Conquering Polio | The Cutter Fiasco | 3

Audible subscribers can listen to all episodes of American History Tellers ad-free right now. Join Audible today by downloading the Audible app. Imagine it's April 24th, 1955, and Poca Tello Idaho. You and your seven-year-old daughter, Susan, are sitting in an exam room at her pediatrician's office. The room smells of rubbing alcohol and floor polish. You hold your daughter next to you, her face drawn, her arm hanging uselessly by her side. And at last, the doctor enters the room, his gaze fixed on his clipboard. All right, let's see, when did this start? You take a deep breath and run your finger through Susan's hair, trying to stay calm for her say. Yesterday, it began with a little next stiffness, but by night time she had a fever. When she woke up this morning, she couldn't move her left arm. Is this what I think it is? Does she have polio? The doctor examines her quietly, moving her head, tapping her knees, testing her grip. You try to read his face, but it stays blank. That certainly seems that way, but we'll have to do a spinal tap to confirm. What, how could this happen? She was vaccinated for polio only a few days ago, just as past Monday. Was there something wrong with the vaccine? I followed last year's field trials closely. The vaccine is safe. It may not be perfect, but it's not dangerous. So what happened? Susan was probably exposed to polio virus just before she received her injection. I'm sorry to say, this is just a case of bad timing. The vaccine was unfortunately just too late to protect her. But that doesn't make any sense. I don't know of anyone else who's sick with polio. There have been no other cases in Susan's class. It's April. I've never heard of anyone getting polio this early in the year. Polio season usually starts when it warms up in June. Yes, but viruses don't always follow the calendar. You know, let's not jump to conclusions. We can confirm the diagnosis first, and I'll keep a close eye on things. Make sure the Susan receives the best care possible. The doctor makes a note on his chart and then leaves the room. You squeeze your daughter's shoulder and try to give her a reassuring smile. Deep down, all you feel is dread. As her eyelids flutter closed, your gut is telling you that something has gone horribly wrong. From Wondery, I'm Lindsay Graham, and this is American History Tellers, Our History, Your Story. In April 1955, a seven-year-old girl in Idaho came down with polio just days after receiving a polio vaccine. And when similar cases surfaced, health officials began to question whether it was a coincidence or something far more troubling. One year had passed since the National Foundation of Infantile Paralysis executed an unprecedented field trial of Jonas Salk's polio vaccine. In the spring of 1954, the country held its breath as hundreds of thousands of children known as polio pioneers rolled up their sleeves to receive Salk's experimental vaccine. It was a logistical triumph with no parallel in American history, requiring the mass production of a carefully formulated vaccine, teams of doctors, nurses and volunteers in nearly every state, and scientists monitoring the result with painstaking precision. And it was done with no money from the federal government. The NFIP single-handedly mobilized the nation in the hopes that modern science would finally defeat the era's most terrifying disease. But then the unthinkable happened, and scientists scrambled to discover what went wrong. This is Episode 3, The Cutter Fiasco. In the spring of 1953, Jonas Salk pushed forward with his efforts to develop a polio vaccine made from a killed virus. His Pittsburgh lab now occupied 6,000 square feet across three floors of the city's municipal hospital. It was a bustling operation with dozens of staff members and a colony of 500 monkeys used for developing his vaccine. And it was all made possible by funding from the National Foundation of Infantile Paralysis. Salk received $400,000 in grants in 1953 alone. And he would need that money because his goal was to start large-scale field trials as soon as his vaccine was ready. But in the early 1950s, the federal government had almost no machinery for guiding vaccine development, apart from the rudimentary public health service, the forerunner to the Centers for Disease Control. So the privately funded National Foundation for Infantile Paralysis stepped into support Salk's research. And once Salk's vaccine was ready for field trials, it was the foundation that would control every aspect of the operation with critical support from local communities. And that spring, Salk felt confident enough with his formula to vaccinate himself and his family. He had three boys under the age of 10, and blood test showed that after their injections, all three had elevated levels of polio antibodies, and none of them had suffered side effects. Salk's laboratory staff also received injections. But while Salk had favorable data and the steadfast support of the National Foundation on his side, he could not escape the scrutiny of his fellow scientists. In June 1953, Albert Sabin simmering rivalry with Salk exploded into the open. At a national meeting of pediatricians, Sabin attacked Salk's vaccine and ridiculed the public's impression that a vaccine was