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\title{Racist Polio Vaccines and Scientific Credit}


\author{Jeff Montgomery}
\affil{Affiliation not available}



\date{\today}

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\textbf{Who gave summer back to children of the 50s and 60s?}\\
Yesterday was Dr. Jonas Salk's 100th birthday. The Google Doodle celebrating it was profiled in \href{http://www.theguardian.com/science/head-quarters/2014/oct/28/jonas-salk-google-doodle-celebrates-polio-vaccine-pioneer}{The Guardian}, which acknowledged: 
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The story of Salk's search for a vaccine isn't one that should be told in isolation, stopping with the elimination of polio in the US. Instead, it sits within a rich tapestry of stories about scientific discovery and progress.
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Except that Salk's treatment \textit{wasn't} responsible for eradicating polio in the US.  His treatment was too expensive for millions of Americans at a time when children were kept indoors during summer to prevent infection. Despite the oft-repeated Salkian quote, "There is no patent.  \href{http://www.biotech-now.org/public-policy/patently-biotech/2012/01/the-real-reason-why-salk-refused-to-patent-the-polio-vaccine-a-myth-in-the-making}{Could you patent the sun}?", adminstrative powers above Salk (his involvement is unclear) determined they \textbf{could not legally patent the vaccine}, given previous works.  Still, three vaccine shots and a booster priced polio protection only within the reach of middle class Americans and above.

So infection rates dropped among demographics that could afford the Salk vaccine, while rates expanded in lower income communities, especially among under-served minority groups.  This was an economic as well as access problem: pediatricians could command higher prices as there was high demand for the multi-course regimen. Dr. Albert Sabin, another polio researcher, knew that Salk's vaccine was not the best possible solution or even sufficiently safe.  His arguments for impartiality and caution were largely ignored by the council backing Salk's vaccine (see link below), yet Sabin labored on.  He developed a single orally-dosed drug that allowed low-cost, wide-scale distribution of this life-saving treatment.

As described in the aptly titled review, \href{http://www.technologyreview.com/review/404390/the-myth-of-jonas-salk/}{The Myth of Jonas Salk}, Sabin's treatment was truly responsible for ending polio in the US (and is currently the one in use to eradicate polio across the globe):
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Beginning in January 1962, pediatricians in two Arizona counties ... conducted separate but similar voluntary mass immunizations using Sabin's vaccine. "Previous programs using the Salk vaccine had failed to bring polio immunization to a satisfactory level," they reported a year later in the Journal of the American Medical Association.... More than 700,000 people were immunized -- 75 percent of the total population in both counties. The vaccine was given at the cost of 25 cents, for those who could pay. It was given to population groups that were socially, racially, and culturally diverse, on Indian reservations and military posts and in urban and rural areas. The program became a model for subsequent U.S. mass-immunization programs. By the mid-1960s, Sabin's vaccine was the only one in use in the United States. It was the Sabin vaccine that closed the immunity gap and effectively put an end to polio in the States.
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Of course aspects of Sabin's work were built off the work of Salk - all of science is inherently iterative.  But we as a community and society at large need to have systems in place to ensure credit is given where credit is due. Thanks to a half-century of good PR and first-mover advantage, Dr. Salk is heralded as the vanquisher of polio, while it was Sabin's dogged persistence at achieving a better solution that tipped the scales (not to mention countered an economically and racially-biased course of treatment).  

There is an entire subset of scientists who passed through history largely undetected, while making tremendous impacts.  Female scientists have made up a disproportionate amount of this subset, routinely discouraged from research (e.g. see comments in \href{https://www.authorea.com/users/2/articles/10288/_show_article}{this post}). For every triumphant Salk, there is almost always a Sabin (or Rosalind Franklin, et al) who deserves equal if not more recognition.  Hopefully with improved access and documentation, the scientific community can better allocate credit, resources, support, and realize improvements faster. 

Share this on \href{http://www.facebook.com/Authorea}{Facebook} to extend Salk's celebration to Sabin (and the other researchers who contributed to the polio vaccine), and to serve as a reminder of the less-than-famous scientists who are giants in their own right.

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