THE FIGHT AGAINST POLIO
First identified in 1908, poliovirus causes poliomyelitis, or polio disease. Although it has impacted humans for centuries, epidemics arose in the early twentieth century with increasing frequency in Australia, Europe, and North America. Before a polio vaccine became available, several polio epidemics occurred between 1948 and 1955 killing nearly half a million people worldwide each year and leaving even more paralyzed. It’s often reported that polio was the biggest fear of parents in the United States during the 1950s.
Dr. Jonas Salk and his team at the University of Pittsburgh created potentially the most famous vaccine in the world between 1952-1955. The polio vaccine created by Dr. Salk and his colleagues was licensed in 1955, and one day later the first polio vaccine arrived at Mayo Clinic on April 13, 1955. The development of the first polio vaccine became a signature achievement of the medical industry and the promise of vaccines.
Polio is considered eliminated in the United States as of 1994, meaning that there is no year-round transmission of poliovirus. Since 1979, no cases of polio have originated in the United States. However, the virus has been brought into the country by travelers with polio. The last time this happened was in 1993.
LIVING THROUGH POLIO AND COVID-19: HISTORIC PARALLELS
Similarities between yesterday’s polio epidemics and today’s coronavirus pandemic can be observed in the lived experiences of survivors. Impacted regions were often subjected to identical protocols to what’s been implemented today during the SARS-CoV-2 pandemic: quarantines for exposed individuals and families, travel restrictions, canceled events, and closed businesses. Cases of polio were very different from one another, just as we see with COVID-19. Some people had no idea they had polio, like COVID-19, which facilitated the quick spread of the disease.
One of the most prominent similarities in the two viruses is the existence of debilitating, persistent adverse health effects in some of the exposed. Both long-haul COVID-19 and post-polio syndrome occur in a subset of survivors. There are believed to be about 300,000 polio survivors in the U.S., and from one-fourth to one-half of them may experience some degree of post-polio syndrome. Studies indicate that about 10% of people infected with COVID-19 will experience long-haul symptoms. Young and old, and otherwise healthy people can still suffer from persistent COVID-19 symptoms despite recovering and testing negative for the virus.
There are countless people who contracted and survived polio in the 1940s-50s that live with the effects of post-polio syndrome today, and now they are living through yet another pandemic with COVID-19. PAIC had the unique opportunity to speak with three polio survivors from the PA Polio Survivors Network who were willing to share their extraordinary experiences and unique perspectives on COVID-19:
Deborah ‘Deb’ Stambaugh was five years old, living in Petersburg, West Virginia when she felt ill while playing outside of her family home in the summer of 1954. After three home visits from a doctor, Deb was taken to a hospital in Morgantown, West Virginia where a spinal tap revealed she had polio. Her right arm was paralyzed by this time, and she was placed in quarantine. She was treated with the “Sister Kenny” Treatment, whirlpool treatments, and stretching exercises. Eventually Deb was moved to the Easton Convalescent Home for Children in Morgantown where her parents would travel 100 miles each way to visit her on the weekends, never missing one. Deb was placed in an upper body cast with her right arm at shoulder height on a bar, then came the brace that she was sent home with on February 14th. Her bill was paid by the March of Dimes, and she settled in back at home. Deb still had monthly check-up visits in Morgantown, where her parents were once told her arm-concentrated exercises would no longer be necessary. Her right arm muscles were completely, permanently paralyzed.
Shirley Smith was born in 1938 in Wilkes Barre, Pennsylvania, where she lived on a subsistence farm. Everyone that was old enough had a job on the farm, hers was to feed to feed the chickens. One day, 12-year old Shirley was too tired to feed those chickens or hold her 9-month-old niece. The family doctor was called who told her parents she had the flu. When Shirley was unable to walk, she was taken to the Contagious Hospital where a spinal tap determined it was polio and she was quarantined. She had spinal polio, in which there was minimal movement from the waist down. She was moved to the Home of the Merciful Savior (HMS), a residential facility for polio patients, in Philadelphia in 1950. She lived at HMS until she was 17. Her treatment included the “Sister Kenny” method, and she was fitted with long leg braces and crutches, which she still utilizes today along with a scooter.