almost ready for testing. Sabin's primary argument against Salk's killed virus vaccine was that it contained an inactivated version of an extremely potent strain of polio virus. Sabin argued that if anything went wrong with the inactivation process, it would be a recipe for disaster. In contrast, Sabin had spent more than two years working on a live virus vaccine containing a weakened version of a live polio virus, and he insisted his approach was the only viable option. He also condemned the NFIP, declaring that the organization was publicity mad. But Sabin's criticism did nothing to hinder the momentum for Salk's vaccine. In November 1953, NFIP director Basil O'Connor made the long awaited announcement that large-scale polio vaccine trials would be held in the spring of 1954. It was a momentous decision. The foundation would be testing an experimental vaccine on hundreds of thousands of children across America. To oversee the trials, O'Connor enlisted leading epidemiologist Thomas Francis, who was Salk's former mentor. Not only would Francis supervise the trials, but he would also evaluate their results at his lab at the University of Michigan. And to do all this, Francis planned a double-blind study focusing on children in the first, second, and third grades. Roughly 420,000 children would receive the vaccine in three doses, while 200,000 children would receive saline placebo. Nobody involved would know who got what until the trials were over. A third group of 1.2 million children designated as a control group would receive nothing. And when the polio season arrived in the summer of 1954, scientists would measure the rate of polio in all three groups. The NFIP sought volunteers from a broad range of children from different races representing urban, suburban, and rural populations. And they chose counties that had previously seen high rates of polio and seemed likely to experience outbreaks again. They also focused on counties with public health departments equipped to handle the trials. And after finishing their evaluations, they narrowed the list down to 211 counties in 44 states. The sheer size of these trials demanded extensive logistical planning and the foundation relied on its large network of local chapters to coordinate support. Each of the 211 counties held two day workshops to train tens of thousands of teachers, doctors, nurses, and local volunteers. Basil O'Connor wrote letters to parents in each of the counties to request permission for their children's participation. Downplaying potential risks, he framed participation as a historic act, writing, this is one of the most important projects in medical history. We feel sure you'll want your child to take part. But he had little trouble convincing parents to give their consent. In the early 1950s, polls showed that public fear of polio ranked only second to fears of the atomic bomb. Americans were desperate for a vaccine that could find the end polio, the most dreaded childhood disease. They also had faith in the power of medical science, and they trusted the NFIP. Many had volunteered for the March of Dines or donated their money to the organization. But finding volunteers was not the only logistical hurdle. The NFIP also had to produce enough vaccine doses for the trials. Salks Lab would not be able to handle the required volume on its own, so O'Connor turned to commercial manufacturers. He made agreements with pharmaceutical companies Eli Lilly and Park Davis to produce the vaccine lots needed for the trials. To scale up production, government experts compiled detailed specifications based on Salk's notes, and tough quality controls were introduced. Each batch was triple tested by the manufacturer, Salks Lab, and the Public Health Service. It was rigorous and expensive. The pharmaceutical companies needed to cover the costs of manufacturing throughout the trial period, but if the trial succeeded, and the federal government approved the Salk vaccine for commercial use, these companies stood to gain substantial profits. So with a supply vaccine secured, in February 1954, Thomas Francis opened the Vaccine Evaluation Center at the University of Michigan. He soon found himself inundated by questions from the community participants in the trials. Local health officer asked him whether he was certain there was no live virus in the vaccine, and they expressed their fears about potential contamination. Francis worked hard to assuage concerns, but just before the trials were set to begin, a popular radio broadcaster sowed new doubts. Imagine its early April 1954 in Lansing, Michigan. You're the virologist and charge of the Salk polio vaccine trials, which are scheduled to begin at the end of the month, and with time running out, you're suddenly fighting a new wave of public uncertainty. That's why you're here at the medical practice of Dr. Baker, the president of the Michigan State Medical Society. Baker gives you a look of recognition as you sink into the winged back chair across from his desk. With a small sigh, he folds his newspaper neatly in half. May I help you, doctor? I hope so. I want to know what the hell you're thinking, recommending Michigan parents pull their children out of the vaccine trials? Well, what can I say? Walter Winshall hosts one of the most popular radio shows