Polio, swine flu and now COVID-19: How today's vaccination effort echoes Louisville's past

Matthew Glowicki Louisville Courier Journal

Published 5:38 a.m. ET Feb. 10, 2021

After countless hours of logistical planning and an intensive, monthslong public health campaign, vaccination day arrived in Louisville. By car, by bus and by foot they came to one of nearly 50 sites in Jefferson County for the first of three doses to again fight polio.

Adults, teens and parents with children close at their side or resting on their hips waited in line. Helicopters buzzed overhead, whizzing additional vials across Louisville. Hundreds of volunteers at each site directed traffic, prepared paperwork and doled out doses in tiny paper cups.

Oct. 7, 1962, had finally come, and with it hope that the dreaded disease that paralyzed children and struck fear into parents would finally be stamped out.

Polio was already dealt a significant strike in the United States after a massive push a few years earlier to inoculate children with the first polio vaccine, an injection developed by Dr. Jonas Salk.

Now, a newly developed oral vaccine was aiming to knock another big blow to the disease — on a tiny cube of sugar. Ruth Carrico clearly remembers standing in line at a local union hall for her sugar cube.

Now a family nurse practitioner and professor with a specialty in infectious diseases at the University of Louisville School of Medicine, Carrico is working on the frontlines of the COVID-19 vaccination campaign.

“We were able to gather together for that vaccine and go and stand in lines," she said of the polio program. “Now, of course, we can’t.”

While today’s vaccination effort reminds Carrico of mass immunization events of the past, including the polio program and Louisville’s mobilization against the swine flu a decade ago, coronavirus poses unprecedented challenges.

“You can see that everything is different with this vaccine and this disease,” she said. “The sense of urgency is not just for the health of the individual, it’s for the health of the world, the shared economy, our shared value systems and our desires to keep people at work, at church, at play.”

Since January, Carrico has spent her days at Louisville’s Broadbent Arena, making sure health care workers know how to prepare and administer the COVID-19 vaccine to the hundreds of people that pass through the arena each day.

The 6,600-person stadium, better known for hosting graduations, Kentucky Derby Festival events and state fair equestrian competitions, has been converted into a drive-thru mass vaccination site known as LouVax.

The work at Broadbent is part of the largest mass inoculation drive in history. But as the nation fights the coronavirus, which has killed millions globally and taken more American lives than were lost in World War II, it's worth looking back at other efforts.

Polio, the fear of families

In the mid-1950s, the effort to wipe out polio via vaccination marked the largest mass vaccination program ever.

Naomi Rogers, professor of the history of medicine at the Yale School of Medicine, said while polio was not a large driver of childhood illness or death, the possible paralytic effects of polio struck fear in many American families, particularly during the summer months when polio cases were known to rise.

Cases of polio — which we now know is spread through contact with an infected person's feces (perhaps through water) or less often by droplets from a sneeze or cough — peaked in the United States in 1952. That year Kentucky saw nearly 1,800 cases of the disease and Jefferson County almost 740.

Tom Owen, a former Louisville Metro Council member and a longtime U of L archivist, said he remembers the fear associated with polio from his childhood.

The disease left visual scars, forcing children onto crutches or into wheelchairs, leg braces or iron lungs – large metal tanks used in those days to help patients breathe.

Believing the disease was transmitted in dust, Owen’s parents told him not to play in the dirt that collected in street gutters. He remembers how polio fears forced the closure of public swimming pools and how a boy who lived just a block from him, Bobby, was infected and paralyzed for life.

Owen’s grandmother prodded his parents to place small cloth asafetida bags, a tool of old alternative medicine, around his and his brother's necks.

“The bag contained some kind of noxious herbal mix that smelled so badly as the summer progressed that no one would get near us,” he said. “It must have worked! We didn’t come down with polio!”

A scientific search for a cure accelerated in 1938 when President Franklin D. Roosevelt — the most well-known American to have suffered polio at the time — founded the National Foundation for Infantile Paralysis.

The foundation later became known as the March of Dimes, inspired by the campaign encouraging people to donate even a single dime to the cause.

This private fundraising supported rehabilitation efforts, including those at the Warm Springs treatment center in Georgia where Roosevelt received treatment — as did current Senate Minority Leader Mitch McConnell of Kentucky, who was sickened by polio as a child.

The funds also helped enable Salk’s development of the vaccine, which in 1954 was given in experimental field trials involving about 1.8 million schoolchildren across the country.

Nearly 7,500 second graders in Louisville and Lexington were part of the field tests, receiving a certificate and pin that read “Polio Pioneer” after getting their third shot. The Courier Journal reported the students were also rewarded with a lollipop.

