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How was the polio vaccine developed? · Daniel and Kelly’s Extraordinary Universe

• 0:03
  Speaker 1: Daniel Here. Before we jump into today's episode, I want
• 0:06
  Speaker 1: to remind you of my new book Do Aliens Speak Physics?
• 0:08
  Speaker 1: Comes out very soon. It's all about what it might
• 0:11
  Speaker 1: be like to try to talk to aliens about physics.
• 0:14
  Speaker 1: Sean Carroll said the book quote is lighthearted and fun,
• 0:16
  Speaker 1: but also shows a way to think truly deeply about
• 0:19
  Speaker 1: what physics is and how we come to learn about it.
• 0:22
  Speaker 1: So go check out the book at www dot Aliensspeakphysics
• 0:26
  Speaker 1: dot com. Okay, on to the show.
• 0:32
  Speaker 2: Quick disclaimer here this episode is about polio and touches
• 0:36
  Speaker 2: on issues related to death and suicide. In a past episode,
• 0:48
  Speaker 2: we talked about what I consider to be one of
• 0:51
  Speaker 2: humanity's most incredible achievements, the eradication of smallpox. Let's keep
• 0:56
  Speaker 2: the good vibes going and talk about another massive win
• 0:59
  Speaker 2: for hu hmanity. How science eradicated wild polio in the
• 1:03
  Speaker 2: United States and many other nations around the world towards
• 1:07
  Speaker 2: the middle of the twentieth century. For reasons we don't
• 1:11
  Speaker 2: totally understand, cases of severe polio in the United States
• 1:15
  Speaker 2: started to rise. In nineteen forty eight, over twenty seven
• 1:18
  Speaker 2: thousand kids got polio, which was three times more than
• 1:21
  Speaker 2: the prior year. In nineteen forty nine, there were forty
• 1:25
  Speaker 2: two thousand cases, and by nineteen fifty two there were
• 1:28
  Speaker 2: fifty seven thousand cases, which included twenty one thousand cases
• 1:32
  Speaker 2: of paralysis and three thousand deaths. Initially, poliosymptoms are pretty
• 1:37
  Speaker 2: similar to cold symptoms, so for thousands of parents, every
• 1:41
  Speaker 2: time their child came down with cold like symptoms, they
• 1:44
  Speaker 2: had to wonder is this polio? But today no parent
• 1:49
  Speaker 2: in the United States goes to bed wondering if cold
• 1:52
  Speaker 2: like symptoms are actually polio. Two polio vaccines developed in
• 1:56
  Speaker 2: the United States paved the way to eradicating wild polio
• 2:00
  Speaker 2: from most of the world. Today, we're going to talk
• 2:02
  Speaker 2: about the development of these amazing vaccines. We'll also talk
• 2:06
  Speaker 2: about how polio vaccine testing played a role in the
• 2:09
  Speaker 2: current high standards we set for things like informed consent
• 2:13
  Speaker 2: vaccine trials and industry standards for vaccine manufacturing and testing.
• 2:18
  Speaker 2: And now feels like a great time to remind everyone
• 2:21
  Speaker 2: to get their yearly flu vaccine. If you have questions
• 2:24
  Speaker 2: about vaccines, please ask your doctor. Welcome to Daniel and
• 2:28
  Speaker 2: Kelly's Extraordinary Universe.
• 2:43
  Speaker 1: Hi, I'm Daniel, I'm a particle physicist, and I'm very
• 2:46
  Speaker 1: grateful to biologists and to doctors.
• 2:48
  Speaker 2: Hello, I'm Kelly Wiener Smith. I study parasites and space,
• 2:51
  Speaker 2: and I am so excited that I knew pretty much
• 2:54
  Speaker 2: nothing about polio because I haven't had to worry about it.
• 2:57
  Speaker 1: Yeah, exactly, blissful ignores beautiful thing. So, Kelly, my question
• 3:02
  Speaker 1: for you today has to do with vaccines, and my
• 3:05
  Speaker 1: question is are you afraid of shots or can you
• 3:08
  Speaker 1: take like a big honkin needle in the arm without flinching.
• 3:11
  Speaker 2: So when I am going to answer your question, just
• 3:14
  Speaker 2: it's going to be a tortuous path to get there.
• 3:16
  Speaker 1: Are we going to start with fish guts?
• 3:18
  Speaker 2: No, we're going to start with organic chemistry.
• 3:20
  Speaker 1: Okay, that's the other place Kelly's stories start.
• 3:22
  Speaker 2: Yeah, I'd say it's way worse than fish guts, But
• 3:27
  Speaker 2: give me a dump truck full of fish guts before
• 3:29
  Speaker 2: an OKEM class any day.
• 3:30
  Speaker 1: But wow, that's fire, all right. So you're in OAKM.
• 3:34
  Speaker 2: So I'm in OKAM. I took it over the summer,
• 3:36
  Speaker 2: and I was taking it with my friends. We were
• 3:38
  Speaker 2: the Benzene Ring. There were six of us, the six
• 3:40
  Speaker 2: Garbons and a Benzene ring. And at the end of
• 3:42
  Speaker 2: each week there'd be an exam and we would stay
• 3:45
  Speaker 2: up all night staying for the exam. But every exam
• 3:47
  Speaker 2: that I passed, I would reward myself by getting a piercing. Oh,
• 3:51
  Speaker 2: and I was pretty well pierced by the end of
• 3:55
  Speaker 2: that summer. And so the lesson I'm trying to convey here,
• 3:59
  Speaker 2: or the point I'm trying to convey here, is I'm
• 4:01
  Speaker 2: not super worried about needles, and so I can handle shots.
• 4:05
  Speaker 2: It's not a big deal. In my opinion. I've had
• 4:07
  Speaker 2: bigger needles passed through my face, so it's not so bad.
• 4:13
  Speaker 2: What about you?
• 4:13
  Speaker 1: Will you anticipate in my next question, because I was
• 4:16
  Speaker 1: going to say, you don't look like you have a
• 4:17
  Speaker 1: lot of piercings, and so is that just a phase
• 4:19
  Speaker 1: and you let them close or are they piercings of
• 4:22
  Speaker 1: a less visible nature?
• 4:23
  Speaker 2: I let them close. I think at some point I
• 4:25
  Speaker 2: was trying to get a job where I thought they
• 4:27
  Speaker 2: wouldn't be appreciated, and some of them were just kind
• 4:30
  Speaker 2: of like you know. I decided I didn't actually look
• 4:32
  Speaker 2: as good with the nose ring as I thought. And
• 4:34
  Speaker 2: then I had the tragus, which is like the spot
• 4:37
  Speaker 2: right underneath your lip. Oh man, the metal back kept
• 4:39
  Speaker 2: rubbing my teeth and I was like, oh, I don't
• 4:41
  Speaker 2: like that feeling. But you know, I kept my eyebrow
• 4:44
  Speaker 2: ring for a while, but mostly it was a lot
• 4:45
  Speaker 2: of piercings in my ear. But my ear is weird.
• 4:48
  Speaker 2: This is way more information than anyone needs. My ear
• 4:50
  Speaker 2: is weird and would grow around my piercings.
• 4:52
  Speaker 1: Oh my gosh.
• 4:53
  Speaker 2: And so that was that was like less attractive and
• 4:56
  Speaker 2: hard to get them out at some point. So I
• 4:57
  Speaker 2: was like, all right, maybe this phase of my life
• 4:59
  Speaker 2: is done, but it might come back. Who knows.
• 5:02
  Speaker 1: Well, I'm not afraid of shots. It's just not a
• 5:04
  Speaker 1: big deal to me. I mean, obviously they hurt, but
• 5:06
  Speaker 1: I don't flinch or whatever. But my daughter is terrified
• 5:09
  Speaker 1: of shots. I mean, she understands the concept obviously, and
• 5:12
  Speaker 1: she's into it, but she like sometimes faints when she
• 5:15
  Speaker 1: gets a shot. But she's also really interested in piercing,
• 5:19
  Speaker 1: and so I've been with her multiple times when she
• 5:24
  Speaker 1: has passed out after getting a piercing.
• 5:25
  Speaker 2: Oh wow.
• 5:26
  Speaker 1: And so just you know something you have to know,
• 5:28
  Speaker 1: make sure she's sitting down.
• 5:30
  Speaker 2: Yeah, I think the weirdest piercing I ever got was
• 5:35
  Speaker 2: the eyebrow piercing, because they like pinch your eyebrow. And
• 5:37
  Speaker 2: then this this person went up from the bottom up
• 5:40
  Speaker 2: with the needle before they put the ring in, so
• 5:42
  Speaker 2: you could see the like needle like going up and
• 5:45
  Speaker 2: you could like see it was right in front of
• 5:46
  Speaker 2: your eye, and I was like, Oh, that's that's maybe
• 5:49
  Speaker 2: a little disconcerting.
• 5:52
  Speaker 1: All right, Well, we're not here to talk about Kelly
• 5:54
  Speaker 1: punching holes in her body. We're here to talk about
• 5:57
  Speaker 1: saving lives with vaccines. Kelly, tell us why you decided
• 6:01
  Speaker 1: to talk about the polio vaccine.
• 6:03
  Speaker 2: So I'm kind of interested in stories about people who
• 6:06
  Speaker 2: infect themselves with parasites on purpose. This is just sort
• 6:09
  Speaker 2: of like a weird thing that I'm interested in learning about.
• 6:12
  Speaker 2: And I had heard that everyone who made a polio
• 6:15
  Speaker 2: vaccine tested it on themselves first, and so I bought
• 6:18
  Speaker 2: an audiobook Polio, An American Story by David Oshinski, and
• 6:23
  Speaker 2: the story about the development of the vaccine was so fascinating.
• 6:27
  Speaker 2: I was like, you know what, I'm going to read
• 6:28
  Speaker 2: this book again. I'm going to take forty four pages
• 6:30
  Speaker 2: of notes, and I'm going to share the highlights with
• 6:32
  Speaker 2: the dKu audience, and just to make sure that I
• 6:35
  Speaker 2: was getting the story right. I also read Splendid Solution
• 6:38
  Speaker 2: Jonas Sock in The Quest of Polio by Jeffrey Krueger,
• 6:41
  Speaker 2: So both great stories about how polio was developed.
• 6:44
  Speaker 1: I love reading stories about how science happens or how
• 6:47
  Speaker 1: progress is made, because it's hard for us to put
• 6:50
  Speaker 1: ourselves in the minds of people who didn't understand the
• 6:53
  Speaker 1: early universe, or didn't have a solution, or didn't know
• 6:56
  Speaker 1: if there was a solution to vaccinations for polio, and
• 7:00
  Speaker 1: I think it's so important to bring us back to
• 7:02
  Speaker 1: those moments and understand what they were fighting against the
• 7:05
  Speaker 1: challenges there. Remember when Sean Carroll was on the podcast
• 7:07
  Speaker 1: and he said it's so important to read the original
• 7:10
  Speaker 1: papers because they didn't know the answers and you can
• 7:13
  Speaker 1: see them trying to work it out. And I think
• 7:15
  Speaker 1: that process is so important to illuminate and so fun
• 7:18
  Speaker 1: and so inspiring, right because it shows you how to
• 7:20
  Speaker 1: make discoveries. Well.
• 7:21
  Speaker 2: Yeah, and another lesson that the Polio story is going
• 7:24
  Speaker 2: to teach us that we're going to return to at
• 7:25
  Speaker 2: the end of the episode is that none of our
• 7:27
  Speaker 2: listeners are going to be surprised to learn that scientists
• 7:29
  Speaker 2: are humans and we make mistakes. Yeah, and there is
• 7:32
  Speaker 2: also some unethical decisions along the way. And so we're
• 7:35
  Speaker 2: going to get to one of my pet peeves, which
• 7:38
  Speaker 2: is when people act like because a scientist said so,
• 7:41
  Speaker 2: you don't have any right to ask follow up questions.