in the country. You can't expect people not to listen when they hear him calling the vaccine a killer. I've been feeling calls all day from spoof parents. Walter Mitchell is a gossip commentator. He's trying to create sensation. I mean, he's not an epidemiologist. He doesn't know what he's talking about. The Salk vaccine is triple checked, while it seems clear that Winshall's so-called reporting isn't even checked once. Are you denying the problems were found with a commercially produced vaccine? I admit that a handful of batches failed to pass extremely rigid safety tests, but don't you see that's a good thing. It's proof of how well the triple testing process is working. Oh, I don't know. I don't see why Michigan children need to be guinea pigs. I'd feel better leaving it to the other states. But we need a large sample size, Dr. Baker. I can't have an entire state pull out of the trials. I don't know what more proof you need. Dr. Salk has already inoculated hundreds of children in the Pittsburgh area, including his own three sons, not a single mishap. And I'm glad to hear that. I can't risk the public's trust. I expected you to know better. You shove your chair back and walk out of the office, anxiety, coiling in your chest. You fear what all this means for the trials. If they're not up and running by the start of the summer polio season, they'll have to be put off for a year, wasting months of effort, putting more American children at risk. On April 4, 1954, the famous gossip commentator Walter Windschill used his popular Sunday night radio show to attack the Salk vaccine. He claimed that the vaccine may be a killer and announced that seven out of ten tested batches at one facility contained live polio virus that killed several monkeys. He also claimed that the NFIP was stockpiling little white coffins in the expectation that the trial would cause fatalities. Windschill based these claims on a tip he received from a disgruntled former NFIP associate who had learned that traces of live virus were found in four vaccine lots produced by Park Davis and Eli Lilly. But Windschill's broadcast was a gross exaggeration of the truth. The NFIP responded by confirming the tainted batches had been found and eliminated by rigorous safety testing. Thereafter, the NFIP put additional safety measures in place. Manufacturers were required to produce 11 consecutive lots of vaccine that passed safety standards before any could be approved for public use. If even one batch failed, all 10 of the other batches would be discarded. But Windschill's broadcasts damaged public confidence nonetheless. Several local and state medical societies withdrew their support and parents pulled roughly 150,000 children out of the field trials. Still, the vast majority of participants trusted the NFIP and planned to continue. So on April 25th, both a vaccine advisory committee and the public health service voted to approve the field trials on the sole polio vaccine. The next day, April 26th, 1954, a group of first graders lined up in the gymnasium of an elementary school in McLean, Virginia. Camers flashed as a six-year-old boy named Randy rolled up his sleeve and became the first to receive an injection. He boasted, I could hardly feel it. The same procedure was repeated thousands of times over the next several weeks. Each school had a five-member volunteer vaccination team, which included a doctor, a nurse, a recorder, and two-eighths. Together, they oversaw and did a vacation, consent forms, preparation, injection, and disposal of syringes. But despite meticulous planning, logistical problems did arise from children receiving extra or misdoses to doctors stealing vaccines to use on their own families. But nonetheless, by late spring, more than 600,000 children had received an injection, with 95% of that number completing all three doses. This unprecedented achievement was a testament to the NFIP's careful planning and publicity and the dedicated involvement of more than 300,000 volunteers. The field trials amounted to the largest peacetime mobilization of volunteers in American history. But with the injections over, now all eyes turned to Thomas Francis, who faced a mammoth task of analyzing the data and determining whether salt had finally created a safe and effective vaccine for polio, bringing an end to 40 years of fear. Hello, I'm Matt Ford. And I'm Alice Levine. And we're the hosts of British scandal. Now, Britain loves a royal scandal. Abdications, affairs, dodgy uncles, we've had the lot. But this series is about two brothers. Raised in palaces found by tragedy, supposed to be inseparable. So how did they end up barely speaking? Was it jealousy, the press, the firm? Or was this royal rift always inevitable? This is the story of Harry and Will's and the scandal that split the House of Windsor. Follow British scandal wherever you get your podcasts, or listen early and ad-free on Aldebal. I'm in Dravama and in the latest season of The Spy Who, we open the file on Larry Chin, The Spy Who Outplayed Nixon. For decades, Chin was embedded deep inside US intelligence. Then comes an opportunity, Richard Nixon's secret plan to reopen relations with China. Information Chin can place directly into Mao's hands. But the CIA has a weapon of their own, a Chinese mole ready to defect, how