Ladies Home Journal, December 1954

Have We Won The Fight Against Polio?

This spring we’ll know the results of the biggest field trial in medical history—made possible by the determined, devoted efforts of thousands of volunteers. Here’s how they helped test a new vaccine.

A common piece of advice doctors once gave during a polio epidemic was, "Get out of town." No one understood poliomyelitis; no one could stop a panic once it struck. Research studies on the dread infection were so hit-and-miss that it was impossible to separate fact from fiction. Then in 1938, with the establishment of the National Foundation for Infantile Paralysis, scientists began an orderly, painstaking search for clues to the mystery. Progress was slow at first, but by the end of ten years there was strong evidence that polio might respond to immunization.The next five years saw three important discoveries: 1-identification of three kinds of polio virus; 2--a way to grow polio virus cheaply in a test tube; 3-presence of the virus in the blood of animals. Development of a vaccine was now a real and practical possibility. It was no longer a question of can polio be prevented, but how?

ON a warm afternoon toward the end of May in 1946 eleven-year-old Jenny Molloy, a dark-eyed redhead with freckles to match her hair, was chasing her dog across the moist grass surrounding her parents' farm home. Fritzi, a pudgy little dachshund, darted behind a tree and out of sight. Suddenly Jenny stopped running, limped over to the porch steps and flopped down.

Her mother, who was reading in a garden chair nearby, called out, "What's the matter, can't you keep up with Fritzi?"

Jenny could only murmur, "My legs hurt- I can't walk."

Alarmed by the child's apparent pain, Mrs. Molloy hurried her upstairs to bed, then called the family doctor.

Jenny's parents waited tensely as the doctor examined her, then gave his frightening diag- nosis: polio.

"Better take her to Louisville as soon as pos- sible," he advised. "They've got the only isola- tion ward in the state."

Within an hour the Molloys were on their way, Jenny bundled into the back seat of the car. At the Louisville General Hospital, the doctors made no promises about Jenny's chance for recovery. But the chief physical therapist asked Mrs. Molloy to visit twice a day to learn how to give physical-therapy treatments. Mrs. Molloy, a pretty, slender-faced woman with large brown eyes and prematurely gray hair combed smoothly away from the face and tied back with a ribbon, suddenly felt hopeful. At least she would have a chance to help Jenny get well! Within three weeks she got that chance. Jenny had grown so much stronger with the help of hot packs administered in the isolation ward that the doctor in charge said she could go home-provided her mother gave regular physical-therapy treatments. In late October, though still on a strict therapy schedule, Jenny was well enough to go back to school.

That winter, even after the doctor pronounced Jenny completely well, Betty and James Molloy were disturbed. They couldn't forget the feeling of helplessness when they learned their daugther had polio—or that there had been no place in their town for her to go for treatment. Thinking of other children who might be endangered as their Jenny was, they visited St. Joseph's, one of Lexington's three general hospitals, asked, "Why don't we have an isolation ward here in town?" A tall, well-built, boyish-looking man with merry blue eyes and a jovial smile, James Molloy was now deeply serious.

"We're adding a new wing to this building," the superintendent said. "We might be able to plan an entire floor for polio patients, if we had the money. Do you think you could raise half the cost-$45,000'?"

Neither James nor Betty Molloy had ever worked on a fund-raising campaign before, and $45,000 seemed like a lot to ask people to give. But Lexington is largely a community of families. Famous for its Burley tobacco, horse farms and blue grass, it has little "metropolitan" atmosphere, and people do things at a leisurely pace. They are quick, though, to consider the welfare of their children. James Mallor sounded out editors of the Leader and the Herald, the two local newspapers, first. They promised to run daily stories. People were willing to listen to the appeals because Lexington had had six bad polio cases besides Jenny Molloy that year. Within a few days money began pouring in, bills, checks, money orders and coins. One morning while a girl at the front desk of the Herald was taking down a classified ad, someone thrust an old envelope into her hand. Too preoccupied to look up at the moment, she continued to write. The ad completed, she finally opened the envelope, gasped-it contained an anonymous note reading "For polio" and ten $1000 bills!

At the end of three weeks when James Molloy tallied the contributions, he made a frantic call to the newspaper office. "Please tell people to stop sending in money!" he exclaimed. "We've got twice as much as we asked for!"

