Wadman - The vaccine race: science, politics, and the human costs of defeating disease

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First published in Great Britain in 2017 by Doubleday
an imprint of Transworld Publishers
Copyright Meredith Wadman 2017

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Version 1.0 Epub ISBN 9781473509375
ISBNs 9780857522726 (hb)
9780857522733 (tpb)

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For my mother, Barbara Constance Greenfield Wadman

And in loving memory of my father, Hamilton Gray Wadman

A sane society whose riches are happy children, men and women, beautiful with peace and creative activity, is not going to be ordained for us. We must make it ourselves.

Helen Keller

The role of the infinitely small in nature is infinitely great.

Louis Pasteur, nineteenth-century French microbiologist

ON OCTOBER 9 , 1964, a baby girl was born at Philadelphia General Hospital. She arrived early, when her mother was about thirty-two weeks pregnant. The baby weighed 3.2 pounds and was noted to be blue, floppy, and not breathing. The only sign of life was her slow heartbeat. Nonetheless, she clung to life, and her seventeen-year-old mother named her.

One month later the baby was still in the hospital, and a doctor leaning close with a stethoscope heard a harsh heart murmur. A chest X-ray showed that she had a massively enlarged heart because a hole in the muscular organ was preventing it from pumping blood efficiently. Doctors also noticed that the baby was staring into space, not fixing her gaze on anything. An ophthalmologist was called in. It emerged that the baby had cataracts blinding both eyes. Later other signs indicated that she was profoundly deaf, although a formal hearing test was never conducted.

In January 1965, after surgery attempting to repair one of the cataracts, the mother took her three-month-old daughter home. Nine days later the baby was back in the hospital with diarrhea. She remained in the hospital, where she suffered from recurring respiratory infections. She had trouble gaining weight, which is a common problem in infants with heart problems like hers. A psychologist who assessed her in July 1965, after a second heart defect was found, judged the nine-month-old to be the size of a two- or three-month-old infant and at about that stage of development; she couldnt sit up or grasp an object placed in her hand.

The baby needed heart surgery if she was going to survive. Just before her first birthday, surgeons cut a seven-inch incision in her chest wall and repaired her heart. After the operation she remained in the hospital. The chronic respiratory infections continued. The baby was sixteen months old and weighed eleven pounds when she died of pneumonia at 3:30 a.m. on February 18, 1966. She had lived all but nine days of her brief life at Philadelphia General Hospital.

The young mother had told the doctors something when she brought her daughter back to the hospital. When she was one month pregnant, she had had German measles, which is also known as rubella.

The early 1960s marked a coming of age for the study of viruses like the one that causes rubellatiny infectious agents that invade cells and hijack their machinery in order to reproduce themselves. Biologists, with new tools in hand, were racing to capture viruses in throat swabs or urine or even snippets of organs from infected people and to grow them in lab dishes. Isolating a virus in the lab made it possible to make a vaccine against it. And making antiviral vaccines promised huge inroads against common childhood diseases like measles, mumps, and rubella, along with less-common killers like hepatitis. The principle of vaccination is simple: if a person is injected with, or swallows, a tiny amount of a viruseither a killed virus or a weakened live virusthat person will develop antibodies against the virus. Then, if he or she is exposed in the future to the naturally occurring, disease-causing form of the virus, those antibodies will attack the invader and prevent it from causing disease.

But if the concept is simple, making effective vaccines is anything but. In the early 1960s that reality was all too evident in recent tragedies. In 1942 as many as 330,000 U.S. servicemen were exposed to the hepatitis B virus in a yellow fever vaccine that was contaminated with blood plasma from donorsplasma that was used to stabilize the vaccine. It turned out that some of those donors carried hepatitis B. About 50,000 of the vaccinated servicemen came down with the dangerous liver disease and between 100 and 150 died.

Then in the summer of 1961, Americans learned that the monkey kidney cells used to make the famous Salk polio vaccine often harbored a monkey virus called SV40. Tens of millions of American children had already received contaminated injections, and while the jury was still out on the tainted vaccines long-term health consequences, the unknown risks were weighing on regulators in the United States and elsewhere.

It was against this backdrop that, on a drizzly June morning in 1962, a young scientist went to work in his lab at the Wistar Institute of Anatomy and Biology, an elegant 1890s brownstone tucked in the heart of the University of Pennsylvania campus. Leonard Hayflick had just turned thirty-four years old. A serious, slight, reserved man with close-cropped dark hair, Hayflick was a product of working-class Philadelphia and was hungry to make his name. He was in love with biology and was plenty smarthe had come to believebut that fact was far from appreciated. His boss, the famous polio-vaccine pioneer Hilary Koprowski, saw him as a mere technician, hired to serve up bottles of lab-grown cells to the institutes impressive cadre of biologists.

This hadnt deterred the ambitious Hayflick. The previous year the junior scientist had published a paper challenging a major piece of scientific dogma: the belief that cells grown in a lab bottle, if properly nurtured, would multiply indefinitely. His findings had been met with skepticism from some outstanding biologists. Let the critics carp, he thought. Time would prove that he was rightthat normal cells cultivated in the lab eventually died, just like human beings.