long until Chin's gig is up. Follow The Spy Who Now wherever you listen to podcasts. In the summer of 1954, Thomas Francis and his team in Ann Arbor, Michigan began evaluating the results of the Saul Colio vaccine. Every day, bulging male sacks arrived containing data in the form of letters, telegrams, laboratory reports, and health records. All of it needed to be collected and analyzed by statisticians that Francis hired from the US Census Bureau, as well as dozens of Michigan graduate students. In total, 1.8 million children had participated in the trial. So now, a staff of 120 kept records on all of them, constantly updating the files as new information arrived. Much of the data entry was done by hand, but Francis also sent some of it to Detroit to be processed by early IBM computers. But despite intense interest in the outcome of the trials, Francis refused to rush his work, insisting that it would be finished when it's finished. It took a full year to process and interpret the data. Anticipation mounted in the spring of 1955, as the annual summer polio season approached, but at last, Francis stole Basil O'Connor that he was ready to release his final report. On the morning of April 12, 1955, hundreds of reporters and scientists packed a university of Michigan auditorium eagerly awaiting advanced copies of the report. One journalist described his colleagues as hungry dogs at a garbage pail. At 9.20am, the news went nationwide when an NBC correspondent went on air and declared the vaccine works. It is safe, effective, and potent. Shortly after, Francis stood in the auditorium and delivered a lengthy lecture confirming the vaccine's success. He said that it was roughly 60 to 90% effective in preventing paralytic polio with a degree of success varying based on the type of polio virus. Though he had some caveats about the integrity of the data, the overall conclusion was unmistakable, the sock vaccine was a triumph. Next, Jonas Salk himself took to the stage to a standing ovation. He thanked the schoolchildren known as polio pioneers, the NFIP and Basil O'Connor, calling him the one person without whom all of this would not have been possible. He announced that he was already working on improvements for the vaccine, predicting the potential for 100% protection from polio. Later that same day, Edward R. Murrow of CBS News interviewed Salk, asking him who owns the patent on this vaccine. Salk replied, well, the people, I would say, there is no patent. Could you patent the sun? This Ramara came to symbolize the spirit of the polio crusade, a volunteer-driven effort made possible by millions of small donations. All across the country, American celebrated their shared victory. Schoolchildren cheered, church bells rang, and parents wept with relief. Salk returned to Pittsburgh to a hero's welcome. He was an instant celebrity, hailed as the man who conquered polio. He explained that his vaccine had been built on ideas and techniques developed by many scientists before him, and by doing so, he acknowledged the critics who had long insisted that there was nothing novel about the science of his vaccine. What his comments did nothing to diminish his star power, the public credited him for single-handedly defeating polio. And on April 22, the White House held a ceremony in Salk's honor. Resident Dwight D. Eisenhower fought back tears as he declared, I have no words to thank you. I am very, very happy. Eisenhower promised to give the vaccine formula to every country that welcomed the knowledge, including the Soviet Union, and called Salk a benefactor to mankind. But though it was only hours after the release of the Francis report that the Eisenhower administration approved the Salk vaccine for commercial use, supplies were still limited. All across the country, pediatricians were inundated with calls from parents demanding that their child be vaccinated, and 10 million doses were released over the next two weeks, but most doses had already been promised to first and second graders, the age group considered most vulnerable to polio and to children who had received placebo in the 1954 trials. This left most American children unprotected as summer approached. So Americans urged the federal government to step in. But the Eisenhower administration had made no plans to coordinate vaccine distribution. Secretary Ovetta Kall-Pabi had of the newly formed Department of Health, Education, and Welfare admitted as much. Many Americans reacted with disbelief when she told a Senate committee, I think no one could have foreseen the public demand. Letters flooded the White House calling her incompetent and heartless and editorial demanded her resignation. But Secretary Habi and her colleagues in the Eisenhower administration insisted that the government's only role was to license the vaccine not to distribute it. In the 1950s at the dawn of the Cold War, even limited government intervention in the health industry sparked accusations of socialism, and the pharmaceutical companies warned that government control of distribution would stifle innovation. But with supplies or the vaccine falling short of demand, price gouging became common, and although each shot cost two dollars, some doctors charged as much as $20 for a vaccination. Americans blamed Washington for the shortages, high