• 7:44
  Speaker 2: And I saw a lot of this during COVID, a
• 7:45
  Speaker 2: lot of you know, people posting on their Facebook page like.
• 7:48
  Speaker 1: The science is settled.
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  Speaker 2: Yeah, the science is settled. The good thing about science
• 7:52
  Speaker 2: is you don't have to believe in it. It's just
• 7:54
  Speaker 2: true or whatever. And I'm like, oh man, but like
• 7:57
  Speaker 2: there's different levels of evidence to support claims, and I
• 8:01
  Speaker 2: think you should be very willing to answer questions about
• 8:03
  Speaker 2: what you did and how confident you are. And the
• 8:06
  Speaker 2: polio story has a lot of ups and downs, and
• 8:09
  Speaker 2: all right, reveal some errors made along the way.
• 8:11
  Speaker 1: Well, before we share that whole story, we were wondering
• 8:13
  Speaker 1: what people already knew about the polio vaccine. So Kelly
• 8:16
  Speaker 1: went out there and asked folks what did they know
• 8:18
  Speaker 1: about the development of the polio vaccine? So think about
• 8:22
  Speaker 1: it for a moment. What is your understanding of the
• 8:24
  Speaker 1: development of the polio vaccine. Here's what's in the minds
• 8:27
  Speaker 1: of our listeners.
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  Speaker 3: Medically, I don't know the development of the polio vaccine,
• 8:31
  Speaker 3: only that it worked and then it was a big deal.
• 8:34
  Speaker 3: I mean, millions suffered from a debilitating disease and it
• 8:38
  Speaker 3: essentially ended that. I mean, think about the advantages that
• 8:41
  Speaker 3: you've just created for society. I don't know. Vaccines are incredible.
• 8:46
  Speaker 4: Yes, I remember a vaccination day in kindergarten nineteen seventy nine.
• 8:50
  Speaker 4: I'm older than you, excepting now you claim your hundred
• 8:55
  Speaker 4: I'm still twenty eight. Lies.
• 8:59
  Speaker 1: I'm in my fifties.
• 9:00
  Speaker 5: Well, I know that was very welcome and the ginas
• 9:03
  Speaker 5: sulk and I seemed to saw as to whatever you
• 9:06
  Speaker 5: call it, and that he gave war any roots to
• 9:10
  Speaker 5: it so that people can get it chaply. So well
• 9:13
  Speaker 5: in all a good story.
• 9:15
  Speaker 1: My mother's from England.
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  Speaker 6: When my grandfather was diagnosed with polio, my grandparents were
• 9:19
  Speaker 6: told it would likely kill him, but we're given the
• 9:22
  Speaker 6: option to try an experimental vaccine. He took it and
• 9:25
  Speaker 6: lived with just a slight limp to show for it.
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  Speaker 2: I think it was developed in the late nineteen forties
• 9:30
  Speaker 2: it worked, and all to there in the US were
• 9:32
  Speaker 2: and still are, required to get the polio vaccine to
• 9:35
  Speaker 2: attend school.
• 9:36
  Speaker 7: I know the polio vaccine helped the world tremendously.
• 9:39
  Speaker 1: I think. That's all I know.
• 9:40
  Speaker 6: I was so knowledgeable about the polio vaccine, especially considering
• 9:44
  Speaker 6: that it probably saved my life and a whole lot
• 9:46
  Speaker 6: of other people's lives.
• 9:48
  Speaker 8: I know that the most commonly used polio vaccine is
• 9:52
  Speaker 8: an inactivated polio vaccine, which means it contains dead poliovirus.
• 9:59
  Speaker 8: There's all so an oral vaccine which contains weakened polio virus,
• 10:05
  Speaker 8: but you still have the risk of catching polio from it.
• 10:09
  Speaker 1: As far as I know.
• 10:10
  Speaker 7: So it's a vaccine against polio. Boom, that's it, podcast done.
• 10:18
  Speaker 7: I know there was a huge campaign in Brazil to
• 10:21
  Speaker 7: eradicate polio and it was a great success. The most
• 10:25
  Speaker 7: memorable thing I remember about this campaign was a mascot
• 10:29
  Speaker 7: called Zego China, something like Joseph Droplet, which is famous
• 10:34
  Speaker 7: up to this day.
• 10:35
  Speaker 5: Well, all I know is that I got it when
• 10:37
  Speaker 5: I was a little kid, and since then I've never
• 10:42
  Speaker 5: owned a.
• 10:42
  Speaker 6: Polo shirt at all, so it must have worked pretty well.
• 10:47
  Speaker 5: The idea for the vaccine came about when Louis Pasteur
• 10:51
  Speaker 5: was hanging out with those milkmaids.
• 10:53
  Speaker 3: I know that smart people get the polio vaccine, Kelly.
• 10:56
  Speaker 1: So you heard these answers after you did your deep
• 10:59
  Speaker 1: research dive, like fifty pages of notes here.
• 11:02
  Speaker 2: Episode I'll talk fast.
• 11:06
  Speaker 1: Did the listeners have sort of the same impression you
• 11:08
  Speaker 1: did before you did all your research.
• 11:10
  Speaker 2: Well, some of them knew a lot more, to be honest.
• 11:12
  Speaker 2: So one of the listeners mentioned that there's a killed
• 11:15
  Speaker 2: virus version of the vaccine and a live virus version
• 11:18
  Speaker 2: of the vaccine. I didn't realize there were multiple versions
• 11:20
  Speaker 2: of the vaccine. I was excited to hear the story
• 11:23
  Speaker 2: about Brazil. But I think the only thing I knew
• 11:26
  Speaker 2: about this vaccine was that it worked, and I didn't
• 11:30
  Speaker 2: have to know about polio because it worked so well.
• 11:32
  Speaker 2: And I think I had heard that Jonassack gave his
• 11:36
  Speaker 2: vaccine away for free and he has been sort of
• 11:38
  Speaker 2: lionized for that. Had you heard that.
• 11:41
  Speaker 1: Too, Yeah, I have heard that story. Yeah, I hope
• 11:44
  Speaker 1: that's true.
• 11:44
  Speaker 2: Yeah, it's more complicated. Uh oh no, we're going to
• 11:47
  Speaker 2: get to it.
• 11:49
  Speaker 1: And so that reveals that this podcast secretly is actually
• 11:51
  Speaker 1: just a project to give me and Kelly excuses to
• 11:53
  Speaker 1: do deep dives in research and stuff we always wanted
• 11:56
  Speaker 1: to know about.
• 11:57
  Speaker 2: Yeah, I don't think that should be a secret, you know.
• 11:59
  Speaker 2: I think our excitement about the universe is. You know,
• 12:04
  Speaker 2: that's part of why I love researching for this this podcast.
• 12:07
  Speaker 1: There is so much really cool stuff to learn. But
• 12:09
  Speaker 1: today we're talking about not the whole universe, just polios.
• 12:11
  Speaker 1: To tell us what is polio? How does it work?
• 12:14
  Speaker 1: It's not a preon, It's not a bacteria. Is it
• 12:16
  Speaker 1: a virus?
• 12:17
  Speaker 2: It is a virus, and it's a virus that you
• 12:19
  Speaker 2: can get either through droplets in the air, like if
• 12:21
  Speaker 2: someone sneezes or coughs, or through the We've talked about
• 12:25
  Speaker 2: the fecal oral route before the butt to mouth routes.
• 12:28
  Speaker 1: I don't like talking about the round.
• 12:31
  Speaker 2: That is a very delicate opinion for someone who lives
• 12:34
  Speaker 2: with a microbiologist who studies poop. I know.
• 12:36
  Speaker 1: And we just did a freezer clean out last weekend,
• 12:39
  Speaker 1: and boy, there was a corner of that freezer I
• 12:41
  Speaker 1: did not want to touch. Yeah, were in the corner.
• 12:45
  Speaker 1: I didn't get a definitive answer. I got to like
• 12:47
  Speaker 1: you don't really want to open that bag kind of
• 12:48
  Speaker 1: an answer anyway. So polio's a virus and it lives
• 12:58
  Speaker 1: in fluid bodily fluids, Does that mean that, like it
• 13:01
  Speaker 1: can't live outside of water if it like landed on
• 13:03
  Speaker 1: our surface and it dried up the polio and break
• 13:05
  Speaker 1: apart or something, it needs those droplets.
• 13:07
  Speaker 2: Well, So, because it's fecal oral, that means that, Like
• 13:10
  Speaker 2: you know, so if you wipe your rear end and
• 13:13
  Speaker 2: then you touch a surface, the virus can stay alive
• 13:16
  Speaker 2: on that surface for a while. And then if somebody
• 13:18
  Speaker 2: else comes by and they touch the same surface and
• 13:21
  Speaker 2: then they put their fingers in their mouth, then they
• 13:22
  Speaker 2: can get it that way, so it can survive in
• 13:24
  Speaker 2: the environment.
• 13:25
  Speaker 1: I like the way you made that indirect fecal table oral,
• 13:29
  Speaker 1: Like that's a nice intermediary there. I appreciate it.
• 13:31
  Speaker 2: It is nice if there's a step in between.
• 13:36
  Speaker 1: All right, So it can come in through the mouth
• 13:38
  Speaker 1: of the nose, and then where does it go in the.
• 13:41
  Speaker 2: Body, So it can go to your gut and start
• 13:44
  Speaker 2: replicating in your gut, it can go to your lymph
• 13:46
  Speaker 2: nodes and start replicating in your lymph nodes. And for
• 13:49
  Speaker 2: a lot of people, actually they get pretty lucky and
• 13:51
  Speaker 2: this replication sort of stops there, your immune system gets
• 13:55
  Speaker 2: it under control. Some people don't even realize they have polio, really,
• 13:58
  Speaker 2: and that's actually the majority of people don't realize they
• 14:01
  Speaker 2: have polio, like they don't have bad symptoms.
• 14:03
  Speaker 1: So it might be that a lot of people have
• 14:05
  Speaker 1: had polio and didn't know.
• 14:06
  Speaker 2: It eighty years ago. Yes, yeah, but yeah in the past, yeah,
• 14:10
  Speaker 2: but not now.
• 14:10
  Speaker 1: Wow. Fascinating.
• 14:11
  Speaker 2: And so for that small subset of people who are
• 14:14
  Speaker 2: super unlucky, the virus keeps replicating and gets into the bloodstream.
• 14:18
  Speaker 2: And then once it gets into the blood stream, it
• 14:20
  Speaker 2: moves to the nerves and it can kill some nerves.
• 14:23
  Speaker 2: And so a lot of times it will kill nerves
• 14:25
  Speaker 2: that go to your legs or your arms, And so
• 14:27
  Speaker 2: you'll wake up and discover you can't use an appendage,
• 14:31
  Speaker 2: or sometimes you'll wake up and discover you can't use
• 14:33
  Speaker 2: multiple appendages.
• 14:34
  Speaker 1: It's that sudden that you just like go to sleep
• 14:36
  Speaker 1: being able to walk, and you wake up paralyzed.
• 14:38
  Speaker 2: Yeah. So when Franklin delan Or Roosevelt got it, he
• 14:41
  Speaker 2: went to bed feeling kind of like he had the
• 14:43
  Speaker 2: cold or like a flu. And then the next morning
• 14:45
  Speaker 2: his legs started to feel kind of numbed and like
• 14:48
  Speaker 2: he couldn't really use it, and then on the way
• 14:50
  Speaker 2: to the bathroom he fell over and was paralyzed. So
• 14:53
  Speaker 2: it's pretty quick.
• 14:54
  Speaker 1: Oh my god, that is terrifying.