Joe Randig started school in September of 1952 when he didn’t feel well two weeks later. Coming in from playing outside early, his mother grew concerned. He had a fever, headache, and stiff neck. A doctor diagnosed him with poliomyelitis on September 16th, which was confirmed via spinal tap. He was quickly transferred to Municipal Hospital in Pittsburgh where he remained in isolation for a month. He was admitted to the D. T. Watson Home for Crippled Children in Sewickley Pennsylvania on October 25th, where he would call home for the next 20 months. Although he doesn’t remember his initial treatment, Joe recalls being fitted with full length leg braces and a back brace connected at the hips after 5 months of physical therapy. While in the hospital, he learned how to walk again and continued his first-grade education until his discharge in June of 1954. His hospitalizations and braces were covered by the March of Dimes, and around his release he and his family had the chance to be involved in the field testing of the Salk polio vaccine.
We asked our three survivors to discuss these similarities between COVID-19 and their experiences with polio; are there any significant similarities you’ve noticed between the Polio Epidemic and the current COVID-19 Pandemic?
Deb – “The uncertainty of how severe the disease you have contracted will affect your body. The unknown of what was ahead.
Long stays in a hospital quarantined from everyone, No physical contact with loved ones. As a child, age 5, being 100 miles away from family, only to see them through a window during quarantine days. Then only on weekend for the remainder of a 6 month stay. It was also hard on the families financially and emotionally. It was a long road ahead to recovery and rehabilitation even when being released from the hospital, Exercises every evening after supper and monthly visits for checkups at the hospital.”
Shirley – “The long-term effects. You live with the belief if you keep trying, you’ll get better. I walk with 2 crutches and leg braces. My husband also had polio when he was 3 years old, and it is believed because of the high fever that he still had a tremor. There are certain amounts of brain damage that occur. People who contract COVID-19 don’t know what their long-term effects will be, and it is different for everyone.
Irrational fears about the epidemic and pandemic are also similar. Although we lived on an isolated farm, I still remember them closing the pools and the summer fears. The family was quarantined when I was diagnosed.”
Joe – “I think the main similarities between the polio virus and the coronavirus would be fear. Even though the polio virus has been around probably forever it still would bring fear to parents. A family never knew who or where it was going to strike and how severe the outcome would be. Fear of the coronavirus was fear of the unknown. At first, we didn’t know where it came form or how it was transmitted, and it spread around the world like a wildfire. The results of the polio virus were unpredictable. There was no way of knowing if your child was going to be sick for a few weeks or never walk again or die. COVID-19 was more contagious, and many more people became infected very quickly and more people have died from it than the polio virus. In the 1940’s and 50’s people had trust and confidence in our medical profession and government. Today people and very skeptical of the medical professionals and untrusting of our government. I think talk radio and social media has had a lot to do with that.”
TWO DIFFERENT VACCINE ERAS
Both polio and COVID-19 are highly contagious, but some measures taken to prevent their spread differ. Throughout the country, the quarantining of the sick was deployed in a limited way as one medical response with some shutdowns. Travel between affected cities was sometimes restricted by local officials. However, the thought of locking down an entire nation was inconceivable. Efforts for “social distancing” were voluntary and selective in nature. Businesses in localities would close when there was an outbreak, such as bowling alleys, movie theaters, and public pools. Masking was not implemented. Interventions targeted the vulnerable, affected populations rather than on a state or even national basis.
A more prominent difference in the polio epidemics and the current COVID-19 pandemic lies within the distinct reactions to the vaccines. When Salk’s vaccine underwent initial testing, approximately two million children were involved. Once the vaccine was licensed and proven effective there were massive programs launched to bring the shot, and eventually the oral vaccine, to the public via large events that families attended to be vaccinated. During these times Americans unified against polio, feeling a sense of community through donating to protect the lives of children, and maintaining a “do everything that you can within reason” belief. Messaging was focused on saving the lives of children and getting back to normal.
Though the messaging may be similar, the coronavirus vaccine is more polarizing than the polio vaccine. Widespread vaccine hesitancy and misinformation have been significant markers of the pandemic. Based on the successes of the past with diseases like polio, vaccines can be created faster and more safely than before. Yet now there is less trust in authority, and many people rely on doing ‘their own research’ or the media rather than medical professionals and scientific agencies. The fear of disease is no longer enough of a motivating factor alone either, as some people perceive a higher magnitude of risk in potential adverse effects of vaccines than in the diseases themselves.