prices, and poor planning. Even Republican newspapers that supported the Eisenhower administration demanded federal leadership to safeguard their children. One editorial affirmed this is an emergency answer to an emergency situation, not a step towards socialized medicine. Eisenhower responded to this public outrage by agreeing to a temporary federal role in vaccine distribution. But meanwhile, problems began to surface with the shift to mass production. On April 24th, an Idaho doctor diagnosed a seven-year-old girl with polio. She had received the salt vaccine earlier that week, three days after being brought in, she was dead. Similar cases emerged in Illinois, Georgia, and California, so government investigators sprang into action. They traced the infections back to vaccine lots manufactured by cutter laboratories in Berkeley, California. And on April 28th, the US Surgeon General Leonard Shealy persuaded Qatar to recall its vaccine, which had already been administered to 400,000 children. As this investigation unfolded, public panic spread. The New York Times declared the nation is now badly scared. Millions of parents fear that if their children don't get the vaccine, they may get polio, but if they do get the vaccine, it might give them polio. And by April 29th, 26 cases had been confirmed, prompting cities to halt vaccinations altogether. When the count reached 44 on May 7th, the Surgeon General faced an impossible choice. Imagine it's late at night in May 1955 in Washington, DC. You're the US Surgeon General, and you're in your office at the Public Health Service. You've just received the latest numbers of polio cases traced back to cutter labs. You've been fielding calls all night from scientific experts, drug manufacturers, and panic state health departments. You never imagined such a nightmare scenario. Children falling sick from the very vaccine meant to protect them. You straighten up in your chair, bracing yourself as basil, o'connor, barges into your office, raw anger, written all over his face. All right, give it to me straight. What do you plan to do? You close your eyes and disbelief, letting out alongside. Mr. O'connor, I see it wasn't enough to call me half a dozen times today. Well, I haven't gotten an answer. My advisors are urging me to pause the entire national vaccination program. Oh, you can't be serious. Do I look like I'm joking? I've got reports of 44 people with polio, all because of this vaccine. 44 is nothing compared to the millions who've received the vaccine with no problem. You can't punish the entire country just because of one sloppy laboratory. If you stop the program now, you'll be putting millions of children at risk of getting polio this summer, while the consequences of letting the inoculations continue might be worse. No one is getting polio from any of the vaccines made by the other companies. I could have you fired you know. Do I really need to explain that you have no authority over me? This isn't your foundation's call anymore. The government licensed this vaccine, and that means the government is in charge of making sure the vaccine is safe. I cannot risk jeopardizing the public's trust, so I'm going to suspend the program. O'Connor shakes his head, his face bright red. Oh, you're making a mistake. I'm telling you, you're going to regret this. O'Connor turns and storms out of your office, and as you face the likelihood of another sleepless night, a small part of you wonders if O'Connor is right. But you know you can't sit back and allow a man made polio epidemic spiral out of control. As incidents of polio in vaccinated children climbed, experts urged surgeon general Leonard Shealy to stop the vaccinations. Basil O'Connor furiously disagreed, going so far as to threaten to have Shealy fired. Nevertheless, on May 8th, 1955, Shealy went on national television and announced that the government was temporarily suspending the entire polio vaccination program, pending a review of all six manufacturers. It was a stunning turnaround, less than a month after the vaccine was declared a success. The New York Times affirmed that the era victories surrounding the vaccine had quickly devolved into confusion, conflict, and doubt. Fingers were pointed in every direction. Democrats attacked the Eisenhower administration for negligence, with one senator insisting that meat was tested more carefully than the polio vaccine. Basil O'Connor, furious that his crusade had been tarnished, can damn both the government and the drug companies. And Jonas Salk blamed the manufacturers for failing to carefully follow his exact specifications. Salk was devastated by the damage done by a vaccine that bore his name. And adding insult to injury, colleagues he admired publicly accused him of quack medicine. He later confessed, this was the first and only time in my life that I felt suicidal. There was no hope, no hope at all. For many researchers, what became known as the cutter incident confirmed their longstanding fears that Basil O'Connor had allowed publicity and fun raising to take precedence over scientific rigor. But one man felt vindicated by the fiasco. Albert Sabin would long doubted the safety and efficacy of Salk's killed virus vaccine. For months, Sabin had watched as the country heaped praise on a man he considered