• 14:56
  Speaker 2: I know, I don't But even more terrifying is that
• 14:59
  Speaker 2: it can go after a part of your brain stem
• 15:02
  Speaker 2: that controls the muscles that are important for breathing. And
• 15:05
  Speaker 2: so the way you breathe is, you know, you have
• 15:08
  Speaker 2: a diaphragm that goes up and down, and as it
• 15:10
  Speaker 2: goes up and down, it changes the pressure in your
• 15:12
  Speaker 2: lungs and pulls air into your lungs and pushes the
• 15:14
  Speaker 2: air out of your lungs. So when your diaphragm isn't working,
• 15:18
  Speaker 2: you can't breathe.
• 15:19
  Speaker 1: Breathing's kind of important, right.
• 15:20
  Speaker 2: Yeah, this is a major cause of death from the disease.
• 15:23
  Speaker 2: Oh no, And if you caught it fast enough, you
• 15:25
  Speaker 2: could get put in an iron lung, and the iron
• 15:28
  Speaker 2: lung it has a change in pressure inside that sort
• 15:31
  Speaker 2: of does the job of the diaphragm, and so it
• 15:33
  Speaker 2: breathes for you. But it means you have no control
• 15:36
  Speaker 2: over your breathing, which makes it hard to talk, it
• 15:38
  Speaker 2: makes it hard to eat because you're just on the
• 15:41
  Speaker 2: timer of the iron lung. And some people could stay
• 15:44
  Speaker 2: in the iron lung for a little while and they
• 15:45
  Speaker 2: got better and they'd get.
• 15:46
  Speaker 1: Out they got better, meaning you can recover control of
• 15:49
  Speaker 1: your nerves.
• 15:49
  Speaker 2: Yeah. So I think in some cases your nerves will
• 15:52
  Speaker 2: like grow back, or you know, your body will sort
• 15:56
  Speaker 2: of rewire things, but that's not always the case. Plenty
• 15:59
  Speaker 2: of people were pair for their entire lives, and some
• 16:01
  Speaker 2: people stayed in an iron lung for their entire life,
• 16:04
  Speaker 2: for their entire life.
• 16:05
  Speaker 1: Wow, yeah, yeah, I mean I've seen pictures of these things.
• 16:08
  Speaker 1: It's basically like a head sticking out of a wall, right,
• 16:11
  Speaker 1: and the rest of your body's just like inside this tube. Yes,
• 16:14
  Speaker 1: and that's you.
• 16:15
  Speaker 2: Just live like that, yeah, right, and if like you know,
• 16:18
  Speaker 2: if your nose is itchy, you can't scratch it. Like
• 16:21
  Speaker 2: Mary Roach had this story where she in her most
• 16:25
  Speaker 2: recent book, Irreplaceable You, which highly recommend and you should
• 16:28
  Speaker 2: check out our episode with Mary Roach. Anyway, she got
• 16:31
  Speaker 2: in an iron lung to see what it was like,
• 16:34
  Speaker 2: and she said, like the second you get in there,
• 16:36
  Speaker 2: you want to scratch your face, but you can't because
• 16:37
  Speaker 2: you can't get your hands out of the tube that
• 16:39
  Speaker 2: you're in. And she said that she was in there
• 16:41
  Speaker 2: for like five minutes and it felt like hours, and
• 16:44
  Speaker 2: it was like a very very uncomfortable experience, and she
• 16:47
  Speaker 2: wanted to get out like right away.
• 16:48
  Speaker 1: But there are people who spent like decades in those things. Yes,
• 16:51
  Speaker 1: oh my gosh, wow.
• 16:53
  Speaker 2: Yeah, And so, as we've discussed, this happened pretty quickly
• 16:56
  Speaker 2: and so and a lot of times the symptoms started
• 16:59
  Speaker 2: as sort of like a cold or a flu, and
• 17:02
  Speaker 2: often it would hit kids. So can you imagine like
• 17:05
  Speaker 2: when your kids in first grade, all the times that
• 17:07
  Speaker 2: they came home with cold or flu like symptoms, and
• 17:10
  Speaker 2: every time that happened, having to worry like, oh my gosh,
• 17:13
  Speaker 2: is this polio? Like my kids were constantly snotty for
• 17:17
  Speaker 2: like kindergarten, first grade, second grade. I'd like just never
• 17:21
  Speaker 2: would have slept for those years me either.
• 17:23
  Speaker 1: I mean, I'm a worrier, So anything that goes wrong,
• 17:26
  Speaker 1: I'm like, oh, is this the end? Is it all
• 17:28
  Speaker 1: coming crashing down?
• 17:29
  Speaker 4: Yep?
• 17:29
  Speaker 1: And so to have a real reason to worry every
• 17:32
  Speaker 1: time your kid gets a cold, yeah, I would be
• 17:34
  Speaker 1: like checking on them in the middle of the night
• 17:35
  Speaker 1: every hour. Though. I guess there's nothing you can do, right,
• 17:38
  Speaker 1: I mean, is there something you can do if they
• 17:40
  Speaker 1: catch it? Can they Is there an intervention or something?
• 17:43
  Speaker 2: No, there wasn't like a medication or anything like that.
• 17:45
  Speaker 2: You know, the best you can do is make sure
• 17:47
  Speaker 2: that you're at the hospital if your kiddo is going
• 17:49
  Speaker 2: to need the iron lung so you can get them
• 17:51
  Speaker 2: in there right away.
• 17:52
  Speaker 1: Oh my god.
• 17:53
  Speaker 2: Yeah, it was. And one of the weird things about
• 17:55
  Speaker 2: this illness is that, you know, we know that this
• 17:57
  Speaker 2: illness has been running through the human pop for a
• 18:00
  Speaker 2: really long time, but most of the time it didn't
• 18:03
  Speaker 2: produce really bad symptoms. But then in the nineteen forties
• 18:08
  Speaker 2: and into the nineteen fifties, suddenly a lot more cases
• 18:11
  Speaker 2: of paralytic polio started happening. Wow, And we kind of
• 18:15
  Speaker 2: stopped studying polio after we got a vaccine, so we
• 18:17
  Speaker 2: don't really understand why this is the case. But in
• 18:21
  Speaker 2: nineteen forty eight there were almost twenty eight thousand kids
• 18:24
  Speaker 2: who got polio, which was three times more than the
• 18:27
  Speaker 2: prior year, And in nineteen forty nine it was forty
• 18:30
  Speaker 2: two thousand cases, and in nineteen fifty two it was
• 18:33
  Speaker 2: fifty seven thousand cases. Twenty one thousand of those kids
• 18:37
  Speaker 2: got paralyzed and three thousand of them died. So we're
• 18:40
  Speaker 2: I mean, to be fair, we're not talking millions of deaths.
• 18:44
  Speaker 2: But still, like you know, twenty one thousand kids being
• 18:47
  Speaker 2: paralyzed is nothing to sneeze at if it's happening for
• 18:51
  Speaker 2: one year in the United States.
• 18:52
  Speaker 1: Yeah, and it made a big impact on that generation.
• 18:55
  Speaker 1: I think anybody who knows people that from that generation
• 18:58
  Speaker 1: has met somebody impacted by polio. My teacher in fifth
• 19:01
  Speaker 1: grade walked with crutches and didn't have complete use of
• 19:04
  Speaker 1: his legs because he had polio as a kid.
• 19:06
  Speaker 2: Now, I have never met anyone who has shared a
• 19:08
  Speaker 2: polio's story with me. I think we're moving far enough
• 19:11
  Speaker 2: away from when the vaccine was developed that it's rarer
• 19:14
  Speaker 2: and rarer to hear those stories. But certainly it was
• 19:17
  Speaker 2: common in the fifties.
• 19:18
  Speaker 1: Didn't Mitch McConnell have polio? I mean, I think he's
• 19:20
  Speaker 1: like five hundred years old. Yeah, Yeah, Mitch McConnell is
• 19:23
  Speaker 1: a polio survivor. Wow, his upper left leg was paralyzed.
• 19:26
  Speaker 2: Huh, Well, he was one of the lucky ones who
• 19:29
  Speaker 2: made it through.
• 19:30
  Speaker 1: So do we understand now why this started to ramp up?
• 19:33
  Speaker 1: Was there some like mutation in the virus or a
• 19:35
  Speaker 1: change in the environmental situation or.
• 19:37
  Speaker 2: As far as I know, we don't know. We kinda
• 19:40
  Speaker 2: we felt like we licked polio and so we moved
• 19:41
  Speaker 2: on to other things, which makes sense. But it would,
• 19:45
  Speaker 2: you know, still be interesting to know and interesting to
• 19:47
  Speaker 2: understand because you know, there could be other viruses that
• 19:50
  Speaker 2: might mutate that we should be like keeping an eye
• 19:51
  Speaker 2: on if we understood why this happened.
• 19:53
  Speaker 1: Are there silly conspiracies based on like random correlations, like
• 19:57
  Speaker 1: that's when rock and roll started to spread across the
• 19:59
  Speaker 1: country or something.
• 20:02
  Speaker 2: There were a lot of crazy conspiracy theories about how
• 20:05
  Speaker 2: polio was transmitted. For example, a lot of people thought
• 20:08
  Speaker 2: it had to do with cats, so thousands of cats
• 20:10
  Speaker 2: in New York City got killed. I oh, so there.
• 20:13
  Speaker 2: You know, there were plenty of conspiracy theories. But to
• 20:16
  Speaker 2: be honest, I didn't look too much into why I
• 20:19
  Speaker 2: didn't look for conspiracy theories. They're so easy to find
• 20:23
  Speaker 2: most of the time, all.
• 20:24
  Speaker 1: Right, And so at this point we have vaccines already
• 20:27
  Speaker 1: for other diseases, right, So it must have been like
• 20:29
  Speaker 1: on the radar, like, let's get a vaccine for polio.
• 20:31
  Speaker 2: Yeah, And so our early research into polio unfortunately set
• 20:35
  Speaker 2: us on kind of the wrong track. So there was
• 20:37
  Speaker 2: a guy named Simon Flexner at the Rockefeller Institute and
• 20:40
  Speaker 2: he was trying to infect Reesis monkeys to understand how
• 20:43
  Speaker 2: the virus is transmitted. But one of the hard things
• 20:46
  Speaker 2: about studying human diseases in other animals is that sometimes
• 20:50
  Speaker 2: it works different in those animals, and so in the
• 20:53
  Speaker 2: Reesis monkeys, the way you got them infected was you
• 20:55
  Speaker 2: swabbed their nasal passage and essentially you were sending the
• 20:59
  Speaker 2: virus like really close to the nervous system. And so
• 21:03
  Speaker 2: the Reesis monkey's got polio, but if you put it
• 21:05
  Speaker 2: in their mouth and had them swallow it, they didn't.
• 21:08
  Speaker 2: And so there was this idea that the only way
• 21:11
  Speaker 2: polio could get to people is if it went directly
• 21:14
  Speaker 2: into the nervous system, and that you couldn't get it
• 21:17
  Speaker 2: by ingesting it. And that's bad for a couple of reasons.
• 21:19
  Speaker 2: So one it's throwing off your understanding of how the
• 21:22
  Speaker 2: disease is actually transmitted, which means public health measures are
• 21:25
  Speaker 2: harder to create. And the other thing is it suggests
• 21:29
  Speaker 2: that the virus is never passing through the bloodstream and
• 21:32
  Speaker 2: that is your best chance at hitting it with your
• 21:35
  Speaker 2: immune system. So if you're going to have a vaccine,
• 21:38
  Speaker 2: it's probably going to create antibodies that will be in
• 21:41
  Speaker 2: your bloodstream. And if the virus is never in the bloodstream,
• 21:44
  Speaker 2: how's your body gonna attack it?
• 21:46
  Speaker 1: All Right? So now you've questioned your immune system is
• 21:49
  Speaker 1: only in the blood or is that where most of
• 21:51
  Speaker 1: it is?
