Dear Editor,
Your nicely written editorial (SN June 25) highlighting the US-Soviet Union cooperation in space exploration reminds me of another example of their collaboration, relevant to these times, hence this letter.
I am referring to that time in the 1950s where the US and the Soviet Union collaborated on vaccine development and manufacturing for the common good, highlighting one of the best examples of vaccine diplomacy. Vaccine diplomacy being defined as the use of vaccines to strengthen diplomatic relationships between countries since vaccines have such an enormous global reach and impact on global health which in turn impacts many other things including the economy; its hard to have a properly functioning economy without a healthy population as we’ve seen in the current pandemic. Vaccine diplomacy can also manifest itself as collaborative research and development which was the case between US and Soviet scientists that developed and undertook large scale manufacturing of the oral polio vaccine (those drops many have taken as children) to undergo clinical trials in the Soviet Union.
Polio epidemics were rampant in the first half of the 20th century and scared parents as young children were among the most susceptible to the paralytic form. In the US, Jonas Salk a virologist and medical researcher, developed the first effective polio vaccine in 1952 which was licensed for widespread use in 1955. It was made of three inactivated (killed) strains of polio and administered via injections. At the same time Albert Sabin, a professor at the Cincinnati College of Medicine doing research in virology, was also working on a polio vaccine but one that could be administered orally. It was an attenuated live-virus vaccine – a type of vaccine where the virus is modified to make it much less virulent or harmless. He and colleagues grew and tested many virus strains in animals and tissue cultures. They found three mutant strains of the virus that appeared to stimulate antibody production without causing paralysis; antibodies being those defense molecules that protect us. He then tested these strains on himself, family, colleagues and prisoners. Antibodies were produced after these tests indicating a successful immune response but the challenge was that there wasn’t that much interest for another polio vaccine since the Salk vaccine was already in widespread use with devastating polio epidemics at the time. In addition, he wouldn’t have enough unvaccinated children in the US to include in a clinical trial to achieve licensure. There was however a global need for a cheaper vaccine (especially in the developing world), one that was easy to administer to children without the need for specially trained personnel. So, he collaborated with Russian virologists Mikhail Chumakov and Anatoli Smorodintsev, at the height of the cold war, to produce (in the Soviet Union) the oral polio vaccine on a large scale to be tested on millions of children in the Soviet Union. This was facilitated by the US State Department and its counterpart in the Soviet Union who helped to iron out bureaucratic and political challenges to make it happen.
Polio epidemics began to occur in the Republics of the Soviet Union shortly after World War II and led to the establishment of the Poliomyelitis Research Institute in Moscow headed by Mikhail Chumakov who would later on collaborate with Albert Sabin. The US-Russia collaboration began in 1956 when Drs. Chumakov and Smorodintsev visited Dr. Sabin in his research lab in the US accompanied by a suspected KGB agent [Swanson W (2012) Birth of a cold war vaccine. Sci Am 306(4): 66–9. pmid:22486119]. In return, Dr. Sabin visited Moscow the same year speaking and interacting with scientists and lobbying for his vaccine trial. Within two years, a shipment of Sabin’s polio virus strains arrived in the Soviet Union on dry ice where manufacturing of these strains was scaled up with clinical trials to be conducted in children. This collaboration wasn’t without challenges. Journalist, William Swanson wrote in the Scientific American that Dr. Chumakov had to use his connections to go over the Russian Minister of Health who would not authorize clinical trials of the vaccine. Ultimately, the Russians manufactured 10 million doses and used it to vaccinate millions of children. The WHO asked Dr. Dorothy Horstmann (a US Doctor/Scientist) to assess quality control in the vaccine manufacturing in the Soviet, for six weeks, to mainly determine that steps were incorporated to ensure safety. In her report to the WHO, she concluded that the manufacturing standards in Russia were good and “the marked reduction in cases in 1959 in orally vaccinated Republics suggests that the vaccine may have played a significant role in reducing the incidence of paralytic poliomyelitis.” The Russians went on to manufacture enough to vaccinate 100 million citizens after Dr. Chumakov’s successful promotion of the significant benefits of vaccination on local media. The success of the vaccine in the Soviet Union paved the way for trials in the US which led to its licensure there in 1961-62.
This oral polio vaccine (administered in drops or on a sugar cube for children) went on to replace the injectable vaccine in many parts of the world and in 1994 the WHO declared the Western Hemisphere was free from naturally occurring polio due to repeated mass immunization with the Sabin vaccine. Thanks to both Salk and Sabin vaccines, polio is now eradicated from world except for Afghanistan and Pakistan where it is endemic. The Sabin vaccine being born out of an extraordinary collaboration between US and Soviet scientists.
Unfortunate is the politicization of vaccination in these times when we need a collaborative effort to encourage vaccination to all since this is what is going to get us out of the pandemic (eventually). We have seen the power of vaccination from the eradication of smallpox and near elimination of polio. Look, at what happens when people on different sides of the political divide collaborate for the common good – a deadly disease is nearly eradicated. Perhaps we can achieve the same for COVID-19. It will take a collective local and global effort. We need everyone on board.
Sincerely,
Jacquelyn Jhingree, PhD.
