Last week, I discussed parts of Dr. Saul Benison’s book on Tom Rivers that related to Dr. Sabin. One thing I didn’t include was when Dr. Benison asked Dr. Rivers about how countries were chosen to conduct field trials for the Sabin vaccine. Dr. Rivers said, “No one chose the country. Generally, it was the public health officials or virologists of a given country that did the choosing, and usually for reasons of their own.”[1] Dr. Rivers then proceeded to discuss how Czechoslovakia came to be part of the field trials. Instead of giving you Dr. Rivers’ brief account of it, I thought I would share some letters that tell the story. It’s actually a great example of international cooperation.
Letter from Dr. Payne to Dr. Sabin regarding the interest in the oral polio vaccine by the Czechoslovak health authorities, May 1958.
In May 1958, Dr. A. M.-M. Payne, Chief of the Endemo-epidemic Diseases Section of the World Health Organization, wrote to Dr. Sabin and included a copy of a letter from the Ministry of Foreign Affairs in Czechoslovakia. The letter from Czechoslovakia said, “[T]here are favourable conditions for organising a highly specialized and extensive epidemiological and virological control of large scale immunisation with living vaccine.” They hoped to begin working on the research program with Dr. Sabin’s virus strains in later on in 1958.[2] With regard to this potential research program, Dr. Payne wrote the letter to Dr. Sabin seen on the left, where he said, “I believe that subject to satisfactory information regarding the proposed programme and the persons responsible for carrying it out, we should if possible support this proposal.”[3]
Dr. Sabin wrote back saying he thought it should not be a problem in obtaining a license to ship the vaccine to Czechoslovakia, since he was able to ship doses for 100,000 to Dr. Smorodintsev in Leningrad. His letter also said, “I am prepared to provide them with enough vaccine to carry out tests on 100,000 to 500,000 persons depending on their plans.”[4] From there, Dr. Sabin wrote to his colleagues in Czechoslovakia and eventually arranged the shipment of his vaccine for their program.
Letter from Dr. Škovránek to Dr. Sabin regarding the oral polio vaccine field trial in Czechoslovakia, October 1958.
On September 25, Dr. Sabin wrote to Dr. Karel Raška, “This is to let you know that I have just received a license from the U.S. Department of Commerce to ship you 2,000 cc. of each of the 3 types of attenuated poliovirus vaccine (enough for 200,000 doses) (total of 6,000 cc.).” He also asked Dr. Raška if he could be sent a formal plan for the vaccine study.[5] The letter seen here on the right is from Dr. Vilém Škovránek, Chief Public Health Officer of the Czechoslovak Republic , whose letter gave Dr. Sabin a brief description of the plans for the Czechoslovak program.
A couple months later, Dr. Karel Žáček sent Dr. Sabin a letter with the formal live polio vaccination program. They planned to start on December 15, 1958, in 4 different regions of Czechoslovakia, and hoped to vaccinate 150,000 children between the ages of 2-6 years old. He went on to describe some of the studies they would undertake to determine how effective the vaccine was in their country. One study involved testing stool samples before and after the vaccination. Dr. Žáček asked Dr. Sabin for recommendations on how to do these tests the best way.[6] In a lengthy letter written to Dr. Žáček, Dr. Sabin was happy to help by describing the techniques and methods he used in his lab for the “quantitative determination of virus in stools.”[7]
Three days after the vaccination program began in Czechoslovakia, Dr. Sabin received a letter from Dr. Škovránek. He reported that they estimated that between 90 and 95% of the children in the four regions where they planned to implement the vaccination program participated, which was well over their 60% estimate. They ran out of the vaccine, but were able to contact Dr. Smorodintsev to borrow some. Near the end of the letter, Dr. Škovránek wrote, “We, Czechoslovak health workers, in line with the principles of the United Nations are eager to collaborate with scientists all over the world and it is our main aim to put into effect the noble principles of peaceful relationship among nations.”[8]
A second letter from Dr. Škovránek was sent at the beginning of January 1959. This letter described a problem that they encountered during the vaccination campaign, where the “commercial droppers used did not produce equal-sized drops,” which led to a temporary shortage of the vaccine. Dr. Škovránek wrote, “Despite these technical difficulties, which are entirely our fault, I feel that the campaign was successful and we are among the first countries in the world which have undertaken vaccination with live poliovaccine on such a large scale.” It seems that Dr. Škovránek wanted to emphasize that there was no pressure for children to take the vaccine. In fact, Dr. Škovránek wrote that many were insisting that they expand their vaccination campaign to others.[9]
The Czechoslovak scientists completed their field trial in January 1959. Dr. Škovránek continued to send Dr. Sabin weekly reports of reported polio cases in Czechoslovakia through 1959. A report on the trial run by the scientists called “Field Trial with Sabin’s Live Poliovirus Vaccine in Czechoslovakia 1958-1959” appeared in Live Poliovirus Vaccine, Papers Presented and Discussions Held at First International Conference on Live Poliovirus Vaccines, scientific publications no. 44, Washington, D.C.: Pan American Sanitary Bureau, 1959, pp. 530-571. Later, Dr. Škovránek and Dr. Žáček published an article in the Journal of the American Medical Association about the nationwide use of the oral poliovirus vaccine in Czechoslovakia in 1960.
By supplying his oral polio vaccine, Dr. Sabin helped to immunize hundreds of thousands of children in Czechoslovakia. Dr. Sabin’s scientific colleagues helped him by providing the resources needed to conduct large scale trials of his vaccine. During the Cold War era, this level of cooperation was pretty amazing.
References
[1] Saul Benison, Tom Rivers: Reflections on a Life in Medicine and Science, (Cambridge: The M.I.T. Press, 1967), 570.
[2] Copy of letter from Ministerstvo Zahranicnich Veci to M. G. Candau, Director of the WHO, 10 April 1958. Sent to Dr. Sabin by Dr. Payne.
[3] Letter from Dr. Payne to Dr. Sabin, 27 May 1958.
[4]Letter from Dr. Sabin to Dr. Payne, 31 May 1958.
[5] Letter from Dr. Sabin to Dr. Raška, 25 September 1958.
[6] Letter from Dr. Žáček to Dr. Sabin, 25 November 1958.
[7] Letter from Dr. Sabin to Dr. Žáček, 9 December 1958.
[8] Letter from Dr. Škovránek to Dr. Sabin, 18 December 1958.
[9] Letter from Dr. Škovránek to Dr. Sabin, 7 January 1959.
Note: All of the letters mentioned above can be found in Series #7 – Oral Poliovirus Vaccine, Sub-Series Correspondence, Box #2, Folder #3 – Czechoslovakia, 1958-1960.
In 2010, the University of Cincinnati Libraries received a $314,258 grant from the National Endowment for the Humanities (NEH) to digitize the correspondence and photographs of Dr. Albert B. Sabin. This digitization project has been designated a NEH “We the People” project, an initiative to encourage and strengthen the teaching, study, and understanding of American history and culture through the support of projects that explore significant events and themes in our nation’s history and culture and that advance knowledge of the principles that define America. Any views, findings, conclusions, or recommendations expressed in this blog do not necessarily reflect those of the National Endowment for the Humanities.