• 21:52
  Speaker 2: Or what your immune system is in lots of places.
• 21:55
  Speaker 2: But my understanding is that the strongest part of the
• 21:57
  Speaker 2: immune system, and the part of the immune system that
• 21:59
  Speaker 2: gets act devated by vaccines, tends to be in the blood.
• 22:02
  Speaker 1: Yeah, And since we're doing an immune system primer, what
• 22:05
  Speaker 1: is an antibody exactly? Is it one of these crazy
• 22:08
  Speaker 1: white blood cells that you see on those videos like
• 22:10
  Speaker 1: searching around and killing bacteria?
• 22:12
  Speaker 2: Ah? No, not quite. So your immune system makes an
• 22:15
  Speaker 2: antibody when it encounters a pathogen for the first time.
• 22:18
  Speaker 2: And what the antibody does, it's like a protein and
• 22:21
  Speaker 2: it binds to the pathogen. And one of the things
• 22:23
  Speaker 2: that it does is it keeps the pathogen from, for example,
• 22:27
  Speaker 2: getting into a cell. So this could keep polio from
• 22:29
  Speaker 2: getting into a nervous system cell because it's essentially like
• 22:32
  Speaker 2: blocking it from doing anything that it wants. Another thing
• 22:36
  Speaker 2: that it does is it flags the pathogens so that
• 22:39
  Speaker 2: those white blood cells can then find it. So it
• 22:41
  Speaker 2: essentially is like white blood cells over here, I've got something.
• 22:44
  Speaker 2: And so you make antibodies that are specific to different
• 22:48
  Speaker 2: kinds of pathogens. So if your body encounters the poliovirus,
• 22:52
  Speaker 2: it will create antibodies that remember the poliovirus. And so
• 22:55
  Speaker 2: the next time you encounter polio, your immune system is
• 22:59
  Speaker 2: ready to attack it right off of the bat.
• 23:01
  Speaker 1: And you say, remember, And that makes me think of like,
• 23:03
  Speaker 1: you know, I remember somebody's face, and I have no
• 23:06
  Speaker 1: idea how that works inside the brain. How does it
• 23:08
  Speaker 1: work for the immune system. Is it like it builds
• 23:11
  Speaker 1: some protein which latches onto the something on the surface
• 23:14
  Speaker 1: of that thing. I'm totally guessing here. How does it work?
• 23:17
  Speaker 2: Yes, So I think you are the amount of antibodies
• 23:19
  Speaker 2: that you have for a specific pathogen does kind of
• 23:21
  Speaker 2: go down over time. And like you may have had
• 23:24
  Speaker 2: the experience where you go to get a booster vaccine.
• 23:27
  Speaker 2: And so sometimes your body does seem to sort of
• 23:30
  Speaker 2: forget if it hasn't seen something for a while, and
• 23:33
  Speaker 2: so you're essentially just reminding your immune system like, hey,
• 23:36
  Speaker 2: this is a bad thing. You should be prepared. And
• 23:38
  Speaker 2: it's not like it always has loads of antibodies for
• 23:42
  Speaker 2: all pathogens that could possibly encounter, but there's some of
• 23:45
  Speaker 2: them in there, and then the number of them can
• 23:47
  Speaker 2: be rapidly increased if the pathogen is encountered.
• 23:50
  Speaker 1: Again, I see, And so you're saying remember and forget.
• 23:52
  Speaker 1: It's sort of like anthropomorphizing our immune system. Really, it's
• 23:55
  Speaker 1: like do you have a bunch of antibodies for this
• 23:57
  Speaker 1: or do you not?
• 23:58
  Speaker 2: Absolutely?
• 23:59
  Speaker 1: Yeah, that's right, all right. And so it's a big
• 24:02
  Speaker 1: challenge to develop a vaccine for something if it doesn't
• 24:04
  Speaker 1: go through the blood I, which just like bypasses our
• 24:07
  Speaker 1: major defense system. So what does that mean about developing
• 24:10
  Speaker 1: a vaccine? What else can we do?
• 24:12
  Speaker 2: Well? So it turns out that Simon Flexner, because he
• 24:16
  Speaker 2: had studied Reesei's monkeys, he thought it never went through
• 24:19
  Speaker 2: the blood. But he was wrong.
• 24:21
  Speaker 1: He was wrong.
• 24:22
  Speaker 2: He was wrong, and he was wrong because he was
• 24:24
  Speaker 2: studying monkeys and polio is different in riesis monkeys than
• 24:28
  Speaker 2: it is in humans. In those monkeys, it can only
• 24:31
  Speaker 2: get in through the nose if you put it really
• 24:32
  Speaker 2: close to the nervous system. But in humans, we can
• 24:35
  Speaker 2: get it through our mouth and then it goes into
• 24:36
  Speaker 2: our stomach and into our lymph nodes, and then it
• 24:38
  Speaker 2: goes into our blood before it goes to the nerves.
• 24:40
  Speaker 2: So you do have a shot. But for a long
• 24:43
  Speaker 2: time we were all sort of thrown off track by
• 24:45
  Speaker 2: this research that didn't quite get it right because the
• 24:48
  Speaker 2: animal model set us on the wrong track.
• 24:50
  Speaker 1: All right, So bad news for the recis monkeys, but
• 24:52
  Speaker 1: good news for humans.
• 24:54
  Speaker 2: So eventually good news when we figure it out.
• 24:57
  Speaker 1: Where we figure it out. Yeah, all right, so let's
• 24:59
  Speaker 1: take a break. Can we come back. We'll hear more
• 25:01
  Speaker 1: of the saga of how we developed a polio vaccines,
• 25:04
  Speaker 1: the twists that turns the ups the downs. Get your
• 25:06
  Speaker 1: popcorn and get some tissues because it's gonna get emotional.
• 25:29
  Speaker 1: All right, we're back, and we're telling a story of
• 25:31
  Speaker 1: how we developed the polio vaccine. Kelly, what is the
• 25:34
  Speaker 1: next step in this story?
• 25:36
  Speaker 2: Well, you know, like so many scientific endeavors. The next
• 25:38
  Speaker 2: step is get the money, because it's expensive to do science.
• 25:43
  Speaker 2: And the story for how the vaccine got funded starts
• 25:46
  Speaker 2: with Franklin Delano Roosevelt, who in nineteen twenty one, at
• 25:50
  Speaker 2: the age of thirty nine, got polio himself and his
• 25:53
  Speaker 2: legs were paralyzed. In nineteen twenty four, he hears that
• 25:57
  Speaker 2: this person went to these nice warm springs, and by
• 26:00
  Speaker 2: going in the warm springs and moving his body around
• 26:02
  Speaker 2: in the springs, he was able to walk again. Oh,
• 26:05
  Speaker 2: and FDR was like, Wow, what that's great, I'm gonna go.
• 26:09
  Speaker 2: And so he goes, and he falls in love with
• 26:11
  Speaker 2: the place. He feels like, actually he can move a
• 26:14
  Speaker 2: little bit better in the warm strings. That might have
• 26:16
  Speaker 2: been a placebo effect, but also it's just sort of
• 26:18
  Speaker 2: nice to have a lot of your body supported by
• 26:20
  Speaker 2: the water, and the warm water probably felt pretty good.
• 26:23
  Speaker 1: Hot tubs are fun, they sure.
• 26:24
  Speaker 2: Are, yes, And so he decides, you know what, I
• 26:27
  Speaker 2: love this place. I'm gonna buy it.
• 26:29
  Speaker 1: Wait, I'm gonna buy it.
• 26:31
  Speaker 2: I'm gonna buy it. Yeah. He came from a rich family,
• 26:33
  Speaker 2: so he was like, I'm gonna buy it.
• 26:35
  Speaker 1: I'm not just enjoying the hot tubs. I'm in the
• 26:36
  Speaker 1: hot tub business now, Wow cool.
• 26:39
  Speaker 2: Yeah, And so he buys it, but he buys it
• 26:41
  Speaker 2: and tries to make it a place where lots of
• 26:43
  Speaker 2: polio folks can go oka. And so he will sometimes
• 26:46
  Speaker 2: even charge people less if they have polio and they
• 26:49
  Speaker 2: want to come to the warm springs but they can't
• 26:50
  Speaker 2: afford to. And that's great, but he's having trouble making money,
• 26:55
  Speaker 2: one because he's giving people all these discounts, and two
• 26:57
  Speaker 2: because it turns out people who don't have polio are
• 27:00
  Speaker 2: worried about getting into the water with people who do
• 27:02
  Speaker 2: have polio because we don't know how it's transmitted. And
• 27:05
  Speaker 2: so this place is financially going down the tubes.
• 27:09
  Speaker 1: Comes soak in hot disease water doesn't really work.
• 27:11
  Speaker 2: It turns out, yeah, well right, yes, that's right. You know,
• 27:14
  Speaker 2: for these patients, the polio had passed through their body.
• 27:17
  Speaker 2: They were still paralyzed, but they almost certainly weren't shedding
• 27:19
  Speaker 2: virus anymore. So it probably was safe. But you know,
• 27:23
  Speaker 2: stigma being what it is, people were staying away.
• 27:25
  Speaker 1: Nobody wants to slip into polio soup anyway.
• 27:28
  Speaker 2: Yeah, yeah, that's right. So in nineteen twenty eight, FDR
• 27:32
  Speaker 2: becomes New York Governor, and in nineteen thirty two he
• 27:35
  Speaker 2: becomes pregnant. Pregnant, oh my god. In nineteen thirty two.
• 27:41
  Speaker 1: He becomes accomplishment.
• 27:42
  Speaker 2: Yeah, that's right, that's right. Who knew polio was the
• 27:45
  Speaker 2: cue anyway? All right, So in nineteen thirty two he
• 27:49
  Speaker 2: becomes president and he no longer has time to run
• 27:52
  Speaker 2: warm Springs, and so his work colleague, Basil O'Connor, takes
• 27:56
  Speaker 2: over and he's trying to figure out how he's going
• 27:58
  Speaker 2: to take this financial disaster and turn it around, and
• 28:03
  Speaker 2: he essentially starts a campaign that's sort of focused on
• 28:07
  Speaker 2: FDR where he says, hey, let's start to raise money
• 28:10
  Speaker 2: for polio by having like big gala balls, And eventually
• 28:13
  Speaker 2: he brings in famous actors and actresses to try to
• 28:16
  Speaker 2: raise money, and this becomes the National Foundation for Infantile Paralysis,
• 28:21
  Speaker 2: which ultimately becomes the March of Dimes, which I think
• 28:24
  Speaker 2: a lot of people have heard of. Ye, And this
• 28:27
  Speaker 2: is why FDR's face is on the dime. Oh because this, yeah,
• 28:30
  Speaker 2: this became like a super popular thing. Okay, well, they've
• 28:33
  Speaker 2: raised loads of money. A lot of their money was
• 28:36
  Speaker 2: spent on helping to care for people who were paralyzed,
• 28:40
  Speaker 2: and so they offered a lot of support for polio victims,
• 28:44
  Speaker 2: but they also saved a bunch of money for research,
• 28:46
  Speaker 2: and so this is how the research is going to
• 28:47
  Speaker 2: get funded.
• 28:48
  Speaker 1: So if you're out there and you're a disease and
• 28:50
  Speaker 1: you're listening, it's a bad idea to infect a white
• 28:53
  Speaker 1: guy who becomes really important, because those are the diseases
• 28:57
  Speaker 1: that get attention.
• 28:58
  Speaker 2: I wish that that were otherwise, but no, you're right,
• 29:01
  Speaker 2: And in fact, there's a pretty good argument that you
• 29:03
  Speaker 2: could make that polio in particular was getting a lot
• 29:06
  Speaker 2: of attention because it tended to hit the middle class,
• 29:09
  Speaker 2: and so there was this idea that maybe because the
• 29:11
  Speaker 2: middle class were living in like super sanitary environments, they
• 29:14
  Speaker 2: were more susceptible to polio. But this was a disease
• 29:18
  Speaker 2: of like upper middle class white people, and that is
• 29:23
  Speaker 2: probably part of why it got so much attention.
