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, we are once again hearing about reports of deaths after kids were vaccinated with the MMR vaccine.
Two children in Samoa, both one-year-olds, 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 had been suspended in Samoa.
So what happened?
“Until the investigations have been completed and reported on we cannot say what did happen.
However, given the batch of vaccine involved had been in use in that country since August last year, and given the same batch of vaccine has been used in South American countries and the Caribbean island nations without incident, it seems unlikely that there was anything wrong with the vaccine.
The reports from the parents of the children affected on Friday indicate the reactions occurred within minutes after vaccination. This would preclude a response to the vaccine viruses as this takes at least a week. While anaphylaxis occurs within minutes and can be fatal when not treated the odds of seeing this twice in a day at the same place, given a chance of 1 in a million doses, is literally astronomical.”
Dr. Helen Petousis Harrison on What happened in Samoa?
Since it happened so quickly, it sounds like it could have been 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.
What about 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).
Considering how quickly these children got died though (within minutes), it isn’t likely that the vaccines became contaminated with Staphylococcus toxins. There have been reports of TSS following vaccination in the past, usually with vaccines that don’t use preservatives, but symptoms typically develop over four to 24 hours.
“This particular vaccine batch lot arrived to Samoa in August 2017 and has been in use since then. The same vaccine batch lot used in Samoa is also in use in a number of South American and Caribbean countries (Belize, Ecuador, St. Vincent, Trinidad Tobago, Chile, Aruba, Dutch Antilles, St. Kitts & Nevis and Cuba) with no reports of adverse events from those countries.”
Could this be related to what happened to two other children in Samoa who had died after getting their MMR vaccines?
Almost certainly not. Those children, siblings, died years earlier, one in 2015 and the other in 2017. Neither died immediately after being vaccinated and there are reports that they may have had some kind of an immunodeficiency syndrome that contributed to their deaths.
“A number of media outlets are already covering these tragic events, speculating on the cause of death before the investigation is completed, and the stories have been picked up by the anti-vaccination movement.”