When Betty and James Molloy caught their breath long enough to try to figure out how and why the campaign had been so successful, they could find just one answer: people fighting polio, the only way they knew how, with dimes and dollars. Somehow the Molloys began to feel their part in the fight against polio was just beginning.

There was the new ward in the hospital, for example, which opened in March, 1948, with equipment loaned by the National Foundation. Molloy, an engineering graduate of the University of Kentucky, volunteered to check the respirators and keep them in good working condition. There was new need for funds to carry on research and pay medical bills. And again the Molloys volunteered. With the help of a group of volunteers, they organized March of Dimes drives for polio in 1948, 1949 and 1950.

Shortly after the Lexington Convalescent Home with beds for 50 polio patients opened in 1950, 35 women trained as Polio Emergency Volunteers. In addition to general nursing care they learned to give hot packs, therapy baths, feed and turn patients and handle polio equipment. One polio aide, whose nephew had been stricken with polio, told the supervising nurse, "I feel my time is only a small repayment for all the help he got from other volunteers. "

By fall, 1953, the people's fight against polio was beginning to show results. In New York, groups of scientists meeting informally to piece together the jigsaw-puzzle picture of polio research began concentrating on reports of Doctor Salk's new antipolio vaccine. Was this at last a formidable weapon against polio? Their discussions turned to definite plans--dates--for a nationwide trial. Was there time to manufacture and package enough vaccine for hundreds of thousands of inoculations by February? They thought so at first, but later postponed the trials till late March or early April, 1954. Finally, state boards of health throughout the country were alerted to prepare to inoculate children in the second grade of school beginning April 26. This, too, was a tentative date. No one could say for sure when the trial would begin.

And no one was really sure what preparations to make. But the Moneys felt this was going to be a bigger job than simply giving inoculations. You had to tell parents what it was all about, get their signatures before a single child could be inoculated.

Mrs. James Strauss, past chairman of the City Mothers' March on Polio, offered her home for a meeting of top organizers. Mrs. Strauss, a tall, smartly dressed woman with short curly hair and an alert, intelligent face, has two infant grandchildren. ("They're too young to get the vaccine this year, but the time is coming when it will be availalbe to all," she says confidently.) Along with a dozen P.T.A. mothers, the Molloys and Dr. Franklin Moosnick, chairman of the medical advisory committee of the National Foundation's local chapter, the Strausses studied printed material on the trails. Then they wrote out simple instructions for Lexington volunteer workers. The P.T.A. representatives jotted down names of mothers, who they thought would do a good job of organizing clinics in each school.

The "head mammas," as James called the unit chairmen from the schools, got together in March. This was before any of the supplies-the master health record sheets, registration forms and parent-request slips-had come from New York, and "' Betty Molloy had to hold up one sample sheet before a roomful of 28 people. The somewhat complicated routine of keeping these health records had to be explained again and again to groups of volunteers.

Every child was to take three shots, first two a week apart and the third "booster shot"four weeks later. If a child failed to keep any one of his three appointments, Betty Molloy emphasized, the vaccine was not good.

There never were enough chairs at P.T.A. meetings during April. Parents who never been to a P.T.A. meeting before came to hear about the polio vaccine. It was as though they wanted to be convinced their children ought to have it. The chapter Speakers' Bureau (Mr. and Mrs. Malloy, Mrs. Strauss and Mrs. Ballard Cassady) covered 28 such meetings. One question seemed to be on everyone's mind: do you know it's safe?" Citing the Pittsburgh tests, the triple tests made by independent laboratories, Mrs. Strauss said simply, "It's safe. It can't be safer than safe."

