In America and elsewhere, governments are considering whether to replace the current polio vaccine, which is causing the only new cases of polio.
The polio vaccine is often considered the essential vaccine, even among those parents most militantly opposed to vaccination. Perhaps because of the horror stories of children in wheelchairs and iron lungs remembered by grandparents of today's toddlers, most mothers who have decided not to give their child the diphtheria, tetanus, pertussis (DTP) vaccine nevertheless believe that they would be irresponsible not to immunize against this most dreaded disease. Particularly, their health worker assures them, as the oral version now given is perfectly safe, so that a weakened form of the disease occurs in their child the way it would do naturally. Indeed, the polio vaccine has been called the safest vaccine known to man.But how safe is that? In America the government is considering a complete change in vaccination product and policy, following convincing evidence that all the cases of polio today are caused by the vaccine itself. The long term debate between Jonas Salk, who developed a killed viral vaccine, and Albert Sabin, the founder of the live virus used mostly in England and America, has been sparked again, a debate that looks set to rage on before being resolved.
In order for you to make the most informed choice, we consulted with our panel member J. Anthony Morris, a vaccine expert formerly of the National Institutes of Health and the Food and Drug Administration, who testified in Congress about all vaccines, including the polio one. Dr Morris opened his foot thick files to us. Here is what we found there and among other books, notably Immunization: The Reality Behind the Myth by Walene James (Bergin & Garvey, 670 Amherst Road, South Hadley, Massachusetts 01075).
There are genuine questions that the vaccine may not be wholly responsible for wiping out polio. More than any other, this particular vaccine is pointed to with pride by every government as definitive proof that mass vaccination programmes work. The US government uses as evidence the fact that during the plague years of polio, 20,000-30,000 cases per year occurred in America, compared to 20-30 cases a year today. But in just one of the instances James points out in her book, Dr Bernard Greenberg, head of Department of Biostatistics of the University of North Carolina School of Public Health, testified that polio increased substantially after the introduction of mass immunization by 50 per cent between 1957 and 1958 and 80 per cent from 1958 to 1959, even though statistics were manipulated to give the opposite impression.
A member of the North Carolina Health Department attempted to extol the virtues of the vaccine in helping to cause cases to decrease from 1953-57 until it was pointed out to him that vaccinations were given in mass numbers until 1956, when the cases of polio then began going up!
One way that the figures were manipulated, says James, was to redefine the disease, distinguishing it from cases of viral or aseptic meningitis or cocksackie virus. She quotes statistics from the Los Angeles County Health Index, showing that in July 1955 there were 273 cases of polio reported for 50 cases of aseptic meningitis, compared to five cases of polio in 1966 and 256 cases of aseptic meningitis!
Furthermore, she and others believe that diseases operate cyclically. The great polio epidemics occurred in the 1910s, the Thirties and the Fifties and then sharply dropped off down to nearly zero. But at the height of the fifties epidemic, after the vaccine was introduced, as James quotes another writer, "the vaccine took the credit instead of nature."
This view is borne out by an Australian study presented at the Natural Hygiene Society in Milwaukee, Wisconsin, showing that the polio vaccine has not had any impact on the polio epidemic, and by more recent studies showing that the vaccine does not control polio in Senegal and other Third World countries, to the puzzlement of the medical profession.
The American government census has said that about one third of all children and 40 per cent of all Americans are not vaccinated against polio. "So where's polio?" medical critic Dr Robert Mendelsohn once wrote. "Diseases are like fashions; they come and go, like the flu epidemic of 1918."
In many cases, outbreaks of polio occur more among immunized than unimmunized populations. According to Congressional hearings cited by James, in 1961, Massachusetts had a polio outbreak with more paralytic cases among the vaccinated than the unvaccinated. "Every time we have an outbreak, the FDA blames it on a 'subpotent' vaccine," says Dr Morris. "The fact is that many lots of the vaccine used fail."
Polio is not the virulent, mass killer it is always made out to be. Largely because of the 1950s epidemic (following on the heels of the US presidency of Franklin Roosevelt, who was a victim), polio has been seen to strike randomly and viciously. In fact, most cases of polio are harmless infections. The current statistics are that only 10 per cent of persons exposed to polio will contract it, and only 1 per cent of those will come down with the paralytic variety. Medical homoeopath Dr Richard Moskowitz has called this a "special anatomical susceptibility" to develop paralysis from this ordinarily harmless virus.
The reason behind a renewed fuss over the vaccine has to do partly with the difference in the way the two varieties work. Both live and killed viruses work on the same principle which is to contain altered, supposedly safe forms of the three major strains of the wild polio virus. When administered to a patient either by injection (the Inactivated Polio Vaccine, or IPV) or orally (the Oral Polio Vaccine, or OPV) they trick the body into creating antibodies, which "recognize" and counteract the real thing if they ever come in contact with it.
In true cases of polio, the virus lives in the intestine, creating what is ordinarily a harmless infection. The problem is when it travels to the bloodstream and makes its way to the nervous system, it can cause paralysis. The killed virus originally developed by Jonas Salk, injected under the skin, supposedly works by travelling to the bloodstream and creating antibodies there, which will "block" the virus before it reaches the nervous system. However, the IPV does not give you "gut immunity" that is, does not raise antibodies in your intestines. That means that while you won't get paralytic polio, the wild virus could live on in your gut and you could theoretically pass it on to someone else. Furthermore, the original Salk vaccine required three or more boosters every five years.
