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Story Publication logo May 11, 2015

Polio: The Salk-Sabin Rivalry


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After dozens of vaccination workers were killed in Afghanistan, polio once again began to spread...

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Pakistani children at a health care clinic offering polio vaccination in Bannu. Image by Syeda Amna Hassan. Pakistan, 2015.

Even as America thrived following World War II, there was one affliction the nation couldn't seem to shake: polio. In 1952, there were more than 57,000 cases, the worst year on record. Confronted by this epidemic, virologists sat down to discuss a game plan, but a rift quickly developed between the two leading scientists.

Raised in Jewish immigrant communities throughout New York, Jonas Salk would become one of the most cherished scientists of his generation and the widely-accepted conqueror of polio. He believed the answer lay in a "killed" vaccine, in which the virus is grown in tissue culture, neutralized by a chemical agent and injected. Albert Sabin, who as a teenager moved to New Jersey to escape the pogroms in Poland in 1920, championed the cause of the oral "live" vaccine, where the amount of virus is too small to prevent transmission but just enough to give immunity.

Sabin was a brilliant but strong-headed virologist who clashed with Salk from the beginning. Eight years his senior, Sabin was already working on polio research when Salk was finishing high school.
In his book Polio: An American Story, David M. Oshinsky describes one early encounter in 1948 at a conference discussing the best methods to map the different strains of polio virus.

When scientist Thomas Turner raised the possibility of using a different approach—one that Salk had been mulling over himself—the young researcher made the mistake of jumping in enthusiastically.
"Dr. Salk, you should know better than to ask a question like that," Sabin snapped back.

Salk later compared the experience to "being kicked in the teeth." He added: "I could feel the resistance and hostility and the disapproval," he said. "I never attended a single one of those meetings afterward without that same feeling."

Ill-blood between the two scientists lingered after that public put-down. Salk would gain recognition for inventing the first polio vaccine, but the elder Sabin would never come around to the idea of using a killed virus.

That argument would outlive the two scientists.

After a series of trials in the late 1950s, Sabin's live vaccine has seemingly won the race for supremacy in the fight against polio.

But a report released in July last year by the World Health Organization (WHO) may provide a poetic resolution to the debate between the two camps. The answer: a combination of both vaccines may be the most effective way to defeat the disease. After a series of trials in India in 2011 and 2012, researchers found that administering the injected vaccine alongside the live virus boosted immunity significantly. Now the WHO is recommending this approach throughout the remaining polio endemic countries.

In 1988, the year the Global Polio Eradication Initiative began, there were more than 350,000 new cases of polio, according to the WHO. In 2013, there were 416 cases.

The oral vaccine has proved so successful that the time has come for a reintroduction of the inactivated vaccine, leading up to what the scientific community has dubbed the "endgame." This would wipe out the last traces of the poliovirus in the few places around the world where it still remains endemic.

Roland Sutter, a WHO doctor who is the head of research for the Global Polio Eradication Initiative, says the discovery gives Salk's vaccine a new role in the developing world.

"You have always had people who feel like they need to be in one or another camp," Sutter says. "Now I think everybody is comfortable with the inactivated vaccine."

So even if the two rival scientists were never able to end their lifetime feud, their combined methods for combating polio are man's best chance for eradicating polio.

James Reddick is a graduate student at U.C. Berkeley's School of Journalism and part of the Investigative Reporting Program's team.






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