• 29:25
  Speaker 1: Yeah, Unfortunately, folks in government need like a personal connection
• 29:28
  Speaker 1: to some kind of experience before they take action. Sometimes
• 29:32
  Speaker 1: it's too bad. Yeah, Anyway, it's good news that there
• 29:34
  Speaker 1: was a lot of research money towards developing a vaccine.
• 29:37
  Speaker 1: It's a bummer that FDR had to get polio for
• 29:39
  Speaker 1: that to happen. But then how did that research effort
• 29:42
  Speaker 1: kick off?
• 29:42
  Speaker 8: All?
• 29:42
  Speaker 3: Right?
• 29:42
  Speaker 2: Well, so first they had to decide what kind of
• 29:45
  Speaker 2: vaccines they wanted to fund, and it turned out there
• 29:47
  Speaker 2: were two competing camps that both felt very strongly and
• 29:52
  Speaker 2: the competing camps were live attenuated virus. So you essentially
• 29:57
  Speaker 2: get a wimpy version of the virus and inject that
• 29:59
  Speaker 2: into peace people, or a killed virus where you kill
• 30:03
  Speaker 2: the virus before you inject it into people, but you
• 30:06
  Speaker 2: make sure that you haven't like totally destroyed it. You
• 30:09
  Speaker 2: need your immune system to still recognize it.
• 30:11
  Speaker 1: Okay, And did we have working examples of both in
• 30:14
  Speaker 1: other diseases.
• 30:15
  Speaker 2: Yes, The live attenuated virus was pretty common at the time,
• 30:19
  Speaker 2: and it was thought that that was the best way
• 30:21
  Speaker 2: to make vaccines. But Jonassock, early in his career, is
• 30:24
  Speaker 2: going to get experience working on a killed version of
• 30:27
  Speaker 2: the influenza virus. Oh, and he's one of the people
• 30:31
  Speaker 2: who helps develop the first flu virus, and that kind
• 30:34
  Speaker 2: of convinces him that killed viruses are the way to go.
• 30:38
  Speaker 2: But there's a couple problems. So the live virus people
• 30:41
  Speaker 2: argue that a killed virus will never stimulate the immune
• 30:45
  Speaker 2: system as well, and so you might get weaker immunity
• 30:48
  Speaker 2: or immunity that fails more quickly. And they're concerned that
• 30:54
  Speaker 2: it's going to be really hard to be sure you've
• 30:56
  Speaker 2: always killed all of the virus, Like if you know,
• 30:59
  Speaker 2: you've got a batch of virus that is alive, and
• 31:02
  Speaker 2: then usually what happened is they put formulin a formaldehyde
• 31:04
  Speaker 2: in there. How can you be sure that it got
• 31:06
  Speaker 2: to every single virus particle. How can you be sure
• 31:08
  Speaker 2: you're not going to give people polio?
• 31:10
  Speaker 1: Oh my god, imagine injecting polio into some kid. That'd
• 31:13
  Speaker 1: be terrible.
• 31:15
  Speaker 2: Yeah, hang on, we're going to get there. And so, yeah,
• 31:18
  Speaker 2: I know, it's it's a sad story. And so the
• 31:21
  Speaker 2: problem with the live attenuated virus is that viruses mutate,
• 31:27
  Speaker 2: and so a virus that has been made sort of
• 31:29
  Speaker 2: wimpy over time can mutate and go back to being
• 31:32
  Speaker 2: really bad. And when you make a live attenuated virus,
• 31:37
  Speaker 2: people shed that virus and it gets into the environment,
• 31:40
  Speaker 2: and so anywhere people are defecating, you've now got this
• 31:43
  Speaker 2: polio virus in the environment, and you can't really control
• 31:46
  Speaker 2: where it goes and what it does.
• 31:47
  Speaker 1: Yeahs, both of these seem like bad ideas. Now, Kelly,
• 31:49
  Speaker 1: you've got me almost over the.
• 31:53
  Speaker 2: Okay. The lesson at the end is going to be
• 31:56
  Speaker 2: that we have really good protocols for killing viruses now,
• 31:59
  Speaker 2: and it's been going well for like fifty or sixty years.
• 32:02
  Speaker 2: There have been no mistakes as far as I know.
• 32:05
  Speaker 1: All Right, So what were some of the early tests?
• 32:06
  Speaker 1: How did they go?
• 32:07
  Speaker 2: Okay? So, one of the early trials is called the
• 32:10
  Speaker 2: Park Brodie vaccine, and this is named after the two
• 32:12
  Speaker 2: scientists who worked on it, and this was around nineteen
• 32:15
  Speaker 2: thirty four, and they essentially infect monkeys with polio, grind
• 32:19
  Speaker 2: up their nervous tissue, and add a little bit of formalin,
• 32:22
  Speaker 2: hoping the formulin will kill the virus. And they first
• 32:26
  Speaker 2: give it to twenty monkeys, and the monkeys make antibodies
• 32:29
  Speaker 2: to polio, which suggests it works. And then they try
• 32:32
  Speaker 2: the vaccine on themselves and it goes pretty well.
• 32:35
  Speaker 1: They gave the vaccine to themselves.
• 32:37
  Speaker 2: They did give the vaccine to themselves. They were pretty confident.
• 32:40
  Speaker 1: Wow, okay.
• 32:41
  Speaker 2: And then they give it to twelve kids and it
• 32:43
  Speaker 2: goes okay. Okay, and so they say, hey, we've got
• 32:47
  Speaker 2: a safe polio vaccine, and they start scaling things up
• 32:50
  Speaker 2: really quickly, because everybody really wants a polio vaccine, right
• 32:53
  Speaker 2: and so as soon as there's like evidence that you've
• 32:55
  Speaker 2: got something that works, people start scaling up. But the
• 32:58
  Speaker 2: problem is it wasn't really safe and it might not
• 33:02
  Speaker 2: have been protecting against polio.
• 33:04
  Speaker 1: So but before they scaled up, they must have had
• 33:06
  Speaker 1: some evidence that it was working. That was the evidence,
• 33:09
  Speaker 1: just that it was creating antibodies in the humans, and
• 33:12
  Speaker 1: that doesn't mean necessarily that it's protecting against polio. Having
• 33:15
  Speaker 1: antibodies isn't enough.
• 33:17
  Speaker 2: One of the lessons we're going to learn from this
• 33:19
  Speaker 2: is that there hadn't been enough basic research before they
• 33:21
  Speaker 2: started making the vaccine. And it turns out there's three
• 33:24
  Speaker 2: types of polio, not just one, and so you can
• 33:27
  Speaker 2: protect against one type, but someone can still die or
• 33:30
  Speaker 2: get paralyzed by some of the other types I see,
• 33:32
  Speaker 2: and so they didn't have complete protection. And then the
• 33:35
  Speaker 2: other problem was we didn't know at the time that
• 33:38
  Speaker 2: there's a lot of people who will have very strong
• 33:40
  Speaker 2: immune system reactions to monkey nervous tissue, and so some
• 33:45
  Speaker 2: of the nervous system cells were still in the vaccine,
• 33:48
  Speaker 2: and people had like massive abscesses and their whole body
• 33:52
  Speaker 2: would be inflamed. And kids were getting super sick from
• 33:55
  Speaker 2: this vaccine and it was because of the monkey cells.
• 33:59
  Speaker 2: At the same time, this guy Comer is making another vaccine,
• 34:03
  Speaker 2: but this one is a live virus vaccine with the
• 34:05
  Speaker 2: wimpy version of the virus. This was in nineteen thirty five.
• 34:08
  Speaker 2: He also vaccinates himself. He vaccinates his two kids. Oh
• 34:12
  Speaker 2: my gosh, and so he must have been confident. And
• 34:14
  Speaker 2: then he vaccinates twenty three other kids whose kids are
• 34:18
  Speaker 2: these kids? Right?
• 34:20
  Speaker 1: So sometimes treat jab jab.
• 34:24
  Speaker 7: Oh.
• 34:24
  Speaker 2: You know, I if somebody confidently told me I can
• 34:27
  Speaker 2: protect your kid from polio, there's some chance I'd be like, like,
• 34:30
  Speaker 2: I wouldn't want my kid to be the first one
• 34:32
  Speaker 2: in line. Yeah, but I can imagine why he was
• 34:35
  Speaker 2: able to find twenty three kids.
• 34:37
  Speaker 1: Well, it's a terrible decision to make, like do you
• 34:39
  Speaker 1: maybe take this vaccine that protects your kids or do
• 34:42
  Speaker 1: you not take it? And then they're still risking their lives, right,
• 34:44
  Speaker 1: this risks either way.
• 34:45
  Speaker 2: Yeah, there absolutely are. But he then goes on to
• 34:48
  Speaker 2: vaccinate ten thousand kids. Wow, so a pretty big trial.
• 34:52
  Speaker 2: And at least a dozen kids get paralytic polio from
• 34:56
  Speaker 2: his vaccine and nine of them die.
• 34:58
  Speaker 1: Oh my gosh.
• 34:59
  Speaker 2: Yeah, And so they're there's a scientific conference where the
• 35:01
  Speaker 2: Park Brody vaccine and the Comer vaccine are discussed, and
• 35:04
  Speaker 2: it's a bunch of polio scientists and at the end,
• 35:08
  Speaker 2: essentially Colmer gets accused of murder by one of the
• 35:11
  Speaker 2: other scientists and he says, gentlemen, this is one time
• 35:14
  Speaker 2: I wish the floor would open up and swallow me.
• 35:17
  Speaker 1: Oh my god. He must have felt terrible.
• 35:19
  Speaker 2: He felt horrible. And Brody dies at age thirty six
• 35:22
  Speaker 2: or something of a heart attack. There's some argument that
• 35:25
  Speaker 2: maybe it was he brought the heart attack on, you know, purposefully.
• 35:30
  Speaker 2: But anyway, really horrible episode for everyone involved. And the
• 35:33
  Speaker 2: lesson they end up taking away from this is that
• 35:36
  Speaker 2: we need a lot more basic research.
• 35:38
  Speaker 1: And these guys were all acting in good faith.
• 35:40
  Speaker 6: Right.
• 35:40
  Speaker 1: Maybe they rushed a little bit, maybe they got unlucky,
• 35:43
  Speaker 1: but they were trying to.
• 35:44
  Speaker 2: Do good Yeah. Yeah, And you know, I think that
• 35:46
  Speaker 2: Comer who tested the vaccine on his kids, he must
• 35:50
  Speaker 2: have thought he had the solution, or he didn't like
• 35:52
  Speaker 2: his kids.
• 35:53
  Speaker 1: Oh wow, one or the other. I was trying to say,
• 35:56
  Speaker 1: these people are not monsters, they're not villains. But you're like,
• 35:59
  Speaker 1: maybe he hates it's his children.
• 36:01
  Speaker 2: No, I'm just joking. They're not monsters like they really,
• 36:05
  Speaker 2: no doubt part of them was thinking, I will be
• 36:08
  Speaker 2: a really big deal if I soalve this polio thing.
• 36:10
  Speaker 1: Right.
• 36:10
  Speaker 2: I can't imagine that that wasn't on their minds, but
• 36:13
  Speaker 2: I do genuinely believe the fact that they tested it
• 36:16
  Speaker 2: on themselves first, they tested it on their kids, that
• 36:18
  Speaker 2: they really they were trying to save lives. I think
• 36:20
  Speaker 2: their intentions were good, but they rushed into it and
• 36:23
  Speaker 2: they didn't realize how little we knew.
