Anti-vaccine folks rarely talk about the complications of vaccine-preventable diseases. For that matter, they also often push the idea that vaccines don’t even work and that these diseases aren’t even vaccine preventable, don’t they?
Did Modern Ventilators Replace the Iron Lung for Folks with Polio?
In addition to thinking that we just change the names of diseases when we want them to go away, some folks think that we don’t see anyone in iron lungs anymore, not because polio has been eliminated, but because modern ventilators simply replaced the iron lung.
Is that true?
The iron lung, invented in 1927, helped people with polio breath.
Unlike most of today’s ventilators, the iron lung is a negative pressure ventilator. In contrast, most modern ventilators, the ones that you see people hooked up to with a tube going down to their lungs, are positive pressure ventilators.
What’s the difference?
A positive pressure ventilator pushes air into your lungs. They are useful when you have a lung disease or simply can’t breath on your own.
When people had polio, there usually wasn’t anything wrong with their lungs – it was their chest muscles and diaphragm that were the problem. So the negative pressure in the iron lung would compress and decompress their chest.
One benefit of the iron lung included that it was less invasive than ventilating someone through a tracheostomy, which became an option in the 1960s. While many new options became available for those needing long term ventilation since then, including noninvasive positive pressure ventilation, some still like to use their iron lungs.
And while it is true that they don’t make them anymore, iron lungs have not disappeared. There are some folks with polio that still use them.
But what if someone developed polio now, would they be put in an iron lung?
No, they wouldn’t. For one thing, they don’t make iron lungs anymore. Instead, they would likely use mouth intermittent positive pressure ventilation.
Still, we don’t see a lot of folks getting diagnosed with polio, needing to use mouth intermittent positive pressure ventilation, instead of iron lungs these days. And that’s because we don’t see a lot of folks getting diagnosed with polio.
What to Know About Polio, Modern Ventilators and Iron Lungs
Although some people with polio are still using their iron lungs, the main reason we don’t see more people with polio needing to use iron lungs or modern ventilators is simply because polio is almost eradicated.
“Before the vaccine was developed, the diagnosis of polio required 24 or more hours of paralysis. After the vaccine release, the diagnosis changed to at least 60 days of paralysis. As you can imagine, cases of polio dropped significantly.”
The Myth That Polio Went Away Because They Changed the Diagnostic Criteria
In 1952, there were 21,000 cases of paralytic polio in the United States.
But were there really?
Didn’t they change the way they diagnosed polio a few years later, right after the first polio vaccines came out, making it less likely that folks would be diagnosed with polio?
The original diagnostic criteria for polio came from the World Health Organization and included:
“Signs and symptoms of nonparalytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two examinations at least 24 hours apart.”
It changed in 1955 to include residual paralysis 10 to 20 days after onset of illness and again 50 to 70 days after onset.
“In the past children’s paralysis was often not correctly diagnosed as polio. Stool samples need to be analyzed to be able to distinguish paralytic symptoms from Guillain-Barré Syndrome, transverse myelitis, or traumatic neuritis.”
Polio – Data Quality and Measurement
But you coulld’t just use stool samples, as many kids might have recently had non-paralytic polio, and could test positive for polio (false positive test), but have another reason to have paralysis.
“Isolation of poliovirus is helpful but not necessary to confirm a case of paralytic poliomyelitis, and isolation of poliovirus itself does not confirm diagnosis.”
Alexander et al. on Vaccine Policy Changes and Epidemiology of Poliomyelitis in the United States
Since polio causes residual paralysis, the new diagnostic criteria helped to make sure that kids were diagnosed correctly.
Did We Overestimate the Number of Kids with Polio?
Some folks think that since we changed the criteria, we overestimated the number of kids with polio in the years before the vaccine came out.
Most of this idea seems to come from a panel discussion in 1960 by critics of the original polio vaccine, The Present Status of Polio Vaccines, including two, Dr. Herald R. Cox and Dr. Herman Kleinman, who were working on a competing live-virus vaccine.
