Table of Contents • I. Poliomyelitis, Treatment, and Prevention Prior to 1955 • II. The Arrival of the Salk Polio Vaccine: Documents, April-July 1955 • A. Optimism Abounds • B. Confronting Challenges • C. Maintaining Momentum • III. Postscript - Polio Prevention after Jonas Salk • IV. Bibliography and Resources • V. Student Assignments • VI. Catalogue of Sources

Section II. The Arrival of the Salk Polio Vaccine: Documents, April-July 1955

B. Confronting Challenges

Throughout the summer of 1955, polio vaccine from six manufacturers was distributed to children as quickly as it could be produced, as newsreels from the period illustrate (Video Clip R).

Video Clip R - "Victory over Polio," U.I. News, Date Unknown

The National Foundation for Infantile Paralysis had donated enough doses for all nine million American first and second graders, partially easing the financial burden on parents, states, and the federal government. However, demand for the vaccine extended far beyond this age group, requiring urgent programs to maximize production and address financial obstacles to vaccination. At the meeting of the President's Cabinet on 29 April 1955 (Document E), these issues were addressed, as were late-breaking reports of polio cases appearing among recently vaccinated children in several states.

Document E - Minutes of Cabinet Meeting, 29 April 1955

With numerous questions and much confusion about the status of the polio vaccination program even among the Cabinet, as the minutes reveal, Secretary of Health, Education, and Welfare Oveta Culp Hobby distributed a reference document on past, present, and future issues related to the vaccination effort (Document F). As noted in the meeting minutes, the Cabinet Paper was intended to be used as 'ammunition' by members of the Cabinet.

Document F - Cabinet Paper, "The Salk Vaccine," 29 April 1955

As the Cabinet Paper explains, reports were made to the Public Health Service two days earlier of six cases of polio among children vaccinated with vaccine manufactured by Cutter Laboratories. While an investigation of these reports and the possible existence of widespread safety would require urgent attention, the report makes clear planning for the overall vaccine distribution effort would proceed as normal for the time being.

A major issue facing the federal government was understanding and resolving the financial implications of the massive vaccination campaign already underway. Complicating the analysis was a lack of certainty regarding how many doses were sufficient for protection, how large the target age groups for vaccination should be, and how the financial burden should be divided among the federal government, states, and individuals (particularly those who could not afford the vaccine).

Estimates of the costs of various programs were provided in Document G.

Document G - "Alternative Calculations of Total Costs and Federal Shares," undated

None of these projections would be of any value if the reports of vaccine-associated polio cases were part of a widespread safety issue. To examine the observed problems with the Cutter Laboratories vaccine, a blue-ribbon panel of experts on polio vaccines met with government officials on 29-30 April. The ad hoc committee included Jonas Salk, Albert Sabin, Thomas Francis, and John Enders. Only a day after the Cabinet meeting, the number of reported polio cases had risen from 6 to 29, according to a statement released summarizing the meeting (Document H).

Document H - Department of Health, Education, and Welfare Statement on Advisory Committee Meeting Regarding Cutter Laboratories Vaccine, 30 April 1955

A remarkable fact reported in the document is that approximately four million children had been vaccinated by April 30, less than three weeks following the announcement of the field study results. Without concluding whether the reported cases were the result of a problem with the Cutter Laboratories vaccine or caused by another process, the committee recommended that the suspension the Cutter vaccine continue indefinitely while those of other manufacturer could still be used.

As noted in the minutes of the 29 April meeting of the Cabinet, President Eisenhower requested to speak publicly about vaccine distribution and safety at his press conference the following Wednesday, 4 May. A portion of his remarks is provided in Audio Clip S. In it, Eisenhower suggests that the polio cases following vaccination may be the result of the injection stimulating dormant poliovirus already present in the child. This was a hypothesis voiced in the Cabinet meeting a week earlier and one of several offered by the ad hoc committee assembled to examine the Cutter vaccine situation.

Audio Clip S - Audio of President Eisenhower on Safety of Salk Polio Vaccine, 4 May 1955

In May 1955, the national vaccination program did not maintain the remarkable pace it had established a month earlier, in part to ensure that vaccine-associated polio cases were confined to the Cutter Laboratories vaccine. A subsequent analysis concluded that they were. Overall, an error in Cutter's manufacturing protocol was deemed responsible for 164 cases of paralysis and 10 deaths among vaccinated children and those in contact with them.

As the month progressed, efforts turned increasingly to developing strategies to maintain over the long-term at least some of the vaccination program's initial momentum. At the same time, safeguards were implemented in hopes of ensuring the vaccine's safety.

Continue to Maintaining Momentum