When Dr. Julius Youngner moved to Pittsburgh in 1949, he thought he’d be in the city for two years. Though a commissioned officer in the Public Health Service at the Cancer Institute, he wanted to work on viruses and took a position in a University of Pittsburgh lab directed by Dr. Jonas E. Salk, developing a vaccine for polio, said Youngner.
“And the rest is history,” he said from his Squirrel Hill living room, 66 years later.
The Fifth Avenue lab where he and the original five-person team worked was located below a ward of polio patients who couldn’t breathe on their own. Machines, “iron lungs” did it for them, said Youngner.
“They had these machines that drove the in and out of breathing," he said. "I mean it just kept them alive.”
The ward was enormously loud. The machines created a terrible din and drove home the reality of the disease, Youngner said.
“We had motivation right there in the building," he said. "Everybody was very serious about what we were doing. I never worked so hard in my life. I worked seven days a week.”
Polio is caused by a virus that lives in the throat and intestine. It attacks the nervous system and can result in paralysis. Children are most at risk. Throughout the 1940s and 1950s, prevalence of the disease increased, said Youngner.
“People were so afraid of their kids getting polio during the summertime, they wouldn’t let them go to swimming pools,” he said, trying to explain how polio affected society in those years. “They wouldn’t let them go to movies, they tried to keep them away from other kids. People were hysterically afraid of it.”
So much so that they sought any protection. When he was a boy, Youngner’s grandmother used to tie a cake of camphor around his neck when he went out to play, he said.
“What she didn’t know is that when I left the house, I would take the thing off and put it in the mailbox,” he said. “And put it on again when I came home. But she was convinced for the rest of her life that she had kept me from getting polio, and that was nice.”
Years later, Youngner developed a cell culture method that sped up creation of a vaccine.
“You could take one monkey kidney and go millions and millions of cells,” he said.
More cells meant more virus, which meant more and faster testing.
“This was a complete break with the old guard,” Youngner said.
The Salk lab in its entirety was a break with familiar wisdom: It aimed to develop a killed vaccine, one in which the virus was inactivated, he said.
“Live virus vaccines had always been the ones that worked. There was a lot of doubt that the vaccine would work among people in the field,” he said.
The National Foundation for Infantile Paralysis, now the March of Dimes Foundation, funded the Salk lab while simultaneously supporting Albert Sabin, who was working on a live vaccine. Youngner said that by 1952 the Salk lab had demonstrated its vaccine could produce an immune response.
“What was needed to really make the vaccine acceptable was a phase three trial. In 1954, 800,000 children in the United States participated,” he said.
Conducted in 12 states, the human trial was a double-blind study: vaccinators didn’t know what they were giving and children didn’t know what they were getting, said Youngner.
“What they did then was just wait for summer,” he said.
On edge throughout the summer of 1954, the trial proved the Salk vaccine’s efficacy, and it went into widespread use in 1955. By 1979, polio was eradicated in the United States.
Kelly Stefano-Cole, associate professor at the University of Pittsburgh and associate director of the regional biocontainment laboratory, said developing a vaccine today is very different. It can take more than 10 years for one to be approved for use in the general population. It’s a methodical, highly-regulated process she described as “cookbook.”
“We want to be absolutely sure that it’s safe," she said. "We ask one question, get the answer, ask the next question."
But viruses themselves aren’t getting any more straightforward. Stefano-Cole said pathogens, and the people who carry them, are mixing faster than ever before. Meanwhile, diseases kept at bay by standard vaccination can easily resurge.
“It only takes one or two children or one or two adults introduced into the population and enough people not vaccinated to just bring that epidemic back again,” she said.
According to the World Health Organization, polio persists in Nigeria, Pakistan and Afghanistan. The three nations had been using Sabin’s live, oral vaccine to attack the disease, but recently switched to the Salk lab’s injectable killed vaccine. In places where polio has almost been eradicated, it’s safer to use the killed vaccine. In rare instances, the weakened, live vaccine can result in a case of polio, which may reinfect the population.
There is no cure for polio. It can only be prevented. To have helped develop that prevention, said Youngner, is the kind of thrill few people ever have.
“It was a moment of complete and total enthusiasm," he said. "And pride. Pride.”
90.5 WESA Celebrates Inventing Pittsburgh is supported by UPMC.