Victory Against Polio

When a 'safe, effective and potent' vaccine
was unveiled at U-M in 1955, the world hailed
Victory against polio

Thomas Francis Jr. led trials of Salk's weapon
BY DAVE GERSHMAN
News Staff Rtporttr He was the general.
To open a new front against the
frightening virus polio, Thomas
Francis Jr., an epidemiologist at the
University of Michigan, assembled
his own army in tlle 1950s.
A corps of 150,000 volunteers, including
many doctors and nurses, helped test a vaccine
for polio with about 1.8 million children
in 44 states in this country, and in Canada
and Finland.
Laboratories across the country studied
blood samples to determine how well the
vaccine produced antibodies to fight polio.
The reams of data were sent to Ann Arbor,
filling a room full of file cabinets at U-M.
Thomas orchestrated this massive undertaking
from U-M. He was chosen because of
his meticulous nature, coolness under fire
and his impartiality.
"You are organizing a military campaign,"
said Dr. Howard Markel, a professor at U~M
and director of the Center for the History of
Medicine, "and Francis was the general."
His was a reputation that was above re~
proach, Markel said. It needed to be. This
was one of the most highly scrutinized and
public drug trials in history. The country was
watching.
Millions of dollars, much of it raised in
small amounts from ordinary people, were at
stake. That fund~raising, ultimately paying
the $7.5 million tab for the vaccine field test,
was coordinated by the National Foundation
for Infantile Paralysis. It was so successful in
drawing small donations from so many people-
just dimes in many cases - that the organization's
name was eventually changed to
the March of Dimes.
"Most of us would spontaneously combust
with that kind of pressure," Markel said.
The foundation asked Francis to run the
drug bials in 1953. He bad Ute rigbt combination
of experience. He had developed a vaccine
for flu that used a killed form of the virus.
PHOTOCOORT1SY8£1flUYfiSTOAICALUIIRAAY
Dr. Thomas Francis Jr., left, and Dr. Jonas
Salk at the April 12, 1955, news conference
at the University of Michigan announcing
the effectiveness of a polio vaccine
developed by Salk, of the University of
Pittsburgh. From 1941-69, Francis was the
chairman of the U-M department of
epidemiology In the School of Public Health,
whic:h ran the trials for Salk's vaccine.
And during World War II, he ran a huge field
trial that tested flu vaccine among soldiers.
It was a very different time. The public
held doctors and medical science in extraordinary
esteem. And polio was a parent's
worst nightmare.
In the 1950s, polio outbreaks were especially
harsh: About 55,000 people annually
would contract polio, typically during the
summer. Many were children. While most
survived, polio could cause debilitating in~
juries. Because it kills nerve cells, polio could
cause paralysis in parts of the body.
SEE POLIO,A12

Trials held in an era of trust
Though the vaccine had performed
well in tests of several
thousand people, it had not been
proven safe among a large population.
In years past, vaccines
said to prevent polio had actuallycausedit.
Despite this, it wasn't hard to
find schoolchildren to participate
in trials in 1954. Parents,
haunted by images of children
in wheelchairs and on crutches,
wanted their kids to be the first
to get the vaccine, Markel said.
Francis, who at first had
turned down the job, insisted as
a condition of leading the study
that the foundation not interfere
in it and that it be conducted as
a double-blind study.
That meant neither the child
getting the shot nor the person
giving it knew whether the syringe
contained the vaccine or a
placebo. Only the administrators
back in Ann Arbor knew.
"Parents were just very anxious
to do it,'' Markel said. "Today,
I don't think that would happen."
As a carrot to entice participation,
all children who received
the placebo were first in line for
the vaccine when the study was
finished.
Schools were identified for
participation by their location.
Francis wanted areas that were
populated and had a high incidence
of polio, and sought out
departments of public health in
44 states. Professional associations
of doctors also were recruited.
Everybody wanted to
help.
Still, there were a lot of questions.
School superintendents,
for instance, often had concerns
and wrote about them to the
man in charge - Francis. And
amid all of his duties, which
ranged from the technical aspects
of the drug trial to the
packaging of the vaccine, Francis
wrote back and answered
their questions, Markel said.
Dr. Arnold Monto, a professor
of epidemeology who knew
Francis later in his career, said
Francis was dedicated and
cared about getting it right.
Francis' father was a steelworker
and part-time minister.
Francis grew up in small-town
Pennsylvania. In his career, he
worked with people from much
more urban backgrounds. He
carried himself with some formality,
always calling his secretary
by her last name.
While he worked hard, he
wasn't a slave driver. And he had
a youthful mind; he was always
open to new ideas, said Monto.
"He, in fact, was very youthful
in his approach to science,"
Monto said.
As the study wrapped up,
there was some tension between
the foundation that paid
for it and the scientists who ran
it at U-M. Both wanted to make
the announcement about the results
of the trials.
"Tommy Francis said there
was no way you're going to
have it in New York,'' recalled
Lou Graff, the university's
press secretary to Francis. "He
said it's our story and we're go-
U-M polio vaccine
anniversary events
On Tuesday, the University of
Michigan is celebrating the
50th anniversary of the
announcement of an effective
vaccine for polio. Events are at
the Rackham Building, 915 E.
Washington St. Here's the
schedule:
• 9:30 a.m.-noon:
Presentation of Thomas
Francis Jr. Medal in Global
Public Health to William H.
Foege, a senior adviser to the
Gates Foundation's Global
Health Program. Dr. Howard
Markel, director of the U-M
Center for the History of
Medicine, will discuss the
polio vaccine field trials
conducted by U-M. A video on
the historic announcement
will be followed by a lecture
by Forge on the social and
medical implications of the
polio vaccine. The session will
conclude with a panel
discussion on the global view
of current public health
challenges in general and
polio in particular.
• Noon: Public reception in
Rackham.
• 3-4 p.m.: Panel discussion, a
historical perspective of polio
in America, moderated by
Markel.
For details about the lecture
or panel presentations, call
{734) 647-7900. The Web site is
www.polio.umich.edu/program/.
ing to announce it when we're
ready."
Finally, the big news was set
to be announced in Rackham
Auditorium on April 12, 1955.
After spending much of his
time fending off reporters,
Graff set out to write the news
release that the vaccine was
"safe, effective and potent."
But only a handful of people
knew what was in the announcement.
-'-<
To maintain secrecy, the stencil
used to print the release was
destroyed.
Reporters and scientists from
around the world filled the auditorium
when Francis stepped
on stage. After he delivered the
news, there was mayhem in the
auditorium.
Reporters rushed Graff to -"'
get a copy of the summary report.
Graff stood on a table
and threw out copies to the
crowd.
Francis, U-M and Ann Arbor
were center stage in a story that
changed lives and was told
around the world.
"It was a drama," recalled
Wayne DeNeff, who was then a
young reporter covering the
event for The News. "Every science
writer from all over the
world was there. I know, because
some even misspelled the
name of the town."