little more than a kitchen chemist. He believed that America's children needed a safer alternative and was determined to be the man to offer them wine. In mid-May 1955, the surgeon general allowed vaccinations to resume following careful inspections of all production facilities. But the public was still nervous about the deadly error in the vaccine. In the end, roughly 200 cases were traced back to six contaminated vaccine lots at the laboratory in Berkeley, California. The victims included vaccinated children, along with family and community contacts. Most were severely paralyzed, but 11 people died. Investigators concluded that technicians at Cutter Labs in Berkeley had not adequately followed the strict safety protocols developed by Jonas Salk. They had allowed virus mixtures to sit too long in storage, which permitted particles to clump together and shielded them from the formaldehyde used to kill the virus. Their negligence allowed live polio virus to get into six lots of the vaccine. And as a result of the tragedy, manufacturers were now required to filter the virus liquid just before adding the formaldehyde. It was one of several new rules and safety tests introduced in the wake of the fiasco. These reforms prevented a repeat of the Cutter incident, but it would take time to repair public trust. In the summer of 1955, several state and local health departments refused to administer the vaccine, insisting that starting the process that far into the polio season was not worth the risk. But that summer, Boston and Chicago saw major polio outbreaks. In the end, there were 28,000 reported cases in 1955. Experts believed most of the cases could have been avoided. And for many Americans, the Cutter incident was proof of the need for greater government oversight of public health. And the next few years saw a major expansion in the federal health bureaucracy. Vaccine testing became a major function of the National Institutes of Health and the NIH budget soared from $81 million in 1955 to $400 million in 1960, marking a shift from private to government-led medical research. The 1954 polio field trial would be the last to be run entirely by a private organization. Public scrutiny also extended to the NFIP. Many blamed basal-oconours aggressive campaign for rushing and unsafe vaccine. Some scientists argued that polio had been exaggerated as a national menace, and journalists began questioning why a disease that was far less deadly than cancer and heart disease dominated public donations. The Cutter incident also had consequences for cutter labs. They would pay out millions of dollars in damages to the victims of the botched vaccine loss, with salt frequently testifying on the victims' behalf. But with improvements in testing, salt vaccine proved to be safe and highly effective. Polio cases plummeted in the late 1950s from 28,000 in 1955 to 15,000 in 1956 to just 7,000 cases in 1957. The disease no longer caused widespread fear. Swimming pools reopened in the summer of 1956 and newspapers stopped printing daily tallies of polio victims on their front pages. Still, gaps remained. Many lower-income children went unvaccinated, turning polio into a disease of the underprivileged. So in 1956, the NFIP introduced a new slogan, polio isn't like yet, but enthusiasm and donations waned. In the late 1950s, basal-oconours steered the march of dimes in a new direction beyond polio, focusing on prenatal care and other children's health issues. It continues to this day. But the cutter incident also had far-reaching implications for the field of polio research, shifting focus from the kill virus vaccine to a live virus alternative. Albert Sabin received growing media attention for his argument that instead of killing an extremely virulent strain of virus, vaccine should be made from a live virus that is non- virulent to begin with. Sabin had been working away on his vaccine since 1951. His research progressed slowly because the process of weakening live polio viruses was far more complex than killing them. As one science writer explained, it's the difference between slaughtering an ox and breeding from it, between ringing a parrot's neck and teaching it to talk. Sabin spent years conducting painstaking experiments to keep the virus strong enough to produce an immune response, but weak enough not to cause polio. The result was the oral polio vaccine administered in the form of a drop or a sugar cube given by mouth, making it cheaper and easier to manufacture and administer. It also had the benefit of following the same path through the digestive system as the naturally occurring polio virus. And Sabin believed that a single dose would guarantee protection for life without the need of multiple injections or boosters. In the winter of 1954 to 1955, while the country was waiting for the results of the Salk field trials, Sabin tested his vaccine on himself, his daughters, and 30 prisoners in Ohio in exchange for $25 and time off their sentence. Experiments were success. But with the Salk vaccine in wide use in the late 1950s, the country had little interest in conducting another large-scale field trial. So instead, Sabin turned to a surprising ally, the Soviet Union. Despite the ongoing cold war, US-Soviet relations had thawed following the death of Joseph Stalin, and