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Polio Vaccination in Cold War Hungary
Today's blog post is contributed by Dora Vargha, Rutgers Univeristy, Philadelphia Area Center for the History of Science Research Fellow.
The small airplane of the Swiss company Belair was already two and a half hours late, when it finally appeared above the skies of Budapest after 6 pm on July 13, 1957. A quite prestigious group greeted its West German pilot at the airport. The Communist party official shook the hands of the Western hero in the name of all Hungarian mothers, while experts from the Health Ministry and the National Public Health Institute inspected the cargo: a long-awaited shipment of polio vaccines. It had been a difficult summer with a record number of children becoming paralyzed with the disease, which caused growing concern since the beginning of the decade.
Polio epidemics hit Hungary more severely than ever before in the 1950s. Preceding World War II, poliomyelitis epidemics appeared usually every four years in Hungary, but as in many parts of the globe, outbreaks became more frequent and more deadly from 1952 and were perceived as a constant threat until 1959. Polio symbolized a destructive threat to the communist and modernist projects. It affected children in a war-stricken society, leaving crippled bodies behind at a time of heightened industrial production and recuperation from the war. The communist state, which positioned itself as a provider of free childcare and healthcare, was facing a serious challenge with the epidemic that worked against all of its ideals of production. Vaccinating the population in Hungary became a top priority soon after the vaccine became available.
In the midst of the epidemic, there was new hope: an inactivated vaccine, developed by Jonas Salk in the US in 1955, became available. The vaccine contained dead viruses that helped the immune system of the body to develop defense against the poliomyelitis virus. Albert Sabin worked simultaneously on an oral vaccine containing live viruses. However, by the time he got to the phase of trials, an unfortunate event, which became known as the Cutter incident, raised suspicions against polio vaccines, when almost 200 patients (mostly children and family members) were stricken with paralytic polio from a faulty batch of vaccine. The political effect of the incident was huge, and the US government did not want to invest more money into potentially risky trials of a second vaccine. Therefore, with the blessing of the US State Department, Sabin moved his vaccine research to the USSR, where he worked with Soviet scientist Chumakov on developing and testing the new solution to polio, conducting large scale field trials in the fall of 1959.
Although vaccines containing dead and live viruses appeared as solutions to curb contagion, they also held the potential power to cause disease instead of fighting it. Thereby, vaccines contained the potential power to cause serious damage to the most innocent and pure members of society, the promise of the future: children. Questions about where the vaccine was arriving from, where and from what it was made, who produced it and who distributed it became important political problems on both sides of the Iron Curtain.
The validity of vaccine trials and the effectiveness of the Salk and Sabin vaccines were evaluated in the US, the USSR and in Hungary as well, according to whether they were developed on the Western or Eastern side of the Iron Curtain. The bodies of healthy and disabled children became terrains of nationalist sentiments or signs of industrial productivity.
The official Hungarian standpoint seemed to be dogmatic about the Salk vaccine at first, especially when news of the Cutter incident broke. Using the image of the innocence of children, the party newspaper accused the US of negligence: “The effectiveness of a new vaccine can be established only after a long time and numerous experiments. It is a dramatic fact that due to such negligence many thousands of children became the guinea pigs of the savage protectors of free enterprise.”
In the midst of the Cold War, it was important that the Soviet vaccine trials were validated by Western scientific authorities as well. The WHO, already highly interested in global polio eradication, sent an American specialist, Dorothy Horstmann to the Soviet Union to report on the safety of the vaccine and the validity of the trials. The favorable report was followed by yet another international polio conference, this time specifically on live poliovirus vaccines, in Washington D.C. One American scientist bluntly confronted the Soviet results, questioning the reliability of their data and considering the reports of Soviet epidemiological teams. The Soviet reply came: “I would like to assure [you] of one thing, that we in the Soviet Union love our children and are as concerned for their well being as much as people in the United States, or any other part of the world are for their children.” Thus, polio became an equalizer, pointing to the common familial bond, a bond of responsibility, between parents and children.
Although vaccination started in Hungary in 1957 with the Salk vaccine, two years later another severe epidemic hit Hungary. The introduction of oral Sabin vaccination in December 1959 marked success, Hungary being one of the first countries to start efficient free, mass vaccination, along with Czechoslovakia. It seemed that in the case of the vaccine arriving from the East, "long time and numerous experiments" were not required. Hungary remained in the forefront of polio eradication, recording the last wild polio case in 1969, 10 years prior to US elimination of polio.
Photo: Rezső Hargitai, and Ákosné Kiss, eds. A Gyermekbénulás Elleni Küzdelem: Beszámoló Egy Ma Már Múlttá Váló Rettegett Betegség Ellen Folytatott Hősies Küzdelemről És Felszámolásának Lehetőségéről: A Szent László Kórház Centenáriumára Készült Összeállítás [the Fight against Polio: Collection Published for the Centennial of the St László Hospital] Budapest: Literatura Medica, 1994. p.22. Fig.1.
 Radio Free Europe, "Polio in Hungary. Background Report," (RFE News & Information Service - Evalluation & Research Section, 1957 July 13).
 Saul Benison, "International medical cooperation: Dr. Albert Sabin, live poliovirus vaccine and the Soviets," Bulletin of the history of medicine 56 (1982).