Polio could be making a comeback – and it started with a mistaken link between autism and vaccination

On of my earliest memories, perhaps the oldest of all, dates back to when I was about four years old, in 1946, living in the Bronx neighborhood of New York. I woke up with a searing headache and a fiery fever, aching all over. I remember a tube inserted into my private parts, to help remove urine. I woke up again, I don’t know how much later, hours or days, in a hospital ward. In the bed next to me was a man hired with a terrifying contraption that I now know to be an iron lung, to help him breathe.

I could breathe well, and the terrible fever and headache had subsided. But I couldn’t move my legs.

My disease, I soon learned, was called infantile paralysis, poliomyelitis or simply poliomyelitis. I had a relatively mild version. Within two or three weeks when the acute phase was over, I was taken across the Hudson River to a rehabilitation hospital in a place called Haverstraw, New York. In a few months there, helped by a determined staff, I gradually regained strength in my legs. I could walk but not yet run. Still, I could go home to our apartment in the Bronx, reconnect with my brother and my parents, and start kindergarten, on time, with my age mates.

Professor Monica Trujillo holds a sewage sample in a lab at Queens College on August 25, 2022. The disease has been detected in sewage in New York City.
Professor Monica Trujillo holds a sewage sample in a lab at Queens College on August 25, 2022. The disease has been detected in sewage in New York City. Photograph: Angela Weiss/AFP/Getty Images

Like much of America, we moved to the suburbs, to Connecticut and then to New Jersey. But summer after summer, the fear of the virus followed us, especially for my mother. Her brother, a young man, had contracted a version of the disease that left him in a wheelchair for the last decades of his life. She lived in continuous terror that one or both of her younger sons would be afflicted, perhaps more severely than her eldest.

The emergence of effective vaccines, beginning in 1954, miraculously released such fears.

It left me as the only member of our family with an ongoing link to polio. For me, having been spared the more serious consequences of partial or total paralysis, the permanent sequelae of poliomyelitis were sometimes quite painful but above all an embarrassment.

Until now. The advent of new viral disease agents, most notably the coronavirus, and my own experience of polio manifestations later in life, have made me more sensitive to the risks that the polio virus might pose to the coming. Unless we humans can commit to greater discipline to completely eradicate the virus, polio might have another day in the sun. More broadly, other viruses may prove harder to control because vaccines, by far the most effective tool against them, work best when everyone is treated.

Just a few years ago, things looked much more encouraging.

An Indian health volunteer holds a vial containing the oral polio vaccine in Bangalore, India, February 28, 2022.
An Indian health volunteer holds a vial containing the oral polio vaccine in Bangalore, India in February 2022. Photograph: Jagadeesh Nv/EPA

David M Oshinsky’s 2005 book Polio, An American Story, winner of the Pulitzer Prize for History, dramatically describes how scientists, universities, pharmaceutical companies, private charities and governments at all levels – working separately and together in the 1940s and 1950s – proved the safety and efficacy of two competing polio vaccines. Vaccines then became part of the routine for countless children in the United States and most other economically developed countries, largely eliminating new polio infections.

Then, efforts turned to less developed countries in Asia, Africa and elsewhere.

In 1988, the World Health Organization, Rotary International and what is now the Centers for Disease Control and Prevention launched their Global Polio Eradication Program, aiming to eliminate poliomyelitis, like earlier efforts the had done with smallpox. At the time, 350,000 children in 125 countries were infected with the disease, according to Rosemary Rochford, a virologist and professor of immunology and microbiology at the University of Colorado School of Medicine, in The Conversation. By 2021, the number had dropped to six cases worldwide, she wrote.

Meanwhile, success in eliminating poliomyelitis had helped pave the way in the United States for the development and introduction of vaccines against measles in 1963, and subsequently against other diseases such as mumps and rubella. Combination “MMR” vaccines have become the standard for babies in the United States.

Then the trouble appeared. Some reports, although definitely discredited, suggested a link between vaccination and autism. When the coronavirus hit, researchers and pharmaceutical companies quickly produced safe and effective vaccines to fend off multiple versions of the mutant Covid virus. But the other side of the vaccine-versus-virus equation – getting everyone vaccinated – was no longer so easy to achieve.

Whether it’s politics, religion, fear of side effects, or the prioritization of individualism, some people no longer embrace the spirit of collaboration that made other mass vaccination campaigns successful.

The commitment to social good needed to address public health challenges has become evident not only in the coronavirus, but also in seemingly defeated diseases like polio. An unvaccinated adult in one of New York’s suburbs has been diagnosed with the disease. Polio virus samples have been detected in the city’s sewage.

These are small signs so far. But these are my neighbours, my close quarters. And we know viruses mutate and can cause long-term damage.

I sympathize with people struggling with long Covid, as polio is a disease that can recur with age. I was in my 60s when I started noticing the atrophy of my leg muscles. For a while, exercise helped. But as I turned 80 this summer, my leg weakness increased. I struggle with slightly hilly sidewalks, for example. My doctor is the same age. No poliomyelitis. No problem with hills.

As a species, we are slowly beginning to take steps to keep our physical world livable. We also learn how the tiniest organisms – insects, and yes viruses – adapt to our changing environment. Inventing vaccines may not be enough. We may need to adapt our behavior to help vaccines work.

The scratch and scar I had on my arm as a child was enough to ensure my age cohort didn’t have to worry about smallpox, as long as we all had the same scar. It is time to recognize that personal well-being depends on individual investment in the common good.

Paul Steiger is the founder of ProPublica and former editor of The Wall Street Journal. Dean Rotbart’s biography about him is expected to be released next year

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