The following April, results from the 1954 experiment would be released, potentially greenlighting the vaccine for national distribution. A 1955 Courier Journal article optimistically declared April 12 “V-P (Victory Over Polio) Day.”

1/3

It was on that day scientists declared the vaccine safe, and within two weeks Kentucky schoolchildren were lined up for it.

The Courier Journal reported approximately 182,000 Kentucky students would be eligible to get the vaccine, including about 40,000 in Jefferson County.

Civic clubs volunteered to transport children. Polio foundation volunteers, PTA groups and homemaker clubs sterilized needles, packed supply baskets and kept records. Doctors and nurses administered shots.

Related: COVID-19 vaccine: What to know about immunization rules for Kentucky schools

The program begins to work

Much like it has with the coronavirus pandemic, The Courier Journal published articles answering questions about the polio vaccine, such as who was eligible (primarily first and second graders), if the vaccine was safe (“Yes, beyond any doubt”) and where to get more information (call CL 5204).

About 34,000 children across 117 sites in schools received the first dose of the vaccine April 28, 1955.

“When they put that stuff in that ‘fringe’ (syringe), I was looking the other way, so I didn’t even know when it happened!” said a child after he got his shot. Black-and-white photos from the time show children, some with closed eyes or pained faces wrapped in adults’ arms, as the needle drew near.

The process was apparently enjoyed by some.

An Associated Press story that April told of how New Mexico clinic organizers debated not giving ice cream and candy bars to vaccinated kids, as “two youngsters had gotten back in line and received two ice-cream cones — and two vaccinations — each.”

Rogers said schools made perfect sense to use as vaccination sites for polio. They were a familiar part of every neighborhood and had the ability to efficiently reach large numbers of children.

“That was seen as the natural logistical institutional setup,” Rogers said.

In the early rollout, limited supply contributed to a prioritization of who could be vaccinated, much like is happening today. Vaccine distribution focused on first and second graders, as children were considered to be most at risk.

In time, older youths were eligible for vaccinations and later, adults were encouraged to roll up their sleeves.

To boost vaccination rates among teens, a 21-year-old Elvis Presley was photographed in 1956 receiving his dose backstage at "The Ed Sullivan Show" before singing “Hound Dog” to screaming fans.

By 1957, the county was recording promising new data. Cases fell from nearly 300 in 1954 to less than 50 in 1957.

By January 1958, about 45% of children under 10 in Jefferson County had received all three doses of the Salk vaccine and 80% had received two, The Courier Journal reported. The program, it seemed, was working.

‘Nothing scary about a sugar cube’

Seven years after the introduction of the first polio vaccine, John F. Kennedy was early in his term as president, the Vietnam War was in its infancy and a liquid polio vaccine invented by Dr. Albert Sabin was newly approved.

People of all ages were encouraged to get the oral vaccine, including those who received the Salk injection, as the new version would help create community immunity.

Jefferson County embarked on a monthslong effort aimed at vaccinating 95% of its citizens, and in doing so, again faced the challenge of designing a program to quickly immunize as many people as possible.

Dubbed Sabin Oral Sundays — S.O.S. for short — the Sabin vaccine drives came in three phases in Louisville, each made up of two Sundays in October and November 1962 and February 1963. Each month's dosage protected against a different type of polio.

Unlike today’s COVID vaccination rollout, supply was not an issue.

Three drops of tasteless, colorless and odorless liquid were dropped onto sugar cubes, cutting vaccine administration time and taking needles out of the equation. “That was considered a much easier way to vaccinate everybody against polio because there’s nothing scary about a sugar cube,” Rogers said.

A state law passed in 1962 required the immunization of all those under 18 against polio, whooping cough, tetanus and diphtheria.

First graders were required to show proof before starting school that fall, though Louisville leaders and the state agreed to allow students to start classes with the understanding they would be vaccinated in October.

Related: 'This is fantastic': Mass vaccination clinics to play key role in ending COVID-19 pandemic

In the summer of 1962, more than 100 communities across the country held mass vaccination programs, including Cleveland, Cincinnati and various Kentucky counties.

In Bourbon County, among the 6,000 recipients were toothless babies who took the vaccine via dropper. A Lexington clinic was so slammed with students it had to turn many away when supply ran dry.

These spring and summer campaigns caused some who were eager to receive protection to question why Louisville was waiting until the fall. In July, The Courier Journal editorial page called for an earlier mass vaccination date, without success.

Local steering committee organizers pointed to a need to plan and initial concerns over procuring enough doses. It would also be harder to organize a mass effort during the summer, when people take vacations, officials argued.

Forty-six sites at schools across the county were selected by Louisville’s organizers from the Jefferson County Medical Society, Junior Chamber of Commerce and Advertising Club of Louisville. Sites were selected with walkability in mind and locations with stairs and common entrances and exits were avoided.