They were part of a large clinical trial, getting either the polio shot or a saline placebo, and helped prove that the vaccine was safe and effective.
Do You Remember Sabin Sundays?
Of course, that wasn’t the end of the story though.
After the Cutter Incident, Albert Sabin soon proved that his live, oral polio vaccine was better than Salk’s inactivated polio vaccine.
And it was first given in the United States on April 24, 1960 – the first Sabin Sunday, when 20,000 children came to Cincinnati Children’s to receive his sugar cube vaccine.
“On three consecutive Sundays — “Sabin Sundays” — in 1960, millions of families lined up at churches and schools across the country to swallow a spoonful of pink syrup or a sugar cube treated with a life-saving polio vaccine, developed by UC researcher Albert Sabin.”
Sabin Sunday, 1960
Sabin Oral Sunday immunization programs continued over the next few years all over the country as kids got caught up on their polio vaccines.
Can you imagine taking your kids to school to get them vaccinated on a Sunday?
Millions of parents did it!
They lined up to get their kids vaccinated and protected.
In fact, morbidity/mortality from polio vaccines are decreasing, as we are using much less oral polio vaccine (OPV) in the transition (OPV cessation) to just using inactivated polio vaccine (IPV).
“Over the past ten years, more than 10 billion doses of OPV have been given to nearly three billion children worldwide. More than 16 million cases of polio have been prevented, and the disease has been reduced by more than 99%. It is the appropriate vaccine through which to achieve global polio eradication.”
And while most developed countries already use IPV, those that are still using OPV recently switched from a trivalent (tOPV) to a bivalent (bOPV) form of OPV. We could do this because type 2 poliovirus has already been eradicated (2015)!
So morbidity (getting sick)/mortality (dying) from polio vaccines is low.
What about morbidity/mortality from polio?
“As recently as 30 years ago, wild poliovirus paralysed more than 350 000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”
“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan
With a 99.9% drop in polio cases since 1998, your risk of getting polio in most parts of the world is very low, but you still have to consider both the morbidity/mortality of polio in the pre-vaccine era and the risk of polio returning if we stop vaccinating before it is eradicated.
What about the idea that you don’t have to worry about polio because only 1% of kids with polio developed paralysis?
“The mortality rate for acute paralytic polio ranges from 5–15%.”
Disease factsheet about poliomyelitis
Well, when everyone gets polio, even 1% is a lot.
With such a safe vaccine, why put your kids at risk of getting polio?
Do you even understand what the risks are?
No, it isn’t just the risk of wild polio in Afghanistan and Pakistan.
Since the oral polio vaccines shed, if you are unvaccinated, in addition to the risk of wild polio, there is a small risk of getting circulating vaccine-derived polioviruses (cVDPV) if you are not vaccinated and protected. No, it is not a big risk, as there were only 102 cases of cVDPV in 7 countries in 2018, but it isn’t zero either.
And the other big risk is that if enough folks stop getting vaccinated, taking their chances hiding in the herd, polio will come back and our chance to eradicate another vaccine-preventable disease will fail.
More on the Morbidity and Mortality Rates of Polio
brought the Morbidity and Mortality Weekly Report to CDC
investigated the swine influenza virus vaccine incident, when it was thought that some people developed GBS after getting the new swine flu vaccine in 1976
His work saved the lives of hundreds of thousands of people.
Did he ever tell folks to not get a flu shot?
Was he ever concerned about mercury in flu shots?
Considering that Dr. Langmuir died in 1993, before folks became concerned about thimerosal in vaccines, that’s unlikely. That’s especially so considering that the only place you can find these types of quotes are on anti-vaccine websites.
Still, Langmuir was critical of flu shots.
“From this appraisal of the experience in the past three and one-half years, it is apparent that progress in the control of influenza has not been impressive.”
Langmuir et al. on The Epidemiological Basis For The Control Of Influenza
He didn’t think that they worked well enough. Or more importantly, he didn’t think we had enough information about how well they worked.
“Our information regarding the occurrence of influenza is largely qualitative. Schools close, absenteeism increases, medical services become taxed, virus isolations and serological identifications are made in great numbers, and daily accounts appear in our newspapers and on television. We know we have an epidemic and we know its specific cause, but we have few quantitative measures of incidence, age- and sex-specific attack rates, and character and severity of complications. Further- more, we have only crude data regarding mortality. We do not know what proportion of excess deaths occurs among reasonably active and productive citizens in contrast to deaths among persons who are already invalids suffering from severely debilitating pre-existing disease. Despite this serious deficiency we base our recommendations for vaccine use largely on mortality experience. We undertake major efforts to produce influenza vaccine in large amounts, but we have no meaningful information regarding its actual distribution. We do not know to what extent it actually reaches persons at highest risk.”
Langmuir et al. on A Critical Evaluation of Influenza Surveillance
“The availability of potent and effective measles vaccines, which have been tested extensively over the past 4 years, provides the basis for the eradication of measles in any community that will raise its immune thresholds to readily attainable levels.”
Langmuir et al. on Epidemiologic Basis For Eradication Of Measles In 1967
And concerning all that he did in the field of public health, he is certainly not someone that anti-vaccine folks should be quoting.
With billions of doses of vaccines being given each year, it is likely not surprising that we see some problems. But when many of those vaccines are being given to kids, even one mishap, especially if it leads to life-threatening complications, is too many.