• 36:25
  Speaker 1: I think, well, it's a tragedy either way it is.
• 36:28
  Speaker 1: So then we did a bunch of basic research to
• 36:30
  Speaker 1: understand polio and the immune system better. How did that
• 36:33
  Speaker 1: help shape the next step in the vaccine story.
• 36:36
  Speaker 2: Yeah, So the next thing that we wanted to do
• 36:38
  Speaker 2: was work on figuring out how many types of polio
• 36:41
  Speaker 2: there are. So it became clear to us that that
• 36:43
  Speaker 2: is a question we didn't really have a good answer to.
• 36:45
  Speaker 2: And this is where Jonas Sack comes in. So I
• 36:47
  Speaker 2: think a lot of people have heard of Sock. He's,
• 36:49
  Speaker 2: you know, a fairly famous scientist. His family were Jewish
• 36:53
  Speaker 2: immigrants from Russia who moved to New York City.
• 36:56
  Speaker 1: Yay scientists immigrants, yayay.
• 36:59
  Speaker 2: Oh, there's a lot of stories of scientists' immigrants here.
• 37:02
  Speaker 2: They're like, we have a lot of immigrants to thank
• 37:04
  Speaker 2: for protection against polio.
• 37:05
  Speaker 1: It's almost like we should be welcoming smart, hardworking people
• 37:08
  Speaker 1: into our country, especially if they bring expertise and want
• 37:10
  Speaker 1: to help us.
• 37:11
  Speaker 2: Yeah, you know, I think you and I try to
• 37:12
  Speaker 2: not be political on the show very often.
• 37:14
  Speaker 1: I don't think that's political. I don't think that's just
• 37:17
  Speaker 1: common sense.
• 37:18
  Speaker 2: I am one hundred percent behind you. Yes, I agree.
• 37:21
  Speaker 2: This is a small subset of the many immigrants who
• 37:23
  Speaker 2: have made our country better. So, as we mentioned, Slock
• 37:26
  Speaker 2: had some experience working on the flu vaccine, which was
• 37:30
  Speaker 2: a killed virus vaccine. He did that at the University
• 37:33
  Speaker 2: of Michigan with an advisor who we're going to hear
• 37:36
  Speaker 2: about later, Thomas Francis Junior. But then he starts his
• 37:39
  Speaker 2: own lab at the University of Pittsburgh, and when he's
• 37:41
  Speaker 2: at the University of Pittsburgh, he meets a representative for
• 37:44
  Speaker 2: the National Foundation for Infantile Paralysis. This is the funding
• 37:47
  Speaker 2: agency we were talking about before, and they're like, hey, look,
• 37:50
  Speaker 2: you're starting up a lab. You clearly need a lot
• 37:52
  Speaker 2: of equipment and some extra space. What if we gave
• 37:54
  Speaker 2: you a bunch of money to try to figure out
• 37:56
  Speaker 2: how many types of poliovirus there are? And he was like,
• 38:01
  Speaker 2: I need money. That's I'm in. And so he starts
• 38:04
  Speaker 2: typing polio and he works on this for two years,
• 38:07
  Speaker 2: from forty nine to fifty one, and he confirms that
• 38:10
  Speaker 2: there are three types. The first type is the most common,
• 38:13
  Speaker 2: and it's the most likely to lead to paralysis. The
• 38:16
  Speaker 2: second type tends to lead to asymptomatic cases, but sometimes
• 38:20
  Speaker 2: it can still paralyze the unlucky. And type three is
• 38:23
  Speaker 2: the most rare, but it's also the most likely to
• 38:25
  Speaker 2: go after your brain stem and put you in an
• 38:28
  Speaker 2: iron lung or kill you. Oh boy, Yeah, so you
• 38:30
  Speaker 2: want protection from all three of those?
• 38:33
  Speaker 1: I certainly do, yes.
• 38:35
  Speaker 2: Okay. So around this time there are some other really
• 38:38
  Speaker 2: exciting advances, one of them being that we figure out
• 38:41
  Speaker 2: how to grow the virus in monkey kidney cells in
• 38:45
  Speaker 2: dishes rather than nervous system cells. And so now we're
• 38:49
  Speaker 2: in a position where if we need to grow up
• 38:51
  Speaker 2: this virus to make vaccines, we don't have to be
• 38:53
  Speaker 2: doing it in monkey nervous systems anymore, and we don't
• 38:56
  Speaker 2: have to worry about that horrible reaction. The first set
• 38:58
  Speaker 2: of kids had key nervous system tissue.
• 39:01
  Speaker 1: All right, that's good news.
• 39:02
  Speaker 2: That is good news. And then a woman named Dorothy Horseman,
• 39:05
  Speaker 2: while doing some experiments, realizes, hey, actually polio does have
• 39:11
  Speaker 2: a phase where it goes through the blood. At this point,
• 39:13
  Speaker 2: we knew that sometimes it gets in through the stomach,
• 39:15
  Speaker 2: and she figures out that sometimes it goes through the
• 39:17
  Speaker 2: blood on the way to the nervous tissue, and she's like, hey,
• 39:21
  Speaker 2: that's good news. We might be able to make a vaccine.
• 39:23
  Speaker 2: This is promising. But then she stopped working on that question.
• 39:26
  Speaker 2: But now it's in the air that you could go
• 39:29
  Speaker 2: after it in the blood.
• 39:30
  Speaker 1: Okay.
• 39:31
  Speaker 2: So in nineteen fifty one, Stalk starts growing the virus
• 39:35
  Speaker 2: in the lab and he has to pick the three
• 39:37
  Speaker 2: strains that he wants to use. So he knows that
• 39:40
  Speaker 2: there's lots of different like, even if it's just type one,
• 39:42
  Speaker 2: there's still different kinds of strains, and some of them
• 39:44
  Speaker 2: are worse than the others. And so what he does
• 39:47
  Speaker 2: is he puts the poliovirus into kidney cells. He gently
• 39:52
  Speaker 2: rocks it in an incubator with nutrients, gently rocks it well,
• 39:56
  Speaker 2: not like you know, not like with a senetic. I'm
• 40:01
  Speaker 2: sure he had a piece of equipment that was moving
• 40:04
  Speaker 2: it around on a tray.
• 40:05
  Speaker 1: He's whispering sweet nothings to it as it grows.
• 40:08
  Speaker 2: That's a come on, babies, you got this.
• 40:12
  Speaker 1: There is something kind of a cob about growing them
• 40:14
  Speaker 1: up just so you can kill them and then kill
• 40:16
  Speaker 1: all their brethren. Right, but all right, anyway, go ahead,
• 40:19
  Speaker 1: So you grow up all these polio vaccines in these
• 40:21
  Speaker 1: monkey kidney cells.
• 40:23
  Speaker 2: You're growing up all these polioviruses, right, I gotta say,
• 40:25
  Speaker 2: I don't feel bad for them. Yeah, So then you
• 40:27
  Speaker 2: filtrate out as much as you can to make sure
• 40:29
  Speaker 2: you're just left with viruses. And viruses are really tiny,
• 40:32
  Speaker 2: so it's pretty easy to filter them out. But remember
• 40:36
  Speaker 2: some nervous system cells got through the last time, so
• 40:39
  Speaker 2: you got to be careful. And now he tries to
• 40:41
  Speaker 2: kill the viruses with formaldehyde. Formaldehyde is a super nasty
• 40:45
  Speaker 2: chemical and it's hard to do because you need to
• 40:48
  Speaker 2: be absolutely sure that every time you do this procedure
• 40:52
  Speaker 2: you kill all of the virus. Yeah, any free living
• 40:56
  Speaker 2: virus can really cause some trouble. Because one of the
• 40:59
  Speaker 2: types that he picks is a super virulent strain called
• 41:02
  Speaker 2: the Mahoney virus, and he picks it because it would
• 41:05
  Speaker 2: be really good to have resistance against this particular strain.
• 41:08
  Speaker 2: It's very common, it's very lethal. So he decides to
• 41:11
  Speaker 2: go with it, but you got to be sure you
• 41:13
  Speaker 2: kill it. And so they worked really hard on this procedure.
• 41:16
  Speaker 2: And one of the things you got to be worried
• 41:17
  Speaker 2: about is if at any point your vile sits for
• 41:20
  Speaker 2: too long, stuff can sort of accumulate at the bottom
• 41:23
  Speaker 2: and form like clumps, and virus particles in the middle
• 41:26
  Speaker 2: of that clump can stay alive and kill things.
• 41:30
  Speaker 1: And so at this point he's using what seems like
• 41:32
  Speaker 1: an established procedure. You take the virus, you makes it
• 41:35
  Speaker 1: from aldehyde, you have a killed version of the virus.
• 41:37
  Speaker 1: There's no innovation yet, right, that's.
• 41:39
  Speaker 2: One hundred percent right, that's a really good observation, and
• 41:41
  Speaker 2: that is going to continue throughout a lot of this story.
• 41:44
  Speaker 2: Saul didn't really do anything one hundred percent new. He
• 41:49
  Speaker 2: was taking procedures that other people had used, and he
• 41:52
  Speaker 2: was the first one to sort of put them together
• 41:54
  Speaker 2: and get it right. That's important. Other people had not
• 41:57
  Speaker 2: established a protocol that like definitely killed all the virus
• 42:00
  Speaker 2: every time, but Salk manages to do that.
• 42:03
  Speaker 1: Wow.
• 42:03
  Speaker 2: Interesting, Yes, And so he eventually gets something that's worth trying,
• 42:08
  Speaker 2: and he tries it on monkeys and it goes well.
• 42:11
  Speaker 2: And after the break, let's talk about how he starts
• 42:13
  Speaker 2: his human testing.
• 42:34
  Speaker 1: Okay, we're back, and we're talking about the development of
• 42:36
  Speaker 1: the polio vaccine. And so far Salk has discovered there
• 42:40
  Speaker 1: are three kinds of poliovirus. He's grown them up whispering
• 42:44
  Speaker 1: sweet nothings as he incubates them in monkey kidney cells,
• 42:48
  Speaker 1: and that he's mixed them with from aldehyde to kill them.
• 42:50
  Speaker 1: And you said this was successful in monkeys, but we've
• 42:53
  Speaker 1: seen that before, right.
• 42:55
  Speaker 2: Yep, we've seen that before. And so it's important to
• 42:57
  Speaker 2: note that at this stage, Sulk also injects his vaccine
• 43:02
  Speaker 2: into himself and his children because he's confident that it's
• 43:05
  Speaker 2: going to work. But then he goes on to find
• 43:07
  Speaker 2: a larger community that he can test it on, and
• 43:09
  Speaker 2: here I feel a little bit uncomfortable. So he found
• 43:13
  Speaker 2: the D. T. Watson Home for Crippled Children. Crippled is
• 43:17
  Speaker 2: the word they were using at the time. He also
• 43:19
  Speaker 2: reaches out to the person running the Pope School for
• 43:22
  Speaker 2: Mental Defectives. Wow, really, you know from today that is
• 43:27
  Speaker 2: a pretty insulting name for the facility. But it was
• 43:31
  Speaker 2: basically children who had some intellectual disabilities who were getting
• 43:35
  Speaker 2: cared for there, and there was this general feeling in
• 43:38
  Speaker 2: the community that this was a good population. So there
• 43:42
  Speaker 2: was a sort of condescending attitude that this is some
• 43:45
  Speaker 2: way they can contribute to society by essentially being these
• 43:48
  Speaker 2: guinea pigs, and the implication there being that they weren't
• 43:51
  Speaker 2: contributing in any way otherwise, which upsets me, or that.
• 43:55
  Speaker 1: There's somehow less valuable because if something goes wrong, it's
• 43:58
  Speaker 1: not as big a deal or something exact.