When first administered, the Salk vaccine was deemed a terrific success until the polio victim rate went up in the Sixties. Coming so shortly on the heels of the double digit victim rates of the Fifties, this new development was greeted as proof that the Salk vaccine didn't work, particularly in the hysteria to find a "cure" , and the live virus was introduced.
The live oral vaccine became the vaccine of choice largely so that you or your children would act as an immunizing force for other, unvaccinated individuals. The live vaccine, developed by Sabin, came into use in the Sixties, virtually replacing the Salk vaccine, now used for only 1 per cent of the American population, because it not only supposedly confers life long immunity on its recipient, but stops him from becoming a carrier of the wild virus. And because recipients can excrete the vaccine virus for a number of weeks through the mouth and faeces, the theory is that you can pass on immunity to nonvaccinated individuals, thus raising the "herd immunity".
The problem is that in some cases, this "attenuated" or weakened version of the vaccine virus genetically altered in the gut, transforming into its virulent form, causing paralytic polio in its recipient or those that the recipient has recently come into contact with. These days, virtually the only cases of polio that occur in Britain or America are from the vaccine (see box, p3), more among so called contacts than recipients ie, grandparents, parents or siblings whose vaccine immunity has worn off or who are in some way, susceptible. According to ASM News (1988) there have been more than 100 cases of vaccine induced paralytic polio in America between 1975-86.
In a letter to doctors, Lederle Laboratories, which manufactures the live vaccine in the States, admitted that 18 recipients of the vaccine, 47 contacts and 11 other "immunodeficient" contacts have contracted paralytic polio between 1969 and 1978 . The Centres for Disease Control in Atlanta estimates the current risk for vaccine induced polio is at 5 per million doses given or one case per 500,000 first doses, which are said to be the most risky. That figure could be too low; West German doctors from the University of Cologne writing in the Lancet (15 Dec 1984) put their country's risk at 5 per million cases, or one case per 200,000 doses. Among immunocompromised people, that risk multiples 10,000 times. In Germany, most of the cases of vaccine induced paralytic polio have been among children aged two years or younger that is, recipients themselves.
Besides polio, your child also risks poor weight gain or other paralytic diseases with the vaccine. According to a American Journal of Clinical Nutrition report (April 1977), children immunized with the DTP and polio vaccines) "suffered statistically significant reductions in their weight for age, compared to matched nonimmunized controls." Those who were smaller anyway were especially affected. The report ended up recommending that live vaccines only be given in developing countries in actual epidemics or if vaccination was otherwise difficult to achieve.
Finland, like Sweden and The Netherlands, has always favoured the killed IPV vaccine. However, following an outbreak of 10 cases in 1985, the government organized a mass vaccination campaign with the live vaccine. A few weeks after the campaign, the Department of Paediatrics at the University of Oulu in Finland, in The Lancet (19 August 1989) reported a cluster of 27 cases of childhood Guillain Barre syndrome (GBS), a paralytic condition that also occurred in America following mass immunization for the swine flu vaccine in the Seventies. Eleven of the children had been immunized before the onset of symptoms. There are also safety questions about its administration with the DTP jab. "Since simultaneous intramuscular injections may increase the incidence of paralytic poliomyelitis, injections such as diphtheria tetanus immunization should not be given at the same time as OPV," wrote the authors of the University of Cologne letter to the Lancet cited above.
There is no evidence that the live vaccine actually does achieve this so called "backdoor" immunity among the unvaccinated. This was the conclusion of a February 1984 Lancet article about an outbreak of 1000 cases in Taiwan, despite the fact that some 80 to 98 per cent of young children was immunized.
Because of the risk of getting polio from the live vaccine, the governments in America and elsewhere are now considering reverting to the IPV, particularly as the Merieux pharmaceutical company in Europe and Connaught Labs in America have come up with an enhanced killed vaccine (or E-IPV, in science speak), which supposedly confers immunity on children against all three polio types after two doses.
Millions of children receiving the Salk vaccine in the Fifties and Sixties have been infected with another, potentially cancer causing virus. Speaking before the Committee to Study the Poliomyelitis Vaccine at the Institute of Medicine, National Academy of Sciences, A. D. Langmuir pointed out that in the Sixties a virus named SV 40 was found to be a "fellow traveller" of the polio virus. The process of killing the polio virus was not sufficient to kill SV 40. "Many millions of doses of this 'contaminated' vaccine had been administered to children during the initial 1955 campaign and more later," he said. When a combined DTP and polio shot was found to contain SV 40, it was discontinued.
Meanwhile, says Dr Anthony Morris, SV 40 and similar agents have been recovered from human brain tumours "and also precancerous conditions in the brain." It has been shown to cause cancer in hampsters after the equivalent of 20 years in man.
Before you jump on the E-IPV bandwagon, it may be wise to consider that this vaccine has never been tested long term in man and that there have been other neurological complications following the used of the killed vaccine, including GBS, lower motor neuron weakness, encephalitis, meningitis, and convulsions, according to a Danish study, where the killed vaccine is used.
Says Dr. Morris: "If I were asked would I vaccinate my grandchildren against polio, the answer is: only if they were travelling to Egypt in the summer."
For more information about polio and other childhood vaccinations there are still copies available of The WDDTY Vaccine Handbook, a 24 page guide available from WDDTY at lb4.95.