Washington's expanding science bureaucracy pushed for greater international collaboration. In a massive 1959 field trial, Sabin's oral vaccine was administered to 10 million Soviet children. Independent review by the World Health Organization declared the trial a success, the oral vaccine was cheap, safe, and easy to administer, and it soon became the world's polio vaccine of choice, crumbling support for Salk's vaccine. Imagine it's July 1961 in New York City. You're the scientific director of the American Medical Association, and you're walking through a hallway in the New York Coliseum, where the AMA is holding its national convention. In a few minutes, you're scheduled to deliver a presentation and you're silently running through your notes. As you round a corner though, a tap on your shoulder stops you in your tracks. You turn around and find yourself face-to-face with Jonas Salk. Excuse me, do you have a moment? You glance at your watch and then shake your head. Oh, not really, Dr. Salk. This won't take long. I just want to know why the AMA voted to endorse Albert Sabin's vaccine over mine. Since when did this organization start weighing in on scientific debates? Well, we needed to pick a sign. Doctors are confused about competing vaccines. They wanted guidance and clarity from an unbiased source. Well, the AMA is hardly unbiased. I can name a half dozen of your colleagues who are friendly with Sabin. This reeks of favoritism. Well, there's plenty of evidence that Sabin's oral vaccine is both more effective and more easily administered than your vaccine. It's based on evidence, not favoritism. There's nothing wrong with my vaccine. The only problem is it hasn't been used enough. Recent outbreaks all took place in neighborhoods with low vaccination rates, you know? This is a social problem, not a scientific one, but the AMA is continually refused to promote mandatory vaccination of my formula. It seems to me that you and your colleagues have blood on your hands. Hearing this, you ball your hands into fists, your anger rising. Now, Dr. Salk, Sabin's live virus formula has the overwhelming support of researchers in the field. It says simple as that. Nothing about this is simple. If the AMA won't see a reason, I'll just have to go to the surgeon general and commence him not to license Sabin's formula. Oh, Dr. Salk, you're facing a losing paddle. I think it's time you accept that your vaccine is a relic of the past. Now, please, if you'll excuse me. You push past Salk and hurry after your presentation. Salk can rage all he wants, but you won't be swayed. His fame doesn't make him immune to scientific scrutiny. And as far as you're concerned, his command over the polio crusade is over. Despite Jonas Salk's protests in the summer of 1961, the American Medical Association endorsed Sabin's oral polio vaccine and the federal government licensed it for commercial use. Sabin's vaccine became the dominant polio vaccine in America for the next three decades. Salk's son Peter later reflected on his father's refusal to accept defeat, declaring this was so terribly painful, so personally insulting to him as a scientist that he couldn't let it go. It's no exaggeration to say that it haunted him for the rest of his life. Still, together, the Salk and Sabin vaccines brought an end to polio in the United States and throughout much of the world. The last case of polio was reported in the US in 1979. In the 21st century, the virus is only endemic in Afghanistan and Pakistan. Experts predict that polio will follow smallpox and becoming the second infectious disease to be eradicated worldwide. The crusade against polio stands as one of America's greatest public health victories. For two decades, the march of dimes harnessed the power of mass media and grassroots fundraising to unite the nation in a common cause. The vaccine research it funded led to the defeat of a dreaded disease and ushered in a new era of government leadership in public health. So that today, what was once one of the most feared diseases in the United States exists only in memory. A remarkable achievement made possible by the collective actions of millions of Americans bound by a shared civic responsibility and an unwavering faith in the power of scientific progress. From wondering, this is the last episode of our three-part series on conquering polio from American history tellers. In the next episode, I'll speak with Karen Torgayli, an epidemiologist and author of the upcoming book Albert Sabin, a life of a polio vaccine pioneer, due to hit shells in June 2026. Follow American history tellers on the Audible app or wherever you get your podcasts. You can listen to all episodes of American history tellers ad-free by joining Audible. And to find out more about me and my other projects, including my live stage show coming to a theater near you, go to notthatlinsigram.com. That's not thatlinsigram.com. American history tellers is hosted, edited and produced by me, Lindsey Graham for airship, audio editing by Mohammed Shazie, sound design by Molly Bach, music by Thrum. This episode is written by Ellie Stanton, edited by Dorian Marina, managing producer Desi Blaylock, senior producers Alita Rizanski and Andy Beckerman. Executive producers are Genial Hour Beckman and Marshall Lui for Wondering.