None in the group were arguing against vaccines, or even really, that the Salk polio vaccine didn’t work at all though. They just didn’t think that it was effective as some folks thought.
“I’ve talked long enough. The only other thing I can say is that the live poliovirus vaccine is coming. It takes time. The one thing I am sure of in this life is that the truth always wins out.”
Dr. Herald R. Cox on The Present Status of Polio Vaccines
Dr. Cox did talk a lot about the oral polio vaccine. He talked about successful trials in Minneapolis, Nicaragua, Finland, West Germany, France, Spain, Canada, Japan, and Costa Rica, etc.
When anti-vaccine folks cherry pick quotes from The Present Status of Polio Vaccines discussion panel, they seem to leave out all of the stuff about how well the oral polio vaccine works.
“Since nothing is available, there seems to be no alternative but to push the use of it. I don’t think we should do so in ignorance, nor too complacently, believing that as long as we have something partially effective there is no need to have something better.”
Dr. Bernard Greenberg on The Present Status of Polio Vaccines
And of course, they did, fairly soon, switch to something better – the Sabin live-virus oral polio vaccine.
Interestingly, using the idea that we changed the diagnostic criteria to make polio go away in an argument about vaccines is known as the Greenberg Gambit.
It tells you something about anti-vaccine arguments, that these folks are misinterpreting something someone said about vaccines almost 60 years ago.
In pushing the idea that polio hasn’t been eliminated, but rather just redefined, they also miss that:
But isn’t polio still around and just renamed as transverse myelitis, Guillain-Barré syndrome (GBS), and aseptic meningitis?
Let’s do the math.
Using the adjusted numbers in the The Present Status of Polio Vaccines discussion, there were at about 6,000 cases of paralytic polio in the United States in 1959.
While 3,000 to 6,000 people in the United States develop Guillain-Barré syndrome each year, the risk increases with age, and it is rare in young kids. Remember, paralytic polio mostly affected younger children, typically those under age 5 years.
“Transverse myelitis can affect people of any age, gender, or race. It does not appear to be genetic or run in families. A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years.”
Transverse Myelitis Fact Sheet
Similarly, transverse myelitis is uncommon in younger children, and there are even fewer cases, about 1,400 a year.
What about aseptic meningitis? That doesn’t usually cause paralysis.
So do the math.
You aren’t going to find that many kids (remember, the incidence was 5-7 per 1,000) under age 5 years who really have “polio,” but instead, because of a worldwide conspiracy about vaccines, are getting diagnosed with transverse myelitis, Guillain-Barré syndrome (GBS), or aseptic meningitis instead.
Anyway, kids with acute flaccid paralysis are thoroughly tested to make sure they don’t have polio. And both transverse myelitis and Guillain-Barré syndrome have different signs and symptoms from paralytic polio. Unlike polio, which as asymmetric muscle atrophy, the atrophy in transverse myelitis and Guillain-Barré syndrome is symmetrical. Also, unlike those other conditions that cause AFP, with polio, nerve conduction velocity tests and electromyography testing will be abnormal. Plus, polio typically starts with a fever. The other conditions don’t. So while these conditions might all be included in a differential diagnosis for someone with AFP, they are not usually that hard to distinguish.
“Each case of AFP should be followed by a diagnosis to find its cause. Within 14 days of the onset of AFP two stool samples should be collected 24 to 48 hours apart and need to be sent to a GPEI accredited laboratory to be tested for the poliovirus.”
Polio – Data Quality and Measurement
But why be so strict on following up on every case of AFP?
It’s very simple.
If you miss a case of polio, then it could lead to many more cases of polio. And that would tmake it very hard to eradicate polio in an area.
If anything, until the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, it is thought that cases of polio and paralytic polio were greatly underestimated in many parts of the world!
And now polio is almost eradicated.