We asked our three survivors to discuss the differences they’ve noticed with the two vaccines, are there differences that you can recall between the Polio Vaccine rollout and prevention measures compared to those for COVID-19? Was there opposition to the Polio Vaccine that you can recall? Why do you think one was generally celebrated and the other has been met with controversy?
Deb – “The differences I can recall, there were no age Categories when the Vaccine was rolled out, it was given to every age at the same time.
What I remember is that everyone got in line at fire companies, schools, and clinics. People couldn’t wait for that precious sugar cube to protect them from the Polio Virus. No one questioned it. This is how the Polio Vaccine is received in foreign countries. The Rotary Clubs raises money to Vaccinate Children in countries that are not Polio Free. Children are so scared of Polio, that they get in line again. To prevent a second dose their pinkies are painted purple. Thus the “Purple Pinky”!
The opposition that occurs from the Covid-19 seems to be met by the Internet propaganda and anti-vaxxers. People years ago had faith in the doctors and caregivers to provide them with the latest information and people did not question as they do today.”
Shirley – “I had polio in 1950, and the vaccine came out in 1955. I went to a residential rehab in Philadelphia. We thought we were “the last of the kind” once the vaccine was proven effective, we believed nobody would have polio anymore. It was a welcome relief. Even though there was one bad batch, people still believed in the science and were not discouraged. I taught at the Widener School for Physical Disabilities, where I had gone myself, and there was a booklet in 1960 with statistics that 74 children had polio at the school that year. After having my children, when I came back in 1972 there were only 4 children – all from other countries.
I believe there is a distinct difference in leadership. President Roosevelt was an inspiration for those that had polio. Him and his administration were the primary force in the March of Dimes and eradication of polio.”
Joe – “The development of the polio vaccine was an enormous, long-awaited achievement. Scientists worked on creating the vaccine for years followed by several years of testing. The March of Dimes established by Franklin D. Roosevelt in 1938 was the leading force behind the research that produced a polio vaccine. Advertising agencies and public relations firms were very involved in promoting the March of Dimes “The War on Polio” and fund raising to find a cure for polio. That was a misconception created by this campaign. There is no cure for polio, people wanted to cure these little kids who had been taken down by polio. In the 1940’s there was a completely different mindset for the people in this country. There was more awareness and concern for “the greater good”. For the most part people wanted to pitch in and do their share to conquer polio. On April 12, 1955, researchers announced the vaccine is safe and effective. Total joy and relief spread across the country. Church bells rang, newspapers had big headlines on the front page. “SALK VACCINE IS SAFE”. We won; we beat polio. People lined up as soon as possible to get vaccinated.
65 years later when COVID-19 and the coronavirus was first diagnosed in the US the mood could not have been more different. Our country had a new and very unusual president. He was a Washington outsider with different ideas and an unusual way of expressing himself. Rather than trying to unite the country against the coronavirus he was a divider. A vaccine was quickly developed which many people were skeptical of. The new vaccine quickly turned into a political issue. If you were a member of one political party, you were all for the vaccine. If you were partial to the other political party, you wanted nothing to do with the vaccine. People didn’t understand that science knew how to make a vaccine. With the help of modern Biology, Immunology, Virology, and computers a COVID-19 vaccine was quickly developed. But a lot of people didn’t buy in to it and wanted nothing to do with it. Three years later, 600,000 dead and some people refuse to get vaccinated some even think that COVID -19 is not real. In this country the entire COVID/coronavirus pandemic turned into a political/medical mess.”
LESSONS FROM THE PAST
The survivors we had the pleasure of speaking with have unique perspectives, living with pervasive effects of a virus they contracted in childhood and enduring yet another pandemic. They are familiar with the ailments of a contagious disease and hope to see families learn from the experiences of the COVID-19 pandemic.
Are there any major lessons from the Polio Epidemic and your personal experiences with past Polio Syndrome that you would like parents and other individuals to learn from?