One of the hardest was explaining the need for volunteer blood donors among children in first and third grades well as second-graders receiving inoculations. These blood samples were to be sent to the University of Michigan for study. By comparing blood samples of vaccinated children with those of nonvaccinated children, the National Foundation's team expected to discover how effectively the vaccine had built up resistance to polio. One mother expressed the sentiments of many parents of first- and third grade children when she said, "I don't think it's fair that children who don't get the vaccine should have to give blood." Mrs. Strauss tried to reassure her by explaining that if the vaccine proved effective, millions of children would get it next year. There was a moment of silence--everyone appeared thoughtful. Then a father spoke out. "I'll go along with that. Now what we do to help?" "Sign the request slip giving your child permission to be inoculated--and urge your neighbors to do the same," James Malloy said. He was wearing a wrinkled blue suite he had promised his wfe to send to the cleaners. But these night meetings didn't give anyone much time to think about clothes. "We'll need people to drive children to the third clinics--after school is out ," he added. Mrs. R. V. Stevenson, who had organized the health program at Christ the King parochial school four years ago, felt a little chill of exitement as she listened to the plans. A former Army nurse who met her doctor husband in Algiers during World War II, she knew the importance of inoculations. But here was the change to be in on a new discovery! On April 19, when the packages of supplies arrived in Lexington, Mrs. Stevenson took a bundle home and typed all the records for the children in her school and for St. Peter Claver, a small parochial school with no P.T.A. She also addressed envelopes to parents for a friend, a member of another P.T. A. ("I wanted everything to be perfect," she explains. "I've never been able to shake my GI passion for routine and detail.") Mrs. Stevenson's first grade daughter was the first to volunteer to give blood. But her mother's enthusiasm was contagious. So many other parents clamored to let their children give blood that Mrs. Stevenson was forced to cross her own youngster's name off the list.

When you have 949 first-, second- and third- graders as at Picadome, the city's largest public elementary school, things don't go so smoothly. Mrs. T. C. Walker, P.T.A. health chairman, counted anxiously every time a teacher turned in a batch of parent-request slips giving permission for the inoculations. The day before spring vacation, nearly 100 were missing. These request slips had to be signed---or else! Ignoring the rainstorms that blew up, Mrs. Walker and three other mothers put on overshoes and raincoats, tramped over hills and back roads calling on parents until every single child had been accounted for.

In the classrooms seven-, eight- and nine- year-olds were leaming some basic facts about polio. Nearly everyone knew a neighbor or classmate who had had polio. Tommy Walker, a blond, round-faced second-grader,went home and told his parents that he had learned a new word: immunization. He also told about the orange and syringe his teacher brought to class. First she filled the syringe with a tiny, tiny needle and jabbed it into the orange, very gently, and pulled it out. As Tommy spoke, he flexed his muscle proudly. "Only the needle really goes into the arm, about there. It didn't look bad at all-I bet I could take a dozen of those!"

Classroom posters pictured the souvenir lapel button each child was to receive after the final shot. It bore the silhouette of a research scientist, his microscope and test tubes, symbolizing the years of laboratory work preceding the development of the Salk vaccine, and the words, "Polio Pioneer." Pioneer was a new word, too, for most children. Their teachers told the story of the Western settlers, how they pioneered their way into an unexplored country. "Pioneer means being the first to take part in a great new adventure," one teacher said. That made every child eager to earn and wear the Polio Pioneer.buttons. By April 21 more than 500 mothers, fathers, teachers and doctors were ready to inoculate 1276 children in Lexington. The vaccine, which had come by plane that very day, was sitting in the Molloys' refrigerator. Now everyone wanted to know: "When do we start?"

In Washington that April 24 the Vaccine Advisory Committee, a group of doctors representing leading medical organizations, completed its study of laboratory reports on the vaccine. They now knew it met all the safety tandards, and on Sunday, April 25, notified the National Foundation to go ahead with “evaluation of poliomyelitis vaccine, types 1, 2, and 3." Telegrams went out immediately to the 48 state boards of health, then to local boards. By 5:30 P.M. Betty Molloy, who hadn't dared leave the house all day,, had called 15 unit chairmen. "Pass the word along," she said. “We start tomorrow morning."

Promptly at 8:30 A.M. the great volunteer organization that had been marking time these many weeks went into action. At Picadome chool, the first stop for the team from the board of health, twelve room mothers and four teachers waited at the door of the auditorium. One classroom had already filed inside. In the adjoining gymnasium a mother was stringing a row of sheets over a clothesline to form a makeshift partition. "Where shall I put these wastebaskets?" asked a second-grade boy wearing a Polio Volunteer arm band. As he set them down, in came the doctor, two navy blue-clad public-health nurses, four Polio Emergency Volunteers in neat blue-and-white-striped jumpers, and four recorders guarding the bottles of vaccine and the health records. After the nurses had filled the syringes and set out packages of tiny needles, a wide-eyed little boy peeked curiously through the doorway. A room mother took his hand and steered him toward the doctor.

And here the story of the people's fight against polio ends-for the time being, Now the National Foundation, the parents and children, teachers, doctors, nurses and all the Polio volunteers await hopefully, patiently the results of the University of Michigan study. Before the start of the next polio season, late spring, 1955, we will know the answer to the question, Have we conquered polio?