• 44:00
  Speaker 2: Yes, right. Also, you know they are in one place,
• 44:03
  Speaker 2: and we'll stay in one place for a long time,
• 44:05
  Speaker 2: so you can go back and test them, and you
• 44:07
  Speaker 2: know who they're interacting with. So there's a lot of
• 44:09
  Speaker 2: things you can control with this population. So for better
• 44:13
  Speaker 2: or worse, he gets permission to work with both of
• 44:15
  Speaker 2: those communities. Now the DT wants at home for crippled children.
• 44:19
  Speaker 2: Most of those children who are disabled are disabled because
• 44:22
  Speaker 2: of polio. And so what he does is he figures
• 44:25
  Speaker 2: out by looking at antibodies in their blood what kind
• 44:28
  Speaker 2: of polio they encountered, and then he gives them a
• 44:31
  Speaker 2: shot of the same type of polio that he killed
• 44:35
  Speaker 2: in his lab. And he thinks this should be a
• 44:37
  Speaker 2: pretty safe way to test things, because if I didn't
• 44:39
  Speaker 2: kill all the virus, it's not going to be bad
• 44:42
  Speaker 2: for them because their immune system is going to be
• 44:43
  Speaker 2: able to respond. And I can see if they start
• 44:46
  Speaker 2: making even more antibodies when I give them the vaccine,
• 44:49
  Speaker 2: so they shouldn't get hurt, but they'll give us some
• 44:51
  Speaker 2: information about whether or not we're stimulating the immune system.
• 44:54
  Speaker 1: All right, So they have like natural immunity already because
• 44:56
  Speaker 1: they've been exposed to the disease itself.
• 44:58
  Speaker 2: That's right, Okay, go that went great, actually, and it
• 45:01
  Speaker 2: went so great that they moved on to the other community.
• 45:04
  Speaker 2: And when they moved on to the other community, this
• 45:07
  Speaker 2: time they you know, these kids had no expected immunity
• 45:11
  Speaker 2: to polio. They didn't have polio. You could check that
• 45:14
  Speaker 2: with blood tests initially, and they are not sick after
• 45:18
  Speaker 2: they get the vaccine and they start making antibodies and
• 45:21
  Speaker 2: those antibody levels stay good for months. And these are
• 45:24
  Speaker 2: some really good results. So he's super excited.
• 45:26
  Speaker 1: Do you think, by the way that they got parental
• 45:29
  Speaker 1: approval to test it on these kids? Do you think
• 45:32
  Speaker 1: the parents were like, yeah, go ahead and test it
• 45:34
  Speaker 1: on my kid and I put in the institution or
• 45:36
  Speaker 1: do you think they sort of did it without asking
• 45:38
  Speaker 1: the parents.
• 45:38
  Speaker 2: So, in the interest of time, we skipped another vaccine
• 45:42
  Speaker 2: story where Hillary Kaprowski did not get good parental consents
• 45:48
  Speaker 2: and the Lancet even jokes about his use of the
• 45:51
  Speaker 2: word quote unquote volunteer.
• 45:53
  Speaker 5: No.
• 45:53
  Speaker 2: And so there are some questions about consent that are
• 45:56
  Speaker 2: raised earlier in the vaccine story, and so Sok had
• 45:59
  Speaker 2: this on his mind. He contacted a lawyer to make
• 46:03
  Speaker 2: sure he had insurance to cover him in case he
• 46:05
  Speaker 2: got sued, and he worked with the state to come
• 46:08
  Speaker 2: up with great parental consent forms that were very clear
• 46:11
  Speaker 2: about all this stuff. Yeah, so some lessons were learned there,
• 46:15
  Speaker 2: which is good. And so he goes to write up
• 46:18
  Speaker 2: his results to publish them in the Journal of the
• 46:20
  Speaker 2: American Medical Association. But word gets out before his article
• 46:24
  Speaker 2: is published that there is a polio vaccine that could
• 46:27
  Speaker 2: start saving kids before the next polio season.
• 46:29
  Speaker 1: Oh my gosh.
• 46:31
  Speaker 2: And so Salk is freaking out because everybody is like, oh,
• 46:33
  Speaker 2: you got to give us the vaccine, and he's like, no,
• 46:35
  Speaker 2: I'm not ready yet. This was like a small scale study.
• 46:38
  Speaker 2: This is not ready for large scale distribution.
• 46:40
  Speaker 1: And we learned a lesson from earlier rapid scale ups
• 46:43
  Speaker 1: and that we need to be careful.
• 46:44
  Speaker 2: Yes, exactly right. And so he goes on a radio
• 46:47
  Speaker 2: show and essentially tells the nation, Look, we don't have
• 46:50
  Speaker 2: a vaccine yet. We have some good results, but like,
• 46:52
  Speaker 2: I don't think we're going to have something for the
• 46:54
  Speaker 2: next polio season. So we're working on it. But now
• 46:58
  Speaker 2: the ball is rolling right, and the national foundation that's
• 47:01
  Speaker 2: paid for his research is like, we need to do
• 47:04
  Speaker 2: a massive national trial, and Sox sort of gets pulled along.
• 47:08
  Speaker 2: And so they give the protocol for making this vaccine
• 47:12
  Speaker 2: to some drug companies and they say, okay, start making
• 47:14
  Speaker 2: this vaccine. Wow, And now this debate starts about how
• 47:18
  Speaker 2: do you design this nationwide experiment that's about to happen,
• 47:22
  Speaker 2: and the big debate is about whether you want observed
• 47:24
  Speaker 2: controls or double blind injected controls. So here's the difference.
• 47:29
  Speaker 2: For the observed controls. They wanted to open enrollment to
• 47:33
  Speaker 2: second graders, and any second grader who wanted the shot
• 47:36
  Speaker 2: could get it, and then they would compare polio rates
• 47:40
  Speaker 2: in the second graders who got the shots to first
• 47:43
  Speaker 2: and third graders, so similarly aged kids who were probably
• 47:46
  Speaker 2: engaging in the same activities, and then compare how much
• 47:49
  Speaker 2: those two groups got polio.
• 47:51
  Speaker 1: And then this is an issue there because there could
• 47:52
  Speaker 1: be a bias because people are selecting right, and there
• 47:55
  Speaker 1: would be some confounding factor with that selection.
• 47:58
  Speaker 2: Yes, exactly, there's a concern that the higher income families,
• 48:02
  Speaker 2: whose risk is a little bit higher, might be more
• 48:04
  Speaker 2: likely to enroll their kids in the trial, and low
• 48:08
  Speaker 2: income populations were less likely to get paralytic polio, again
• 48:12
  Speaker 2: for reasons we don't totally understand. But those two confounding
• 48:15
  Speaker 2: factors made this experimental design not ideal. And so there
• 48:19
  Speaker 2: were people who were pushing for signing up a bunch
• 48:22
  Speaker 2: of kids who want the vaccine and giving half of
• 48:24
  Speaker 2: them the vaccine and half of them the placebo.
• 48:26
  Speaker 1: All right, so the first plan was observed controls. But
• 48:29
  Speaker 1: this is the other plan, that double blind study.
• 48:32
  Speaker 2: Yeah, and Salk is pretty hard against this initially because
• 48:35
  Speaker 2: he believes his vaccine works and it's not ethical to
• 48:38
  Speaker 2: randomly not vaccinate a bunch of kids whose parents want
• 48:41
  Speaker 2: them to get the vaccine. And in the human way
• 48:44
  Speaker 2: that we often find imperfect solutions to our problems, what
• 48:48
  Speaker 2: they ended up doing was in some places they use
• 48:51
  Speaker 2: observe controls and in other places they used this double
• 48:55
  Speaker 2: blind placebo situation. So you end up with both kinds
• 48:58
  Speaker 2: of data, and this lab at the University of Michigan
• 49:01
  Speaker 2: collects and analyzes all the data. It was a massive
• 49:04
  Speaker 2: record keeping wow fiasco because you you know, you couldn't
• 49:08
  Speaker 2: let the doctors or the kids know who was getting
• 49:10
  Speaker 2: placibo and who was getting the actual virus, because like,
• 49:12
  Speaker 2: if you give a doctor a vile and you say
• 49:15
  Speaker 2: this has the actual vaccine, they're going to vaccinate their
• 49:18
  Speaker 2: family like they're humans, you know, and maybe they're not
• 49:20
  Speaker 2: going to give anyone the placibo, and so you have
• 49:22
  Speaker 2: to actually make sure nobody knows. And then someone's job
• 49:24
  Speaker 2: was to track down every kid that died that was
• 49:27
  Speaker 2: part of the study and figure out did they die
• 49:30
  Speaker 2: of polio or did they could they have died of
• 49:32
  Speaker 2: something else? So very depressing.
• 49:34
  Speaker 1: And this is before computerized records, so this is like
• 49:37
  Speaker 1: literally a lot of paperwork and scraps of paper and
• 49:40
  Speaker 1: oh my gosh.
• 49:41
  Speaker 2: It was a massive, massive undertaking. So Thomas Francis Junior,
• 49:45
  Speaker 2: who was Socks advisor, was the one who undertook this
• 49:48
  Speaker 2: work and it was like, you know, years of what
• 49:50
  Speaker 2: his lab did was crunching these data. But right before
• 49:54
  Speaker 2: this vaccine trial was about to roll out and they
• 49:56
  Speaker 2: were about to start, you know, giving the kids the vaccines,
• 50:00
  Speaker 2: some of the monkeys in some of the labs where
• 50:02
  Speaker 2: they're testing the vaccine to make sure it's safe get polio.
• 50:05
  Speaker 2: Oh and it looks like it was just one monkey,
• 50:09
  Speaker 2: maybe two, that actually got polio, and the system of
• 50:12
  Speaker 2: checks worked right, so they did say, okay, there's some
• 50:15
  Speaker 2: monkeys that got polio. We need to pull those vaccine lots.
• 50:19
  Speaker 2: There was something wrong with them. But it gets out
• 50:21
  Speaker 2: and this celebrity gossip show has a host named Walter Winchell,
• 50:25
  Speaker 2: and he announces that seven out of ten tested batches
• 50:29
  Speaker 2: contain live virus. It's been killing monkeys. He starts a
• 50:33
  Speaker 2: rumor that coffins for kids are being made and distributed
• 50:37
  Speaker 2: around the world in advance of the release of the
• 50:39
  Speaker 2: Salk vaccine. Sorry, not around the world, around the United States.
• 50:42
  Speaker 2: But you know, a lot of what he said wasn't wrong.
• 50:46
  Speaker 2: There were monkeys dying of the vaccine, but that had
• 50:50
  Speaker 2: been our way of catching a mistake in the vaccine process.
• 50:54
  Speaker 2: But the word was out, and it's estimated that one
• 50:56
  Speaker 2: hundred and fifty thousand children were pulled from the trial
• 50:59
  Speaker 2: due to this brat And in response to the monkey incident,
• 51:03
  Speaker 2: they now have a protocol where companies have to submit
• 51:07
  Speaker 2: eleven consecutive lots of the vaccine that they made, and
• 51:11
  Speaker 2: every single one needs to pass testing before any are
• 51:14
  Speaker 2: cleared for use. So if in a batch of eleven,
• 51:17
  Speaker 2: one monkey dies, then all of that has to get
• 51:19
  Speaker 2: thrown out and you've got to start again. Yeah, they're
• 51:22
  Speaker 2: trying to be extra super careful about it. So the
• 51:25
  Speaker 2: vaccine trial happens. It's like the biggest vaccine trial in
• 51:30
  Speaker 2: the history of the United States at the time, and
• 51:33
  Speaker 2: it turns out if you look at the data where
• 51:36
  Speaker 2: we had that placebo, like the best quality data, the
• 51:39
  Speaker 2: vaccine is eighty to ninety percent effective against paralytic polio.