“DR. SABIN: Let us agree, at least, that things are not being brushed aside. Let us say that we might disagree on the extent to which certain things have received study. But I hope that Dr. Bodian realizes that nobody is brushing things aside. I would not have taken the trouble of spending several months studying viremia with different strains in chimpanzees and human volunteers, and viremia produced by certain low temperature mutants to correlate it with their invasive capacity, if I were merely brushing it aside.”
Live Polio Vaccines – Papers Presented and Discussions Held at the First International Conference on Live Poliovirus Vaccines
If they redefined how paralytic polio was diagnosed in 1955 as part of a conspiracy to make it look like the polio vaccines were working, then why did the number of cases continue to drop into the 1960s?
Shouldn’t they have just dropped in 1955 and then stayed at the same lower level?
And why don’t any of the folks with other conditions that cause paralysis, like transverse myelitis and Guillain-Barré syndrome (GBS) ever have polio virus in their system when they are tested?
Also, if the renaming theory explains why the polio vaccine didn’t work, then why do anti-vaccine folks also need to push misinformation about DDT and polio?
What to Know About Polio Myths and Conspiracies
The near eradication of polio from the world is one of the big success stories of the modern era, just as those who push the idea that has all been faked is a snapshot of society at one of our low points.
It’s because some folks think that everything that happens to their kids is a vaccine injury.
Personal Stories About Vaccine-Preventable Diseases
If you are going to watch those videos and listen to their stories, getting scared in the process, be sure to also listen to the stories of parents who’s kids have suffered through actually getting a vaccine-preventable disease.
While it’s great that these diseases are much less common because most people vaccinate and protect their kids, one side effect of that progress is that we don’t have many reminders of just how terrible these diseases are anymore.Have you ever seen a baby with congenital rubella syndrome?
“Kimberly Coffey was buried three days before her high school graduation in the prom dress she didn’t get to wear. She didn’t have the opportunity to be vaccinated against Meningitis B.”
Kim’s Meningitis Story
In Kimberly‘s case, the Men B vaccine wasn’t yet available, but in many other cases, parents have shared their stories of unvaccinated children who suffered with a disease that was vaccine preventable at the time.
“From 2010 to 2016, young children continued to be at the greatest risk for influenza-associated pediatric deaths. Children without preexisting medical conditions accounted for half of all deaths. Vaccination coverage was low among influenza-associated pediatric deaths.”
Shang et al. on Influenza-Associated Pediatric Deaths in the United States, 2010–2016
Are the stories supposed to scare you into vaccinating your kids?
Of course not. Just like you shouldn’t let the myths and propaganda from the anti-vaccinate movement scare you away from vaccinating and protecting your kids.
Instead of being motivated by fear, you should make your decision because you understand that the many benefits of vaccines are far greater than their small risks.
What to Know About Vaccine-Preventable Disease Stories
Reading stories of vaccine-preventable diseases are a good reminder that these diseases are not so mild as some folks suggest, and they are instead life-threatening diseases that are best avoided by getting fully vaccinated.
And they certainly wouldn’t think that these are mild diseases that they wanted their kids to get, thinking natural immunity would be better than the immunity that they could more easily and safely get from a vaccine.
I know what some of you are thinking. And no, just because these vaccine-preventable diseases aren’t as common as they used to be doesn’t mean that any of these vaccines aren’t necessary.
Benjamin Franklin later wrote in his autobiography that:
“In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way. I long regretted bitterly, and still regret that I had not given it to him by inoculation. This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”
Fortunately, not all of the stories are quite so tragic.
“The doctors told my parents that little could be done for me, so my father prepared for my funeral. Fortunately, I recovered, except for the use of my right hand.”
Archbishop Desmond Tutu on Vaccination’s Lifetime of Blessings
John Salamone – probably the only real pro-safe vaccine advocate there has been, as he fought to replace the OPV vaccine with the IPV vaccine, to prevent further cases of VAPP, like had happened to his son
And there are other fathers to recognize on Father’s Day.
As we wish a Happy Father’s Day to all dads, please take some time to take some time to learn why getting your kids vaccinated and protected is the best choice, because the overwhelming evidence shows that vaccines are safe and necessary.