History of Polio Vaccination

Polio is a highly infectious disease, mostly affecting young children, that attacks the nervous system and can lead to spinal and respiratory paralysis, and in some cases death.

Polio has existed since prehistoric times – ancient Egyptian images show children walking with canes, with withered limbs characteristic of the disease. 

While it affected children around the world for millennia, the first known clinical description of polio, by British doctor Michael Underwood, was not until 1789, and it was formally recognized as a condition in 1840 by German physician Jakob Heine.

Many who survived the disease faced lifelong consequences. Deformed limbs meant they needed leg braces, crutches or wheelchairs, and some needed to use breathing devices like the iron lung, an artificial respirator invented for treatment of polio patients. 

A breakthrough occurred in 1949, when poliovirus was successfully cultivated in human tissue by John Enders, Thomas Weller and Frederick Robbins at Boston Children’s Hospital. Their pioneering work was recognized with the 1954 Nobel Prize.

Not long afterwards, in the early 1950s, the first successful vaccine was created by US physician Jonas Salk. Salk tested his experimental killed-virus vaccine on himself and his family in 1953, and a year later on 1.6 million children in Canada, Finland and the USA. 

Salk was committed to equitable access to his vaccine, and understood that elimination efforts would not work without universal low- or no-cost vaccination.

Sabin’s vaccine was live-attenuated (using the virus in weakened form) and could be given orally, as drops or on a sugar cube. 

Like Salk, Sabin tested his experimental vaccine on himself and his family; but he had to go further afield for larger-scale trials. 

He struck up a longstanding collaboration with Mikhail P Chumakov, who was also responsible for tests of the Salk vaccine in the Soviet Union, and Chumakov carried out initial tests of the live-attenuated vaccine using a seed virus that Sabin had provided. 

Independent review of the trials for the World Health Organization by United States specialist Dorothy Horstmann endorsed their findings – a crucial validation in the time of the Cold War.

In 1962, Cuba began to administer the OPV in nationwide immunization programmes. OPV had an added benefit that paved the road to eradication. While IPV protected the vaccinated child, it did not stop the poliovirus from spreading between children. 

In 1979 Rotary International started a multi-year project to immunize 6 million children in the Philippines.  

In 1988, the World Health Assembly passed a resolution to eradicate polio – to achieve its permanent reduction to zero, with no risk of reintroduction –  and in the same year, the Global Polio Eradication Initiative (GPEI) was launched. 

Immense contributions by individual countries were combined with international initiative and assistance, with WHO working to support the global collaboration.

National Immunization Days were coordinated in 19 European and Mediterranean countries in 1995, and in 23 African countries in 2004. By 1994, polio had been eliminated from the Americas, and by 2000 the Western Pacific was polio free. 

By 2003, polio remained endemic in only 6 countries – and by 2006, that number had dropped to 4. 

The 21st century saw further advances, with cases brought down by more than 99% worldwide in less than 2 decades.

WHO’s South-East Asia region was certified polio-free in 2014, the African region in 2020, and the Eastern Mediterranean region has restricted the virus’s reach to just a handful of districts. 

But alongside the success of the OPV comes a disadvantage: continued use of the vaccine poses a risk to wiping out the disease.
While OPV is safe and effective, in areas where vaccination coverage is low, the weakened vaccine virus originally contained in OPV can begin to circulate in undervaccinated communities. 

Since 2017, cases of cVDPV have outnumbered those of wild poliovirus. For this reason, the global eradication of polio requires OPV to be phased out of routine and supplementary immunization, as soon as possible after the eradication of wild poliovirus.

Based on global collaboration and countries sharing scientific knowledge, a new vaccine, novel oral polio vaccine type 2 (nOPV2), has been developed to combat the most common strain of vaccine-derived poliovirus

Through full implementation of the new strategy, with strong political will and the continued support of donors and stakeholders, the world can achieve this extraordinary public health feat.