That’s why many safe guards have been put in place in the manufacturer and distribution of modern vaccines, so that we don’t see these types of vaccine tragedies:
the Cutter Incident, when, in 1955, at least 56 people developed polio and 5 children died after being vaccinated with inactivated polio vaccine that was poorly manufactured by Cutter Laboratories and still contained live polio virus
hepatitis-contaminated yellow fever vaccines – some lots of yellow fever vaccines used in the military in 1942 were unintentionally contaminated with the hepatitis B virus
the Lubeck Disaster – 75 children died and others got tuberculosis in 1929 Germany after there was a mixup between the BCG vaccine and the strain of Mycobacterium tuberculosis that causes tuberculosis. The BCG vaccine was supposed to be made with a weakened strain of Mycobacterium bovis bacteria instead.
the Bundaberg incident – 12 children died in Australia in 1928 after being given contaminated diphtheria vaccine from a multidose vial without preservative
tetanus contaminated smallpox vaccine in the 1890s and early 20th century
Although vaccines are much safer now, some rare incidents still occur.
Fifteen infants died and 75 children got sick in Syria in 2014 after they received a neuromuscular blocking agent, atracurium, instead of the measles vaccine they were supposed to get. How? The measles vaccine that was being used is mixed with a diluent, but instead of using the proper diluent, the health worker unintentionally used a bottle of atracurium instead.
In 2015, at least two kids died and 29 got sick in Chiapas, Mexico, among 52 children who were vaccinated. The children were reportedly given a BCG vaccine, the rotavirus vaccine, and/or a hepatitis B vaccine that day. However, the only vaccine that all of the sick children received in common was the hepatitis B vaccine. Since 130,000 doses from the same batch of vaccines had been given in the area, it was not thought to be a manufacturing problem or widespread issue. It was instead bacterial contamination of hepatitis B vaccine vials at that one clinic.
Fifteen children died in 2017 in a village in South Sudan after a poorly trained team that wasn’t adhering to WHO immunization safety standards used the same syringe to reconstitute measles vaccines over a four day period. They also didn’t keep the vaccine vials refrigerated.
“A single reconstitution syringe was used for multiple vaccine vials for the entire four days of the campaign instead of being discarded after single use. The reuse of the reconstitution syringe causes it to become contaminated which in turn contaminates the measles vaccine vials and infects the vaccinated children.”
Statement regarding findings of joint investigation of 15 deaths of children in Nachodokopele village, Kapoeta East County in South Sudan
As you can imagine, the conditions that led to these tragedies aren’t present when most kids get vaccinated.
Even in developing countries, most children get vaccinated by people adhering to WHO immunization safety standards. Why did they happened then? Both Syria and South Sudan have been rocked by war for years, leading to a breakdown in the ability to provide routine health care, even as basic as getting kids vaccinated. And Comunidad La Pimienta, Simojovel, Chiapas is a very poor part of southern Mexico.
These kinds of tragedies aren’t going to happen at your pediatrician’s office, as they don’t even have drugs like atracurium.
What Happened in Samoa?
In Samoa, four years after the deaths of the children in Syria, two children died within minutes of being vaccinated on the same day in the same hospital on the island of Savai’i.
Not surprisingly, as health officials investigate the cause, use of the MMR vaccine was suspended in Samoa.
So what happened?
On 4 June 2019, both nurses pleaded guilty to negligence causing manslaughter. On 2 August, both nurses were sentenced to five years in prison. During the sentencing hearing, it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine. Eight Samoan speaking New Zealand nurses visited Samoa in June to provide training for vaccinating nurses at district hospitals.
Infant deaths in Samoa a tragic outcome from error preparing MMR vaccine
As suspected, since it happened so quickly, it ended up being a mix-up with the diluent, as happened in Syria. A five dose vial of MMR is used in Samoa, which means that unlike premixed vaccines, it does have to be mixed with a diluent.
Unfortunately, we are now hearing of a case in Cuba.
The Ministry of Health in Cuba released a statement a few days after her death:
“Between October 7 and 8 of this
year, three one-year-old children were diagnosed with an adverse event
associated with vaccination with PRS, which protects against Mumps,
Rubella and Measles, this is applied according to official scheme to
children one and six years old.
All had been vaccinated on October
7 at the “Betancourt Neninger” Polyclinic in the municipality of Habana
del Este, province of Havana, and immediately after symptoms appeared,
they were admitted and received medical attention by professionals of
high scientific level in the Pediatric Hospitals ” Borrás Marfán ”and
Through the active research carried out on all
children vaccinated in that Health Area, two more children were detected
with symptoms, which motivated their admission.
October 9 at night, the one-year-old girl Paloma Domínguez Caballero
dies, admitted to the “Borrás Marfán” Hospital as a result of
complications. The remaining four children remain admitted: one with
intensive attention, which is stable and the others evolve favorably.
system of active surveillance of the events associated with vaccination
carried out in the country has not identified any other children with
The PRS vaccine has been used for years in Cuba,
imported from India, is endorsed by the World Health Organization and
certified by the Center for State Control of Medicines, Equipment and
Medical Devices (CECMED).
A Commission of the Ministry of Public Health investigates the causes that caused this unfortunate event.”
Official Note from the Ministry of Public Health on adverse event associated with vaccination with PRS (computer translation)
Unlike the case in Samoa and Syria, this one sounds like contamination.
It is known that vaccine vials can be contaminated with Staphylococcus bacteria if they are mishandled. Although Staphylococcus bacteria can directly cause infections, they can also release a toxin that can cause toxic shock syndrome (TSS).
There have been reports of TSS following vaccination in the past, usually with vaccines that don’t use preservatives, with symptoms developing over four to 24 hours.
Fortunately, these kinds of tragedies are very rar. Remember that billions of doses of vaccines are given each year without problems, saving millions of lives.