Deb – “IT WILL CHANGE THEIR LIVES FOREVER! As a child I learned to live with few disabilities and was able to take care of myself with little difficulty. As a child, other children accept you as you are. When I entered high School, the Discrimination started. I stayed in my small group of friends and kept a low profile. After Graduation I went to a Business School and was Accepted for me. I often said I preferred business school over high school any day.
As I see survivors of COVID-19, I see discrimination because of long lasting effects that they will endure as long haulers, the discrimination is still with us only in different aspects.”
Shirley – “The idea of herd immunity. The “I’ll eventually come down with it and then I’ll be immune” general belief for COVID-19 is not the best. People need to know there’s long-term effects with these infectious diseases, even if you survive. You may recover, but there are long-term effects that will potentially alter the rest of your life and the quality of it. There is neurological damage that occurs from viruses. My takeaway message is to be aware, listen, and believe scientists. Make sure your information comes from a good source.”
PROTECTING THE FUTURE
The best way to keep the United States polio-free is to maintain high immunity in the population through vaccination against polio. Likewise, the best way to protect yourself and your family from COVID-19 and unnecessary illness or death is through a completed coronavirus vaccination series. After their experiences, the polio survivors we spoke with want to urge others to get their routine immunizations and COVID-19 vaccines.
Would you consider yourself a Vaccine advocate? Why are vaccines important to you? Do you encourage your family to get a COVID-19 vaccine? Why was getting a COVID vaccine important to you?
Deb – “I am adamant about vaccines because that was proven to be effective in eradicating polio in the past. And as I deal with post-polio syndrome and the inability two maneuver around as I did in the past, with no limitations, I feel it is most important that vaccinations are taken seriously. COVID-19 long haulers may someday face the same issues as they deal with complications of the COVID-19.
I do face the opposition to the COVID-19 vaccine with family members. My children were all vaccinated during their childhood visits to their doctor. Schools require updated vaccines to participate in school. But when it came to the COVID-19 some family members refuse to get the vaccine. I have used my own experiences to help them to make the right choice. I have pointed out to my family members that refused to be vaccinated that I raised my children with the use of only one arm and had there been a vaccine available when I was a child, I could have avoided coming down with polio. I know my parents wished that there had been a vaccine and they did not hesitate to get us in line for the sugar cube when it came available. But some of my family have chosen to believe the internet and the anti-vaxxers.
It is very important to me that everyone get vaccinated with the COVID-19 vaccine because I personally do not want to see people deal with the issues that we Polio Survivors have dealt with throughout our lives. Medical science is a wonderful thing, and we should appreciate that we have a choice.”
Shirley – “Most definitely. All of my children are vaccinated, the only one they couldn’t get yet at that time was the chickenpox vaccine. My daughter is interested in vaccines, my entire family is very avid vaccine encouragers and so is my church community. I remember before the rubella vaccine came out, I was pregnant at the time and know what could happen to the baby if she got rubella. When that vaccine came out, it was a sigh of relief. My lasty grandson is in his twenties, I took him to get his first COVID dose. He got the second dose, but he was not boosted so he actually got a mild case of COVID.
Before COVID there were still anti-vaxxers, I think that spurred some of the COVID rhetoric.”
Joe – “I am definitely a vaccine advocate and have been since my involvement with Dr. Salk’s vaccine work.
I got polio in September of 1952 and was a patient at the D. T. Watson Home until August of 1954, about 22 months. The Salk polio vaccine was undergoing more and more public testing and Dr. Salk was recruiting a group of volunteers to be vaccinated then monitored for several years. In April of 1954 my dad signed up my family along with other Watson Home families to be injected with the Salk polio vaccine. First blood samples were taken to determine if the person already had the polio antibody in their system, then the vaccine was given and two weeks later blood samples were taken again to check on the polio antibody. The polio vaccine monitoring continued for about 10 years. We would periodically return to the D. T. Watson Home for blood testing. My Dad made a 10-year commitment to Dr. Salk’s vaccine testing program. We made the 70-mile roundtrip drive many, many from 1954 to 1961 and that has always impressed me.
I believe that vaccines are a miracle of modern medicine, they should be understood and appreciated and accepted. Over the years vaccines have saved millions from death and disease.”
A special thank you to Carol Ferguson, Deb Stambaugh, Shirley Smith, Joe Randig, and the PA Polio Survivors Network.