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Polio vaccine triumph could speed coronavirus pandemic end

Peter Salk still remembers the trepidation he felt when his father came home from work one day in May 1953 and promptly began boiling a set of needles and syringes on the kitchen stove.

With several years of research and promising results in monkeys fueling high hopes, Dr. Jonas Salk had brought from his lab at the University of Pittsburgh a still-experimental vaccine candidate to their Pine home. His family would become among the first humans in the world to test a shot against the mysterious polio virus crippling and killing children.

“I’m sure that my father told us (the importance of) what was happening,” said Dr. Peter Salk, 76, a Pitt professor of infectious diseases and microbiology and president of the Jonas Salk Legacy Foundation, speaking by phone from his California home. “I … was just not happy at the notion of having another shot.”

Peter Salk was 9 years old. He didn’t have a sense of the medical history that he and his family were making, nor the millions of lives that would benefit.

All he knew was that, like many kids his age, he hated needles — so much that he’d previously crouched and hid behind the kitchen wastebasket to avoid getting one.

Standing beside his two brothers, he braced for the injection. Two weeks later, they received a second dose while photographed to generate publicity for the March of Dimes, which was pumping millions of dollars into polio research.

“The point of that was to demonstrate my father’s confidence in the vaccine,” Salk said. “But … it was also, from my father’s side and my mother’s side, ‘Let’s get these kids protected.’ ”

Last month marked the 66th anniversary of the day when the first inoculations began on nearly 2 million children who received Salk’s vaccine candidate in 1954. By 1955, the pivotal public health experiment was deemed a success, with the vaccine proving to be safe, potent and 90% effective in thwarting polio.

The achievement put Pittsburgh on the global map as a leader in cutting-edge medical research and set the stage for decades of investments and advancements in Pitt’s vaccine research capabilities. As the nation confronts the covid-19 pandemic, Pittsburgh scientists have joined the global race to stop the spread of yet another disease horrifying the world.

“Pittsburgh has such a tremendous track record in infectious disease research. There are people working on influenza, there are people working on viruses that cause cancer, there are people who work on HIV. There’s a phenomenal cohort of people in the University of Pittsburgh — and that’s what attracted me,” said Paul Duprex, a virologist who took the helm last year as director of Pitt’s Center for Vaccine Research.

More than 53,000 U.S. deaths were attributed to the coronavirus disease as of Saturday, with more than 10,000 deaths linked to nursing homes. The White House coronavirus task force earlier this month projected the pandemic could kill more than 100,000 Americans by this summer.

“The development of a vaccine for this particular virus is possibly one of the most important things that we’re going to have to do in the next few years,” said Dr. Peter Marks, director of the Food and Drug Administration’s Center for Biologics Evaluation and Research. “It is not unlikely that we may see a second wave or even third wave. … We need to get it right and get it done as quickly as we can.”

As last month, about 175 vaccine candidates are in various stages around the world, with at least four efforts now running human clinical trials — including with patients in Philadelphia, Seattle and Kansas City, Mo., the Coalition for Epidemic Preparedness Innovations reports. Researchers say the first phase of human clinical trials in healthy volunteers in the Pittsburgh area could start in the coming months.

“It costs money and time and patience, and so there’s going to be a significant winnowing of the candidates that are going into Phase 1 trials right now,” said David States, chief medical officer at Texas-based Reinvent Biologics. “A significant number of them probably won’t show great responses and won’t get pursued further.”

The FDA is tracking at least 86 active different approaches among pharmaceutical companies, academic researchers and scientists around the globe.

“We expect about two dozen more to enter clinical trials by this summer and early fall,” Marks said.

Experts agree that getting a vaccine to market will take at least 12 to 18 months, and perhaps longer. The bill for the top contenders will ring up more than $1 billion apiece.

“We need to vaccinate basically the entire world’s population, because the entire world is at risk for this virus, so that’s production at a very massive industrial scale. That’s going to take some time. We’re going to be facing this virus for the foreseeable future without a vaccine,” said Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert and scholar at the Johns Hopkins Center for Health Security. “There may be people who have watched the movie ‘Contagion,’ and the vaccine is developed before the credits roll. That’s not what happens in real life.”

Dr. Anthony Fauci and other experts have warned that mass gatherings — including sporting events and live concerts and performances — probably should not resume until a covid-19 vaccine is ready for mass distribution.

“Just think about the contact tracing that a health department would have to do after a Steelers game,” Adalja said. “That could be too much for any health department.”

