:

• Measles: Thomas Ender, considered the Father of Modern Vaccines, was important in developing both the measles and polio vaccines. He was awarded the Nobel Prize in Medicine in 1954, before either vaccine was in use but when they were in sight. In 1960, he and his team carried out trials of the measles vaccine on "mentally retarded" children in New York City. Trials were also carried out in Nigeria on local children by a British pediatrician named David Morley, but — importantly, it seems to me — he included his own children in the trials. In the mid-20th century, the child mortality rate from measles in West Africa was 50% before age 5. The MMR vaccine (probably familiar to many readers: it stands for measles, mumps, Rubella) has been with us since 1971, replacing the measles-only shot.
  
• Polio: Did you know that this vaccine covers three different serotypes of polio? Or that a Canadian woman biochemist and microbiologist named Leone Farrell (and her team) were essential in developing the process to create enough live virus to kill and therefore make the vaccines for distribution? The initial large trial of Jonas Salk's injectable, innactivated virus vaccine was 60% to 94% effective against the various types of polio vs. the control group. (One of its first tests was on kids in a home for "crippled children.") In 1955, after the Salk vaccine was licensed and children's vaccination campaigns launched in the U.S., the annual number of cases dropped dramatically: from 35,000 in 1953 before the vaccine to 5,600 by 1957. Four years later, there were only 161 cases. However, there's also a major cautionary tale in this history: one company that produced the vaccine, Cutter Laboratories, was not properly inactivating the virus and their vaccines directly caused polio in 40,000 people (and killed 10 people). This case serves as a warning to this day to all public health professionals about rushing vaccines.
  
• Smallpox: There's an extensive history of this disease and its vaccines (pox parties, anyone?) and I don't want to talk about Edward Jenner or cows because that's pretty well known. A couple of things I thought were notable were that a Black doctor named Louis Wright introduced intradermal vaccination in the U.S. army during World War I (while most vaccination before that was done through arm-to-arm transfer). And also that getting a vaccine that could be transported without refrigeration was an issue for decades until an English microbiologist named Leslie Collier developed a way to produce a heat-stable, freeze-dried powdered vaccine. This powder was still effective after reconstituting when stored up to 99 °F, which meant it could be used in tropical areas. Her method became the standard for the WHO's global Smallpox Eradication Unit in 1967.
  

I'm glad the ethics of the processes for testing vaccines have been improved. I note that most of the time you can't find the information on these ethical problems on the initial Wikipedia page: you only see them if you click through to read the specific page about the researcher. 

It makes me wonder how much else I missed, or what is not even there to be found.