• 51:44
  Speaker 2: It's sixty to seventy percent effective against type one, and
• 51:47
  Speaker 2: ninety percent or more effective against type two and three. Wow,
• 51:51
  Speaker 2: that is amazing. That is a yeah, that's incredible. And
• 51:54
  Speaker 2: so the vaccine starts getting made in massive quantities. Six
• 51:59
  Speaker 2: different drug commesies start making it. And this is where
• 52:02
  Speaker 2: we have a problem. So it was announced that like, hey, look,
• 52:05
  Speaker 2: we're probably not going to have enough vaccine for the
• 52:07
  Speaker 2: oncoming polio season. We'll have it for the year after.
• 52:10
  Speaker 2: But parents really wanted it right, and so companies started
• 52:13
  Speaker 2: scaling up production and some mistakes were made. And this
• 52:18
  Speaker 2: is where I can imagine there could be some anti
• 52:21
  Speaker 2: vaxxers today that remember stories that their grandparents told them.
• 52:24
  Speaker 2: Because there was a company called Cutter Labs from Berkeley,
• 52:27
  Speaker 2: California that had some batches of vaccine where not all
• 52:32
  Speaker 2: the virus had been killed.
• 52:33
  Speaker 1: Oh no.
• 52:34
  Speaker 2: And so as these cases start getting reported, Cutter vaccine
• 52:38
  Speaker 2: gets completely taken off the shelves. They actually stop all
• 52:41
  Speaker 2: vaccines for a while until they can relook at all
• 52:44
  Speaker 2: of the different drug companies to make sure everything is okay.
• 52:47
  Speaker 2: Cutter never ends up making more vaccine. The rest of
• 52:50
  Speaker 2: the companies are given permission to go ahead. But now
• 52:53
  Speaker 2: there's much stronger controls for what kind of test the
• 52:58
  Speaker 2: vaccines need to pass before they can go public. And
• 53:02
  Speaker 2: in the last fifty maybe even sixty or seventy years,
• 53:06
  Speaker 2: this problem has not happened again. So now that we've
• 53:10
  Speaker 2: got these appropriate controls in place, were good. And this
• 53:13
  Speaker 2: is when the government started stepping in. So you probably
• 53:16
  Speaker 2: couldn't get a vaccine trial run by a foundation that
• 53:19
  Speaker 2: isn't government run again. And so this is part of
• 53:23
  Speaker 2: how like the CDC and the National Institute of Health
• 53:25
  Speaker 2: sort of grew in response to this situation. Wow, so
• 53:29
  Speaker 2: let's real quick get to so Sock sort of famously
• 53:32
  Speaker 2: said something to the effect of you can't patent the sun.
• 53:35
  Speaker 2: I won't patent this vaccine. But as you pointed out, Daniel,
• 53:38
  Speaker 2: he actually hadn't produced any new procedures. He was very
• 53:42
  Speaker 2: clever about taking pre existing procedures and being like absolutely
• 53:46
  Speaker 2: anal retentive and creating a protocol that was failsafe. But
• 53:50
  Speaker 2: he actually probably could not have patented his vaccine anyway.
• 53:53
  Speaker 2: Because there were no new novel procedures, and he did
• 53:56
  Speaker 2: talk to patent lawyers and they were like, yeah, you're right,
• 53:59
  Speaker 2: this probably isn't patentable. So it's not just that he
• 54:02
  Speaker 2: was like a really great guy, although he was a
• 54:05
  Speaker 2: really great guy, I think, but it also was just
• 54:07
  Speaker 2: that like there wasn't really anything to patent there. But
• 54:11
  Speaker 2: at the same time, there was a competing vaccine. So
• 54:13
  Speaker 2: Sabin is a scientist who was born in Poland. In
• 54:16
  Speaker 2: nineteen oh six, he ends up at the University of Cincinnati.
• 54:20
  Speaker 2: He's also getting funded by the National Foundation, and he
• 54:23
  Speaker 2: makes a vaccine with virus that he has run through
• 54:26
  Speaker 2: animals multiple times until the virus is super weak, and
• 54:30
  Speaker 2: he does this with all three strains. But the National
• 54:33
  Speaker 2: Foundation just finished doing this national trial for the salt vaccine.
• 54:37
  Speaker 2: They're not going to do it again for a new
• 54:39
  Speaker 2: vaccine when they've got one that works. And so he
• 54:41
  Speaker 2: goes to Moscow and he and the Soviet Union in
• 54:47
  Speaker 2: nineteen fifty nine. They're like this, this vaccine looks good.
• 54:51
  Speaker 2: We like it. We're going to vaccinate ten million kids.
• 54:54
  Speaker 1: Wow.
• 54:54
  Speaker 2: And so they vaccinate ten million kids and they essentially
• 54:57
  Speaker 2: say you have to show up at the school on
• 54:59
  Speaker 2: this day or factory on this day, and they all
• 55:01
  Speaker 2: get vaccinated. They decide that actually went pretty well, and
• 55:04
  Speaker 2: so they now decide they're going to vaccinate everybody who's
• 55:07
  Speaker 2: under twenty years old. So seventy seven million people get vaccinated.
• 55:10
  Speaker 1: Oh my gosh.
• 55:11
  Speaker 2: And so the Saban vaccine starts making its way back
• 55:14
  Speaker 2: to the United States. And this is after you know,
• 55:17
  Speaker 2: the Cutter incident where people are like, oh, maybe the
• 55:20
  Speaker 2: Salk vaccine isn't safe anymore, and that starts to be
• 55:23
  Speaker 2: on people's mind, and Sabin sort of capitalizes on this fear.
• 55:27
  Speaker 2: And Saban and Sack didn't like each other at all.
• 55:29
  Speaker 2: They were definitely, like, not necessarily racing, but definitely competing.
• 55:33
  Speaker 2: And the Sabin vaccine ends up becoming a lot more popular,
• 55:37
  Speaker 2: and eventually at some point people stop getting the Salt
• 55:40
  Speaker 2: vaccine and they get the Sabin vaccine instead. Oh well,
• 55:44
  Speaker 2: both of these vaccines contributed in bringing the levels of
• 55:47
  Speaker 2: polio down massively. But a problem with the Sabin vaccine,
• 55:50
  Speaker 2: which we mentioned earlier, is that that vaccine is a
• 55:53
  Speaker 2: live virus, and even though it's a weak version of
• 55:56
  Speaker 2: the virus, there are parts of the world where when
• 55:58
  Speaker 2: people get polio, what they're getting is this version that's
• 56:03
  Speaker 2: in the vaccine. The Saban vaccine causes polio in one
• 56:08
  Speaker 2: out of a million doses. So this is the problem
• 56:10
  Speaker 2: with having a live vaccine. And so at some point
• 56:14
  Speaker 2: the United States said, look, we have so little polio,
• 56:18
  Speaker 2: but for one out of a million people who get
• 56:20
  Speaker 2: this polio vaccine, there's a chance they're going to get polio.
• 56:22
  Speaker 2: We're going to switch back to the salt vaccine. So
• 56:25
  Speaker 2: after doing the Saban vaccine for a while, we switch
• 56:27
  Speaker 2: back to SALK and now everybody gets the killed virus version,
• 56:31
  Speaker 2: which has been safe for sixty years. So some parts
• 56:35
  Speaker 2: of the world still have polio, like Pakistan, but we
• 56:38
  Speaker 2: are incredibly lucky in the United States to not have
• 56:41
  Speaker 2: to worry about it. As we mentioned at the beginning
• 56:43
  Speaker 2: of the show. You know, I get frustrated when I
• 56:46
  Speaker 2: hear this quote. The good thing about science is that
• 56:49
  Speaker 2: it's true, whether or not you believe it. And it's
• 56:51
  Speaker 2: like such a condescending attitude to give to people when
• 56:56
  Speaker 2: there have been mistakes in the past. Right, and I
• 56:58
  Speaker 2: still think we have a right to say, hey, you know,
• 57:01
  Speaker 2: if your kid wants to go to public school, or
• 57:03
  Speaker 2: if you want to be a health worker, you have
• 57:05
  Speaker 2: to get these vaccines. I think we have a right
• 57:07
  Speaker 2: to like mandate that kind of stuff. But I also
• 57:09
  Speaker 2: feel like we have this massive responsibility to be super
• 57:12
  Speaker 2: open and transparent about like what we're doing and how
• 57:15
  Speaker 2: we made these decisions, because we've made mistakes in the past,
• 57:18
  Speaker 2: and I think it's reasonable for people to like want
• 57:21
  Speaker 2: to be convinced and to you know, and for you
• 57:23
  Speaker 2: to need to make a good argument for it. Not
• 57:26
  Speaker 2: that I think all the anti vaxxers are anti vax
• 57:28
  Speaker 2: because they are familiar with this history, you know, the
• 57:33
  Speaker 2: like five G from a vaccine is kind of crazy.
• 57:36
  Speaker 2: But anyway, I think these things are complicated. What do
• 57:38
  Speaker 2: you think?
• 57:38
  Speaker 1: Yeah, I think it's important that we share the process,
• 57:41
  Speaker 1: that people understand how scientists come to these decisions, and
• 57:45
  Speaker 1: also that science informs policy but doesn't dictate it. Like
• 57:48
  Speaker 1: the questions of how do you develop a vaccine and
• 57:51
  Speaker 1: the questions of should we inject this into children are
• 57:54
  Speaker 1: different questions. One is science and what is policy. And
• 57:58
  Speaker 1: I do think that's important that people out there there
• 58:00
  Speaker 1: are educated in how science works so they understand where
• 58:04
  Speaker 1: these decisions come from. Because Yeah, nobody wants to be
• 58:06
  Speaker 1: told this is the truth and that's not the truth,
• 58:09
  Speaker 1: and we can't explain it to you. Shut up. That's
• 58:11
  Speaker 1: not the way it should work. If sciences by the people,
• 58:14
  Speaker 1: for the people, and of the people. And that's one
• 58:16
  Speaker 1: reason why I think it's great we do these episodes
• 58:18
  Speaker 1: to show people how we learn this stuff and what
• 58:20
  Speaker 1: we know, what we don't know. We've got to be
• 58:22
  Speaker 1: honest about all of that, because that's what's going to
• 58:25
  Speaker 1: convince people. It's the process that people should trust, not
• 58:28
  Speaker 1: any individual answer or result. And so we've got to
• 58:32
  Speaker 1: include people in that process absolutely.
• 58:34
  Speaker 2: Yea, amen. And also hooray I never had to worry
• 58:38
  Speaker 2: about my kids getting polio.
• 58:39
  Speaker 1: Yeah me either, how terrifying.
• 58:42
  Speaker 2: Yep.
• 58:42
  Speaker 1: And so, as I said at the top of the program, like,
• 58:45
  Speaker 1: I am so grateful to scientists and to doctors and
• 58:48
  Speaker 1: to everybody who's made our lives so much better and safer.
• 58:52
  Speaker 2: Agreed, thank you all right.
• 58:54
  Speaker 1: And thanks to everybody out there who's interested in learning
• 58:57
  Speaker 1: about how the scientific process works, how peer review were,
• 59:00
  Speaker 1: how discoveries are made, how we develop some of these
• 59:02
  Speaker 1: life saving vaccines, and the things we learned along the way,
• 59:05
  Speaker 1: and Thanks to Kelly as always for your patented research
• 59:08
  Speaker 1: deep dive.
• 59:09
  Speaker 2: Well, and thank you to the extraordinaries for giving me
• 59:11
  Speaker 2: the opportunity to read loads of stuff about topics I
• 59:14
  Speaker 2: find fascinated.
• 59:16
  Speaker 1: And apologies to anybody who heard the phrase fecal oral
• 59:19
  Speaker 1: while you were having breakfast. All right, thanks everyone, Tune
• 59:24
  Speaker 1: in next time.
• 59:32
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• 59:41
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