How Salk’s quest differs from race for covid-19 vaccine

Much has changed in terms of medicine, technology and FDA regulations around vaccine development since Salk’s quest in the 1950s. Scientists today, for instance, typically are not allowed to start trying out their experiments on their own kids.

“In 2020, it’s much harder to do that kind of self-experimentation, although it does occur,” Adalja said. “There are a lot of concerns that the FDA would have regarding human research subjects. Was there informed consent? Are they part of a proper trial? All of that would be something that would probably not happen as easily as it could in the 1950s.”

Scientists also have so much more technology and methods available, with the covid-19 genome sequence getting mapped within mere weeks of the first samples studied in early January.

“It’s remarkable how quickly we’re moving,” said States, pointing out that it took nearly five months to pin down the genome sequence for the SARS 1.0 virus in the early 2000s.

Yet, lessons can be gleaned from Salk’s discovery as well as vaccine milestones reached in more recent decades. Perhaps most important: Developing a safe vaccine is a slow, painstaking process — but doing so is critical to reach the long-term goals of saving lives, lessening the severity of a contagious disease and, eventually, annihilating it altogether.

“Vaccines really work. Vaccines are really important. Vaccines have led to the eradication of diseases,” Duprex said. “Smallpox is no more because of a vaccine. Polio virus is gone from the United States because of a vaccine. Measles has been reduced significantly because of a vaccine.”

Though less fatal and prevalent than covid-19, polio stoked intense fears and anxiety in households across the country. It did not spur shutdowns, but it changed daily life for many. Swimming pools and movie theaters closed. Expectant parents snapped up polio-specific insurance policies.

At its peak in 1952, polio crippled more than 21,000 children in the United States.

“People were just terrified because there was no way of predicting when polio was going to strike, where it was going to strike, what cities it was going to strike,” Peter Salk said. “There was no rhyme or reason to which kids would become infected, become paralyzed, and people were just scared.”

Mimi Blake, 67, of Pitcairn was just 9 months old when she contracted polio in 1953.

She can’t be certain how, but her parents thought she might have caught the disease, which spreads person to person, from another child in the neighborhood. She was taken to the Pittsburgh Municipal Hospital for Contagious Diseases — where doctors initially weren’t sure she would survive.

“I was one of those people who had polio the worst,” Blake said. “They had an iron lung in the room in case I needed it.”

Despite needing braces, crutches and later a wheelchair to get around, Blake would go on to excel in school. She eventually earned an English degree from Carnegie Mellon University in the 1970s and later worked as a technical editor for U.S. Steel.

Blake’s room as an infant in the Municipal Hospital Building — now named Salk Hall — was one floor above where Dr. Jonas Salk was testing his inactivated polioviruses on animal subjects such as mice. Salk famously was among the first to use a “killed” rather than live virus and prove it could work just as well while posing fewer risks.

“I’m one of the people who hopes that if we get a vaccine for covid-19, that even the people who are anti-vaxxers will get the vaccine,” Blake said. “A lot of them won’t get the polio vaccine, and I worry about it coming back to this country. I don’t think they realize how bad it could be.”

Multiple covid-19 vaccine efforts now are happening simultaneously on the University of Pittsburgh’s Oakland campus.

The first to advance, dubbed “PittCoVacc,” works the same way as the current flu vaccine: Lab-made pieces of the viral protein, referred to as antigens, are introduced to prompt the body to start building immunity. In animal experiments, the vaccine generated a surge in antibodies against the new coronavirus.

Separately, Duprex and a team of 146 people who work at a biocontainment lab are studying covid-19 disease and antigen models after becoming among the first in the United States to receive covid-19 samples in mid-February.

News broke of Salk’s polio vaccine on April 12, 1955, when The Pittsburgh Press front page proclaimed, “Polio Is Conquered.”

“It was just an extraordinary moment,” Peter Salk recalled. “That moment starting at 10 o’clock in the morning … was just unbelievable. Church bells rang, factory whistles blew, kids were let out of school. It was absolute euphoria on the part of the people in this country because this huge fear that they had been living under for so many years was just lifted.”

Today, there are those who lament that modern medical heroes don’t tend to get such accolades.

“In 2020, we’ve lost respect for scientists in a way that we didn’t in the 1950s,” Adalja said. “I think people should be waiting to hear about vaccines the way they wait to hear about a new iPhone, and that people should be cheering vaccines as great technological marvels.”

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